hospital_name,last_updated_on,version,location_name,hospital_address,license_number|VA,type_2_npi,"To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.",attester_name,,,,,,,,,,,,,,,,,,,
"Centra Rehabilitation Hospital, LLC",2026-06-18,3.0.0,"Centra Rehabilitation Hospital, LLC",1159 Simons Run Lynchburg VA 24502,Pending,1962370668,TRUE,Debbie Manharth,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,code|4,code|4|type,modifiers,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,payer_name,plan_name,standard_charge|negotiated_dollar,standard_charge|negotiated_percentage,standard_charge|negotiated_algorithm,median_amount,10th_percentile,90th_percentile,count,standard_charge|methodology,standard_charge|min,standard_charge|max,additional_generic_notes
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Aetna Medicare,Aetna Medicare,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Cigna,Cigna,2914,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Cigna Medicare Advantage,Cigna Medicare Advantage,75265.79247,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Essence,Essence,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Humana Gold,Humana Gold,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Medica,Medica,2446,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Tricare,Tricare,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,75265.79247,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,UHC Medicare,UHC Medicare,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,A0101,HIPPS,,,,,,,,Inpatient,,,73789.99262,73789.99262,Wellcare,Wellcare,73789.99262,,,,,,,case rate,1241,75265.79247,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Aetna Medicare,Aetna Medicare,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Cigna,Cigna,2914,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Cigna Medicare Advantage,Cigna Medicare Advantage,98623.79014,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Essence,Essence,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Humana Gold,Humana Gold,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Medica,Medica,2446,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Tricare,Tricare,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,98623.79014,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,UHC Medicare,UHC Medicare,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,B0101,HIPPS,,,,,,,,Inpatient,,,96689.99033,96689.99033,Wellcare,Wellcare,96689.99033,,,,,,,case rate,1241,98623.79014,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Aetna Medicare,Aetna Medicare,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Cigna,Cigna,2914,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Cigna Medicare Advantage,Cigna Medicare Advantage,87577.19124,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Essence,Essence,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Humana Gold,Humana Gold,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Medica,Medica,2446,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Tricare,Tricare,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,87577.19124,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,UHC Medicare,UHC Medicare,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,C0101,HIPPS,,,,,,,,Inpatient,,,85859.99141,85859.99141,Wellcare,Wellcare,85859.99141,,,,,,,case rate,1241,87577.19124,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Aetna Medicare,Aetna Medicare,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Cigna,Cigna,2914,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Cigna Medicare Advantage,Cigna Medicare Advantage,79345.79207,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Essence,Essence,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Humana Gold,Humana Gold,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Medica,Medica,2446,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Tricare,Tricare,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,79345.79207,"Per diem rate, all codes are bundled into service package"
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,UHC Medicare,UHC Medicare,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=72.50,D0101,HIPPS,,,,,,,,Inpatient,,,77789.99222,77789.99222,Wellcare,Wellcare,77789.99222,,,,,,,case rate,1241,79345.79207,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Aetna Medicare,Aetna Medicare,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Cigna,Cigna,2914,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Cigna Medicare Advantage,Cigna Medicare Advantage,95798.39042,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Essence,Essence,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Humana Gold,Humana Gold,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Medica,Medica,2446,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Tricare,Tricare,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95798.39042,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,UHC Medicare,UHC Medicare,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,A0102,HIPPS,,,,,,,,Inpatient,,,93919.99061,93919.99061,Wellcare,Wellcare,93919.99061,,,,,,,case rate,1241,95798.39042,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Aetna Medicare,Aetna Medicare,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Cigna,Cigna,2914,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Cigna Medicare Advantage,Cigna Medicare Advantage,125521.1874,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Essence,Essence,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Humana Gold,Humana Gold,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Medica,Medica,2446,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Tricare,Tricare,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,125521.1874,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,UHC Medicare,UHC Medicare,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,B0102,HIPPS,,,,,,,,Inpatient,,,123059.9877,123059.9877,Wellcare,Wellcare,123059.9877,,,,,,,case rate,1241,125521.1874,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Aetna Medicare,Aetna Medicare,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Cigna,Cigna,2914,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Cigna Medicare Advantage,Cigna Medicare Advantage,111465.5889,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Essence,Essence,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Humana Gold,Humana Gold,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Medica,Medica,2446,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Tricare,Tricare,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,111465.5889,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,UHC Medicare,UHC Medicare,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,C0102,HIPPS,,,,,,,,Inpatient,,,109279.9891,109279.9891,Wellcare,Wellcare,109279.9891,,,,,,,case rate,1241,111465.5889,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Aetna Medicare,Aetna Medicare,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Cigna,Cigna,2914,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Cigna Medicare Advantage,Cigna Medicare Advantage,100990.1899,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Essence,Essence,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Humana Gold,Humana Gold,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Medica,Medica,2446,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Tricare,Tricare,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,100990.1899,"Per diem rate, all codes are bundled into service package"
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,UHC Medicare,UHC Medicare,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=63.50 and M <72.50,D0102,HIPPS,,,,,,,,Inpatient,,,99009.9901,99009.9901,Wellcare,Wellcare,99009.9901,,,,,,,case rate,1241,100990.1899,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Aetna Medicare,Aetna Medicare,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Cigna,Cigna,2914,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Cigna Medicare Advantage,Cigna Medicare Advantage,122971.1877,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Essence,Essence,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Humana Gold,Humana Gold,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Medica,Medica,2446,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Tricare,Tricare,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,122971.1877,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,UHC Medicare,UHC Medicare,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,A0103,HIPPS,,,,,,,,Inpatient,,,120559.9879,120559.9879,Wellcare,Wellcare,120559.9879,,,,,,,case rate,1241,122971.1877,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Aetna Medicare,Aetna Medicare,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Cigna,Cigna,2914,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Cigna Medicare Advantage,Cigna Medicare Advantage,161139.5839,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Essence,Essence,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Humana Gold,Humana Gold,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Medica,Medica,2446,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Tricare,Tricare,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,161139.5839,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,UHC Medicare,UHC Medicare,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,B0103,HIPPS,,,,,,,,Inpatient,,,157979.9842,157979.9842,Wellcare,Wellcare,157979.9842,,,,,,,case rate,1241,161139.5839,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Aetna Medicare,Aetna Medicare,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Cigna,Cigna,2914,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Cigna Medicare Advantage,Cigna Medicare Advantage,143095.7857,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Essence,Essence,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Humana Gold,Humana Gold,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Medica,Medica,2446,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Tricare,Tricare,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,143095.7857,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,UHC Medicare,UHC Medicare,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,C0103,HIPPS,,,,,,,,Inpatient,,,140289.986,140289.986,Wellcare,Wellcare,140289.986,,,,,,,case rate,1241,143095.7857,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Aetna Medicare,Aetna Medicare,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Cigna,Cigna,2914,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Cigna Medicare Advantage,Cigna Medicare Advantage,129641.987,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Essence,Essence,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Humana Gold,Humana Gold,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Medica,Medica,2446,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Tricare,Tricare,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,129641.987,"Per diem rate, all codes are bundled into service package"
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,UHC Medicare,UHC Medicare,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=50.50 and M <63.50,D0103,HIPPS,,,,,,,,Inpatient,,,127099.9873,127099.9873,Wellcare,Wellcare,127099.9873,,,,,,,case rate,1241,129641.987,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Aetna Medicare,Aetna Medicare,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Cigna,Cigna,2914,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Cigna Medicare Advantage,Cigna Medicare Advantage,157059.5843,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Essence,Essence,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Humana Gold,Humana Gold,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Medica,Medica,2446,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Tricare,Tricare,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,157059.5843,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,UHC Medicare,UHC Medicare,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,A0104,HIPPS,,,,,,,,Inpatient,,,153979.9846,153979.9846,Wellcare,Wellcare,153979.9846,,,,,,,case rate,1241,157059.5843,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Aetna Medicare,Aetna Medicare,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Cigna,Cigna,2914,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Cigna Medicare Advantage,Cigna Medicare Advantage,205805.3794,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Essence,Essence,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Humana Gold,Humana Gold,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Medica,Medica,2446,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Tricare,Tricare,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,205805.3794,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,UHC Medicare,UHC Medicare,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,B0104,HIPPS,,,,,,,,Inpatient,,,201769.9798,201769.9798,Wellcare,Wellcare,201769.9798,,,,,,,case rate,1241,205805.3794,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Aetna Medicare,Aetna Medicare,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Cigna,Cigna,2914,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Cigna Medicare Advantage,Cigna Medicare Advantage,182763.5817,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Essence,Essence,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Humana Gold,Humana Gold,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Medica,Medica,2446,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Tricare,Tricare,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,182763.5817,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,UHC Medicare,UHC Medicare,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,C0104,HIPPS,,,,,,,,Inpatient,,,179179.9821,179179.9821,Wellcare,Wellcare,179179.9821,,,,,,,case rate,1241,182763.5817,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Aetna Medicare,Aetna Medicare,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Cigna,Cigna,2914,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Cigna Medicare Advantage,Cigna Medicare Advantage,165586.7834,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Essence,Essence,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Humana Gold,Humana Gold,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Medica,Medica,2446,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Tricare,Tricare,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,165586.7834,"Per diem rate, all codes are bundled into service package"
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,UHC Medicare,UHC Medicare,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M >=41.50 and M <50.50,D0104,HIPPS,,,,,,,,Inpatient,,,162339.9838,162339.9838,Wellcare,Wellcare,162339.9838,,,,,,,case rate,1241,165586.7834,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Aetna Medicare,Aetna Medicare,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Cigna,Cigna,2914,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Cigna Medicare Advantage,Cigna Medicare Advantage,195737.9804,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Essence,Essence,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Humana Gold,Humana Gold,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Medica,Medica,2446,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Tricare,Tricare,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,195737.9804,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,UHC Medicare,UHC Medicare,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,A0105,HIPPS,,,,,,,,Inpatient,,,191899.9808,191899.9808,Wellcare,Wellcare,191899.9808,,,,,,,case rate,1241,195737.9804,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Aetna Medicare,Aetna Medicare,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Cigna,Cigna,2914,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Cigna Medicare Advantage,Cigna Medicare Advantage,256489.1744,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Essence,Essence,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Humana Gold,Humana Gold,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Medica,Medica,2446,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Tricare,Tricare,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,256489.1744,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,UHC Medicare,UHC Medicare,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,B0105,HIPPS,,,,,,,,Inpatient,,,251459.9749,251459.9749,Wellcare,Wellcare,251459.9749,,,,,,,case rate,1241,256489.1744,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Aetna Medicare,Aetna Medicare,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Cigna,Cigna,2914,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Cigna Medicare Advantage,Cigna Medicare Advantage,227765.9772,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Essence,Essence,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Humana Gold,Humana Gold,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Medica,Medica,2446,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Tricare,Tricare,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,227765.9772,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,UHC Medicare,UHC Medicare,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,C0105,HIPPS,,,,,,,,Inpatient,,,223299.9777,223299.9777,Wellcare,Wellcare,223299.9777,,,,,,,case rate,1241,227765.9772,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Aetna Medicare,Aetna Medicare,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Cigna,Cigna,2914,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Cigna Medicare Advantage,Cigna Medicare Advantage,206356.1794,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Essence,Essence,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Humana Gold,Humana Gold,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Medica,Medica,2446,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Tricare,Tricare,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,206356.1794,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,UHC Medicare,UHC Medicare,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A >=84.50,D0105,HIPPS,,,,,,,,Inpatient,,,202309.9798,202309.9798,Wellcare,Wellcare,202309.9798,,,,,,,case rate,1241,206356.1794,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Aetna Medicare,Aetna Medicare,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Cigna,Cigna,2914,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Cigna Medicare Advantage,Cigna Medicare Advantage,220483.178,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Essence,Essence,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Humana Gold,Humana Gold,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Medica,Medica,2446,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Tricare,Tricare,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,220483.178,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,UHC Medicare,UHC Medicare,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,A0106,HIPPS,,,,,,,,Inpatient,,,216159.9784,216159.9784,Wellcare,Wellcare,216159.9784,,,,,,,case rate,1241,220483.178,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Aetna Medicare,Aetna Medicare,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Cigna,Cigna,2914,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Cigna Medicare Advantage,Cigna Medicare Advantage,288914.9711,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Essence,Essence,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Humana Gold,Humana Gold,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Medica,Medica,2446,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Tricare,Tricare,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,288914.9711,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,UHC Medicare,UHC Medicare,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,B0106,HIPPS,,,,,,,,Inpatient,,,283249.9717,283249.9717,Wellcare,Wellcare,283249.9717,,,,,,,case rate,1241,288914.9711,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Aetna Medicare,Aetna Medicare,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Cigna,Cigna,2914,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Cigna Medicare Advantage,Cigna Medicare Advantage,256560.5743,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Essence,Essence,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Humana Gold,Humana Gold,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Medica,Medica,2446,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Tricare,Tricare,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,256560.5743,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,UHC Medicare,UHC Medicare,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,C0106,HIPPS,,,,,,,,Inpatient,,,251529.9748,251529.9748,Wellcare,Wellcare,251529.9748,,,,,,,case rate,1241,256560.5743,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Aetna Medicare,Aetna Medicare,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Cigna,Cigna,2914,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Cigna Medicare Advantage,Cigna Medicare Advantage,232447.7768,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Essence,Essence,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Humana Gold,Humana Gold,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Medica,Medica,2446,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Tricare,Tricare,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,232447.7768,"Per diem rate, all codes are bundled into service package"
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,UHC Medicare,UHC Medicare,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Stroke M <41.50 and A <84.50,D0106,HIPPS,,,,,,,,Inpatient,,,227889.9772,227889.9772,Wellcare,Wellcare,227889.9772,,,,,,,case rate,1241,232447.7768,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Aetna Medicare,Aetna Medicare,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Cigna,Cigna,2914,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Cigna Medicare Advantage,Cigna Medicare Advantage,73888.79261,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Essence,Essence,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Humana Gold,Humana Gold,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Medica,Medica,2446,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Tricare,Tricare,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,73888.79261,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,UHC Medicare,UHC Medicare,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,A0201,HIPPS,,,,,,,,Inpatient,,,72439.99276,72439.99276,Wellcare,Wellcare,72439.99276,,,,,,,case rate,1241,73888.79261,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Aetna Medicare,Aetna Medicare,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Cigna,Cigna,2914,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Cigna Medicare Advantage,Cigna Medicare Advantage,108262.7892,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Essence,Essence,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Humana Gold,Humana Gold,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Medica,Medica,2446,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Tricare,Tricare,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,108262.7892,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,UHC Medicare,UHC Medicare,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,B0201,HIPPS,,,,,,,,Inpatient,,,106139.9894,106139.9894,Wellcare,Wellcare,106139.9894,,,,,,,case rate,1241,108262.7892,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Aetna Medicare,Aetna Medicare,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Cigna,Cigna,2914,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Cigna Medicare Advantage,Cigna Medicare Advantage,86087.99139,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Essence,Essence,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Humana Gold,Humana Gold,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Medica,Medica,2446,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Tricare,Tricare,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,86087.99139,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,UHC Medicare,UHC Medicare,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,C0201,HIPPS,,,,,,,,Inpatient,,,84399.99156,84399.99156,Wellcare,Wellcare,84399.99156,,,,,,,case rate,1241,86087.99139,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Aetna Medicare,Aetna Medicare,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Cigna,Cigna,2914,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Cigna Medicare Advantage,Cigna Medicare Advantage,78641.99214,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Essence,Essence,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Humana Gold,Humana Gold,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Medica,Medica,2446,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Tricare,Tricare,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,78641.99214,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,UHC Medicare,UHC Medicare,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=73.50,D0201,HIPPS,,,,,,,,Inpatient,,,77099.99229,77099.99229,Wellcare,Wellcare,77099.99229,,,,,,,case rate,1241,78641.99214,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Aetna Medicare,Aetna Medicare,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Cigna,Cigna,2914,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Cigna Medicare Advantage,Cigna Medicare Advantage,96491.99035,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Essence,Essence,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Humana Gold,Humana Gold,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Medica,Medica,2446,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Tricare,Tricare,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96491.99035,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,UHC Medicare,UHC Medicare,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,A0202,HIPPS,,,,,,,,Inpatient,,,94599.99054,94599.99054,Wellcare,Wellcare,94599.99054,,,,,,,case rate,1241,96491.99035,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna Medicare,Aetna Medicare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna,Cigna,2914,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna Medicare Advantage,Cigna Medicare Advantage,141382.1859,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Essence,Essence,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Humana Gold,Humana Gold,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Medica,Medica,2446,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Tricare,Tricare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Medicare,UHC Medicare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,B0202,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Wellcare,Wellcare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Aetna Medicare,Aetna Medicare,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112414.1888,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Essence,Essence,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Humana Gold,Humana Gold,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Medica,Medica,2446,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Tricare,Tricare,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112414.1888,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,UHC Medicare,UHC Medicare,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,C0202,HIPPS,,,,,,,,Inpatient,,,110209.989,110209.989,Wellcare,Wellcare,110209.989,,,,,,,case rate,1241,112414.1888,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Aetna Medicare,Aetna Medicare,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Cigna,Cigna,2914,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Cigna Medicare Advantage,Cigna Medicare Advantage,102703.7897,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Essence,Essence,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Humana Gold,Humana Gold,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Medica,Medica,2446,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Tricare,Tricare,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,102703.7897,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,UHC Medicare,UHC Medicare,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=61.50 and M <73.50,D0202,HIPPS,,,,,,,,Inpatient,,,100689.9899,100689.9899,Wellcare,Wellcare,100689.9899,,,,,,,case rate,1241,102703.7897,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Aetna Medicare,Aetna Medicare,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,119962.188,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Essence,Essence,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Humana Gold,Humana Gold,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Medica,Medica,2446,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Tricare,Tricare,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,119962.188,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,UHC Medicare,UHC Medicare,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,A0203,HIPPS,,,,,,,,Inpatient,,,117609.9882,117609.9882,Wellcare,Wellcare,117609.9882,,,,,,,case rate,1241,119962.188,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Aetna Medicare,Aetna Medicare,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Cigna,Cigna,2914,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Cigna Medicare Advantage,Cigna Medicare Advantage,175776.5824,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Essence,Essence,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Humana Gold,Humana Gold,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Medica,Medica,2446,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Tricare,Tricare,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,175776.5824,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,UHC Medicare,UHC Medicare,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,B0203,HIPPS,,,,,,,,Inpatient,,,172329.9828,172329.9828,Wellcare,Wellcare,172329.9828,,,,,,,case rate,1241,175776.5824,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Aetna Medicare,Aetna Medicare,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Cigna,Cigna,2914,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Cigna Medicare Advantage,Cigna Medicare Advantage,139760.386,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Essence,Essence,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Humana Gold,Humana Gold,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Medica,Medica,2446,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Tricare,Tricare,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,139760.386,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,UHC Medicare,UHC Medicare,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,C0203,HIPPS,,,,,,,,Inpatient,,,137019.9863,137019.9863,Wellcare,Wellcare,137019.9863,,,,,,,case rate,1241,139760.386,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Aetna Medicare,Aetna Medicare,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Cigna,Cigna,2914,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Cigna Medicare Advantage,Cigna Medicare Advantage,127683.5872,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Essence,Essence,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Humana Gold,Humana Gold,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Medica,Medica,2446,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Tricare,Tricare,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,127683.5872,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,UHC Medicare,UHC Medicare,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=49.50 and M <61.50,D0203,HIPPS,,,,,,,,Inpatient,,,125179.9875,125179.9875,Wellcare,Wellcare,125179.9875,,,,,,,case rate,1241,127683.5872,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Aetna Medicare,Aetna Medicare,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Cigna,Cigna,2914,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Cigna Medicare Advantage,Cigna Medicare Advantage,147848.9852,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Essence,Essence,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Humana Gold,Humana Gold,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Medica,Medica,2446,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Tricare,Tricare,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,147848.9852,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,UHC Medicare,UHC Medicare,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,A0204,HIPPS,,,,,,,,Inpatient,,,144949.9855,144949.9855,Wellcare,Wellcare,144949.9855,,,,,,,case rate,1241,147848.9852,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Aetna Medicare,Aetna Medicare,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Cigna,Cigna,2914,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Cigna Medicare Advantage,Cigna Medicare Advantage,216637.7783,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Essence,Essence,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Humana Gold,Humana Gold,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Medica,Medica,2446,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Tricare,Tricare,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,216637.7783,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,UHC Medicare,UHC Medicare,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,B0204,HIPPS,,,,,,,,Inpatient,,,212389.9788,212389.9788,Wellcare,Wellcare,212389.9788,,,,,,,case rate,1241,216637.7783,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Aetna Medicare,Aetna Medicare,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Cigna,Cigna,2914,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Cigna Medicare Advantage,Cigna Medicare Advantage,172247.3828,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Essence,Essence,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Humana Gold,Humana Gold,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Medica,Medica,2446,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Tricare,Tricare,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172247.3828,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,UHC Medicare,UHC Medicare,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,C0204,HIPPS,,,,,,,,Inpatient,,,168869.9831,168869.9831,Wellcare,Wellcare,168869.9831,,,,,,,case rate,1241,172247.3828,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Aetna Medicare,Aetna Medicare,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Cigna,Cigna,2914,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Cigna Medicare Advantage,Cigna Medicare Advantage,157365.5843,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Essence,Essence,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Humana Gold,Humana Gold,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Medica,Medica,2446,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Tricare,Tricare,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,157365.5843,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,UHC Medicare,UHC Medicare,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M >=35.50 and M <49.50,D0204,HIPPS,,,,,,,,Inpatient,,,154279.9846,154279.9846,Wellcare,Wellcare,154279.9846,,,,,,,case rate,1241,157365.5843,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Aetna Medicare,Aetna Medicare,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Cigna,Cigna,2914,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Cigna Medicare Advantage,Cigna Medicare Advantage,189679.181,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Essence,Essence,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Humana Gold,Humana Gold,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Medica,Medica,2446,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Tricare,Tricare,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,189679.181,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,UHC Medicare,UHC Medicare,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,A0205,HIPPS,,,,,,,,Inpatient,,,185959.9814,185959.9814,Wellcare,Wellcare,185959.9814,,,,,,,case rate,1241,189679.181,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Aetna Medicare,Aetna Medicare,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Cigna,Cigna,2914,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Cigna Medicare Advantage,Cigna Medicare Advantage,277929.5722,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Essence,Essence,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Humana Gold,Humana Gold,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Medica,Medica,2446,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Tricare,Tricare,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,277929.5722,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,UHC Medicare,UHC Medicare,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,B0205,HIPPS,,,,,,,,Inpatient,,,272479.9728,272479.9728,Wellcare,Wellcare,272479.9728,,,,,,,case rate,1241,277929.5722,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Aetna Medicare,Aetna Medicare,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Cigna,Cigna,2914,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Cigna Medicare Advantage,Cigna Medicare Advantage,220982.9779,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Essence,Essence,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Humana Gold,Humana Gold,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Medica,Medica,2446,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Tricare,Tricare,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,220982.9779,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,UHC Medicare,UHC Medicare,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,C0205,HIPPS,,,,,,,,Inpatient,,,216649.9783,216649.9783,Wellcare,Wellcare,216649.9783,,,,,,,case rate,1241,220982.9779,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Aetna Medicare,Aetna Medicare,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Cigna,Cigna,2914,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Cigna Medicare Advantage,Cigna Medicare Advantage,201888.5798,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Essence,Essence,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Humana Gold,Humana Gold,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Medica,Medica,2446,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Tricare,Tricare,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,201888.5798,"Per diem rate, all codes are bundled into service package"
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,UHC Medicare,UHC Medicare,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Traumatic brain injury M <35.50,D0205,HIPPS,,,,,,,,Inpatient,,,197929.9802,197929.9802,Wellcare,Wellcare,197929.9802,,,,,,,case rate,1241,201888.5798,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Aetna Medicare,Aetna Medicare,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Cigna,Cigna,2914,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Cigna Medicare Advantage,Cigna Medicare Advantage,84241.79158,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Essence,Essence,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Humana Gold,Humana Gold,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Medica,Medica,2446,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Tricare,Tricare,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,84241.79158,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,UHC Medicare,UHC Medicare,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,A0301,HIPPS,,,,,,,,Inpatient,,,82589.99174,82589.99174,Wellcare,Wellcare,82589.99174,,,,,,,case rate,1241,84241.79158,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Aetna Medicare,Aetna Medicare,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Cigna,Cigna,2914,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Cigna Medicare Advantage,Cigna Medicare Advantage,121777.7878,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Essence,Essence,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Humana Gold,Humana Gold,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Medica,Medica,2446,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Tricare,Tricare,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,121777.7878,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,UHC Medicare,UHC Medicare,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,B0301,HIPPS,,,,,,,,Inpatient,,,119389.9881,119389.9881,Wellcare,Wellcare,119389.9881,,,,,,,case rate,1241,121777.7878,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Aetna Medicare,Aetna Medicare,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Cigna,Cigna,2914,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Cigna Medicare Advantage,Cigna Medicare Advantage,96512.39035,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Essence,Essence,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Humana Gold,Humana Gold,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Medica,Medica,2446,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Tricare,Tricare,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96512.39035,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,UHC Medicare,UHC Medicare,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,C0301,HIPPS,,,,,,,,Inpatient,,,94619.99054,94619.99054,Wellcare,Wellcare,94619.99054,,,,,,,case rate,1241,96512.39035,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Aetna Medicare,Aetna Medicare,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Cigna,Cigna,2914,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Cigna Medicare Advantage,Cigna Medicare Advantage,89984.391,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Essence,Essence,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Humana Gold,Humana Gold,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Medica,Medica,2446,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Tricare,Tricare,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,89984.391,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,UHC Medicare,UHC Medicare,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=65.50,D0301,HIPPS,,,,,,,,Inpatient,,,88219.99118,88219.99118,Wellcare,Wellcare,88219.99118,,,,,,,case rate,1241,89984.391,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Aetna Medicare,Aetna Medicare,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Cigna,Cigna,2914,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Cigna Medicare Advantage,Cigna Medicare Advantage,108966.5891,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Essence,Essence,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Humana Gold,Humana Gold,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Medica,Medica,2446,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Tricare,Tricare,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,108966.5891,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,UHC Medicare,UHC Medicare,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,A0302,HIPPS,,,,,,,,Inpatient,,,106829.9893,106829.9893,Wellcare,Wellcare,106829.9893,,,,,,,case rate,1241,108966.5891,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Aetna Medicare,Aetna Medicare,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Cigna,Cigna,2914,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Cigna Medicare Advantage,Cigna Medicare Advantage,157538.9842,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Essence,Essence,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Humana Gold,Humana Gold,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Medica,Medica,2446,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Tricare,Tricare,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,157538.9842,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,UHC Medicare,UHC Medicare,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,B0302,HIPPS,,,,,,,,Inpatient,,,154449.9846,154449.9846,Wellcare,Wellcare,154449.9846,,,,,,,case rate,1241,157538.9842,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Aetna Medicare,Aetna Medicare,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Cigna,Cigna,2914,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Cigna Medicare Advantage,Cigna Medicare Advantage,124858.1875,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Essence,Essence,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Humana Gold,Humana Gold,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Medica,Medica,2446,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Tricare,Tricare,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,124858.1875,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,UHC Medicare,UHC Medicare,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,C0302,HIPPS,,,,,,,,Inpatient,,,122409.9878,122409.9878,Wellcare,Wellcare,122409.9878,,,,,,,case rate,1241,124858.1875,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Aetna Medicare,Aetna Medicare,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Cigna,Cigna,2914,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Cigna Medicare Advantage,Cigna Medicare Advantage,116402.3884,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Essence,Essence,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Humana Gold,Humana Gold,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Medica,Medica,2446,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Tricare,Tricare,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,116402.3884,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,UHC Medicare,UHC Medicare,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=52.50 and M <65.50,D0302,HIPPS,,,,,,,,Inpatient,,,114119.9886,114119.9886,Wellcare,Wellcare,114119.9886,,,,,,,case rate,1241,116402.3884,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Aetna Medicare,Aetna Medicare,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Cigna,Cigna,2914,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Cigna Medicare Advantage,Cigna Medicare Advantage,128856.5871,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Essence,Essence,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Humana Gold,Humana Gold,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Medica,Medica,2446,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Tricare,Tricare,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,128856.5871,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,UHC Medicare,UHC Medicare,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,A0303,HIPPS,,,,,,,,Inpatient,,,126329.9874,126329.9874,Wellcare,Wellcare,126329.9874,,,,,,,case rate,1241,128856.5871,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Aetna Medicare,Aetna Medicare,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Cigna,Cigna,2914,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Cigna Medicare Advantage,Cigna Medicare Advantage,186272.3814,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Essence,Essence,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Humana Gold,Humana Gold,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Medica,Medica,2446,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Tricare,Tricare,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,186272.3814,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,UHC Medicare,UHC Medicare,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,B0303,HIPPS,,,,,,,,Inpatient,,,182619.9817,182619.9817,Wellcare,Wellcare,182619.9817,,,,,,,case rate,1241,186272.3814,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Aetna Medicare,Aetna Medicare,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Cigna,Cigna,2914,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Cigna Medicare Advantage,Cigna Medicare Advantage,147634.7852,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Essence,Essence,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Humana Gold,Humana Gold,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Medica,Medica,2446,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Tricare,Tricare,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,147634.7852,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,UHC Medicare,UHC Medicare,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,C0303,HIPPS,,,,,,,,Inpatient,,,144739.9855,144739.9855,Wellcare,Wellcare,144739.9855,,,,,,,case rate,1241,147634.7852,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Aetna Medicare,Aetna Medicare,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Cigna,Cigna,2914,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Cigna Medicare Advantage,Cigna Medicare Advantage,137638.7862,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Essence,Essence,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Humana Gold,Humana Gold,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Medica,Medica,2446,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Tricare,Tricare,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,137638.7862,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,UHC Medicare,UHC Medicare,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M >=42.50 and M <52.50,D0303,HIPPS,,,,,,,,Inpatient,,,134939.9865,134939.9865,Wellcare,Wellcare,134939.9865,,,,,,,case rate,1241,137638.7862,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Aetna Medicare,Aetna Medicare,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Cigna,Cigna,2914,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Cigna Medicare Advantage,Cigna Medicare Advantage,152642.9847,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Essence,Essence,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Humana Gold,Humana Gold,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Medica,Medica,2446,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Tricare,Tricare,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,152642.9847,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,UHC Medicare,UHC Medicare,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,A0304,HIPPS,,,,,,,,Inpatient,,,149649.985,149649.985,Wellcare,Wellcare,149649.985,,,,,,,case rate,1241,152642.9847,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Aetna Medicare,Aetna Medicare,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Cigna,Cigna,2914,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Cigna Medicare Advantage,Cigna Medicare Advantage,220676.9779,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Essence,Essence,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Humana Gold,Humana Gold,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Medica,Medica,2446,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Tricare,Tricare,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,220676.9779,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,UHC Medicare,UHC Medicare,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,B0304,HIPPS,,,,,,,,Inpatient,,,216349.9784,216349.9784,Wellcare,Wellcare,216349.9784,,,,,,,case rate,1241,220676.9779,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Aetna Medicare,Aetna Medicare,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Cigna,Cigna,2914,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Cigna Medicare Advantage,Cigna Medicare Advantage,174899.3825,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Essence,Essence,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Humana Gold,Humana Gold,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Medica,Medica,2446,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Tricare,Tricare,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,174899.3825,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,UHC Medicare,UHC Medicare,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,C0304,HIPPS,,,,,,,,Inpatient,,,171469.9829,171469.9829,Wellcare,Wellcare,171469.9829,,,,,,,case rate,1241,174899.3825,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Aetna Medicare,Aetna Medicare,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Cigna,Cigna,2914,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Cigna Medicare Advantage,Cigna Medicare Advantage,163046.9837,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Essence,Essence,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Humana Gold,Humana Gold,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Medica,Medica,2446,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Tricare,Tricare,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,163046.9837,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,UHC Medicare,UHC Medicare,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A >=78.50,D0304,HIPPS,,,,,,,,Inpatient,,,159849.984,159849.984,Wellcare,Wellcare,159849.984,,,,,,,case rate,1241,163046.9837,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Aetna Medicare,Aetna Medicare,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Cigna,Cigna,2914,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Cigna Medicare Advantage,Cigna Medicare Advantage,167208.5833,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Essence,Essence,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Humana Gold,Humana Gold,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Medica,Medica,2446,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Tricare,Tricare,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,167208.5833,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,UHC Medicare,UHC Medicare,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,A0305,HIPPS,,,,,,,,Inpatient,,,163929.9836,163929.9836,Wellcare,Wellcare,163929.9836,,,,,,,case rate,1241,167208.5833,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Aetna Medicare,Aetna Medicare,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Cigna,Cigna,2914,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Cigna Medicare Advantage,Cigna Medicare Advantage,241729.7758,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Essence,Essence,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Humana Gold,Humana Gold,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Medica,Medica,2446,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Tricare,Tricare,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,241729.7758,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,UHC Medicare,UHC Medicare,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,B0305,HIPPS,,,,,,,,Inpatient,,,236989.9763,236989.9763,Wellcare,Wellcare,236989.9763,,,,,,,case rate,1241,241729.7758,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Aetna Medicare,Aetna Medicare,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Cigna,Cigna,2914,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Cigna Medicare Advantage,Cigna Medicare Advantage,191586.5808,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Essence,Essence,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Humana Gold,Humana Gold,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Medica,Medica,2446,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Tricare,Tricare,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,191586.5808,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,UHC Medicare,UHC Medicare,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,C0305,HIPPS,,,,,,,,Inpatient,,,187829.9812,187829.9812,Wellcare,Wellcare,187829.9812,,,,,,,case rate,1241,191586.5808,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Aetna Medicare,Aetna Medicare,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Cigna,Cigna,2914,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Cigna Medicare Advantage,Cigna Medicare Advantage,178612.1821,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Essence,Essence,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Humana Gold,Humana Gold,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Medica,Medica,2446,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Tricare,Tricare,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,178612.1821,"Per diem rate, all codes are bundled into service package"
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,UHC Medicare,UHC Medicare,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Non-traumatic brain injury M <42.50 and A <78.50,D0305,HIPPS,,,,,,,,Inpatient,,,175109.9825,175109.9825,Wellcare,Wellcare,175109.9825,,,,,,,case rate,1241,178612.1821,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Aetna Medicare,Aetna Medicare,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Cigna,Cigna,2914,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Cigna Medicare Advantage,Cigna Medicare Advantage,99521.39005,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Essence,Essence,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Humana Gold,Humana Gold,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Medica,Medica,2446,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Tricare,Tricare,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,99521.39005,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,UHC Medicare,UHC Medicare,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,A0401,HIPPS,,,,,,,,Inpatient,,,97569.99024,97569.99024,Wellcare,Wellcare,97569.99024,,,,,,,case rate,1241,99521.39005,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Aetna Medicare,Aetna Medicare,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Cigna,Cigna,2914,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Cigna Medicare Advantage,Cigna Medicare Advantage,138189.5862,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Essence,Essence,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Humana Gold,Humana Gold,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Medica,Medica,2446,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Tricare,Tricare,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,138189.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,UHC Medicare,UHC Medicare,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,B0401,HIPPS,,,,,,,,Inpatient,,,135479.9865,135479.9865,Wellcare,Wellcare,135479.9865,,,,,,,case rate,1241,138189.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Aetna Medicare,Aetna Medicare,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Cigna,Cigna,2914,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Cigna Medicare Advantage,Cigna Medicare Advantage,112954.7887,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Essence,Essence,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Humana Gold,Humana Gold,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Medica,Medica,2446,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Tricare,Tricare,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112954.7887,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,UHC Medicare,UHC Medicare,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,C0401,HIPPS,,,,,,,,Inpatient,,,110739.9889,110739.9889,Wellcare,Wellcare,110739.9889,,,,,,,case rate,1241,112954.7887,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Aetna Medicare,Aetna Medicare,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Cigna,Cigna,2914,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Cigna Medicare Advantage,Cigna Medicare Advantage,109986.589,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Essence,Essence,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Humana Gold,Humana Gold,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Medica,Medica,2446,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Tricare,Tricare,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,109986.589,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,UHC Medicare,UHC Medicare,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=56.50,D0401,HIPPS,,,,,,,,Inpatient,,,107829.9892,107829.9892,Wellcare,Wellcare,107829.9892,,,,,,,case rate,1241,109986.589,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Aetna Medicare,Aetna Medicare,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Cigna,Cigna,2914,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Cigna Medicare Advantage,Cigna Medicare Advantage,124766.3875,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Essence,Essence,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Humana Gold,Humana Gold,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Medica,Medica,2446,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Tricare,Tricare,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,124766.3875,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,UHC Medicare,UHC Medicare,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,A0402,HIPPS,,,,,,,,Inpatient,,,122319.9878,122319.9878,Wellcare,Wellcare,122319.9878,,,,,,,case rate,1241,124766.3875,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Aetna Medicare,Aetna Medicare,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Cigna,Cigna,2914,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Cigna Medicare Advantage,Cigna Medicare Advantage,173246.9827,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Essence,Essence,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Humana Gold,Humana Gold,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Medica,Medica,2446,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Tricare,Tricare,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,173246.9827,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,UHC Medicare,UHC Medicare,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,B0402,HIPPS,,,,,,,,Inpatient,,,169849.983,169849.983,Wellcare,Wellcare,169849.983,,,,,,,case rate,1241,173246.9827,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Aetna Medicare,Aetna Medicare,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Cigna,Cigna,2914,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Cigna Medicare Advantage,Cigna Medicare Advantage,141606.5858,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Essence,Essence,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Humana Gold,Humana Gold,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Medica,Medica,2446,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Tricare,Tricare,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,141606.5858,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,UHC Medicare,UHC Medicare,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,C0402,HIPPS,,,,,,,,Inpatient,,,138829.9861,138829.9861,Wellcare,Wellcare,138829.9861,,,,,,,case rate,1241,141606.5858,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Aetna Medicare,Aetna Medicare,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Cigna,Cigna,2914,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Cigna Medicare Advantage,Cigna Medicare Advantage,137883.5862,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Essence,Essence,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Humana Gold,Humana Gold,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Medica,Medica,2446,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Tricare,Tricare,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,137883.5862,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,UHC Medicare,UHC Medicare,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=47.50 and M <56.50,D0402,HIPPS,,,,,,,,Inpatient,,,135179.9865,135179.9865,Wellcare,Wellcare,135179.9865,,,,,,,case rate,1241,137883.5862,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Aetna Medicare,Aetna Medicare,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,144003.5856,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Essence,Essence,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Humana Gold,Humana Gold,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Medica,Medica,2446,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Tricare,Tricare,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,144003.5856,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,UHC Medicare,UHC Medicare,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,A0403,HIPPS,,,,,,,,Inpatient,,,141179.9859,141179.9859,Wellcare,Wellcare,141179.9859,,,,,,,case rate,1241,144003.5856,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Aetna Medicare,Aetna Medicare,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Cigna,Cigna,2914,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Cigna Medicare Advantage,Cigna Medicare Advantage,199960.78,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Essence,Essence,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Humana Gold,Humana Gold,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Medica,Medica,2446,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Tricare,Tricare,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,199960.78,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,UHC Medicare,UHC Medicare,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,B0403,HIPPS,,,,,,,,Inpatient,,,196039.9804,196039.9804,Wellcare,Wellcare,196039.9804,,,,,,,case rate,1241,199960.78,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Aetna Medicare,Aetna Medicare,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Cigna,Cigna,2914,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Cigna Medicare Advantage,Cigna Medicare Advantage,163444.7837,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Essence,Essence,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Humana Gold,Humana Gold,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Medica,Medica,2446,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Tricare,Tricare,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,163444.7837,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,UHC Medicare,UHC Medicare,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,C0403,HIPPS,,,,,,,,Inpatient,,,160239.984,160239.984,Wellcare,Wellcare,160239.984,,,,,,,case rate,1241,163444.7837,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Aetna Medicare,Aetna Medicare,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Cigna,Cigna,2914,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Cigna Medicare Advantage,Cigna Medicare Advantage,159140.3841,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Essence,Essence,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Humana Gold,Humana Gold,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Medica,Medica,2446,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Tricare,Tricare,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,159140.3841,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,UHC Medicare,UHC Medicare,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=41.50 and M <47.50,D0403,HIPPS,,,,,,,,Inpatient,,,156019.9844,156019.9844,Wellcare,Wellcare,156019.9844,,,,,,,case rate,1241,159140.3841,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Aetna Medicare,Aetna Medicare,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Cigna,Cigna,2914,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Cigna Medicare Advantage,Cigna Medicare Advantage,233345.3767,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Essence,Essence,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Humana Gold,Humana Gold,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Medica,Medica,2446,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Tricare,Tricare,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,233345.3767,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,UHC Medicare,UHC Medicare,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,A0404,HIPPS,,,,,,,,Inpatient,,,228769.9771,228769.9771,Wellcare,Wellcare,228769.9771,,,,,,,case rate,1241,233345.3767,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Aetna Medicare,Aetna Medicare,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Cigna,Cigna,2914,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Cigna Medicare Advantage,Cigna Medicare Advantage,324002.9676,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Essence,Essence,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Humana Gold,Humana Gold,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Medica,Medica,2446,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Tricare,Tricare,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,324002.9676,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,UHC Medicare,UHC Medicare,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,B0404,HIPPS,,,,,,,,Inpatient,,,317649.9682,317649.9682,Wellcare,Wellcare,317649.9682,,,,,,,case rate,1241,324002.9676,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Aetna Medicare,Aetna Medicare,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Cigna,Cigna,2914,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Cigna Medicare Advantage,Cigna Medicare Advantage,264832.7735,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Essence,Essence,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Humana Gold,Humana Gold,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Medica,Medica,2446,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Tricare,Tricare,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,264832.7735,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,UHC Medicare,UHC Medicare,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,C0404,HIPPS,,,,,,,,Inpatient,,,259639.974,259639.974,Wellcare,Wellcare,259639.974,,,,,,,case rate,1241,264832.7735,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Aetna Medicare,Aetna Medicare,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Cigna,Cigna,2914,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Cigna Medicare Advantage,Cigna Medicare Advantage,257866.1742,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Essence,Essence,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Humana Gold,Humana Gold,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Medica,Medica,2446,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Tricare,Tricare,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,257866.1742,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,UHC Medicare,UHC Medicare,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <31.50 and A <61.50,D0404,HIPPS,,,,,,,,Inpatient,,,252809.9747,252809.9747,Wellcare,Wellcare,252809.9747,,,,,,,case rate,1241,257866.1742,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Aetna Medicare,Aetna Medicare,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Cigna,Cigna,2914,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Cigna Medicare Advantage,Cigna Medicare Advantage,184834.1815,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Essence,Essence,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Humana Gold,Humana Gold,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Medica,Medica,2446,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Tricare,Tricare,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,184834.1815,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,UHC Medicare,UHC Medicare,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,A0405,HIPPS,,,,,,,,Inpatient,,,181209.9819,181209.9819,Wellcare,Wellcare,181209.9819,,,,,,,case rate,1241,184834.1815,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Aetna Medicare,Aetna Medicare,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Cigna,Cigna,2914,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Cigna Medicare Advantage,Cigna Medicare Advantage,256642.1743,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Essence,Essence,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Humana Gold,Humana Gold,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Medica,Medica,2446,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Tricare,Tricare,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,256642.1743,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,UHC Medicare,UHC Medicare,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,B0405,HIPPS,,,,,,,,Inpatient,,,251609.9748,251609.9748,Wellcare,Wellcare,251609.9748,,,,,,,case rate,1241,256642.1743,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Aetna Medicare,Aetna Medicare,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Cigna,Cigna,2914,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Cigna Medicare Advantage,Cigna Medicare Advantage,209773.179,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Essence,Essence,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Humana Gold,Humana Gold,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Medica,Medica,2446,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Tricare,Tricare,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,209773.179,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,UHC Medicare,UHC Medicare,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,C0405,HIPPS,,,,,,,,Inpatient,,,205659.9794,205659.9794,Wellcare,Wellcare,205659.9794,,,,,,,case rate,1241,209773.179,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Aetna Medicare,Aetna Medicare,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Cigna,Cigna,2914,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Cigna Medicare Advantage,Cigna Medicare Advantage,204254.9796,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Essence,Essence,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Humana Gold,Humana Gold,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Medica,Medica,2446,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Tricare,Tricare,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,204254.9796,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,UHC Medicare,UHC Medicare,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=31.50 and M <41.50,D0405,HIPPS,,,,,,,,Inpatient,,,200249.98,200249.98,Wellcare,Wellcare,200249.98,,,,,,,case rate,1241,204254.9796,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Aetna Medicare,Aetna Medicare,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Cigna,Cigna,2914,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Cigna Medicare Advantage,Cigna Medicare Advantage,243147.5757,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Essence,Essence,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Humana Gold,Humana Gold,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Medica,Medica,2446,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Tricare,Tricare,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,243147.5757,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,UHC Medicare,UHC Medicare,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,A0406,HIPPS,,,,,,,,Inpatient,,,238379.9762,238379.9762,Wellcare,Wellcare,238379.9762,,,,,,,case rate,1241,243147.5757,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Aetna Medicare,Aetna Medicare,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Cigna,Cigna,2914,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Cigna Medicare Advantage,Cigna Medicare Advantage,337619.9662,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Essence,Essence,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Humana Gold,Humana Gold,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Medica,Medica,2446,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Tricare,Tricare,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,337619.9662,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,UHC Medicare,UHC Medicare,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,B0406,HIPPS,,,,,,,,Inpatient,,,330999.9669,330999.9669,Wellcare,Wellcare,330999.9669,,,,,,,case rate,1241,337619.9662,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Aetna Medicare,Aetna Medicare,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Cigna,Cigna,2914,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Cigna Medicare Advantage,Cigna Medicare Advantage,275960.9724,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Essence,Essence,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Humana Gold,Humana Gold,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Medica,Medica,2446,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Tricare,Tricare,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,275960.9724,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,UHC Medicare,UHC Medicare,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,C0406,HIPPS,,,,,,,,Inpatient,,,270549.9729,270549.9729,Wellcare,Wellcare,270549.9729,,,,,,,case rate,1241,275960.9724,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Aetna Medicare,Aetna Medicare,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Cigna,Cigna,2914,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Cigna Medicare Advantage,Cigna Medicare Advantage,268698.5731,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Essence,Essence,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Humana Gold,Humana Gold,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Medica,Medica,2446,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Tricare,Tricare,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,268698.5731,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,UHC Medicare,UHC Medicare,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M >=24.50 and M <31.50 and A >=61.50,D0406,HIPPS,,,,,,,,Inpatient,,,263429.9737,263429.9737,Wellcare,Wellcare,263429.9737,,,,,,,case rate,1241,268698.5731,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Aetna Medicare,Aetna Medicare,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Cigna,Cigna,2914,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Cigna Medicare Advantage,Cigna Medicare Advantage,332968.7667,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Essence,Essence,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Humana Gold,Humana Gold,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Medica,Medica,2446,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Tricare,Tricare,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,332968.7667,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,UHC Medicare,UHC Medicare,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,A0407,HIPPS,,,,,,,,Inpatient,,,326439.9674,326439.9674,Wellcare,Wellcare,326439.9674,,,,,,,case rate,1241,332968.7667,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Aetna Medicare,Aetna Medicare,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Cigna,Cigna,2914,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Cigna Medicare Advantage,Cigna Medicare Advantage,462345.5538,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Essence,Essence,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Humana Gold,Humana Gold,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Medica,Medica,2446,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Tricare,Tricare,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,462345.5538,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,UHC Medicare,UHC Medicare,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,B0407,HIPPS,,,,,,,,Inpatient,,,453279.9547,453279.9547,Wellcare,Wellcare,453279.9547,,,,,,,case rate,1241,462345.5538,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Aetna Medicare,Aetna Medicare,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Cigna,Cigna,2914,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Cigna Medicare Advantage,Cigna Medicare Advantage,377909.9622,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Essence,Essence,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Humana Gold,Humana Gold,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Medica,Medica,2446,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Tricare,Tricare,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,377909.9622,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,UHC Medicare,UHC Medicare,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,C0407,HIPPS,,,,,,,,Inpatient,,,370499.963,370499.963,Wellcare,Wellcare,370499.963,,,,,,,case rate,1241,377909.9622,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Aetna Medicare,Aetna Medicare,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Cigna,Cigna,2914,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Cigna Medicare Advantage,Cigna Medicare Advantage,367964.9632,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Essence,Essence,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Humana Gold,Humana Gold,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Medica,Medica,2446,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Tricare,Tricare,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,367964.9632,"Per diem rate, all codes are bundled into service package"
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,UHC Medicare,UHC Medicare,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Traumatic spinal cord injury M <24.50 and A >=61.50,D0407,HIPPS,,,,,,,,Inpatient,,,360749.9639,360749.9639,Wellcare,Wellcare,360749.9639,,,,,,,case rate,1241,367964.9632,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Aetna Medicare,Aetna Medicare,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Cigna,Cigna,2914,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Cigna Medicare Advantage,Cigna Medicare Advantage,87974.9912,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Essence,Essence,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Humana Gold,Humana Gold,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Medica,Medica,2446,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Tricare,Tricare,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,87974.9912,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,UHC Medicare,UHC Medicare,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,A0501,HIPPS,,,,,,,,Inpatient,,,86249.99138,86249.99138,Wellcare,Wellcare,86249.99138,,,,,,,case rate,1241,87974.9912,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Aetna Medicare,Aetna Medicare,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Cigna,Cigna,2914,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Cigna Medicare Advantage,Cigna Medicare Advantage,133517.9866,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Essence,Essence,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Humana Gold,Humana Gold,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Medica,Medica,2446,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Tricare,Tricare,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,133517.9866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,UHC Medicare,UHC Medicare,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,B0501,HIPPS,,,,,,,,Inpatient,,,130899.9869,130899.9869,Wellcare,Wellcare,130899.9869,,,,,,,case rate,1241,133517.9866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Aetna Medicare,Aetna Medicare,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Cigna,Cigna,2914,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Cigna Medicare Advantage,Cigna Medicare Advantage,102611.9897,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Essence,Essence,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Humana Gold,Humana Gold,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Medica,Medica,2446,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Tricare,Tricare,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,102611.9897,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,UHC Medicare,UHC Medicare,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,C0501,HIPPS,,,,,,,,Inpatient,,,100599.9899,100599.9899,Wellcare,Wellcare,100599.9899,,,,,,,case rate,1241,102611.9897,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Aetna Medicare,Aetna Medicare,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Cigna,Cigna,2914,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Cigna Medicare Advantage,Cigna Medicare Advantage,95461.79045,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Essence,Essence,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Humana Gold,Humana Gold,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Medica,Medica,2446,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Tricare,Tricare,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95461.79045,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,UHC Medicare,UHC Medicare,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=60.50,D0501,HIPPS,,,,,,,,Inpatient,,,93589.99064,93589.99064,Wellcare,Wellcare,93589.99064,,,,,,,case rate,1241,95461.79045,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Aetna Medicare,Aetna Medicare,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Cigna,Cigna,2914,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Cigna Medicare Advantage,Cigna Medicare Advantage,109211.3891,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Essence,Essence,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Humana Gold,Humana Gold,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Medica,Medica,2446,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Tricare,Tricare,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,109211.3891,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,UHC Medicare,UHC Medicare,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,A0502,HIPPS,,,,,,,,Inpatient,,,107069.9893,107069.9893,Wellcare,Wellcare,107069.9893,,,,,,,case rate,1241,109211.3891,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Aetna Medicare,Aetna Medicare,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Cigna,Cigna,2914,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Cigna Medicare Advantage,Cigna Medicare Advantage,165760.1834,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Essence,Essence,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Humana Gold,Humana Gold,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Medica,Medica,2446,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Tricare,Tricare,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,165760.1834,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,UHC Medicare,UHC Medicare,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,B0502,HIPPS,,,,,,,,Inpatient,,,162509.9837,162509.9837,Wellcare,Wellcare,162509.9837,,,,,,,case rate,1241,165760.1834,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Aetna Medicare,Aetna Medicare,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Cigna,Cigna,2914,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Cigna Medicare Advantage,Cigna Medicare Advantage,127387.7873,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Essence,Essence,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Humana Gold,Humana Gold,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Medica,Medica,2446,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Tricare,Tricare,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,127387.7873,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,UHC Medicare,UHC Medicare,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,C0502,HIPPS,,,,,,,,Inpatient,,,124889.9875,124889.9875,Wellcare,Wellcare,124889.9875,,,,,,,case rate,1241,127387.7873,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Aetna Medicare,Aetna Medicare,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Cigna,Cigna,2914,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Cigna Medicare Advantage,Cigna Medicare Advantage,118503.5881,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Essence,Essence,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Humana Gold,Humana Gold,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Medica,Medica,2446,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Tricare,Tricare,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,118503.5881,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,UHC Medicare,UHC Medicare,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=53.50 and M <60.50,D0502,HIPPS,,,,,,,,Inpatient,,,116179.9884,116179.9884,Wellcare,Wellcare,116179.9884,,,,,,,case rate,1241,118503.5881,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Aetna Medicare,Aetna Medicare,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Cigna,Cigna,2914,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Cigna Medicare Advantage,Cigna Medicare Advantage,123664.7876,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Essence,Essence,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Humana Gold,Humana Gold,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Medica,Medica,2446,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Tricare,Tricare,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,123664.7876,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,UHC Medicare,UHC Medicare,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,A0503,HIPPS,,,,,,,,Inpatient,,,121239.9879,121239.9879,Wellcare,Wellcare,121239.9879,,,,,,,case rate,1241,123664.7876,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Aetna Medicare,Aetna Medicare,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Cigna,Cigna,2914,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Cigna Medicare Advantage,Cigna Medicare Advantage,187700.3812,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Essence,Essence,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Humana Gold,Humana Gold,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Medica,Medica,2446,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Tricare,Tricare,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,187700.3812,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,UHC Medicare,UHC Medicare,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,B0503,HIPPS,,,,,,,,Inpatient,,,184019.9816,184019.9816,Wellcare,Wellcare,184019.9816,,,,,,,case rate,1241,187700.3812,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Aetna Medicare,Aetna Medicare,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,144248.3856,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Essence,Essence,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Humana Gold,Humana Gold,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Medica,Medica,2446,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Tricare,Tricare,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,144248.3856,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,UHC Medicare,UHC Medicare,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,C0503,HIPPS,,,,,,,,Inpatient,,,141419.9859,141419.9859,Wellcare,Wellcare,141419.9859,,,,,,,case rate,1241,144248.3856,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Aetna Medicare,Aetna Medicare,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Cigna,Cigna,2914,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Cigna Medicare Advantage,Cigna Medicare Advantage,134191.1866,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Essence,Essence,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Humana Gold,Humana Gold,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Medica,Medica,2446,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Tricare,Tricare,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,134191.1866,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,UHC Medicare,UHC Medicare,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=48.50 and M <53.50,D0503,HIPPS,,,,,,,,Inpatient,,,131559.9868,131559.9868,Wellcare,Wellcare,131559.9868,,,,,,,case rate,1241,134191.1866,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Aetna Medicare,Aetna Medicare,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Cigna,Cigna,2914,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Cigna Medicare Advantage,Cigna Medicare Advantage,147767.3852,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Essence,Essence,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Humana Gold,Humana Gold,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Medica,Medica,2446,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Tricare,Tricare,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,147767.3852,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,UHC Medicare,UHC Medicare,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,A0504,HIPPS,,,,,,,,Inpatient,,,144869.9855,144869.9855,Wellcare,Wellcare,144869.9855,,,,,,,case rate,1241,147767.3852,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Aetna Medicare,Aetna Medicare,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Cigna,Cigna,2914,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Cigna Medicare Advantage,Cigna Medicare Advantage,224287.7776,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Essence,Essence,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Humana Gold,Humana Gold,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Medica,Medica,2446,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Tricare,Tricare,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,224287.7776,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,UHC Medicare,UHC Medicare,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,B0504,HIPPS,,,,,,,,Inpatient,,,219889.978,219889.978,Wellcare,Wellcare,219889.978,,,,,,,case rate,1241,224287.7776,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Aetna Medicare,Aetna Medicare,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Cigna,Cigna,2914,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Cigna Medicare Advantage,Cigna Medicare Advantage,172359.5828,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Essence,Essence,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Humana Gold,Humana Gold,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Medica,Medica,2446,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Tricare,Tricare,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172359.5828,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,UHC Medicare,UHC Medicare,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,C0504,HIPPS,,,,,,,,Inpatient,,,168979.9831,168979.9831,Wellcare,Wellcare,168979.9831,,,,,,,case rate,1241,172359.5828,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Aetna Medicare,Aetna Medicare,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Cigna,Cigna,2914,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Cigna Medicare Advantage,Cigna Medicare Advantage,160343.984,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Essence,Essence,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Humana Gold,Humana Gold,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Medica,Medica,2446,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Tricare,Tricare,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160343.984,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,UHC Medicare,UHC Medicare,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M >=39.50 and M <48.50,D0504,HIPPS,,,,,,,,Inpatient,,,157199.9843,157199.9843,Wellcare,Wellcare,157199.9843,,,,,,,case rate,1241,160343.984,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Aetna Medicare,Aetna Medicare,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Cigna,Cigna,2914,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Cigna Medicare Advantage,Cigna Medicare Advantage,209956.779,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Essence,Essence,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Humana Gold,Humana Gold,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Medica,Medica,2446,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Tricare,Tricare,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,209956.779,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,UHC Medicare,UHC Medicare,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,A0505,HIPPS,,,,,,,,Inpatient,,,205839.9794,205839.9794,Wellcare,Wellcare,205839.9794,,,,,,,case rate,1241,209956.779,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Aetna Medicare,Aetna Medicare,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Cigna,Cigna,2914,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Cigna Medicare Advantage,Cigna Medicare Advantage,318668.3681,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Essence,Essence,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Humana Gold,Humana Gold,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Medica,Medica,2446,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Tricare,Tricare,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,318668.3681,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,UHC Medicare,UHC Medicare,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,B0505,HIPPS,,,,,,,,Inpatient,,,312419.9688,312419.9688,Wellcare,Wellcare,312419.9688,,,,,,,case rate,1241,318668.3681,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Aetna Medicare,Aetna Medicare,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Cigna,Cigna,2914,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Cigna Medicare Advantage,Cigna Medicare Advantage,244891.7755,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Essence,Essence,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Humana Gold,Humana Gold,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Medica,Medica,2446,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Tricare,Tricare,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,244891.7755,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,UHC Medicare,UHC Medicare,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,C0505,HIPPS,,,,,,,,Inpatient,,,240089.976,240089.976,Wellcare,Wellcare,240089.976,,,,,,,case rate,1241,244891.7755,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Aetna Medicare,Aetna Medicare,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Cigna,Cigna,2914,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Cigna Medicare Advantage,Cigna Medicare Advantage,227827.1772,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Essence,Essence,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Humana Gold,Humana Gold,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Medica,Medica,2446,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Tricare,Tricare,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,227827.1772,"Per diem rate, all codes are bundled into service package"
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,UHC Medicare,UHC Medicare,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Non-traumatic spinal cord injury M <39.50,D0505,HIPPS,,,,,,,,Inpatient,,,223359.9777,223359.9777,Wellcare,Wellcare,223359.9777,,,,,,,case rate,1241,227827.1772,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Aetna Medicare,Aetna Medicare,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Cigna,Cigna,2914,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Cigna Medicare Advantage,Cigna Medicare Advantage,85577.99144,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Essence,Essence,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Humana Gold,Humana Gold,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Medica,Medica,2446,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Tricare,Tricare,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,85577.99144,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,UHC Medicare,UHC Medicare,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,A0601,HIPPS,,,,,,,,Inpatient,,,83899.99161,83899.99161,Wellcare,Wellcare,83899.99161,,,,,,,case rate,1241,85577.99144,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Aetna Medicare,Aetna Medicare,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Cigna,Cigna,2914,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Cigna Medicare Advantage,Cigna Medicare Advantage,133568.9866,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Essence,Essence,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Humana Gold,Humana Gold,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Medica,Medica,2446,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Tricare,Tricare,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,133568.9866,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,UHC Medicare,UHC Medicare,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,B0601,HIPPS,,,,,,,,Inpatient,,,130949.9869,130949.9869,Wellcare,Wellcare,130949.9869,,,,,,,case rate,1241,133568.9866,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Aetna Medicare,Aetna Medicare,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Cigna,Cigna,2914,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Cigna Medicare Advantage,Cigna Medicare Advantage,101163.5899,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Essence,Essence,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Humana Gold,Humana Gold,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Medica,Medica,2446,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Tricare,Tricare,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,101163.5899,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,UHC Medicare,UHC Medicare,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,C0601,HIPPS,,,,,,,,Inpatient,,,99179.99008,99179.99008,Wellcare,Wellcare,99179.99008,,,,,,,case rate,1241,101163.5899,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Aetna Medicare,Aetna Medicare,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Cigna,Cigna,2914,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Cigna Medicare Advantage,Cigna Medicare Advantage,95278.19047,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Essence,Essence,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Humana Gold,Humana Gold,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Medica,Medica,2446,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Tricare,Tricare,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95278.19047,"Per diem rate, all codes are bundled into service package"
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,UHC Medicare,UHC Medicare,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=64.50,D0601,HIPPS,,,,,,,,Inpatient,,,93409.99066,93409.99066,Wellcare,Wellcare,93409.99066,,,,,,,case rate,1241,95278.19047,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Aetna Medicare,Aetna Medicare,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Cigna,Cigna,2914,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Cigna Medicare Advantage,Cigna Medicare Advantage,106457.3894,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Essence,Essence,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Humana Gold,Humana Gold,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Medica,Medica,2446,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Tricare,Tricare,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,106457.3894,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,UHC Medicare,UHC Medicare,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,A0602,HIPPS,,,,,,,,Inpatient,,,104369.9896,104369.9896,Wellcare,Wellcare,104369.9896,,,,,,,case rate,1241,106457.3894,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Aetna Medicare,Aetna Medicare,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Cigna,Cigna,2914,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Cigna Medicare Advantage,Cigna Medicare Advantage,166147.7834,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Essence,Essence,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Humana Gold,Humana Gold,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Medica,Medica,2446,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Tricare,Tricare,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,166147.7834,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,UHC Medicare,UHC Medicare,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,B0602,HIPPS,,,,,,,,Inpatient,,,162889.9837,162889.9837,Wellcare,Wellcare,162889.9837,,,,,,,case rate,1241,166147.7834,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Aetna Medicare,Aetna Medicare,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Cigna,Cigna,2914,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Cigna Medicare Advantage,Cigna Medicare Advantage,125837.3874,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Essence,Essence,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Humana Gold,Humana Gold,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Medica,Medica,2446,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Tricare,Tricare,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,125837.3874,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,UHC Medicare,UHC Medicare,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,C0602,HIPPS,,,,,,,,Inpatient,,,123369.9877,123369.9877,Wellcare,Wellcare,123369.9877,,,,,,,case rate,1241,125837.3874,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Aetna Medicare,Aetna Medicare,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Cigna,Cigna,2914,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Cigna Medicare Advantage,Cigna Medicare Advantage,118513.7881,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Essence,Essence,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Humana Gold,Humana Gold,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Medica,Medica,2446,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Tricare,Tricare,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,118513.7881,"Per diem rate, all codes are bundled into service package"
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,UHC Medicare,UHC Medicare,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=52.50 and M <64.50,D0602,HIPPS,,,,,,,,Inpatient,,,116189.9884,116189.9884,Wellcare,Wellcare,116189.9884,,,,,,,case rate,1241,118513.7881,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Aetna Medicare,Aetna Medicare,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126592.1873,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Essence,Essence,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Humana Gold,Humana Gold,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Medica,Medica,2446,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Tricare,Tricare,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126592.1873,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,UHC Medicare,UHC Medicare,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,A0603,HIPPS,,,,,,,,Inpatient,,,124109.9876,124109.9876,Wellcare,Wellcare,124109.9876,,,,,,,case rate,1241,126592.1873,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Aetna Medicare,Aetna Medicare,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Cigna,Cigna,2914,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Cigna Medicare Advantage,Cigna Medicare Advantage,197573.9802,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Essence,Essence,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Humana Gold,Humana Gold,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Medica,Medica,2446,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Tricare,Tricare,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,197573.9802,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,UHC Medicare,UHC Medicare,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,B0603,HIPPS,,,,,,,,Inpatient,,,193699.9806,193699.9806,Wellcare,Wellcare,193699.9806,,,,,,,case rate,1241,197573.9802,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Aetna Medicare,Aetna Medicare,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Cigna,Cigna,2914,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Cigna Medicare Advantage,Cigna Medicare Advantage,149633.985,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Essence,Essence,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Humana Gold,Humana Gold,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Medica,Medica,2446,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Tricare,Tricare,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,149633.985,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,UHC Medicare,UHC Medicare,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,C0603,HIPPS,,,,,,,,Inpatient,,,146699.9853,146699.9853,Wellcare,Wellcare,146699.9853,,,,,,,case rate,1241,149633.985,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Aetna Medicare,Aetna Medicare,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Cigna,Cigna,2914,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Cigna Medicare Advantage,Cigna Medicare Advantage,140933.3859,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Essence,Essence,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Humana Gold,Humana Gold,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Medica,Medica,2446,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Tricare,Tricare,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,140933.3859,"Per diem rate, all codes are bundled into service package"
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,UHC Medicare,UHC Medicare,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M >=43.50 and M <52.50,D0603,HIPPS,,,,,,,,Inpatient,,,138169.9862,138169.9862,Wellcare,Wellcare,138169.9862,,,,,,,case rate,1241,140933.3859,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Aetna Medicare,Aetna Medicare,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Cigna,Cigna,2914,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Cigna Medicare Advantage,Cigna Medicare Advantage,160099.184,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Essence,Essence,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Humana Gold,Humana Gold,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Medica,Medica,2446,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Tricare,Tricare,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160099.184,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,UHC Medicare,UHC Medicare,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,A0604,HIPPS,,,,,,,,Inpatient,,,156959.9843,156959.9843,Wellcare,Wellcare,156959.9843,,,,,,,case rate,1241,160099.184,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Aetna Medicare,Aetna Medicare,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Cigna,Cigna,2914,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Cigna Medicare Advantage,Cigna Medicare Advantage,249879.575,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Essence,Essence,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Humana Gold,Humana Gold,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Medica,Medica,2446,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Tricare,Tricare,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,249879.575,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,UHC Medicare,UHC Medicare,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,B0604,HIPPS,,,,,,,,Inpatient,,,244979.9755,244979.9755,Wellcare,Wellcare,244979.9755,,,,,,,case rate,1241,249879.575,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Aetna Medicare,Aetna Medicare,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Cigna,Cigna,2914,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Cigna Medicare Advantage,Cigna Medicare Advantage,189240.5811,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Essence,Essence,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Humana Gold,Humana Gold,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Medica,Medica,2446,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Tricare,Tricare,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,189240.5811,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,UHC Medicare,UHC Medicare,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,C0604,HIPPS,,,,,,,,Inpatient,,,185529.9814,185529.9814,Wellcare,Wellcare,185529.9814,,,,,,,case rate,1241,189240.5811,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Aetna Medicare,Aetna Medicare,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Cigna,Cigna,2914,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Cigna Medicare Advantage,Cigna Medicare Advantage,178244.9822,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Essence,Essence,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Humana Gold,Humana Gold,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Medica,Medica,2446,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Tricare,Tricare,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,178244.9822,"Per diem rate, all codes are bundled into service package"
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,UHC Medicare,UHC Medicare,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Neurological M <43.50,D0604,HIPPS,,,,,,,,Inpatient,,,174749.9825,174749.9825,Wellcare,Wellcare,174749.9825,,,,,,,case rate,1241,178244.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Aetna Medicare,Aetna Medicare,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Cigna,Cigna,2914,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Cigna Medicare Advantage,Cigna Medicare Advantage,86832.59132,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Essence,Essence,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Humana Gold,Humana Gold,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Medica,Medica,2446,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Tricare,Tricare,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,86832.59132,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,UHC Medicare,UHC Medicare,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,A0701,HIPPS,,,,,,,,Inpatient,,,85129.99149,85129.99149,Wellcare,Wellcare,85129.99149,,,,,,,case rate,1241,86832.59132,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Aetna Medicare,Aetna Medicare,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Cigna,Cigna,2914,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Cigna Medicare Advantage,Cigna Medicare Advantage,125143.7875,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Essence,Essence,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Humana Gold,Humana Gold,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Medica,Medica,2446,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Tricare,Tricare,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,125143.7875,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,UHC Medicare,UHC Medicare,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,B0701,HIPPS,,,,,,,,Inpatient,,,122689.9877,122689.9877,Wellcare,Wellcare,122689.9877,,,,,,,case rate,1241,125143.7875,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Aetna Medicare,Aetna Medicare,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Cigna,Cigna,2914,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Cigna Medicare Advantage,Cigna Medicare Advantage,100051.79,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Essence,Essence,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Humana Gold,Humana Gold,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Medica,Medica,2446,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Tricare,Tricare,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,100051.79,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,UHC Medicare,UHC Medicare,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,C0701,HIPPS,,,,,,,,Inpatient,,,98089.99019,98089.99019,Wellcare,Wellcare,98089.99019,,,,,,,case rate,1241,100051.79,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Aetna Medicare,Aetna Medicare,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Cigna,Cigna,2914,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Cigna Medicare Advantage,Cigna Medicare Advantage,95023.1905,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Essence,Essence,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Humana Gold,Humana Gold,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Medica,Medica,2446,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Tricare,Tricare,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95023.1905,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,UHC Medicare,UHC Medicare,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=61.50,D0701,HIPPS,,,,,,,,Inpatient,,,93159.99068,93159.99068,Wellcare,Wellcare,93159.99068,,,,,,,case rate,1241,95023.1905,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Aetna Medicare,Aetna Medicare,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Cigna,Cigna,2914,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Cigna Medicare Advantage,Cigna Medicare Advantage,107334.5893,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Essence,Essence,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Humana Gold,Humana Gold,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Medica,Medica,2446,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Tricare,Tricare,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,107334.5893,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,UHC Medicare,UHC Medicare,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,A0702,HIPPS,,,,,,,,Inpatient,,,105229.9895,105229.9895,Wellcare,Wellcare,105229.9895,,,,,,,case rate,1241,107334.5893,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Aetna Medicare,Aetna Medicare,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Cigna,Cigna,2914,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Cigna Medicare Advantage,Cigna Medicare Advantage,154682.9845,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Essence,Essence,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Humana Gold,Humana Gold,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Medica,Medica,2446,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Tricare,Tricare,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,154682.9845,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,UHC Medicare,UHC Medicare,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,B0702,HIPPS,,,,,,,,Inpatient,,,151649.9848,151649.9848,Wellcare,Wellcare,151649.9848,,,,,,,case rate,1241,154682.9845,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Aetna Medicare,Aetna Medicare,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Cigna,Cigna,2914,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Cigna Medicare Advantage,Cigna Medicare Advantage,123674.9876,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Essence,Essence,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Humana Gold,Humana Gold,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Medica,Medica,2446,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Tricare,Tricare,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,123674.9876,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,UHC Medicare,UHC Medicare,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,C0702,HIPPS,,,,,,,,Inpatient,,,121249.9879,121249.9879,Wellcare,Wellcare,121249.9879,,,,,,,case rate,1241,123674.9876,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Aetna Medicare,Aetna Medicare,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Cigna,Cigna,2914,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Cigna Medicare Advantage,Cigna Medicare Advantage,117452.9883,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Essence,Essence,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Humana Gold,Humana Gold,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Medica,Medica,2446,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Tricare,Tricare,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,117452.9883,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,UHC Medicare,UHC Medicare,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=52.50 and M <61.50,D0702,HIPPS,,,,,,,,Inpatient,,,115149.9885,115149.9885,Wellcare,Wellcare,115149.9885,,,,,,,case rate,1241,117452.9883,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Aetna Medicare,Aetna Medicare,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Cigna,Cigna,2914,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Cigna Medicare Advantage,Cigna Medicare Advantage,131498.3869,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Essence,Essence,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Humana Gold,Humana Gold,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Medica,Medica,2446,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Tricare,Tricare,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,131498.3869,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,UHC Medicare,UHC Medicare,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,A0703,HIPPS,,,,,,,,Inpatient,,,128919.9871,128919.9871,Wellcare,Wellcare,128919.9871,,,,,,,case rate,1241,131498.3869,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Aetna Medicare,Aetna Medicare,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Cigna,Cigna,2914,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Cigna Medicare Advantage,Cigna Medicare Advantage,189495.5811,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Essence,Essence,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Humana Gold,Humana Gold,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Medica,Medica,2446,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Tricare,Tricare,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,189495.5811,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,UHC Medicare,UHC Medicare,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,B0703,HIPPS,,,,,,,,Inpatient,,,185779.9814,185779.9814,Wellcare,Wellcare,185779.9814,,,,,,,case rate,1241,189495.5811,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Aetna Medicare,Aetna Medicare,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Cigna,Cigna,2914,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Cigna Medicare Advantage,Cigna Medicare Advantage,151510.7848,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Essence,Essence,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Humana Gold,Humana Gold,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Medica,Medica,2446,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Tricare,Tricare,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,151510.7848,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,UHC Medicare,UHC Medicare,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,C0703,HIPPS,,,,,,,,Inpatient,,,148539.9851,148539.9851,Wellcare,Wellcare,148539.9851,,,,,,,case rate,1241,151510.7848,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Aetna Medicare,Aetna Medicare,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,143901.5856,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Essence,Essence,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Humana Gold,Humana Gold,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Medica,Medica,2446,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Tricare,Tricare,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,143901.5856,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,UHC Medicare,UHC Medicare,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M >=41.50 and M <52.50,D0703,HIPPS,,,,,,,,Inpatient,,,141079.9859,141079.9859,Wellcare,Wellcare,141079.9859,,,,,,,case rate,1241,143901.5856,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Aetna Medicare,Aetna Medicare,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Cigna,Cigna,2914,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Cigna Medicare Advantage,Cigna Medicare Advantage,162363.5838,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Essence,Essence,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Humana Gold,Humana Gold,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Medica,Medica,2446,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Tricare,Tricare,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,162363.5838,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,UHC Medicare,UHC Medicare,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,A0704,HIPPS,,,,,,,,Inpatient,,,159179.9841,159179.9841,Wellcare,Wellcare,159179.9841,,,,,,,case rate,1241,162363.5838,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Aetna Medicare,Aetna Medicare,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Cigna,Cigna,2914,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Cigna Medicare Advantage,Cigna Medicare Advantage,233987.9766,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Essence,Essence,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Humana Gold,Humana Gold,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Medica,Medica,2446,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Tricare,Tricare,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,233987.9766,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,UHC Medicare,UHC Medicare,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,B0704,HIPPS,,,,,,,,Inpatient,,,229399.9771,229399.9771,Wellcare,Wellcare,229399.9771,,,,,,,case rate,1241,233987.9766,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Aetna Medicare,Aetna Medicare,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Cigna,Cigna,2914,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Cigna Medicare Advantage,Cigna Medicare Advantage,187088.3813,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Essence,Essence,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Humana Gold,Humana Gold,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Medica,Medica,2446,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Tricare,Tricare,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,187088.3813,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,UHC Medicare,UHC Medicare,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,C0704,HIPPS,,,,,,,,Inpatient,,,183419.9817,183419.9817,Wellcare,Wellcare,183419.9817,,,,,,,case rate,1241,187088.3813,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Aetna Medicare,Aetna Medicare,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Cigna,Cigna,2914,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Cigna Medicare Advantage,Cigna Medicare Advantage,177683.9822,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Essence,Essence,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Humana Gold,Humana Gold,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Medica,Medica,2446,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Tricare,Tricare,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,177683.9822,"Per diem rate, all codes are bundled into service package"
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,UHC Medicare,UHC Medicare,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Fracture of lower extremity M <41.50,D0704,HIPPS,,,,,,,,Inpatient,,,174199.9826,174199.9826,Wellcare,Wellcare,174199.9826,,,,,,,case rate,1241,177683.9822,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Aetna Medicare,Aetna Medicare,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Cigna,Cigna,2914,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Cigna Medicare Advantage,Cigna Medicare Advantage,84761.99152,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Essence,Essence,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Humana Gold,Humana Gold,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Medica,Medica,2446,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Tricare,Tricare,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,84761.99152,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,UHC Medicare,UHC Medicare,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,A0801,HIPPS,,,,,,,,Inpatient,,,83099.99169,83099.99169,Wellcare,Wellcare,83099.99169,,,,,,,case rate,1241,84761.99152,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Aetna Medicare,Aetna Medicare,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120166.188,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Essence,Essence,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Humana Gold,Humana Gold,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Medica,Medica,2446,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Tricare,Tricare,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120166.188,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,UHC Medicare,UHC Medicare,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,B0801,HIPPS,,,,,,,,Inpatient,,,117809.9882,117809.9882,Wellcare,Wellcare,117809.9882,,,,,,,case rate,1241,120166.188,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Aetna Medicare,Aetna Medicare,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Cigna,Cigna,2914,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Cigna Medicare Advantage,Cigna Medicare Advantage,101204.3899,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Essence,Essence,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Humana Gold,Humana Gold,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Medica,Medica,2446,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Tricare,Tricare,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,101204.3899,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,UHC Medicare,UHC Medicare,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,C0801,HIPPS,,,,,,,,Inpatient,,,99219.99008,99219.99008,Wellcare,Wellcare,99219.99008,,,,,,,case rate,1241,101204.3899,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Aetna Medicare,Aetna Medicare,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Cigna,Cigna,2914,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Cigna Medicare Advantage,Cigna Medicare Advantage,90463.79095,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Essence,Essence,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Humana Gold,Humana Gold,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Medica,Medica,2446,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Tricare,Tricare,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,90463.79095,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,UHC Medicare,UHC Medicare,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=63.50,D0801,HIPPS,,,,,,,,Inpatient,,,88689.99113,88689.99113,Wellcare,Wellcare,88689.99113,,,,,,,case rate,1241,90463.79095,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Aetna Medicare,Aetna Medicare,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Cigna,Cigna,2914,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Cigna Medicare Advantage,Cigna Medicare Advantage,96614.39034,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Essence,Essence,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Humana Gold,Humana Gold,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Medica,Medica,2446,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Tricare,Tricare,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96614.39034,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,UHC Medicare,UHC Medicare,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,A0802,HIPPS,,,,,,,,Inpatient,,,94719.99053,94719.99053,Wellcare,Wellcare,94719.99053,,,,,,,case rate,1241,96614.39034,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Aetna Medicare,Aetna Medicare,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Cigna,Cigna,2914,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Cigna Medicare Advantage,Cigna Medicare Advantage,136965.5863,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Essence,Essence,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Humana Gold,Humana Gold,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Medica,Medica,2446,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Tricare,Tricare,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,136965.5863,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,UHC Medicare,UHC Medicare,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,B0802,HIPPS,,,,,,,,Inpatient,,,134279.9866,134279.9866,Wellcare,Wellcare,134279.9866,,,,,,,case rate,1241,136965.5863,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Aetna Medicare,Aetna Medicare,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Cigna,Cigna,2914,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Cigna Medicare Advantage,Cigna Medicare Advantage,115361.9885,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Essence,Essence,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Humana Gold,Humana Gold,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Medica,Medica,2446,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Tricare,Tricare,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,115361.9885,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,UHC Medicare,UHC Medicare,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,C0802,HIPPS,,,,,,,,Inpatient,,,113099.9887,113099.9887,Wellcare,Wellcare,113099.9887,,,,,,,case rate,1241,115361.9885,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Aetna Medicare,Aetna Medicare,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Cigna,Cigna,2914,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Cigna Medicare Advantage,Cigna Medicare Advantage,103111.7897,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Essence,Essence,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Humana Gold,Humana Gold,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Medica,Medica,2446,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Tricare,Tricare,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,103111.7897,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,UHC Medicare,UHC Medicare,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=57.50 and M <63.50,D0802,HIPPS,,,,,,,,Inpatient,,,101089.9899,101089.9899,Wellcare,Wellcare,101089.9899,,,,,,,case rate,1241,103111.7897,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Aetna Medicare,Aetna Medicare,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Cigna,Cigna,2914,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Cigna Medicare Advantage,Cigna Medicare Advantage,106324.7894,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Essence,Essence,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Humana Gold,Humana Gold,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Medica,Medica,2446,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Tricare,Tricare,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,106324.7894,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,UHC Medicare,UHC Medicare,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,A0803,HIPPS,,,,,,,,Inpatient,,,104239.9896,104239.9896,Wellcare,Wellcare,104239.9896,,,,,,,case rate,1241,106324.7894,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Aetna Medicare,Aetna Medicare,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Cigna,Cigna,2914,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Cigna Medicare Advantage,Cigna Medicare Advantage,150735.5849,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Essence,Essence,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Humana Gold,Humana Gold,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Medica,Medica,2446,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Tricare,Tricare,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,150735.5849,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,UHC Medicare,UHC Medicare,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,B0803,HIPPS,,,,,,,,Inpatient,,,147779.9852,147779.9852,Wellcare,Wellcare,147779.9852,,,,,,,case rate,1241,150735.5849,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Aetna Medicare,Aetna Medicare,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126959.3873,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Essence,Essence,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Humana Gold,Humana Gold,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Medica,Medica,2446,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Tricare,Tricare,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126959.3873,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,UHC Medicare,UHC Medicare,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,C0803,HIPPS,,,,,,,,Inpatient,,,124469.9876,124469.9876,Wellcare,Wellcare,124469.9876,,,,,,,case rate,1241,126959.3873,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Aetna Medicare,Aetna Medicare,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Cigna,Cigna,2914,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Cigna Medicare Advantage,Cigna Medicare Advantage,113485.1887,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Essence,Essence,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Humana Gold,Humana Gold,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Medica,Medica,2446,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Tricare,Tricare,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,113485.1887,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,UHC Medicare,UHC Medicare,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=51.50 and M <57.50,D0803,HIPPS,,,,,,,,Inpatient,,,111259.9889,111259.9889,Wellcare,Wellcare,111259.9889,,,,,,,case rate,1241,113485.1887,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Aetna Medicare,Aetna Medicare,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120788.3879,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Essence,Essence,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Humana Gold,Humana Gold,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Medica,Medica,2446,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Tricare,Tricare,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120788.3879,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,UHC Medicare,UHC Medicare,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,A0804,HIPPS,,,,,,,,Inpatient,,,118419.9882,118419.9882,Wellcare,Wellcare,118419.9882,,,,,,,case rate,1241,120788.3879,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Aetna Medicare,Aetna Medicare,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Cigna,Cigna,2914,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Cigna Medicare Advantage,Cigna Medicare Advantage,171237.5829,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Essence,Essence,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Humana Gold,Humana Gold,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Medica,Medica,2446,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Tricare,Tricare,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,171237.5829,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,UHC Medicare,UHC Medicare,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,B0804,HIPPS,,,,,,,,Inpatient,,,167879.9832,167879.9832,Wellcare,Wellcare,167879.9832,,,,,,,case rate,1241,171237.5829,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Aetna Medicare,Aetna Medicare,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,144227.9856,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Essence,Essence,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Humana Gold,Humana Gold,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Medica,Medica,2446,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Tricare,Tricare,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,144227.9856,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,UHC Medicare,UHC Medicare,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,C0804,HIPPS,,,,,,,,Inpatient,,,141399.9859,141399.9859,Wellcare,Wellcare,141399.9859,,,,,,,case rate,1241,144227.9856,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Aetna Medicare,Aetna Medicare,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Cigna,Cigna,2914,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Cigna Medicare Advantage,Cigna Medicare Advantage,128917.7871,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Essence,Essence,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Humana Gold,Humana Gold,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Medica,Medica,2446,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Tricare,Tricare,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,128917.7871,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,UHC Medicare,UHC Medicare,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M >=42.50 and M <51.50,D0804,HIPPS,,,,,,,,Inpatient,,,126389.9874,126389.9874,Wellcare,Wellcare,126389.9874,,,,,,,case rate,1241,128917.7871,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Aetna Medicare,Aetna Medicare,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Cigna,Cigna,2914,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Cigna Medicare Advantage,Cigna Medicare Advantage,150439.785,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Essence,Essence,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Humana Gold,Humana Gold,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Medica,Medica,2446,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Tricare,Tricare,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,150439.785,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,UHC Medicare,UHC Medicare,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,A0805,HIPPS,,,,,,,,Inpatient,,,147489.9853,147489.9853,Wellcare,Wellcare,147489.9853,,,,,,,case rate,1241,150439.785,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Aetna Medicare,Aetna Medicare,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Cigna,Cigna,2914,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Cigna Medicare Advantage,Cigna Medicare Advantage,213281.9787,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Essence,Essence,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Humana Gold,Humana Gold,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Medica,Medica,2446,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Tricare,Tricare,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,213281.9787,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,UHC Medicare,UHC Medicare,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,B0805,HIPPS,,,,,,,,Inpatient,,,209099.9791,209099.9791,Wellcare,Wellcare,209099.9791,,,,,,,case rate,1241,213281.9787,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Aetna Medicare,Aetna Medicare,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Cigna,Cigna,2914,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Cigna Medicare Advantage,Cigna Medicare Advantage,179632.182,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Essence,Essence,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Humana Gold,Humana Gold,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Medica,Medica,2446,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Tricare,Tricare,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,179632.182,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,UHC Medicare,UHC Medicare,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,C0805,HIPPS,,,,,,,,Inpatient,,,176109.9824,176109.9824,Wellcare,Wellcare,176109.9824,,,,,,,case rate,1241,179632.182,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Aetna Medicare,Aetna Medicare,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Cigna,Cigna,2914,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Cigna Medicare Advantage,Cigna Medicare Advantage,160568.3839,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Essence,Essence,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Humana Gold,Humana Gold,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Medica,Medica,2446,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Tricare,Tricare,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160568.3839,"Per diem rate, all codes are bundled into service package"
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,UHC Medicare,UHC Medicare,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Replacement of lower-extremity joint M <42.50,D0805,HIPPS,,,,,,,,Inpatient,,,157419.9843,157419.9843,Wellcare,Wellcare,157419.9843,,,,,,,case rate,1241,160568.3839,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Aetna Medicare,Aetna Medicare,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Cigna,Cigna,2914,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Cigna Medicare Advantage,Cigna Medicare Advantage,82456.79175,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Essence,Essence,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Humana Gold,Humana Gold,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Medica,Medica,2446,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Tricare,Tricare,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,82456.79175,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,UHC Medicare,UHC Medicare,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,A0901,HIPPS,,,,,,,,Inpatient,,,80839.99192,80839.99192,Wellcare,Wellcare,80839.99192,,,,,,,case rate,1241,82456.79175,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Aetna Medicare,Aetna Medicare,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126326.9874,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Essence,Essence,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Humana Gold,Humana Gold,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Medica,Medica,2446,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Tricare,Tricare,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126326.9874,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,UHC Medicare,UHC Medicare,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,B0901,HIPPS,,,,,,,,Inpatient,,,123849.9876,123849.9876,Wellcare,Wellcare,123849.9876,,,,,,,case rate,1241,126326.9874,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Aetna Medicare,Aetna Medicare,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Cigna,Cigna,2914,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Cigna Medicare Advantage,Cigna Medicare Advantage,95686.19043,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Essence,Essence,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Humana Gold,Humana Gold,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Medica,Medica,2446,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Tricare,Tricare,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95686.19043,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,UHC Medicare,UHC Medicare,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,C0901,HIPPS,,,,,,,,Inpatient,,,93809.99062,93809.99062,Wellcare,Wellcare,93809.99062,,,,,,,case rate,1241,95686.19043,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Aetna Medicare,Aetna Medicare,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Cigna,Cigna,2914,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Cigna Medicare Advantage,Cigna Medicare Advantage,90392.39096,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Essence,Essence,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Humana Gold,Humana Gold,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Medica,Medica,2446,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Tricare,Tricare,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,90392.39096,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,UHC Medicare,UHC Medicare,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=63.50,D0901,HIPPS,,,,,,,,Inpatient,,,88619.99114,88619.99114,Wellcare,Wellcare,88619.99114,,,,,,,case rate,1241,90392.39096,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Aetna Medicare,Aetna Medicare,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Cigna,Cigna,2914,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Cigna Medicare Advantage,Cigna Medicare Advantage,104753.9895,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Essence,Essence,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Humana Gold,Humana Gold,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Medica,Medica,2446,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Tricare,Tricare,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,104753.9895,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,UHC Medicare,UHC Medicare,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,A0902,HIPPS,,,,,,,,Inpatient,,,102699.9897,102699.9897,Wellcare,Wellcare,102699.9897,,,,,,,case rate,1241,104753.9895,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Aetna Medicare,Aetna Medicare,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Cigna,Cigna,2914,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Cigna Medicare Advantage,Cigna Medicare Advantage,160476.584,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Essence,Essence,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Humana Gold,Humana Gold,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Medica,Medica,2446,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Tricare,Tricare,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160476.584,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,UHC Medicare,UHC Medicare,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,B0902,HIPPS,,,,,,,,Inpatient,,,157329.9843,157329.9843,Wellcare,Wellcare,157329.9843,,,,,,,case rate,1241,160476.584,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Aetna Medicare,Aetna Medicare,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Cigna,Cigna,2914,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Cigna Medicare Advantage,Cigna Medicare Advantage,121553.3878,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Essence,Essence,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Humana Gold,Humana Gold,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Medica,Medica,2446,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Tricare,Tricare,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,121553.3878,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,UHC Medicare,UHC Medicare,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,C0902,HIPPS,,,,,,,,Inpatient,,,119169.9881,119169.9881,Wellcare,Wellcare,119169.9881,,,,,,,case rate,1241,121553.3878,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Aetna Medicare,Aetna Medicare,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Cigna,Cigna,2914,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Cigna Medicare Advantage,Cigna Medicare Advantage,114821.3885,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Essence,Essence,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Humana Gold,Humana Gold,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Medica,Medica,2446,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Tricare,Tricare,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,114821.3885,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,UHC Medicare,UHC Medicare,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=51.50 and M <63.50,D0902,HIPPS,,,,,,,,Inpatient,,,112569.9887,112569.9887,Wellcare,Wellcare,112569.9887,,,,,,,case rate,1241,114821.3885,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Aetna Medicare,Aetna Medicare,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Cigna,Cigna,2914,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Cigna Medicare Advantage,Cigna Medicare Advantage,124307.3876,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Essence,Essence,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Humana Gold,Humana Gold,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Medica,Medica,2446,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Tricare,Tricare,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,124307.3876,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,UHC Medicare,UHC Medicare,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,A0903,HIPPS,,,,,,,,Inpatient,,,121869.9878,121869.9878,Wellcare,Wellcare,121869.9878,,,,,,,case rate,1241,124307.3876,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Aetna Medicare,Aetna Medicare,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Cigna,Cigna,2914,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Cigna Medicare Advantage,Cigna Medicare Advantage,190433.981,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Essence,Essence,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Humana Gold,Humana Gold,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Medica,Medica,2446,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Tricare,Tricare,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,190433.981,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,UHC Medicare,UHC Medicare,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,B0903,HIPPS,,,,,,,,Inpatient,,,186699.9813,186699.9813,Wellcare,Wellcare,186699.9813,,,,,,,case rate,1241,190433.981,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Aetna Medicare,Aetna Medicare,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,144238.1856,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Essence,Essence,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Humana Gold,Humana Gold,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Medica,Medica,2446,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Tricare,Tricare,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,144238.1856,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,UHC Medicare,UHC Medicare,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,C0903,HIPPS,,,,,,,,Inpatient,,,141409.9859,141409.9859,Wellcare,Wellcare,141409.9859,,,,,,,case rate,1241,144238.1856,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Aetna Medicare,Aetna Medicare,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Cigna,Cigna,2914,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Cigna Medicare Advantage,Cigna Medicare Advantage,136251.5864,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Essence,Essence,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Humana Gold,Humana Gold,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Medica,Medica,2446,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Tricare,Tricare,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,136251.5864,"Per diem rate, all codes are bundled into service package"
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,UHC Medicare,UHC Medicare,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M >=44.50 and M <51.50,D0903,HIPPS,,,,,,,,Inpatient,,,133579.9866,133579.9866,Wellcare,Wellcare,133579.9866,,,,,,,case rate,1241,136251.5864,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Aetna Medicare,Aetna Medicare,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Cigna,Cigna,2914,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Cigna Medicare Advantage,Cigna Medicare Advantage,149684.985,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Essence,Essence,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Humana Gold,Humana Gold,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Medica,Medica,2446,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Tricare,Tricare,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,149684.985,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,UHC Medicare,UHC Medicare,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,A0904,HIPPS,,,,,,,,Inpatient,,,146749.9853,146749.9853,Wellcare,Wellcare,146749.9853,,,,,,,case rate,1241,149684.985,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Aetna Medicare,Aetna Medicare,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Cigna,Cigna,2914,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Cigna Medicare Advantage,Cigna Medicare Advantage,229316.3771,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Essence,Essence,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Humana Gold,Humana Gold,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Medica,Medica,2446,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Tricare,Tricare,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,229316.3771,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,UHC Medicare,UHC Medicare,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,B0904,HIPPS,,,,,,,,Inpatient,,,224819.9775,224819.9775,Wellcare,Wellcare,224819.9775,,,,,,,case rate,1241,229316.3771,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Aetna Medicare,Aetna Medicare,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Cigna,Cigna,2914,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Cigna Medicare Advantage,Cigna Medicare Advantage,173695.7826,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Essence,Essence,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Humana Gold,Humana Gold,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Medica,Medica,2446,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Tricare,Tricare,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,173695.7826,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,UHC Medicare,UHC Medicare,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,C0904,HIPPS,,,,,,,,Inpatient,,,170289.983,170289.983,Wellcare,Wellcare,170289.983,,,,,,,case rate,1241,173695.7826,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Aetna Medicare,Aetna Medicare,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Cigna,Cigna,2914,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Cigna Medicare Advantage,Cigna Medicare Advantage,164077.1836,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Essence,Essence,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Humana Gold,Humana Gold,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Medica,Medica,2446,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Tricare,Tricare,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,164077.1836,"Per diem rate, all codes are bundled into service package"
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,UHC Medicare,UHC Medicare,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Other orthopedic M <44.5,D0904,HIPPS,,,,,,,,Inpatient,,,160859.9839,160859.9839,Wellcare,Wellcare,160859.9839,,,,,,,case rate,1241,164077.1836,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Aetna Medicare,Aetna Medicare,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Cigna,Cigna,2914,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Cigna Medicare Advantage,Cigna Medicare Advantage,87770.99122,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Essence,Essence,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Humana Gold,Humana Gold,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Medica,Medica,2446,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Tricare,Tricare,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,87770.99122,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,UHC Medicare,UHC Medicare,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,A1001,HIPPS,,,,,,,,Inpatient,,,86049.9914,86049.9914,Wellcare,Wellcare,86049.9914,,,,,,,case rate,1241,87770.99122,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Aetna Medicare,Aetna Medicare,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Cigna,Cigna,2914,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Cigna Medicare Advantage,Cigna Medicare Advantage,125347.7875,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Essence,Essence,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Humana Gold,Humana Gold,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Medica,Medica,2446,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Tricare,Tricare,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,125347.7875,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,UHC Medicare,UHC Medicare,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,B1001,HIPPS,,,,,,,,Inpatient,,,122889.9877,122889.9877,Wellcare,Wellcare,122889.9877,,,,,,,case rate,1241,125347.7875,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Aetna Medicare,Aetna Medicare,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Cigna,Cigna,2914,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Cigna Medicare Advantage,Cigna Medicare Advantage,104152.1896,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Essence,Essence,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Humana Gold,Humana Gold,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Medica,Medica,2446,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Tricare,Tricare,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,104152.1896,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,UHC Medicare,UHC Medicare,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,C1001,HIPPS,,,,,,,,Inpatient,,,102109.9898,102109.9898,Wellcare,Wellcare,102109.9898,,,,,,,case rate,1241,104152.1896,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Aetna Medicare,Aetna Medicare,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Cigna,Cigna,2914,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Cigna Medicare Advantage,Cigna Medicare Advantage,94533.59055,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Essence,Essence,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Humana Gold,Humana Gold,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Medica,Medica,2446,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Tricare,Tricare,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,94533.59055,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,UHC Medicare,UHC Medicare,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=64.50,D1001,HIPPS,,,,,,,,Inpatient,,,92679.99073,92679.99073,Wellcare,Wellcare,92679.99073,,,,,,,case rate,1241,94533.59055,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Aetna Medicare,Aetna Medicare,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Cigna,Cigna,2914,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Cigna Medicare Advantage,Cigna Medicare Advantage,106630.7893,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Essence,Essence,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Humana Gold,Humana Gold,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Medica,Medica,2446,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Tricare,Tricare,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,106630.7893,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,UHC Medicare,UHC Medicare,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,A1002,HIPPS,,,,,,,,Inpatient,,,104539.9895,104539.9895,Wellcare,Wellcare,104539.9895,,,,,,,case rate,1241,106630.7893,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Aetna Medicare,Aetna Medicare,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Cigna,Cigna,2914,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Cigna Medicare Advantage,Cigna Medicare Advantage,152275.7848,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Essence,Essence,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Humana Gold,Humana Gold,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Medica,Medica,2446,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Tricare,Tricare,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,152275.7848,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,UHC Medicare,UHC Medicare,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,B1002,HIPPS,,,,,,,,Inpatient,,,149289.9851,149289.9851,Wellcare,Wellcare,149289.9851,,,,,,,case rate,1241,152275.7848,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Aetna Medicare,Aetna Medicare,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126530.9873,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Essence,Essence,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Humana Gold,Humana Gold,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Medica,Medica,2446,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Tricare,Tricare,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126530.9873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,UHC Medicare,UHC Medicare,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,C1002,HIPPS,,,,,,,,Inpatient,,,124049.9876,124049.9876,Wellcare,Wellcare,124049.9876,,,,,,,case rate,1241,126530.9873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Aetna Medicare,Aetna Medicare,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Cigna,Cigna,2914,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Cigna Medicare Advantage,Cigna Medicare Advantage,114841.7885,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Essence,Essence,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Humana Gold,Humana Gold,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Medica,Medica,2446,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Tricare,Tricare,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,114841.7885,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,UHC Medicare,UHC Medicare,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=55.50 and M <64.50,D1002,HIPPS,,,,,,,,Inpatient,,,112589.9887,112589.9887,Wellcare,Wellcare,112589.9887,,,,,,,case rate,1241,114841.7885,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Aetna Medicare,Aetna Medicare,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126908.3873,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Essence,Essence,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Humana Gold,Humana Gold,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Medica,Medica,2446,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Tricare,Tricare,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126908.3873,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,UHC Medicare,UHC Medicare,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,A1003,HIPPS,,,,,,,,Inpatient,,,124419.9876,124419.9876,Wellcare,Wellcare,124419.9876,,,,,,,case rate,1241,126908.3873,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Aetna Medicare,Aetna Medicare,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Cigna,Cigna,2914,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Cigna Medicare Advantage,Cigna Medicare Advantage,181233.5819,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Essence,Essence,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Humana Gold,Humana Gold,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Medica,Medica,2446,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Tricare,Tricare,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,181233.5819,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,UHC Medicare,UHC Medicare,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,B1003,HIPPS,,,,,,,,Inpatient,,,177679.9822,177679.9822,Wellcare,Wellcare,177679.9822,,,,,,,case rate,1241,181233.5819,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Aetna Medicare,Aetna Medicare,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Cigna,Cigna,2914,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Cigna Medicare Advantage,Cigna Medicare Advantage,150592.7849,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Essence,Essence,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Humana Gold,Humana Gold,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Medica,Medica,2446,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Tricare,Tricare,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,150592.7849,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,UHC Medicare,UHC Medicare,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,C1003,HIPPS,,,,,,,,Inpatient,,,147639.9852,147639.9852,Wellcare,Wellcare,147639.9852,,,,,,,case rate,1241,150592.7849,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Aetna Medicare,Aetna Medicare,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Cigna,Cigna,2914,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Cigna Medicare Advantage,Cigna Medicare Advantage,136679.9863,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Essence,Essence,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Humana Gold,Humana Gold,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Medica,Medica,2446,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Tricare,Tricare,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,136679.9863,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,UHC Medicare,UHC Medicare,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M >=47.50 and M <55.50,D1003,HIPPS,,,,,,,,Inpatient,,,133999.9866,133999.9866,Wellcare,Wellcare,133999.9866,,,,,,,case rate,1241,136679.9863,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Aetna Medicare,Aetna Medicare,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Cigna,Cigna,2914,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Cigna Medicare Advantage,Cigna Medicare Advantage,168809.9831,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Essence,Essence,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Humana Gold,Humana Gold,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Medica,Medica,2446,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Tricare,Tricare,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,168809.9831,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,UHC Medicare,UHC Medicare,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,A1004,HIPPS,,,,,,,,Inpatient,,,165499.9835,165499.9835,Wellcare,Wellcare,165499.9835,,,,,,,case rate,1241,168809.9831,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Aetna Medicare,Aetna Medicare,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Cigna,Cigna,2914,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Cigna Medicare Advantage,Cigna Medicare Advantage,241066.7759,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Essence,Essence,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Humana Gold,Humana Gold,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Medica,Medica,2446,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Tricare,Tricare,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,241066.7759,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,UHC Medicare,UHC Medicare,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,B1004,HIPPS,,,,,,,,Inpatient,,,236339.9764,236339.9764,Wellcare,Wellcare,236339.9764,,,,,,,case rate,1241,241066.7759,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Aetna Medicare,Aetna Medicare,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Cigna,Cigna,2914,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Cigna Medicare Advantage,Cigna Medicare Advantage,200307.58,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Essence,Essence,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Humana Gold,Humana Gold,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Medica,Medica,2446,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Tricare,Tricare,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,200307.58,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,UHC Medicare,UHC Medicare,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,C1004,HIPPS,,,,,,,,Inpatient,,,196379.9804,196379.9804,Wellcare,Wellcare,196379.9804,,,,,,,case rate,1241,200307.58,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Aetna Medicare,Aetna Medicare,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Cigna,Cigna,2914,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Cigna Medicare Advantage,Cigna Medicare Advantage,181804.7818,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Essence,Essence,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Humana Gold,Humana Gold,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Medica,Medica,2446,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Tricare,Tricare,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,181804.7818,"Per diem rate, all codes are bundled into service package"
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,UHC Medicare,UHC Medicare,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation lower extremity M <47.50,D1004,HIPPS,,,,,,,,Inpatient,,,178239.9822,178239.9822,Wellcare,Wellcare,178239.9822,,,,,,,case rate,1241,181804.7818,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Aetna Medicare,Aetna Medicare,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Cigna,Cigna,2914,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Cigna Medicare Advantage,Cigna Medicare Advantage,98338.19017,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Essence,Essence,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Humana Gold,Humana Gold,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Medica,Medica,2446,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Tricare,Tricare,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,98338.19017,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,UHC Medicare,UHC Medicare,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,A1101,HIPPS,,,,,,,,Inpatient,,,96409.99036,96409.99036,Wellcare,Wellcare,96409.99036,,,,,,,case rate,1241,98338.19017,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Aetna Medicare,Aetna Medicare,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Cigna,Cigna,2914,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Cigna Medicare Advantage,Cigna Medicare Advantage,137944.7862,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Essence,Essence,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Humana Gold,Humana Gold,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Medica,Medica,2446,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Tricare,Tricare,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,137944.7862,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,UHC Medicare,UHC Medicare,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,B1101,HIPPS,,,,,,,,Inpatient,,,135239.9865,135239.9865,Wellcare,Wellcare,135239.9865,,,,,,,case rate,1241,137944.7862,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Aetna Medicare,Aetna Medicare,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Cigna,Cigna,2914,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Cigna Medicare Advantage,Cigna Medicare Advantage,130600.7869,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Essence,Essence,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Humana Gold,Humana Gold,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Medica,Medica,2446,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Tricare,Tricare,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,130600.7869,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,UHC Medicare,UHC Medicare,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,C1101,HIPPS,,,,,,,,Inpatient,,,128039.9872,128039.9872,Wellcare,Wellcare,128039.9872,,,,,,,case rate,1241,130600.7869,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Aetna Medicare,Aetna Medicare,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112393.7888,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Essence,Essence,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Humana Gold,Humana Gold,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Medica,Medica,2446,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Tricare,Tricare,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112393.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,UHC Medicare,UHC Medicare,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=58.50,D1101,HIPPS,,,,,,,,Inpatient,,,110189.989,110189.989,Wellcare,Wellcare,110189.989,,,,,,,case rate,1241,112393.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Aetna Medicare,Aetna Medicare,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112291.7888,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Essence,Essence,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Humana Gold,Humana Gold,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Medica,Medica,2446,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Tricare,Tricare,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112291.7888,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,UHC Medicare,UHC Medicare,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,A1102,HIPPS,,,,,,,,Inpatient,,,110089.989,110089.989,Wellcare,Wellcare,110089.989,,,,,,,case rate,1241,112291.7888,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Aetna Medicare,Aetna Medicare,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Cigna,Cigna,2914,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Cigna Medicare Advantage,Cigna Medicare Advantage,157528.7842,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Essence,Essence,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Humana Gold,Humana Gold,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Medica,Medica,2446,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Tricare,Tricare,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,157528.7842,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,UHC Medicare,UHC Medicare,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,B1102,HIPPS,,,,,,,,Inpatient,,,154439.9846,154439.9846,Wellcare,Wellcare,154439.9846,,,,,,,case rate,1241,157528.7842,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Aetna Medicare,Aetna Medicare,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Cigna,Cigna,2914,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Cigna Medicare Advantage,Cigna Medicare Advantage,149134.1851,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Essence,Essence,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Humana Gold,Humana Gold,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Medica,Medica,2446,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Tricare,Tricare,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,149134.1851,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,UHC Medicare,UHC Medicare,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,C1102,HIPPS,,,,,,,,Inpatient,,,146209.9854,146209.9854,Wellcare,Wellcare,146209.9854,,,,,,,case rate,1241,149134.1851,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Aetna Medicare,Aetna Medicare,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Cigna,Cigna,2914,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Cigna Medicare Advantage,Cigna Medicare Advantage,128336.3872,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Essence,Essence,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Humana Gold,Humana Gold,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Medica,Medica,2446,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Tricare,Tricare,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,128336.3872,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,UHC Medicare,UHC Medicare,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M >=52.50 and M <58.50,D1102,HIPPS,,,,,,,,Inpatient,,,125819.9874,125819.9874,Wellcare,Wellcare,125819.9874,,,,,,,case rate,1241,128336.3872,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Aetna Medicare,Aetna Medicare,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Cigna,Cigna,2914,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Cigna Medicare Advantage,Cigna Medicare Advantage,140647.7859,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Essence,Essence,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Humana Gold,Humana Gold,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Medica,Medica,2446,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Tricare,Tricare,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,140647.7859,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,UHC Medicare,UHC Medicare,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,A1103,HIPPS,,,,,,,,Inpatient,,,137889.9862,137889.9862,Wellcare,Wellcare,137889.9862,,,,,,,case rate,1241,140647.7859,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Aetna Medicare,Aetna Medicare,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Cigna,Cigna,2914,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Cigna Medicare Advantage,Cigna Medicare Advantage,197308.7803,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Essence,Essence,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Humana Gold,Humana Gold,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Medica,Medica,2446,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Tricare,Tricare,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,197308.7803,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,UHC Medicare,UHC Medicare,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,B1103,HIPPS,,,,,,,,Inpatient,,,193439.9807,193439.9807,Wellcare,Wellcare,193439.9807,,,,,,,case rate,1241,197308.7803,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Aetna Medicare,Aetna Medicare,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Cigna,Cigna,2914,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Cigna Medicare Advantage,Cigna Medicare Advantage,186792.5813,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Essence,Essence,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Humana Gold,Humana Gold,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Medica,Medica,2446,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Tricare,Tricare,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,186792.5813,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,UHC Medicare,UHC Medicare,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,C1103,HIPPS,,,,,,,,Inpatient,,,183129.9817,183129.9817,Wellcare,Wellcare,183129.9817,,,,,,,case rate,1241,186792.5813,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna Medicare,Aetna Medicare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna,Cigna,2914,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna Medicare Advantage,Cigna Medicare Advantage,160751.9839,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Essence,Essence,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Humana Gold,Humana Gold,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Medica,Medica,2446,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Tricare,Tricare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Medicare,UHC Medicare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Amputation non-lower extremity M <52.50,D1103,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Wellcare,Wellcare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Aetna Medicare,Aetna Medicare,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Cigna,Cigna,2914,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Cigna Medicare Advantage,Cigna Medicare Advantage,88760.39112,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Essence,Essence,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Humana Gold,Humana Gold,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Medica,Medica,2446,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Tricare,Tricare,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,88760.39112,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,UHC Medicare,UHC Medicare,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,A1201,HIPPS,,,,,,,,Inpatient,,,87019.9913,87019.9913,Wellcare,Wellcare,87019.9913,,,,,,,case rate,1241,88760.39112,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Aetna Medicare,Aetna Medicare,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Cigna,Cigna,2914,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Cigna Medicare Advantage,Cigna Medicare Advantage,135119.3865,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Essence,Essence,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Humana Gold,Humana Gold,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Medica,Medica,2446,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Tricare,Tricare,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,135119.3865,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,UHC Medicare,UHC Medicare,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,B1201,HIPPS,,,,,,,,Inpatient,,,132469.9868,132469.9868,Wellcare,Wellcare,132469.9868,,,,,,,case rate,1241,135119.3865,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Aetna Medicare,Aetna Medicare,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Cigna,Cigna,2914,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Cigna Medicare Advantage,Cigna Medicare Advantage,107242.7893,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Essence,Essence,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Humana Gold,Humana Gold,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Medica,Medica,2446,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Tricare,Tricare,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,107242.7893,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,UHC Medicare,UHC Medicare,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,C1201,HIPPS,,,,,,,,Inpatient,,,105139.9895,105139.9895,Wellcare,Wellcare,105139.9895,,,,,,,case rate,1241,107242.7893,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Aetna Medicare,Aetna Medicare,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Cigna,Cigna,2914,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Cigna Medicare Advantage,Cigna Medicare Advantage,95839.19042,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Essence,Essence,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Humana Gold,Humana Gold,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Medica,Medica,2446,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Tricare,Tricare,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95839.19042,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,UHC Medicare,UHC Medicare,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=61.50,D1201,HIPPS,,,,,,,,Inpatient,,,93959.9906,93959.9906,Wellcare,Wellcare,93959.9906,,,,,,,case rate,1241,95839.19042,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Aetna Medicare,Aetna Medicare,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Cigna,Cigna,2914,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Cigna Medicare Advantage,Cigna Medicare Advantage,104356.1896,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Essence,Essence,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Humana Gold,Humana Gold,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Medica,Medica,2446,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Tricare,Tricare,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,104356.1896,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,UHC Medicare,UHC Medicare,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,A1202,HIPPS,,,,,,,,Inpatient,,,102309.9898,102309.9898,Wellcare,Wellcare,102309.9898,,,,,,,case rate,1241,104356.1896,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Aetna Medicare,Aetna Medicare,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Cigna,Cigna,2914,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Cigna Medicare Advantage,Cigna Medicare Advantage,158875.1841,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Essence,Essence,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Humana Gold,Humana Gold,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Medica,Medica,2446,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Tricare,Tricare,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,158875.1841,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,UHC Medicare,UHC Medicare,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,B1202,HIPPS,,,,,,,,Inpatient,,,155759.9844,155759.9844,Wellcare,Wellcare,155759.9844,,,,,,,case rate,1241,158875.1841,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Aetna Medicare,Aetna Medicare,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Cigna,Cigna,2914,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Cigna Medicare Advantage,Cigna Medicare Advantage,126092.3874,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Essence,Essence,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Humana Gold,Humana Gold,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Medica,Medica,2446,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Tricare,Tricare,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,126092.3874,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,UHC Medicare,UHC Medicare,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,C1202,HIPPS,,,,,,,,Inpatient,,,123619.9876,123619.9876,Wellcare,Wellcare,123619.9876,,,,,,,case rate,1241,126092.3874,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Aetna Medicare,Aetna Medicare,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112679.3887,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Essence,Essence,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Humana Gold,Humana Gold,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Medica,Medica,2446,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Tricare,Tricare,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112679.3887,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,UHC Medicare,UHC Medicare,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M >=49.50 and M <61.50,D1202,HIPPS,,,,,,,,Inpatient,,,110469.989,110469.989,Wellcare,Wellcare,110469.989,,,,,,,case rate,1241,112679.3887,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Aetna Medicare,Aetna Medicare,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Cigna,Cigna,2914,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Cigna Medicare Advantage,Cigna Medicare Advantage,139699.186,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Essence,Essence,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Humana Gold,Humana Gold,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Medica,Medica,2446,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Tricare,Tricare,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,139699.186,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,UHC Medicare,UHC Medicare,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,A1203,HIPPS,,,,,,,,Inpatient,,,136959.9863,136959.9863,Wellcare,Wellcare,136959.9863,,,,,,,case rate,1241,139699.186,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Aetna Medicare,Aetna Medicare,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Cigna,Cigna,2914,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Cigna Medicare Advantage,Cigna Medicare Advantage,212669.9787,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Essence,Essence,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Humana Gold,Humana Gold,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Medica,Medica,2446,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Tricare,Tricare,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,212669.9787,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,UHC Medicare,UHC Medicare,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,B1203,HIPPS,,,,,,,,Inpatient,,,208499.9792,208499.9792,Wellcare,Wellcare,208499.9792,,,,,,,case rate,1241,212669.9787,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Aetna Medicare,Aetna Medicare,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Cigna,Cigna,2914,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Cigna Medicare Advantage,Cigna Medicare Advantage,168789.5831,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Essence,Essence,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Humana Gold,Humana Gold,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Medica,Medica,2446,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Tricare,Tricare,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,168789.5831,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,UHC Medicare,UHC Medicare,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,C1203,HIPPS,,,,,,,,Inpatient,,,165479.9835,165479.9835,Wellcare,Wellcare,165479.9835,,,,,,,case rate,1241,168789.5831,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Aetna Medicare,Aetna Medicare,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Cigna,Cigna,2914,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Cigna Medicare Advantage,Cigna Medicare Advantage,150837.5849,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Essence,Essence,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Humana Gold,Humana Gold,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Medica,Medica,2446,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Tricare,Tricare,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,150837.5849,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,UHC Medicare,UHC Medicare,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A >=74.50,D1203,HIPPS,,,,,,,,Inpatient,,,147879.9852,147879.9852,Wellcare,Wellcare,147879.9852,,,,,,,case rate,1241,150837.5849,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Aetna Medicare,Aetna Medicare,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,143819.9856,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Essence,Essence,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Humana Gold,Humana Gold,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Medica,Medica,2446,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Tricare,Tricare,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,143819.9856,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,UHC Medicare,UHC Medicare,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,A1204,HIPPS,,,,,,,,Inpatient,,,140999.9859,140999.9859,Wellcare,Wellcare,140999.9859,,,,,,,case rate,1241,143819.9856,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Aetna Medicare,Aetna Medicare,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Cigna,Cigna,2914,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Cigna Medicare Advantage,Cigna Medicare Advantage,218942.9781,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Essence,Essence,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Humana Gold,Humana Gold,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Medica,Medica,2446,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Tricare,Tricare,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,218942.9781,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,UHC Medicare,UHC Medicare,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,B1204,HIPPS,,,,,,,,Inpatient,,,214649.9785,214649.9785,Wellcare,Wellcare,214649.9785,,,,,,,case rate,1241,218942.9781,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Aetna Medicare,Aetna Medicare,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Cigna,Cigna,2914,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Cigna Medicare Advantage,Cigna Medicare Advantage,173777.3826,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Essence,Essence,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Humana Gold,Humana Gold,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Medica,Medica,2446,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Tricare,Tricare,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,173777.3826,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,UHC Medicare,UHC Medicare,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,C1204,HIPPS,,,,,,,,Inpatient,,,170369.983,170369.983,Wellcare,Wellcare,170369.983,,,,,,,case rate,1241,173777.3826,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Aetna Medicare,Aetna Medicare,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Cigna,Cigna,2914,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Cigna Medicare Advantage,Cigna Medicare Advantage,155294.9845,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Essence,Essence,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Humana Gold,Humana Gold,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Medica,Medica,2446,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Tricare,Tricare,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,155294.9845,"Per diem rate, all codes are bundled into service package"
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,UHC Medicare,UHC Medicare,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Osteoarthritis M <49.50 and A <74.50,D1204,HIPPS,,,,,,,,Inpatient,,,152249.9848,152249.9848,Wellcare,Wellcare,152249.9848,,,,,,,case rate,1241,155294.9845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Aetna Medicare,Aetna Medicare,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Cigna,Cigna,2914,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Cigna Medicare Advantage,Cigna Medicare Advantage,85027.1915,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Essence,Essence,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Humana Gold,Humana Gold,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Medica,Medica,2446,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Tricare,Tricare,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,85027.1915,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,UHC Medicare,UHC Medicare,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,A1301,HIPPS,,,,,,,,Inpatient,,,83359.99166,83359.99166,Wellcare,Wellcare,83359.99166,,,,,,,case rate,1241,85027.1915,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Aetna Medicare,Aetna Medicare,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Cigna,Cigna,2914,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Cigna Medicare Advantage,Cigna Medicare Advantage,127775.3872,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Essence,Essence,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Humana Gold,Humana Gold,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Medica,Medica,2446,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Tricare,Tricare,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,127775.3872,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,UHC Medicare,UHC Medicare,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,B1301,HIPPS,,,,,,,,Inpatient,,,125269.9875,125269.9875,Wellcare,Wellcare,125269.9875,,,,,,,case rate,1241,127775.3872,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Aetna Medicare,Aetna Medicare,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Cigna,Cigna,2914,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Cigna Medicare Advantage,Cigna Medicare Advantage,102152.9898,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Essence,Essence,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Humana Gold,Humana Gold,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Medica,Medica,2446,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Tricare,Tricare,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,102152.9898,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,UHC Medicare,UHC Medicare,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,C1301,HIPPS,,,,,,,,Inpatient,,,100149.99,100149.99,Wellcare,Wellcare,100149.99,,,,,,,case rate,1241,102152.9898,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Aetna Medicare,Aetna Medicare,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Cigna,Cigna,2914,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Cigna Medicare Advantage,Cigna Medicare Advantage,93595.19064,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Essence,Essence,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Humana Gold,Humana Gold,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Medica,Medica,2446,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Tricare,Tricare,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,93595.19064,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,UHC Medicare,UHC Medicare,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=62.50,D1301,HIPPS,,,,,,,,Inpatient,,,91759.99082,91759.99082,Wellcare,Wellcare,91759.99082,,,,,,,case rate,1241,93595.19064,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Aetna Medicare,Aetna Medicare,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Cigna,Cigna,2914,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Cigna Medicare Advantage,Cigna Medicare Advantage,104254.1896,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Essence,Essence,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Humana Gold,Humana Gold,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Medica,Medica,2446,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Tricare,Tricare,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,104254.1896,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,UHC Medicare,UHC Medicare,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,A1302,HIPPS,,,,,,,,Inpatient,,,102209.9898,102209.9898,Wellcare,Wellcare,102209.9898,,,,,,,case rate,1241,104254.1896,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Aetna Medicare,Aetna Medicare,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Cigna,Cigna,2914,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Cigna Medicare Advantage,Cigna Medicare Advantage,156671.9843,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Essence,Essence,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Humana Gold,Humana Gold,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Medica,Medica,2446,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Tricare,Tricare,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,156671.9843,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,UHC Medicare,UHC Medicare,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,B1302,HIPPS,,,,,,,,Inpatient,,,153599.9846,153599.9846,Wellcare,Wellcare,153599.9846,,,,,,,case rate,1241,156671.9843,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Aetna Medicare,Aetna Medicare,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Cigna,Cigna,2914,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Cigna Medicare Advantage,Cigna Medicare Advantage,125255.9875,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Essence,Essence,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Humana Gold,Humana Gold,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Medica,Medica,2446,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Tricare,Tricare,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,125255.9875,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,UHC Medicare,UHC Medicare,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,C1302,HIPPS,,,,,,,,Inpatient,,,122799.9877,122799.9877,Wellcare,Wellcare,122799.9877,,,,,,,case rate,1241,125255.9875,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Aetna Medicare,Aetna Medicare,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Cigna,Cigna,2914,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Cigna Medicare Advantage,Cigna Medicare Advantage,114770.3885,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Essence,Essence,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Humana Gold,Humana Gold,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Medica,Medica,2446,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Tricare,Tricare,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,114770.3885,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,UHC Medicare,UHC Medicare,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=51.50 and M <62.50,D1302,HIPPS,,,,,,,,Inpatient,,,112519.9887,112519.9887,Wellcare,Wellcare,112519.9887,,,,,,,case rate,1241,114770.3885,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Aetna Medicare,Aetna Medicare,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120482.388,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Essence,Essence,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Humana Gold,Humana Gold,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Medica,Medica,2446,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Tricare,Tricare,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120482.388,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,UHC Medicare,UHC Medicare,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,A1303,HIPPS,,,,,,,,Inpatient,,,118119.9882,118119.9882,Wellcare,Wellcare,118119.9882,,,,,,,case rate,1241,120482.388,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Aetna Medicare,Aetna Medicare,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Cigna,Cigna,2914,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Cigna Medicare Advantage,Cigna Medicare Advantage,181070.3819,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Essence,Essence,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Humana Gold,Humana Gold,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Medica,Medica,2446,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Tricare,Tricare,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,181070.3819,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,UHC Medicare,UHC Medicare,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,B1303,HIPPS,,,,,,,,Inpatient,,,177519.9822,177519.9822,Wellcare,Wellcare,177519.9822,,,,,,,case rate,1241,181070.3819,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Aetna Medicare,Aetna Medicare,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Cigna,Cigna,2914,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Cigna Medicare Advantage,Cigna Medicare Advantage,144758.3855,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Essence,Essence,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Humana Gold,Humana Gold,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Medica,Medica,2446,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Tricare,Tricare,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,144758.3855,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,UHC Medicare,UHC Medicare,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,C1303,HIPPS,,,,,,,,Inpatient,,,141919.9858,141919.9858,Wellcare,Wellcare,141919.9858,,,,,,,case rate,1241,144758.3855,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Aetna Medicare,Aetna Medicare,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Cigna,Cigna,2914,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Cigna Medicare Advantage,Cigna Medicare Advantage,132640.7867,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Essence,Essence,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Humana Gold,Humana Gold,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Medica,Medica,2446,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Tricare,Tricare,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,132640.7867,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,UHC Medicare,UHC Medicare,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M >=44.50 and M <51.50 and A >=64.50,D1303,HIPPS,,,,,,,,Inpatient,,,130039.987,130039.987,Wellcare,Wellcare,130039.987,,,,,,,case rate,1241,132640.7867,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Aetna Medicare,Aetna Medicare,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Cigna,Cigna,2914,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Cigna Medicare Advantage,Cigna Medicare Advantage,155509.1844,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Essence,Essence,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Humana Gold,Humana Gold,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Medica,Medica,2446,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Tricare,Tricare,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,155509.1844,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,UHC Medicare,UHC Medicare,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,A1304,HIPPS,,,,,,,,Inpatient,,,152459.9848,152459.9848,Wellcare,Wellcare,152459.9848,,,,,,,case rate,1241,155509.1844,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Aetna Medicare,Aetna Medicare,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Cigna,Cigna,2914,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Cigna Medicare Advantage,Cigna Medicare Advantage,233702.3766,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Essence,Essence,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Humana Gold,Humana Gold,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Medica,Medica,2446,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Tricare,Tricare,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,233702.3766,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,UHC Medicare,UHC Medicare,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,B1304,HIPPS,,,,,,,,Inpatient,,,229119.9771,229119.9771,Wellcare,Wellcare,229119.9771,,,,,,,case rate,1241,233702.3766,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Aetna Medicare,Aetna Medicare,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Cigna,Cigna,2914,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Cigna Medicare Advantage,Cigna Medicare Advantage,186843.5813,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Essence,Essence,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Humana Gold,Humana Gold,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Medica,Medica,2446,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Tricare,Tricare,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,186843.5813,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,UHC Medicare,UHC Medicare,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,C1304,HIPPS,,,,,,,,Inpatient,,,183179.9817,183179.9817,Wellcare,Wellcare,183179.9817,,,,,,,case rate,1241,186843.5813,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Aetna Medicare,Aetna Medicare,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Cigna,Cigna,2914,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Cigna Medicare Advantage,Cigna Medicare Advantage,171196.7829,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Essence,Essence,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Humana Gold,Humana Gold,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Medica,Medica,2446,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Tricare,Tricare,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,171196.7829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,UHC Medicare,UHC Medicare,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <44.50 and A >=64.50,D1304,HIPPS,,,,,,,,Inpatient,,,167839.9832,167839.9832,Wellcare,Wellcare,167839.9832,,,,,,,case rate,1241,171196.7829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Aetna Medicare,Aetna Medicare,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Cigna,Cigna,2914,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Cigna Medicare Advantage,Cigna Medicare Advantage,155203.1845,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Essence,Essence,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Humana Gold,Humana Gold,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Medica,Medica,2446,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Tricare,Tricare,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,155203.1845,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,UHC Medicare,UHC Medicare,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,A1305,HIPPS,,,,,,,,Inpatient,,,152159.9848,152159.9848,Wellcare,Wellcare,152159.9848,,,,,,,case rate,1241,155203.1845,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Aetna Medicare,Aetna Medicare,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Cigna,Cigna,2914,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Cigna Medicare Advantage,Cigna Medicare Advantage,233243.3767,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Essence,Essence,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Humana Gold,Humana Gold,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Medica,Medica,2446,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Tricare,Tricare,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,233243.3767,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,UHC Medicare,UHC Medicare,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,B1305,HIPPS,,,,,,,,Inpatient,,,228669.9771,228669.9771,Wellcare,Wellcare,228669.9771,,,,,,,case rate,1241,233243.3767,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Aetna Medicare,Aetna Medicare,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Cigna,Cigna,2914,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Cigna Medicare Advantage,Cigna Medicare Advantage,186466.1814,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Essence,Essence,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Humana Gold,Humana Gold,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Medica,Medica,2446,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Tricare,Tricare,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,186466.1814,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,UHC Medicare,UHC Medicare,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,C1305,HIPPS,,,,,,,,Inpatient,,,182809.9817,182809.9817,Wellcare,Wellcare,182809.9817,,,,,,,case rate,1241,186466.1814,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Aetna Medicare,Aetna Medicare,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Cigna,Cigna,2914,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Cigna Medicare Advantage,Cigna Medicare Advantage,170849.9829,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Essence,Essence,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Humana Gold,Humana Gold,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Medica,Medica,2446,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Tricare,Tricare,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,170849.9829,"Per diem rate, all codes are bundled into service package"
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,UHC Medicare,UHC Medicare,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Rheumatoid other arthritis M <51.50 and A <64.50,D1305,HIPPS,,,,,,,,Inpatient,,,167499.9833,167499.9833,Wellcare,Wellcare,167499.9833,,,,,,,case rate,1241,170849.9829,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Aetna Medicare,Aetna Medicare,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Cigna,Cigna,2914,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Cigna Medicare Advantage,Cigna Medicare Advantage,78070.79219,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Essence,Essence,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Humana Gold,Humana Gold,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Medica,Medica,2446,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Tricare,Tricare,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,78070.79219,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,UHC Medicare,UHC Medicare,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,A1401,HIPPS,,,,,,,,Inpatient,,,76539.99235,76539.99235,Wellcare,Wellcare,76539.99235,,,,,,,case rate,1241,78070.79219,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Aetna Medicare,Aetna Medicare,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Cigna,Cigna,2914,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Cigna Medicare Advantage,Cigna Medicare Advantage,113984.9886,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Essence,Essence,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Humana Gold,Humana Gold,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Medica,Medica,2446,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Tricare,Tricare,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,113984.9886,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,UHC Medicare,UHC Medicare,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,B1401,HIPPS,,,,,,,,Inpatient,,,111749.9888,111749.9888,Wellcare,Wellcare,111749.9888,,,,,,,case rate,1241,113984.9886,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Aetna Medicare,Aetna Medicare,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Cigna,Cigna,2914,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Cigna Medicare Advantage,Cigna Medicare Advantage,91820.39082,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Essence,Essence,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Humana Gold,Humana Gold,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Medica,Medica,2446,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Tricare,Tricare,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,91820.39082,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,UHC Medicare,UHC Medicare,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,C1401,HIPPS,,,,,,,,Inpatient,,,90019.991,90019.991,Wellcare,Wellcare,90019.991,,,,,,,case rate,1241,91820.39082,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Aetna Medicare,Aetna Medicare,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Cigna,Cigna,2914,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Cigna Medicare Advantage,Cigna Medicare Advantage,84894.59151,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Essence,Essence,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Humana Gold,Humana Gold,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Medica,Medica,2446,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Tricare,Tricare,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,84894.59151,"Per diem rate, all codes are bundled into service package"
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,UHC Medicare,UHC Medicare,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=68.50,D1401,HIPPS,,,,,,,,Inpatient,,,83229.99168,83229.99168,Wellcare,Wellcare,83229.99168,,,,,,,case rate,1241,84894.59151,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Aetna Medicare,Aetna Medicare,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Cigna,Cigna,2914,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Cigna Medicare Advantage,Cigna Medicare Advantage,99460.19005,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Essence,Essence,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Humana Gold,Humana Gold,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Medica,Medica,2446,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Tricare,Tricare,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,99460.19005,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,UHC Medicare,UHC Medicare,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,A1402,HIPPS,,,,,,,,Inpatient,,,97509.99025,97509.99025,Wellcare,Wellcare,97509.99025,,,,,,,case rate,1241,99460.19005,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Aetna Medicare,Aetna Medicare,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Cigna,Cigna,2914,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Cigna Medicare Advantage,Cigna Medicare Advantage,145207.1855,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Essence,Essence,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Humana Gold,Humana Gold,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Medica,Medica,2446,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Tricare,Tricare,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,145207.1855,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,UHC Medicare,UHC Medicare,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,B1402,HIPPS,,,,,,,,Inpatient,,,142359.9858,142359.9858,Wellcare,Wellcare,142359.9858,,,,,,,case rate,1241,145207.1855,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Aetna Medicare,Aetna Medicare,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Cigna,Cigna,2914,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Cigna Medicare Advantage,Cigna Medicare Advantage,116973.5883,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Essence,Essence,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Humana Gold,Humana Gold,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Medica,Medica,2446,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Tricare,Tricare,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,116973.5883,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,UHC Medicare,UHC Medicare,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,C1402,HIPPS,,,,,,,,Inpatient,,,114679.9885,114679.9885,Wellcare,Wellcare,114679.9885,,,,,,,case rate,1241,116973.5883,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Aetna Medicare,Aetna Medicare,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Cigna,Cigna,2914,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Cigna Medicare Advantage,Cigna Medicare Advantage,108150.5892,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Essence,Essence,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Humana Gold,Humana Gold,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Medica,Medica,2446,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Tricare,Tricare,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,108150.5892,"Per diem rate, all codes are bundled into service package"
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,UHC Medicare,UHC Medicare,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=55.50 and M <68.50,D1402,HIPPS,,,,,,,,Inpatient,,,106029.9894,106029.9894,Wellcare,Wellcare,106029.9894,,,,,,,case rate,1241,108150.5892,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Aetna Medicare,Aetna Medicare,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120217.188,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Essence,Essence,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Humana Gold,Humana Gold,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Medica,Medica,2446,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Tricare,Tricare,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120217.188,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,UHC Medicare,UHC Medicare,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,A1403,HIPPS,,,,,,,,Inpatient,,,117859.9882,117859.9882,Wellcare,Wellcare,117859.9882,,,,,,,case rate,1241,120217.188,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Aetna Medicare,Aetna Medicare,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Cigna,Cigna,2914,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Cigna Medicare Advantage,Cigna Medicare Advantage,175511.3824,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Essence,Essence,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Humana Gold,Humana Gold,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Medica,Medica,2446,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Tricare,Tricare,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,175511.3824,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,UHC Medicare,UHC Medicare,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,B1403,HIPPS,,,,,,,,Inpatient,,,172069.9828,172069.9828,Wellcare,Wellcare,172069.9828,,,,,,,case rate,1241,175511.3824,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Aetna Medicare,Aetna Medicare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna,Cigna,2914,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Cigna Medicare Advantage,Cigna Medicare Advantage,141382.1859,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Essence,Essence,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Humana Gold,Humana Gold,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Medica,Medica,2446,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Tricare,Tricare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,141382.1859,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,UHC Medicare,UHC Medicare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,C1403,HIPPS,,,,,,,,Inpatient,,,138609.9861,138609.9861,Wellcare,Wellcare,138609.9861,,,,,,,case rate,1241,141382.1859,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Aetna Medicare,Aetna Medicare,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Cigna,Cigna,2914,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Cigna Medicare Advantage,Cigna Medicare Advantage,130723.1869,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Essence,Essence,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Humana Gold,Humana Gold,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Medica,Medica,2446,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Tricare,Tricare,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,130723.1869,"Per diem rate, all codes are bundled into service package"
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,UHC Medicare,UHC Medicare,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M >=45.50 and M <55.50,D1403,HIPPS,,,,,,,,Inpatient,,,128159.9872,128159.9872,Wellcare,Wellcare,128159.9872,,,,,,,case rate,1241,130723.1869,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Aetna Medicare,Aetna Medicare,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Cigna,Cigna,2914,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Cigna Medicare Advantage,Cigna Medicare Advantage,149990.985,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Essence,Essence,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Humana Gold,Humana Gold,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Medica,Medica,2446,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Tricare,Tricare,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,149990.985,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,UHC Medicare,UHC Medicare,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,A1404,HIPPS,,,,,,,,Inpatient,,,147049.9853,147049.9853,Wellcare,Wellcare,147049.9853,,,,,,,case rate,1241,149990.985,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Aetna Medicare,Aetna Medicare,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Cigna,Cigna,2914,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Cigna Medicare Advantage,Cigna Medicare Advantage,218973.5781,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Essence,Essence,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Humana Gold,Humana Gold,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Medica,Medica,2446,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Tricare,Tricare,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,218973.5781,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,UHC Medicare,UHC Medicare,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,B1404,HIPPS,,,,,,,,Inpatient,,,214679.9785,214679.9785,Wellcare,Wellcare,214679.9785,,,,,,,case rate,1241,218973.5781,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Aetna Medicare,Aetna Medicare,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Cigna,Cigna,2914,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Cigna Medicare Advantage,Cigna Medicare Advantage,176398.7824,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Essence,Essence,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Humana Gold,Humana Gold,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Medica,Medica,2446,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Tricare,Tricare,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,176398.7824,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,UHC Medicare,UHC Medicare,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,C1404,HIPPS,,,,,,,,Inpatient,,,172939.9827,172939.9827,Wellcare,Wellcare,172939.9827,,,,,,,case rate,1241,176398.7824,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Aetna Medicare,Aetna Medicare,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Cigna,Cigna,2914,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Cigna Medicare Advantage,Cigna Medicare Advantage,163108.1837,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Essence,Essence,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Humana Gold,Humana Gold,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Medica,Medica,2446,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Tricare,Tricare,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,163108.1837,"Per diem rate, all codes are bundled into service package"
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,UHC Medicare,UHC Medicare,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Cardiac M <45.50,D1404,HIPPS,,,,,,,,Inpatient,,,159909.984,159909.984,Wellcare,Wellcare,159909.984,,,,,,,case rate,1241,163108.1837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Aetna Medicare,Aetna Medicare,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Cigna,Cigna,2914,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Cigna Medicare Advantage,Cigna Medicare Advantage,96206.39038,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Essence,Essence,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Humana Gold,Humana Gold,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Medica,Medica,2446,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Tricare,Tricare,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96206.39038,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,UHC Medicare,UHC Medicare,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,A1501,HIPPS,,,,,,,,Inpatient,,,94319.99057,94319.99057,Wellcare,Wellcare,94319.99057,,,,,,,case rate,1241,96206.39038,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Aetna Medicare,Aetna Medicare,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Cigna,Cigna,2914,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Cigna Medicare Advantage,Cigna Medicare Advantage,133650.5866,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Essence,Essence,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Humana Gold,Humana Gold,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Medica,Medica,2446,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Tricare,Tricare,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,133650.5866,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,UHC Medicare,UHC Medicare,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,B1501,HIPPS,,,,,,,,Inpatient,,,131029.9869,131029.9869,Wellcare,Wellcare,131029.9869,,,,,,,case rate,1241,133650.5866,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Aetna Medicare,Aetna Medicare,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Cigna,Cigna,2914,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Cigna Medicare Advantage,Cigna Medicare Advantage,107467.1893,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Essence,Essence,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Humana Gold,Humana Gold,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Medica,Medica,2446,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Tricare,Tricare,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,107467.1893,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,UHC Medicare,UHC Medicare,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,C1501,HIPPS,,,,,,,,Inpatient,,,105359.9895,105359.9895,Wellcare,Wellcare,105359.9895,,,,,,,case rate,1241,107467.1893,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Aetna Medicare,Aetna Medicare,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Cigna,Cigna,2914,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Cigna Medicare Advantage,Cigna Medicare Advantage,100643.3899,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Essence,Essence,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Humana Gold,Humana Gold,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Medica,Medica,2446,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Tricare,Tricare,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,100643.3899,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,UHC Medicare,UHC Medicare,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=68.50,D1501,HIPPS,,,,,,,,Inpatient,,,98669.99013,98669.99013,Wellcare,Wellcare,98669.99013,,,,,,,case rate,1241,100643.3899,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Aetna Medicare,Aetna Medicare,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Cigna,Cigna,2914,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Cigna Medicare Advantage,Cigna Medicare Advantage,117646.7882,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Essence,Essence,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Humana Gold,Humana Gold,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Medica,Medica,2446,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Tricare,Tricare,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,117646.7882,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,UHC Medicare,UHC Medicare,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,A1502,HIPPS,,,,,,,,Inpatient,,,115339.9885,115339.9885,Wellcare,Wellcare,115339.9885,,,,,,,case rate,1241,117646.7882,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Aetna Medicare,Aetna Medicare,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Cigna,Cigna,2914,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Cigna Medicare Advantage,Cigna Medicare Advantage,163424.3837,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Essence,Essence,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Humana Gold,Humana Gold,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Medica,Medica,2446,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Tricare,Tricare,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,163424.3837,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,UHC Medicare,UHC Medicare,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,B1502,HIPPS,,,,,,,,Inpatient,,,160219.984,160219.984,Wellcare,Wellcare,160219.984,,,,,,,case rate,1241,163424.3837,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Aetna Medicare,Aetna Medicare,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Cigna,Cigna,2914,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Cigna Medicare Advantage,Cigna Medicare Advantage,131406.5869,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Essence,Essence,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Humana Gold,Humana Gold,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Medica,Medica,2446,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Tricare,Tricare,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,131406.5869,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,UHC Medicare,UHC Medicare,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,C1502,HIPPS,,,,,,,,Inpatient,,,128829.9871,128829.9871,Wellcare,Wellcare,128829.9871,,,,,,,case rate,1241,131406.5869,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Aetna Medicare,Aetna Medicare,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Cigna,Cigna,2914,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Cigna Medicare Advantage,Cigna Medicare Advantage,123062.9877,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Essence,Essence,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Humana Gold,Humana Gold,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Medica,Medica,2446,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Tricare,Tricare,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,123062.9877,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,UHC Medicare,UHC Medicare,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=56.50 and M <68.50,D1502,HIPPS,,,,,,,,Inpatient,,,120649.9879,120649.9879,Wellcare,Wellcare,120649.9879,,,,,,,case rate,1241,123062.9877,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Aetna Medicare,Aetna Medicare,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Cigna,Cigna,2914,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Cigna Medicare Advantage,Cigna Medicare Advantage,137149.1863,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Essence,Essence,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Humana Gold,Humana Gold,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Medica,Medica,2446,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Tricare,Tricare,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,137149.1863,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,UHC Medicare,UHC Medicare,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,A1503,HIPPS,,,,,,,,Inpatient,,,134459.9866,134459.9866,Wellcare,Wellcare,134459.9866,,,,,,,case rate,1241,137149.1863,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Aetna Medicare,Aetna Medicare,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Cigna,Cigna,2914,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Cigna Medicare Advantage,Cigna Medicare Advantage,190535.9809,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Essence,Essence,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Humana Gold,Humana Gold,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Medica,Medica,2446,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Tricare,Tricare,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,190535.9809,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,UHC Medicare,UHC Medicare,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,B1503,HIPPS,,,,,,,,Inpatient,,,186799.9813,186799.9813,Wellcare,Wellcare,186799.9813,,,,,,,case rate,1241,190535.9809,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Aetna Medicare,Aetna Medicare,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Cigna,Cigna,2914,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Cigna Medicare Advantage,Cigna Medicare Advantage,153203.9847,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Essence,Essence,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Humana Gold,Humana Gold,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Medica,Medica,2446,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Tricare,Tricare,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,153203.9847,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,UHC Medicare,UHC Medicare,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,C1503,HIPPS,,,,,,,,Inpatient,,,150199.985,150199.985,Wellcare,Wellcare,150199.985,,,,,,,case rate,1241,153203.9847,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Aetna Medicare,Aetna Medicare,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Cigna,Cigna,2914,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Cigna Medicare Advantage,Cigna Medicare Advantage,143473.1857,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Essence,Essence,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Humana Gold,Humana Gold,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Medica,Medica,2446,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Tricare,Tricare,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,143473.1857,"Per diem rate, all codes are bundled into service package"
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,UHC Medicare,UHC Medicare,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M >=45.50 and M <56.50,D1503,HIPPS,,,,,,,,Inpatient,,,140659.9859,140659.9859,Wellcare,Wellcare,140659.9859,,,,,,,case rate,1241,143473.1857,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Aetna Medicare,Aetna Medicare,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Cigna,Cigna,2914,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Cigna Medicare Advantage,Cigna Medicare Advantage,171992.3828,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Essence,Essence,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Humana Gold,Humana Gold,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Medica,Medica,2446,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Tricare,Tricare,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,171992.3828,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,UHC Medicare,UHC Medicare,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,A1504,HIPPS,,,,,,,,Inpatient,,,168619.9831,168619.9831,Wellcare,Wellcare,168619.9831,,,,,,,case rate,1241,171992.3828,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Aetna Medicare,Aetna Medicare,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Cigna,Cigna,2914,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Cigna Medicare Advantage,Cigna Medicare Advantage,238934.9761,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Essence,Essence,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Humana Gold,Humana Gold,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Medica,Medica,2446,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Tricare,Tricare,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,238934.9761,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,UHC Medicare,UHC Medicare,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,B1504,HIPPS,,,,,,,,Inpatient,,,234249.9766,234249.9766,Wellcare,Wellcare,234249.9766,,,,,,,case rate,1241,238934.9761,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Aetna Medicare,Aetna Medicare,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Cigna,Cigna,2914,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Cigna Medicare Advantage,Cigna Medicare Advantage,192116.9808,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Essence,Essence,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Humana Gold,Humana Gold,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Medica,Medica,2446,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Tricare,Tricare,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,192116.9808,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,UHC Medicare,UHC Medicare,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,C1504,HIPPS,,,,,,,,Inpatient,,,188349.9812,188349.9812,Wellcare,Wellcare,188349.9812,,,,,,,case rate,1241,192116.9808,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Aetna Medicare,Aetna Medicare,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Cigna,Cigna,2914,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Cigna Medicare Advantage,Cigna Medicare Advantage,179917.782,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Essence,Essence,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Humana Gold,Humana Gold,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Medica,Medica,2446,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Tricare,Tricare,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,179917.782,"Per diem rate, all codes are bundled into service package"
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,UHC Medicare,UHC Medicare,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pulmonary M <45.50,D1504,HIPPS,,,,,,,,Inpatient,,,176389.9824,176389.9824,Wellcare,Wellcare,176389.9824,,,,,,,case rate,1241,179917.782,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Aetna Medicare,Aetna Medicare,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Cigna,Cigna,2914,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Cigna Medicare Advantage,Cigna Medicare Advantage,79672.19203,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Essence,Essence,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Humana Gold,Humana Gold,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Medica,Medica,2446,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Tricare,Tricare,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,79672.19203,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,UHC Medicare,UHC Medicare,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,A1601,HIPPS,,,,,,,,Inpatient,,,78109.99219,78109.99219,Wellcare,Wellcare,78109.99219,,,,,,,case rate,1241,79672.19203,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Aetna Medicare,Aetna Medicare,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Cigna,Cigna,2914,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Cigna Medicare Advantage,Cigna Medicare Advantage,107222.3893,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Essence,Essence,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Humana Gold,Humana Gold,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Medica,Medica,2446,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Tricare,Tricare,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,107222.3893,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,UHC Medicare,UHC Medicare,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,B1601,HIPPS,,,,,,,,Inpatient,,,105119.9895,105119.9895,Wellcare,Wellcare,105119.9895,,,,,,,case rate,1241,107222.3893,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Aetna Medicare,Aetna Medicare,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Cigna,Cigna,2914,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Cigna Medicare Advantage,Cigna Medicare Advantage,96083.99039,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Essence,Essence,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Humana Gold,Humana Gold,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Medica,Medica,2446,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Tricare,Tricare,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96083.99039,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,UHC Medicare,UHC Medicare,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,C1601,HIPPS,,,,,,,,Inpatient,,,94199.99058,94199.99058,Wellcare,Wellcare,94199.99058,,,,,,,case rate,1241,96083.99039,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Aetna Medicare,Aetna Medicare,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Cigna,Cigna,2914,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Cigna Medicare Advantage,Cigna Medicare Advantage,87893.39121,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Essence,Essence,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Humana Gold,Humana Gold,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Medica,Medica,2446,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Tricare,Tricare,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,87893.39121,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,UHC Medicare,UHC Medicare,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=65.50,D1601,HIPPS,,,,,,,,Inpatient,,,86169.99138,86169.99138,Wellcare,Wellcare,86169.99138,,,,,,,case rate,1241,87893.39121,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Aetna Medicare,Aetna Medicare,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Cigna,Cigna,2914,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Cigna Medicare Advantage,Cigna Medicare Advantage,95869.79041,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Essence,Essence,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Humana Gold,Humana Gold,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Medica,Medica,2446,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Tricare,Tricare,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,95869.79041,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,UHC Medicare,UHC Medicare,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,A1602,HIPPS,,,,,,,,Inpatient,,,93989.9906,93989.9906,Wellcare,Wellcare,93989.9906,,,,,,,case rate,1241,95869.79041,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Aetna Medicare,Aetna Medicare,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Cigna,Cigna,2914,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Cigna Medicare Advantage,Cigna Medicare Advantage,129009.5871,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Essence,Essence,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Humana Gold,Humana Gold,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Medica,Medica,2446,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Tricare,Tricare,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,129009.5871,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,UHC Medicare,UHC Medicare,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,B1602,HIPPS,,,,,,,,Inpatient,,,126479.9874,126479.9874,Wellcare,Wellcare,126479.9874,,,,,,,case rate,1241,129009.5871,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Aetna Medicare,Aetna Medicare,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Cigna,Cigna,2914,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Cigna Medicare Advantage,Cigna Medicare Advantage,115616.9884,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Essence,Essence,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Humana Gold,Humana Gold,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Medica,Medica,2446,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Tricare,Tricare,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,115616.9884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,UHC Medicare,UHC Medicare,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,C1602,HIPPS,,,,,,,,Inpatient,,,113349.9887,113349.9887,Wellcare,Wellcare,113349.9887,,,,,,,case rate,1241,115616.9884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Aetna Medicare,Aetna Medicare,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Cigna,Cigna,2914,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Cigna Medicare Advantage,Cigna Medicare Advantage,105753.5894,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Essence,Essence,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Humana Gold,Humana Gold,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Medica,Medica,2446,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Tricare,Tricare,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,105753.5894,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,UHC Medicare,UHC Medicare,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=58.50 and M <65.50,D1602,HIPPS,,,,,,,,Inpatient,,,103679.9896,103679.9896,Wellcare,Wellcare,103679.9896,,,,,,,case rate,1241,105753.5894,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Aetna Medicare,Aetna Medicare,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Cigna,Cigna,2914,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Cigna Medicare Advantage,Cigna Medicare Advantage,116096.3884,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Essence,Essence,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Humana Gold,Humana Gold,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Medica,Medica,2446,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Tricare,Tricare,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,116096.3884,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,UHC Medicare,UHC Medicare,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,A1603,HIPPS,,,,,,,,Inpatient,,,113819.9886,113819.9886,Wellcare,Wellcare,113819.9886,,,,,,,case rate,1241,116096.3884,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Aetna Medicare,Aetna Medicare,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Cigna,Cigna,2914,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Cigna Medicare Advantage,Cigna Medicare Advantage,156233.3844,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Essence,Essence,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Humana Gold,Humana Gold,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Medica,Medica,2446,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Tricare,Tricare,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,156233.3844,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,UHC Medicare,UHC Medicare,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,B1603,HIPPS,,,,,,,,Inpatient,,,153169.9847,153169.9847,Wellcare,Wellcare,153169.9847,,,,,,,case rate,1241,156233.3844,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Aetna Medicare,Aetna Medicare,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Cigna,Cigna,2914,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Cigna Medicare Advantage,Cigna Medicare Advantage,140015.386,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Essence,Essence,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Humana Gold,Humana Gold,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Medica,Medica,2446,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Tricare,Tricare,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,140015.386,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,UHC Medicare,UHC Medicare,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,C1603,HIPPS,,,,,,,,Inpatient,,,137269.9863,137269.9863,Wellcare,Wellcare,137269.9863,,,,,,,case rate,1241,140015.386,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Aetna Medicare,Aetna Medicare,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Cigna,Cigna,2914,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Cigna Medicare Advantage,Cigna Medicare Advantage,128081.3872,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Essence,Essence,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Humana Gold,Humana Gold,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Medica,Medica,2446,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Tricare,Tricare,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,128081.3872,"Per diem rate, all codes are bundled into service package"
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,UHC Medicare,UHC Medicare,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M >=43.50 and M <58.50,D1603,HIPPS,,,,,,,,Inpatient,,,125569.9874,125569.9874,Wellcare,Wellcare,125569.9874,,,,,,,case rate,1241,128081.3872,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Aetna Medicare,Aetna Medicare,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Cigna,Cigna,2914,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Cigna Medicare Advantage,Cigna Medicare Advantage,151959.5848,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Essence,Essence,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Humana Gold,Humana Gold,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Medica,Medica,2446,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Tricare,Tricare,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,151959.5848,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,UHC Medicare,UHC Medicare,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,A1604,HIPPS,,,,,,,,Inpatient,,,148979.9851,148979.9851,Wellcare,Wellcare,148979.9851,,,,,,,case rate,1241,151959.5848,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Aetna Medicare,Aetna Medicare,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Cigna,Cigna,2914,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Cigna Medicare Advantage,Cigna Medicare Advantage,204499.7796,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Essence,Essence,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Humana Gold,Humana Gold,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Medica,Medica,2446,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Tricare,Tricare,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,204499.7796,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,UHC Medicare,UHC Medicare,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,B1604,HIPPS,,,,,,,,Inpatient,,,200489.98,200489.98,Wellcare,Wellcare,200489.98,,,,,,,case rate,1241,204499.7796,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Aetna Medicare,Aetna Medicare,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Cigna,Cigna,2914,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Cigna Medicare Advantage,Cigna Medicare Advantage,183273.5817,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Essence,Essence,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Humana Gold,Humana Gold,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Medica,Medica,2446,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Tricare,Tricare,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,183273.5817,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,UHC Medicare,UHC Medicare,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,C1604,HIPPS,,,,,,,,Inpatient,,,179679.982,179679.982,Wellcare,Wellcare,179679.982,,,,,,,case rate,1241,183273.5817,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Aetna Medicare,Aetna Medicare,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Cigna,Cigna,2914,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Cigna Medicare Advantage,Cigna Medicare Advantage,167647.1832,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Essence,Essence,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Humana Gold,Humana Gold,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Medica,Medica,2446,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Tricare,Tricare,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,167647.1832,"Per diem rate, all codes are bundled into service package"
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,UHC Medicare,UHC Medicare,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Pain syndrome M <43.50,D1604,HIPPS,,,,,,,,Inpatient,,,164359.9836,164359.9836,Wellcare,Wellcare,164359.9836,,,,,,,case rate,1241,167647.1832,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Aetna Medicare,Aetna Medicare,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Cigna,Cigna,2914,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Cigna Medicare Advantage,Cigna Medicare Advantage,91106.39089,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Essence,Essence,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Humana Gold,Humana Gold,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Medica,Medica,2446,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Tricare,Tricare,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,91106.39089,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,UHC Medicare,UHC Medicare,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,A1701,HIPPS,,,,,,,,Inpatient,,,89319.99107,89319.99107,Wellcare,Wellcare,89319.99107,,,,,,,case rate,1241,91106.39089,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Aetna Medicare,Aetna Medicare,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Cigna,Cigna,2914,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Cigna Medicare Advantage,Cigna Medicare Advantage,134548.1865,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Essence,Essence,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Humana Gold,Humana Gold,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Medica,Medica,2446,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Tricare,Tricare,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,134548.1865,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,UHC Medicare,UHC Medicare,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,B1701,HIPPS,,,,,,,,Inpatient,,,131909.9868,131909.9868,Wellcare,Wellcare,131909.9868,,,,,,,case rate,1241,134548.1865,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Aetna Medicare,Aetna Medicare,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Cigna,Cigna,2914,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Cigna Medicare Advantage,Cigna Medicare Advantage,106589.9893,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Essence,Essence,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Humana Gold,Humana Gold,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Medica,Medica,2446,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Tricare,Tricare,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,106589.9893,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,UHC Medicare,UHC Medicare,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,C1701,HIPPS,,,,,,,,Inpatient,,,104499.9896,104499.9896,Wellcare,Wellcare,104499.9896,,,,,,,case rate,1241,106589.9893,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Aetna Medicare,Aetna Medicare,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Cigna,Cigna,2914,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Cigna Medicare Advantage,Cigna Medicare Advantage,98960.3901,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Essence,Essence,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Humana Gold,Humana Gold,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Medica,Medica,2446,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Tricare,Tricare,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,98960.3901,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,UHC Medicare,UHC Medicare,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=57.50,D1701,HIPPS,,,,,,,,Inpatient,,,97019.9903,97019.9903,Wellcare,Wellcare,97019.9903,,,,,,,case rate,1241,98960.3901,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Aetna Medicare,Aetna Medicare,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112301.9888,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Essence,Essence,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Humana Gold,Humana Gold,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Medica,Medica,2446,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Tricare,Tricare,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112301.9888,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,UHC Medicare,UHC Medicare,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,A1702,HIPPS,,,,,,,,Inpatient,,,110099.989,110099.989,Wellcare,Wellcare,110099.989,,,,,,,case rate,1241,112301.9888,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Aetna Medicare,Aetna Medicare,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Cigna,Cigna,2914,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Cigna Medicare Advantage,Cigna Medicare Advantage,165851.9834,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Essence,Essence,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Humana Gold,Humana Gold,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Medica,Medica,2446,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Tricare,Tricare,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,165851.9834,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,UHC Medicare,UHC Medicare,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,B1702,HIPPS,,,,,,,,Inpatient,,,162599.9837,162599.9837,Wellcare,Wellcare,162599.9837,,,,,,,case rate,1241,165851.9834,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Aetna Medicare,Aetna Medicare,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Cigna,Cigna,2914,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Cigna Medicare Advantage,Cigna Medicare Advantage,131386.1869,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Essence,Essence,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Humana Gold,Humana Gold,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Medica,Medica,2446,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Tricare,Tricare,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,131386.1869,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,UHC Medicare,UHC Medicare,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,C1702,HIPPS,,,,,,,,Inpatient,,,128809.9871,128809.9871,Wellcare,Wellcare,128809.9871,,,,,,,case rate,1241,131386.1869,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Aetna Medicare,Aetna Medicare,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Cigna,Cigna,2914,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Cigna Medicare Advantage,Cigna Medicare Advantage,121991.9878,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Essence,Essence,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Humana Gold,Humana Gold,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Medica,Medica,2446,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Tricare,Tricare,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,121991.9878,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,UHC Medicare,UHC Medicare,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=50.50 and M <57.50,D1702,HIPPS,,,,,,,,Inpatient,,,119599.988,119599.988,Wellcare,Wellcare,119599.988,,,,,,,case rate,1241,121991.9878,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Aetna Medicare,Aetna Medicare,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Cigna,Cigna,2914,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Cigna Medicare Advantage,Cigna Medicare Advantage,131773.7868,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Essence,Essence,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Humana Gold,Humana Gold,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Medica,Medica,2446,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Tricare,Tricare,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,131773.7868,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,UHC Medicare,UHC Medicare,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,A1703,HIPPS,,,,,,,,Inpatient,,,129189.9871,129189.9871,Wellcare,Wellcare,129189.9871,,,,,,,case rate,1241,131773.7868,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Aetna Medicare,Aetna Medicare,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Cigna,Cigna,2914,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Cigna Medicare Advantage,Cigna Medicare Advantage,194595.5805,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Essence,Essence,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Humana Gold,Humana Gold,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Medica,Medica,2446,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Tricare,Tricare,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,194595.5805,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,UHC Medicare,UHC Medicare,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,B1703,HIPPS,,,,,,,,Inpatient,,,190779.9809,190779.9809,Wellcare,Wellcare,190779.9809,,,,,,,case rate,1241,194595.5805,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Aetna Medicare,Aetna Medicare,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Cigna,Cigna,2914,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Cigna Medicare Advantage,Cigna Medicare Advantage,154162.7846,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Essence,Essence,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Humana Gold,Humana Gold,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Medica,Medica,2446,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Tricare,Tricare,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,154162.7846,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,UHC Medicare,UHC Medicare,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,C1703,HIPPS,,,,,,,,Inpatient,,,151139.9849,151139.9849,Wellcare,Wellcare,151139.9849,,,,,,,case rate,1241,154162.7846,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Aetna Medicare,Aetna Medicare,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Cigna,Cigna,2914,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Cigna Medicare Advantage,Cigna Medicare Advantage,143136.5857,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Essence,Essence,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Humana Gold,Humana Gold,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Medica,Medica,2446,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Tricare,Tricare,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,143136.5857,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,UHC Medicare,UHC Medicare,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=41.50 and M <50.50,D1703,HIPPS,,,,,,,,Inpatient,,,140329.986,140329.986,Wellcare,Wellcare,140329.986,,,,,,,case rate,1241,143136.5857,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Aetna Medicare,Aetna Medicare,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Cigna,Cigna,2914,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Cigna Medicare Advantage,Cigna Medicare Advantage,151633.1848,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Essence,Essence,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Humana Gold,Humana Gold,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Medica,Medica,2446,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Tricare,Tricare,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,151633.1848,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,UHC Medicare,UHC Medicare,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,A1704,HIPPS,,,,,,,,Inpatient,,,148659.9851,148659.9851,Wellcare,Wellcare,148659.9851,,,,,,,case rate,1241,151633.1848,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Aetna Medicare,Aetna Medicare,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Cigna,Cigna,2914,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Cigna Medicare Advantage,Cigna Medicare Advantage,223920.5776,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Essence,Essence,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Humana Gold,Humana Gold,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Medica,Medica,2446,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Tricare,Tricare,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,223920.5776,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,UHC Medicare,UHC Medicare,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,B1704,HIPPS,,,,,,,,Inpatient,,,219529.978,219529.978,Wellcare,Wellcare,219529.978,,,,,,,case rate,1241,223920.5776,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Aetna Medicare,Aetna Medicare,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Cigna,Cigna,2914,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Cigna Medicare Advantage,Cigna Medicare Advantage,177398.3823,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Essence,Essence,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Humana Gold,Humana Gold,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Medica,Medica,2446,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Tricare,Tricare,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,177398.3823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,UHC Medicare,UHC Medicare,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,C1704,HIPPS,,,,,,,,Inpatient,,,173919.9826,173919.9826,Wellcare,Wellcare,173919.9826,,,,,,,case rate,1241,177398.3823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Aetna Medicare,Aetna Medicare,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Cigna,Cigna,2914,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Cigna Medicare Advantage,Cigna Medicare Advantage,164709.5835,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Essence,Essence,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Humana Gold,Humana Gold,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Medica,Medica,2446,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Tricare,Tricare,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,164709.5835,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,UHC Medicare,UHC Medicare,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M >=36.50 and M <41.50,D1704,HIPPS,,,,,,,,Inpatient,,,161479.9839,161479.9839,Wellcare,Wellcare,161479.9839,,,,,,,case rate,1241,164709.5835,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Aetna Medicare,Aetna Medicare,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Cigna,Cigna,2914,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Cigna Medicare Advantage,Cigna Medicare Advantage,176521.1823,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Essence,Essence,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Humana Gold,Humana Gold,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Medica,Medica,2446,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Tricare,Tricare,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,176521.1823,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,UHC Medicare,UHC Medicare,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,A1705,HIPPS,,,,,,,,Inpatient,,,173059.9827,173059.9827,Wellcare,Wellcare,173059.9827,,,,,,,case rate,1241,176521.1823,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Aetna Medicare,Aetna Medicare,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Cigna,Cigna,2914,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Cigna Medicare Advantage,Cigna Medicare Advantage,260681.3739,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Essence,Essence,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Humana Gold,Humana Gold,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Medica,Medica,2446,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Tricare,Tricare,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,260681.3739,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,UHC Medicare,UHC Medicare,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,B1705,HIPPS,,,,,,,,Inpatient,,,255569.9744,255569.9744,Wellcare,Wellcare,255569.9744,,,,,,,case rate,1241,260681.3739,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Aetna Medicare,Aetna Medicare,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Cigna,Cigna,2914,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Cigna Medicare Advantage,Cigna Medicare Advantage,206519.3793,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Essence,Essence,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Humana Gold,Humana Gold,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Medica,Medica,2446,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Tricare,Tricare,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,206519.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,UHC Medicare,UHC Medicare,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,C1705,HIPPS,,,,,,,,Inpatient,,,202469.9798,202469.9798,Wellcare,Wellcare,202469.9798,,,,,,,case rate,1241,206519.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Aetna Medicare,Aetna Medicare,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Cigna,Cigna,2914,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Cigna Medicare Advantage,Cigna Medicare Advantage,191749.7808,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Essence,Essence,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Humana Gold,Humana Gold,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Medica,Medica,2446,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Tricare,Tricare,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,191749.7808,"Per diem rate, all codes are bundled into service package"
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,UHC Medicare,UHC Medicare,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma without brain or spinal cord injury M <36.50,D1705,HIPPS,,,,,,,,Inpatient,,,187989.9812,187989.9812,Wellcare,Wellcare,187989.9812,,,,,,,case rate,1241,191749.7808,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Aetna Medicare,Aetna Medicare,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Cigna,Cigna,2914,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Cigna Medicare Advantage,Cigna Medicare Advantage,80620.79194,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Essence,Essence,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Humana Gold,Humana Gold,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Medica,Medica,2446,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Tricare,Tricare,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,80620.79194,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,UHC Medicare,UHC Medicare,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,A1801,HIPPS,,,,,,,,Inpatient,,,79039.9921,79039.9921,Wellcare,Wellcare,79039.9921,,,,,,,case rate,1241,80620.79194,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Aetna Medicare,Aetna Medicare,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Cigna,Cigna,2914,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Cigna Medicare Advantage,Cigna Medicare Advantage,114127.7886,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Essence,Essence,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Humana Gold,Humana Gold,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Medica,Medica,2446,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Tricare,Tricare,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,114127.7886,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,UHC Medicare,UHC Medicare,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,B1801,HIPPS,,,,,,,,Inpatient,,,111889.9888,111889.9888,Wellcare,Wellcare,111889.9888,,,,,,,case rate,1241,114127.7886,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Aetna Medicare,Aetna Medicare,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Cigna,Cigna,2914,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Cigna Medicare Advantage,Cigna Medicare Advantage,93370.79066,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Essence,Essence,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Humana Gold,Humana Gold,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Medica,Medica,2446,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Tricare,Tricare,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,93370.79066,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,UHC Medicare,UHC Medicare,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,C1801,HIPPS,,,,,,,,Inpatient,,,91539.99085,91539.99085,Wellcare,Wellcare,91539.99085,,,,,,,case rate,1241,93370.79066,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Aetna Medicare,Aetna Medicare,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Cigna,Cigna,2914,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Cigna Medicare Advantage,Cigna Medicare Advantage,85894.19141,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Essence,Essence,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Humana Gold,Humana Gold,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Medica,Medica,2446,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Tricare,Tricare,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,85894.19141,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,UHC Medicare,UHC Medicare,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=67.50,D1801,HIPPS,,,,,,,,Inpatient,,,84209.99158,84209.99158,Wellcare,Wellcare,84209.99158,,,,,,,case rate,1241,85894.19141,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Aetna Medicare,Aetna Medicare,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Cigna,Cigna,2914,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Cigna Medicare Advantage,Cigna Medicare Advantage,102479.3898,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Essence,Essence,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Humana Gold,Humana Gold,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Medica,Medica,2446,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Tricare,Tricare,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,102479.3898,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,UHC Medicare,UHC Medicare,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,A1802,HIPPS,,,,,,,,Inpatient,,,100469.99,100469.99,Wellcare,Wellcare,100469.99,,,,,,,case rate,1241,102479.3898,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Aetna Medicare,Aetna Medicare,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Cigna,Cigna,2914,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Cigna Medicare Advantage,Cigna Medicare Advantage,145074.5855,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Essence,Essence,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Humana Gold,Humana Gold,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Medica,Medica,2446,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Tricare,Tricare,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,145074.5855,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,UHC Medicare,UHC Medicare,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,B1802,HIPPS,,,,,,,,Inpatient,,,142229.9858,142229.9858,Wellcare,Wellcare,142229.9858,,,,,,,case rate,1241,145074.5855,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Aetna Medicare,Aetna Medicare,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Cigna,Cigna,2914,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Cigna Medicare Advantage,Cigna Medicare Advantage,118687.1881,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Essence,Essence,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Humana Gold,Humana Gold,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Medica,Medica,2446,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Tricare,Tricare,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,118687.1881,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,UHC Medicare,UHC Medicare,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,C1802,HIPPS,,,,,,,,Inpatient,,,116359.9884,116359.9884,Wellcare,Wellcare,116359.9884,,,,,,,case rate,1241,118687.1881,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Aetna Medicare,Aetna Medicare,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Cigna,Cigna,2914,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Cigna Medicare Advantage,Cigna Medicare Advantage,109180.7891,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Essence,Essence,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Humana Gold,Humana Gold,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Medica,Medica,2446,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Tricare,Tricare,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,109180.7891,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,UHC Medicare,UHC Medicare,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=55.50 and M <67.50,D1802,HIPPS,,,,,,,,Inpatient,,,107039.9893,107039.9893,Wellcare,Wellcare,107039.9893,,,,,,,case rate,1241,109180.7891,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Aetna Medicare,Aetna Medicare,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Cigna,Cigna,2914,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Cigna Medicare Advantage,Cigna Medicare Advantage,127479.5873,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Essence,Essence,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Humana Gold,Humana Gold,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Medica,Medica,2446,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Tricare,Tricare,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,127479.5873,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,UHC Medicare,UHC Medicare,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,A1803,HIPPS,,,,,,,,Inpatient,,,124979.9875,124979.9875,Wellcare,Wellcare,124979.9875,,,,,,,case rate,1241,127479.5873,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Aetna Medicare,Aetna Medicare,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Cigna,Cigna,2914,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Cigna Medicare Advantage,Cigna Medicare Advantage,180478.782,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Essence,Essence,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Humana Gold,Humana Gold,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Medica,Medica,2446,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Tricare,Tricare,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,180478.782,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,UHC Medicare,UHC Medicare,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,B1803,HIPPS,,,,,,,,Inpatient,,,176939.9823,176939.9823,Wellcare,Wellcare,176939.9823,,,,,,,case rate,1241,180478.782,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Aetna Medicare,Aetna Medicare,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Cigna,Cigna,2914,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Cigna Medicare Advantage,Cigna Medicare Advantage,147644.9852,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Essence,Essence,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Humana Gold,Humana Gold,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Medica,Medica,2446,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Tricare,Tricare,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,147644.9852,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,UHC Medicare,UHC Medicare,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,C1803,HIPPS,,,,,,,,Inpatient,,,144749.9855,144749.9855,Wellcare,Wellcare,144749.9855,,,,,,,case rate,1241,147644.9852,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Aetna Medicare,Aetna Medicare,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Cigna,Cigna,2914,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Cigna Medicare Advantage,Cigna Medicare Advantage,135823.1864,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Essence,Essence,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Humana Gold,Humana Gold,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Medica,Medica,2446,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Tricare,Tricare,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,135823.1864,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,UHC Medicare,UHC Medicare,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=45.50 and M <55.50,D1803,HIPPS,,,,,,,,Inpatient,,,133159.9867,133159.9867,Wellcare,Wellcare,133159.9867,,,,,,,case rate,1241,135823.1864,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Aetna Medicare,Aetna Medicare,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Cigna,Cigna,2914,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Cigna Medicare Advantage,Cigna Medicare Advantage,148889.3851,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Essence,Essence,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Humana Gold,Humana Gold,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Medica,Medica,2446,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Tricare,Tricare,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,148889.3851,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,UHC Medicare,UHC Medicare,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,A1804,HIPPS,,,,,,,,Inpatient,,,145969.9854,145969.9854,Wellcare,Wellcare,145969.9854,,,,,,,case rate,1241,148889.3851,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Aetna Medicare,Aetna Medicare,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Cigna,Cigna,2914,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Cigna Medicare Advantage,Cigna Medicare Advantage,210782.9789,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Essence,Essence,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Humana Gold,Humana Gold,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Medica,Medica,2446,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Tricare,Tricare,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,210782.9789,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,UHC Medicare,UHC Medicare,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,B1804,HIPPS,,,,,,,,Inpatient,,,206649.9793,206649.9793,Wellcare,Wellcare,206649.9793,,,,,,,case rate,1241,210782.9789,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Aetna Medicare,Aetna Medicare,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Cigna,Cigna,2914,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Cigna Medicare Advantage,Cigna Medicare Advantage,172441.1828,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Essence,Essence,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Humana Gold,Humana Gold,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Medica,Medica,2446,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Tricare,Tricare,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172441.1828,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,UHC Medicare,UHC Medicare,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,C1804,HIPPS,,,,,,,,Inpatient,,,169059.9831,169059.9831,Wellcare,Wellcare,169059.9831,,,,,,,case rate,1241,172441.1828,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Aetna Medicare,Aetna Medicare,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Cigna,Cigna,2914,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Cigna Medicare Advantage,Cigna Medicare Advantage,158630.3841,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Essence,Essence,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Humana Gold,Humana Gold,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Medica,Medica,2446,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Tricare,Tricare,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,158630.3841,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,UHC Medicare,UHC Medicare,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=40.50 and M <45.50,D1804,HIPPS,,,,,,,,Inpatient,,,155519.9844,155519.9844,Wellcare,Wellcare,155519.9844,,,,,,,case rate,1241,158630.3841,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Aetna Medicare,Aetna Medicare,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Cigna,Cigna,2914,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Cigna Medicare Advantage,Cigna Medicare Advantage,178622.3821,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Essence,Essence,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Humana Gold,Humana Gold,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Medica,Medica,2446,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Tricare,Tricare,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,178622.3821,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,UHC Medicare,UHC Medicare,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,A1805,HIPPS,,,,,,,,Inpatient,,,175119.9825,175119.9825,Wellcare,Wellcare,175119.9825,,,,,,,case rate,1241,178622.3821,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Aetna Medicare,Aetna Medicare,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Cigna,Cigna,2914,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Cigna Medicare Advantage,Cigna Medicare Advantage,252878.3747,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Essence,Essence,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Humana Gold,Humana Gold,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Medica,Medica,2446,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Tricare,Tricare,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,252878.3747,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,UHC Medicare,UHC Medicare,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,B1805,HIPPS,,,,,,,,Inpatient,,,247919.9752,247919.9752,Wellcare,Wellcare,247919.9752,,,,,,,case rate,1241,252878.3747,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Aetna Medicare,Aetna Medicare,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Cigna,Cigna,2914,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Cigna Medicare Advantage,Cigna Medicare Advantage,206876.3793,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Essence,Essence,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Humana Gold,Humana Gold,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Medica,Medica,2446,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Tricare,Tricare,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,206876.3793,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,UHC Medicare,UHC Medicare,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,C1805,HIPPS,,,,,,,,Inpatient,,,202819.9797,202819.9797,Wellcare,Wellcare,202819.9797,,,,,,,case rate,1241,206876.3793,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Aetna Medicare,Aetna Medicare,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Cigna,Cigna,2914,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Cigna Medicare Advantage,Cigna Medicare Advantage,190311.581,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Essence,Essence,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Humana Gold,Humana Gold,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Medica,Medica,2446,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Tricare,Tricare,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,190311.581,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,UHC Medicare,UHC Medicare,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M >=30.50 and M <40.50,D1805,HIPPS,,,,,,,,Inpatient,,,186579.9813,186579.9813,Wellcare,Wellcare,186579.9813,,,,,,,case rate,1241,190311.581,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Aetna Medicare,Aetna Medicare,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Cigna,Cigna,2914,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Cigna Medicare Advantage,Cigna Medicare Advantage,258794.3741,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Essence,Essence,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Humana Gold,Humana Gold,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Medica,Medica,2446,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Tricare,Tricare,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,258794.3741,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,UHC Medicare,UHC Medicare,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,A1806,HIPPS,,,,,,,,Inpatient,,,253719.9746,253719.9746,Wellcare,Wellcare,253719.9746,,,,,,,case rate,1241,258794.3741,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Aetna Medicare,Aetna Medicare,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Cigna,Cigna,2914,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Cigna Medicare Advantage,Cigna Medicare Advantage,366373.7634,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Essence,Essence,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Humana Gold,Humana Gold,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Medica,Medica,2446,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Tricare,Tricare,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,366373.7634,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,UHC Medicare,UHC Medicare,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,B1806,HIPPS,,,,,,,,Inpatient,,,359189.9641,359189.9641,Wellcare,Wellcare,359189.9641,,,,,,,case rate,1241,366373.7634,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Aetna Medicare,Aetna Medicare,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Cigna,Cigna,2914,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Cigna Medicare Advantage,Cigna Medicare Advantage,299726.97,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Essence,Essence,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Humana Gold,Humana Gold,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Medica,Medica,2446,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Tricare,Tricare,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,299726.97,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,UHC Medicare,UHC Medicare,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,C1806,HIPPS,,,,,,,,Inpatient,,,293849.9706,293849.9706,Wellcare,Wellcare,293849.9706,,,,,,,case rate,1241,299726.97,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Aetna Medicare,Aetna Medicare,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Cigna,Cigna,2914,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Cigna Medicare Advantage,Cigna Medicare Advantage,275726.3724,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Essence,Essence,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Humana Gold,Humana Gold,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Medica,Medica,2446,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Tricare,Tricare,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,275726.3724,"Per diem rate, all codes are bundled into service package"
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,UHC Medicare,UHC Medicare,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Major multiple trauma with brain or spinal cord injury M <30.50,D1806,HIPPS,,,,,,,,Inpatient,,,270319.973,270319.973,Wellcare,Wellcare,270319.973,,,,,,,case rate,1241,275726.3724,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Aetna Medicare,Aetna Medicare,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Cigna,Cigna,2914,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Cigna Medicare Advantage,Cigna Medicare Advantage,84047.9916,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Essence,Essence,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Humana Gold,Humana Gold,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Medica,Medica,2446,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Tricare,Tricare,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,84047.9916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,UHC Medicare,UHC Medicare,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,A1901,HIPPS,,,,,,,,Inpatient,,,82399.99176,82399.99176,Wellcare,Wellcare,82399.99176,,,,,,,case rate,1241,84047.9916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Aetna Medicare,Aetna Medicare,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Cigna,Cigna,2914,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Cigna Medicare Advantage,Cigna Medicare Advantage,136751.3863,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Essence,Essence,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Humana Gold,Humana Gold,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Medica,Medica,2446,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Tricare,Tricare,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,136751.3863,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,UHC Medicare,UHC Medicare,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,B1901,HIPPS,,,,,,,,Inpatient,,,134069.9866,134069.9866,Wellcare,Wellcare,134069.9866,,,,,,,case rate,1241,136751.3863,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Aetna Medicare,Aetna Medicare,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Cigna,Cigna,2914,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Cigna Medicare Advantage,Cigna Medicare Advantage,96644.99034,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Essence,Essence,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Humana Gold,Humana Gold,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Medica,Medica,2446,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Tricare,Tricare,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,96644.99034,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,UHC Medicare,UHC Medicare,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,C1901,HIPPS,,,,,,,,Inpatient,,,94749.99053,94749.99053,Wellcare,Wellcare,94749.99053,,,,,,,case rate,1241,96644.99034,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Aetna Medicare,Aetna Medicare,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Cigna,Cigna,2914,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Cigna Medicare Advantage,Cigna Medicare Advantage,84017.3916,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Essence,Essence,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Humana Gold,Humana Gold,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Medica,Medica,2446,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Tricare,Tricare,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,84017.3916,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,UHC Medicare,UHC Medicare,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=66.50,D1901,HIPPS,,,,,,,,Inpatient,,,82369.99176,82369.99176,Wellcare,Wellcare,82369.99176,,,,,,,case rate,1241,84017.3916,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Aetna Medicare,Aetna Medicare,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Cigna,Cigna,2914,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Cigna Medicare Advantage,Cigna Medicare Advantage,122267.3878,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Essence,Essence,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Humana Gold,Humana Gold,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Medica,Medica,2446,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Tricare,Tricare,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,122267.3878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,UHC Medicare,UHC Medicare,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,A1902,HIPPS,,,,,,,,Inpatient,,,119869.988,119869.988,Wellcare,Wellcare,119869.988,,,,,,,case rate,1241,122267.3878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Aetna Medicare,Aetna Medicare,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Cigna,Cigna,2914,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Cigna Medicare Advantage,Cigna Medicare Advantage,198950.9801,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Essence,Essence,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Humana Gold,Humana Gold,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Medica,Medica,2446,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Tricare,Tricare,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,198950.9801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,UHC Medicare,UHC Medicare,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,B1902,HIPPS,,,,,,,,Inpatient,,,195049.9805,195049.9805,Wellcare,Wellcare,195049.9805,,,,,,,case rate,1241,198950.9801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Aetna Medicare,Aetna Medicare,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Cigna,Cigna,2914,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Cigna Medicare Advantage,Cigna Medicare Advantage,140606.9859,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Essence,Essence,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Humana Gold,Humana Gold,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Medica,Medica,2446,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Tricare,Tricare,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,140606.9859,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,UHC Medicare,UHC Medicare,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,C1902,HIPPS,,,,,,,,Inpatient,,,137849.9862,137849.9862,Wellcare,Wellcare,137849.9862,,,,,,,case rate,1241,140606.9859,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Aetna Medicare,Aetna Medicare,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Cigna,Cigna,2914,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Cigna Medicare Advantage,Cigna Medicare Advantage,122236.7878,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Essence,Essence,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Humana Gold,Humana Gold,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Medica,Medica,2446,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Tricare,Tricare,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,122236.7878,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,UHC Medicare,UHC Medicare,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=51.50 and M <66.50,D1902,HIPPS,,,,,,,,Inpatient,,,119839.988,119839.988,Wellcare,Wellcare,119839.988,,,,,,,case rate,1241,122236.7878,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Aetna Medicare,Aetna Medicare,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Cigna,Cigna,2914,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Cigna Medicare Advantage,Cigna Medicare Advantage,172991.9827,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Essence,Essence,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Humana Gold,Humana Gold,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Medica,Medica,2446,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Tricare,Tricare,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172991.9827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,UHC Medicare,UHC Medicare,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,A1903,HIPPS,,,,,,,,Inpatient,,,169599.983,169599.983,Wellcare,Wellcare,169599.983,,,,,,,case rate,1241,172991.9827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Aetna Medicare,Aetna Medicare,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Cigna,Cigna,2914,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Cigna Medicare Advantage,Cigna Medicare Advantage,281489.3719,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Essence,Essence,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Humana Gold,Humana Gold,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Medica,Medica,2446,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Tricare,Tricare,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,281489.3719,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,UHC Medicare,UHC Medicare,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,B1903,HIPPS,,,,,,,,Inpatient,,,275969.9724,275969.9724,Wellcare,Wellcare,275969.9724,,,,,,,case rate,1241,281489.3719,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Aetna Medicare,Aetna Medicare,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Cigna,Cigna,2914,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Cigna Medicare Advantage,Cigna Medicare Advantage,198940.7801,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Essence,Essence,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Humana Gold,Humana Gold,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Medica,Medica,2446,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Tricare,Tricare,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,198940.7801,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,UHC Medicare,UHC Medicare,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,C1903,HIPPS,,,,,,,,Inpatient,,,195039.9805,195039.9805,Wellcare,Wellcare,195039.9805,,,,,,,case rate,1241,198940.7801,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Aetna Medicare,Aetna Medicare,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Cigna,Cigna,2914,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Cigna Medicare Advantage,Cigna Medicare Advantage,172951.1827,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Essence,Essence,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Humana Gold,Humana Gold,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Medica,Medica,2446,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Tricare,Tricare,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172951.1827,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,UHC Medicare,UHC Medicare,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M >=38.50 and M <51.50,D1903,HIPPS,,,,,,,,Inpatient,,,169559.983,169559.983,Wellcare,Wellcare,169559.983,,,,,,,case rate,1241,172951.1827,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Aetna Medicare,Aetna Medicare,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Cigna,Cigna,2914,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Cigna Medicare Advantage,Cigna Medicare Advantage,266015.9734,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Essence,Essence,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Humana Gold,Humana Gold,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Medica,Medica,2446,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Tricare,Tricare,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,266015.9734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,UHC Medicare,UHC Medicare,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,A1904,HIPPS,,,,,,,,Inpatient,,,260799.9739,260799.9739,Wellcare,Wellcare,260799.9739,,,,,,,case rate,1241,266015.9734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Aetna Medicare,Aetna Medicare,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Cigna,Cigna,2914,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Cigna Medicare Advantage,Cigna Medicare Advantage,432847.1567,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Essence,Essence,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Humana Gold,Humana Gold,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Medica,Medica,2446,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Tricare,Tricare,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,432847.1567,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,UHC Medicare,UHC Medicare,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,B1904,HIPPS,,,,,,,,Inpatient,,,424359.9576,424359.9576,Wellcare,Wellcare,424359.9576,,,,,,,case rate,1241,432847.1567,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Aetna Medicare,Aetna Medicare,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Cigna,Cigna,2914,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Cigna Medicare Advantage,Cigna Medicare Advantage,305908.1694,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Essence,Essence,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Humana Gold,Humana Gold,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Medica,Medica,2446,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Tricare,Tricare,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,305908.1694,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,UHC Medicare,UHC Medicare,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,C1904,HIPPS,,,,,,,,Inpatient,,,299909.97,299909.97,Wellcare,Wellcare,299909.97,,,,,,,case rate,1241,305908.1694,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Aetna Medicare,Aetna Medicare,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Cigna,Cigna,2914,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Cigna Medicare Advantage,Cigna Medicare Advantage,265934.3734,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Essence,Essence,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Humana Gold,Humana Gold,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Medica,Medica,2446,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Tricare,Tricare,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,265934.3734,"Per diem rate, all codes are bundled into service package"
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,UHC Medicare,UHC Medicare,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Guillain-Barré M <38.50,D1904,HIPPS,,,,,,,,Inpatient,,,260719.9739,260719.9739,Wellcare,Wellcare,260719.9739,,,,,,,case rate,1241,265934.3734,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Aetna Medicare,Aetna Medicare,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Cigna,Cigna,2914,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Cigna Medicare Advantage,Cigna Medicare Advantage,82762.79172,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Essence,Essence,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Humana Gold,Humana Gold,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Medica,Medica,2446,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Tricare,Tricare,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,82762.79172,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,UHC Medicare,UHC Medicare,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,A2001,HIPPS,,,,,,,,Inpatient,,,81139.99189,81139.99189,Wellcare,Wellcare,81139.99189,,,,,,,case rate,1241,82762.79172,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Aetna Medicare,Aetna Medicare,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Cigna,Cigna,2914,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Cigna Medicare Advantage,Cigna Medicare Advantage,121216.7879,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Essence,Essence,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Humana Gold,Humana Gold,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Medica,Medica,2446,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Tricare,Tricare,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,121216.7879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,UHC Medicare,UHC Medicare,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,B2001,HIPPS,,,,,,,,Inpatient,,,118839.9881,118839.9881,Wellcare,Wellcare,118839.9881,,,,,,,case rate,1241,121216.7879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Aetna Medicare,Aetna Medicare,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Cigna,Cigna,2914,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Cigna Medicare Advantage,Cigna Medicare Advantage,97216.19028,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Essence,Essence,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Humana Gold,Humana Gold,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Medica,Medica,2446,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Tricare,Tricare,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,97216.19028,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,UHC Medicare,UHC Medicare,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,C2001,HIPPS,,,,,,,,Inpatient,,,95309.99047,95309.99047,Wellcare,Wellcare,95309.99047,,,,,,,case rate,1241,97216.19028,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Aetna Medicare,Aetna Medicare,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Cigna,Cigna,2914,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Cigna Medicare Advantage,Cigna Medicare Advantage,90412.79096,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Essence,Essence,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Humana Gold,Humana Gold,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Medica,Medica,2446,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Tricare,Tricare,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,90412.79096,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,UHC Medicare,UHC Medicare,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=66.50,D2001,HIPPS,,,,,,,,Inpatient,,,88639.99114,88639.99114,Wellcare,Wellcare,88639.99114,,,,,,,case rate,1241,90412.79096,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Aetna Medicare,Aetna Medicare,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Cigna,Cigna,2914,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Cigna Medicare Advantage,Cigna Medicare Advantage,102754.7897,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Essence,Essence,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Humana Gold,Humana Gold,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Medica,Medica,2446,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Tricare,Tricare,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,102754.7897,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,UHC Medicare,UHC Medicare,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,A2002,HIPPS,,,,,,,,Inpatient,,,100739.9899,100739.9899,Wellcare,Wellcare,100739.9899,,,,,,,case rate,1241,102754.7897,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Aetna Medicare,Aetna Medicare,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Cigna,Cigna,2914,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Cigna Medicare Advantage,Cigna Medicare Advantage,150500.9849,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Essence,Essence,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Humana Gold,Humana Gold,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Medica,Medica,2446,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Tricare,Tricare,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,150500.9849,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,UHC Medicare,UHC Medicare,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,B2002,HIPPS,,,,,,,,Inpatient,,,147549.9852,147549.9852,Wellcare,Wellcare,147549.9852,,,,,,,case rate,1241,150500.9849,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Aetna Medicare,Aetna Medicare,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120696.5879,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Essence,Essence,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Humana Gold,Humana Gold,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Medica,Medica,2446,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Tricare,Tricare,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120696.5879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,UHC Medicare,UHC Medicare,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,C2002,HIPPS,,,,,,,,Inpatient,,,118329.9882,118329.9882,Wellcare,Wellcare,118329.9882,,,,,,,case rate,1241,120696.5879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Aetna Medicare,Aetna Medicare,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Cigna,Cigna,2914,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Cigna Medicare Advantage,Cigna Medicare Advantage,112240.7888,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Essence,Essence,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Humana Gold,Humana Gold,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Medica,Medica,2446,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Tricare,Tricare,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,112240.7888,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,UHC Medicare,UHC Medicare,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=55.50 and M <66.50,D2002,HIPPS,,,,,,,,Inpatient,,,110039.989,110039.989,Wellcare,Wellcare,110039.989,,,,,,,case rate,1241,112240.7888,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Aetna Medicare,Aetna Medicare,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Cigna,Cigna,2914,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Cigna Medicare Advantage,Cigna Medicare Advantage,120665.9879,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Essence,Essence,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Humana Gold,Humana Gold,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Medica,Medica,2446,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Tricare,Tricare,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,120665.9879,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,UHC Medicare,UHC Medicare,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,A2003,HIPPS,,,,,,,,Inpatient,,,118299.9882,118299.9882,Wellcare,Wellcare,118299.9882,,,,,,,case rate,1241,120665.9879,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Aetna Medicare,Aetna Medicare,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Cigna,Cigna,2914,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Cigna Medicare Advantage,Cigna Medicare Advantage,176725.1823,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Essence,Essence,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Humana Gold,Humana Gold,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Medica,Medica,2446,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Tricare,Tricare,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,176725.1823,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,UHC Medicare,UHC Medicare,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,B2003,HIPPS,,,,,,,,Inpatient,,,173259.9827,173259.9827,Wellcare,Wellcare,173259.9827,,,,,,,case rate,1241,176725.1823,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Aetna Medicare,Aetna Medicare,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Cigna,Cigna,2914,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Cigna Medicare Advantage,Cigna Medicare Advantage,141728.9858,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Essence,Essence,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Humana Gold,Humana Gold,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Medica,Medica,2446,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Tricare,Tricare,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,141728.9858,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,UHC Medicare,UHC Medicare,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,C2003,HIPPS,,,,,,,,Inpatient,,,138949.9861,138949.9861,Wellcare,Wellcare,138949.9861,,,,,,,case rate,1241,141728.9858,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Aetna Medicare,Aetna Medicare,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Cigna,Cigna,2914,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Cigna Medicare Advantage,Cigna Medicare Advantage,131804.3868,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Essence,Essence,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Humana Gold,Humana Gold,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Medica,Medica,2446,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Tricare,Tricare,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,131804.3868,"Per diem rate, all codes are bundled into service package"
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,UHC Medicare,UHC Medicare,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M >=46.50 and M <55.50,D2003,HIPPS,,,,,,,,Inpatient,,,129219.9871,129219.9871,Wellcare,Wellcare,129219.9871,,,,,,,case rate,1241,131804.3868,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Aetna Medicare,Aetna Medicare,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Cigna,Cigna,2914,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Cigna Medicare Advantage,Cigna Medicare Advantage,147155.3853,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Essence,Essence,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Humana Gold,Humana Gold,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Medica,Medica,2446,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Tricare,Tricare,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,147155.3853,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,UHC Medicare,UHC Medicare,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,A2004,HIPPS,,,,,,,,Inpatient,,,144269.9856,144269.9856,Wellcare,Wellcare,144269.9856,,,,,,,case rate,1241,147155.3853,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Aetna Medicare,Aetna Medicare,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Cigna,Cigna,2914,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Cigna Medicare Advantage,Cigna Medicare Advantage,215536.1784,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Essence,Essence,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Humana Gold,Humana Gold,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Medica,Medica,2446,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Tricare,Tricare,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,215536.1784,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,UHC Medicare,UHC Medicare,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,B2004,HIPPS,,,,,,,,Inpatient,,,211309.9789,211309.9789,Wellcare,Wellcare,211309.9789,,,,,,,case rate,1241,215536.1784,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Aetna Medicare,Aetna Medicare,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Cigna,Cigna,2914,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Cigna Medicare Advantage,Cigna Medicare Advantage,172849.1827,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Essence,Essence,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Humana Gold,Humana Gold,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Medica,Medica,2446,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Tricare,Tricare,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,172849.1827,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,UHC Medicare,UHC Medicare,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,C2004,HIPPS,,,,,,,,Inpatient,,,169459.9831,169459.9831,Wellcare,Wellcare,169459.9831,,,,,,,case rate,1241,172849.1827,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Aetna Medicare,Aetna Medicare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna,Cigna,2914,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Cigna Medicare Advantage,Cigna Medicare Advantage,160751.9839,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Essence,Essence,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Humana Gold,Humana Gold,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Medica,Medica,2446,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Tricare,Tricare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,160751.9839,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,UHC Medicare,UHC Medicare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A >=77.50,D2004,HIPPS,,,,,,,,Inpatient,,,157599.9842,157599.9842,Wellcare,Wellcare,157599.9842,,,,,,,case rate,1241,160751.9839,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Aetna Medicare,Aetna Medicare,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Cigna,Cigna,2914,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Cigna Medicare Advantage,Cigna Medicare Advantage,154030.1846,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Essence,Essence,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Humana Gold,Humana Gold,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Medica,Medica,2446,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Tricare,Tricare,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,154030.1846,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,UHC Medicare,UHC Medicare,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,A2005,HIPPS,,,,,,,,Inpatient,,,151009.9849,151009.9849,Wellcare,Wellcare,151009.9849,,,,,,,case rate,1241,154030.1846,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Aetna Medicare,Aetna Medicare,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Cigna,Cigna,2914,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Cigna Medicare Advantage,Cigna Medicare Advantage,225603.5774,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Essence,Essence,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Humana Gold,Humana Gold,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Medica,Medica,2446,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Tricare,Tricare,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,225603.5774,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,UHC Medicare,UHC Medicare,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,B2005,HIPPS,,,,,,,,Inpatient,,,221179.9779,221179.9779,Wellcare,Wellcare,221179.9779,,,,,,,case rate,1241,225603.5774,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Aetna Medicare,Aetna Medicare,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Cigna,Cigna,2914,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Cigna Medicare Advantage,Cigna Medicare Advantage,180927.5819,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Essence,Essence,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Humana Gold,Humana Gold,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Medica,Medica,2446,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Tricare,Tricare,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,180927.5819,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,UHC Medicare,UHC Medicare,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,C2005,HIPPS,,,,,,,,Inpatient,,,177379.9823,177379.9823,Wellcare,Wellcare,177379.9823,,,,,,,case rate,1241,180927.5819,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Aetna Medicare,Aetna Medicare,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Cigna,Cigna,2914,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Cigna Medicare Advantage,Cigna Medicare Advantage,168259.1832,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Essence,Essence,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Humana Gold,Humana Gold,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Medica,Medica,2446,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Tricare,Tricare,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,168259.1832,"Per diem rate, all codes are bundled into service package"
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,UHC Medicare,UHC Medicare,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Miscellaneous M <46.50 and A <77.50,D2005,HIPPS,,,,,,,,Inpatient,,,164959.9835,164959.9835,Wellcare,Wellcare,164959.9835,,,,,,,case rate,1241,168259.1832,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Aetna Medicare,Aetna Medicare,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Cigna,Cigna,2914,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Cigna Medicare Advantage,Cigna Medicare Advantage,99602.99004,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Essence,Essence,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Humana Gold,Humana Gold,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Medica,Medica,2446,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Tricare,Tricare,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,99602.99004,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,UHC Medicare,UHC Medicare,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,A2101,HIPPS,,,,,,,,Inpatient,,,97649.99024,97649.99024,Wellcare,Wellcare,97649.99024,,,,,,,case rate,1241,99602.99004,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Aetna Medicare,Aetna Medicare,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Cigna,Cigna,2914,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Cigna Medicare Advantage,Cigna Medicare Advantage,163822.1836,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Essence,Essence,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Humana Gold,Humana Gold,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Medica,Medica,2446,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Tricare,Tricare,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,163822.1836,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,UHC Medicare,UHC Medicare,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,B2101,HIPPS,,,,,,,,Inpatient,,,160609.9839,160609.9839,Wellcare,Wellcare,160609.9839,,,,,,,case rate,1241,163822.1836,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Aetna Medicare,Aetna Medicare,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Cigna,Cigna,2914,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Cigna Medicare Advantage,Cigna Medicare Advantage,137730.5862,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Essence,Essence,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Humana Gold,Humana Gold,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Medica,Medica,2446,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Tricare,Tricare,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,137730.5862,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,UHC Medicare,UHC Medicare,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,C2101,HIPPS,,,,,,,,Inpatient,,,135029.9865,135029.9865,Wellcare,Wellcare,135029.9865,,,,,,,case rate,1241,137730.5862,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Aetna Medicare,Aetna Medicare,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Cigna,Cigna,2914,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Cigna Medicare Advantage,Cigna Medicare Advantage,103866.5896,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Essence,Essence,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Humana Gold,Humana Gold,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Medica,Medica,2446,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Tricare,Tricare,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,103866.5896,"Per diem rate, all codes are bundled into service package"
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,UHC Medicare,UHC Medicare,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M >=52.50,D2101,HIPPS,,,,,,,,Inpatient,,,101829.9898,101829.9898,Wellcare,Wellcare,101829.9898,,,,,,,case rate,1241,103866.5896,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Aetna Medicare,Aetna Medicare,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Cigna,Cigna,2914,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Cigna Medicare Advantage,Cigna Medicare Advantage,157834.7842,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Essence,Essence,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Humana Gold,Humana Gold,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Medica,Medica,2446,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Tricare,Tricare,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,157834.7842,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,UHC Medicare,UHC Medicare,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,A2102,HIPPS,,,,,,,,Inpatient,,,154739.9845,154739.9845,Wellcare,Wellcare,154739.9845,,,,,,,case rate,1241,157834.7842,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Aetna Medicare,Aetna Medicare,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Cigna,Cigna,2914,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Cigna Medicare Advantage,Cigna Medicare Advantage,259600.174,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Essence,Essence,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Humana Gold,Humana Gold,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Medica,Medica,2446,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Tricare,Tricare,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,259600.174,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,UHC Medicare,UHC Medicare,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,B2102,HIPPS,,,,,,,,Inpatient,,,254509.9745,254509.9745,Wellcare,Wellcare,254509.9745,,,,,,,case rate,1241,259600.174,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Aetna Medicare,Aetna Medicare,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Cigna,Cigna,2914,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Cigna Medicare Advantage,Cigna Medicare Advantage,218249.3782,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Essence,Essence,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Humana Gold,Humana Gold,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Medica,Medica,2446,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Tricare,Tricare,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,218249.3782,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,UHC Medicare,UHC Medicare,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,C2102,HIPPS,,,,,,,,Inpatient,,,213969.9786,213969.9786,Wellcare,Wellcare,213969.9786,,,,,,,case rate,1241,218249.3782,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Aetna Medicare,Aetna Medicare,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Cigna,Cigna,2914,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Cigna Medicare Advantage,Cigna Medicare Advantage,164587.1835,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Essence,Essence,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Humana Gold,Humana Gold,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Medica,Medica,2446,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Tricare,Tricare,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,164587.1835,"Per diem rate, all codes are bundled into service package"
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,UHC Medicare,UHC Medicare,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
Burns M <52.50,D2102,HIPPS,,,,,,,,Inpatient,,,161359.9839,161359.9839,Wellcare,Wellcare,161359.9839,,,,,,,case rate,1241,164587.1835,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Aetna Medicare,Aetna Medicare,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Cigna,Cigna,2914,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Cigna Medicare Advantage,Cigna Medicare Advantage,17900.99821,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Essence,Essence,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Humana Gold,Humana Gold,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Medica,Medica,2446,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Tricare,Tricare,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,17900.99821,"Per diem rate, all codes are bundled into service package"
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,UHC Medicare,UHC Medicare,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Short-stay cases, length of stay is 3 days or fewer",A5001,HIPPS,,,,,,,,Inpatient,,,17549.99825,17549.99825,Wellcare,Wellcare,17549.99825,,,,,,,case rate,1241,17900.99821,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Aetna Medicare,Aetna Medicare,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Cigna,Cigna,2914,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Cigna Medicare Advantage,Cigna Medicare Advantage,87097.79129,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Essence,Essence,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Humana Gold,Humana Gold,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Medica,Medica,2446,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Tricare,Tricare,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,87097.79129,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,UHC Medicare,UHC Medicare,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 13 days or fewer",A5101,HIPPS,,,,,,,,Inpatient,,,85389.99146,85389.99146,Wellcare,Wellcare,85389.99146,,,,,,,case rate,1241,87097.79129,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Aetna Medicare,Aetna Medicare,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Cigna,Cigna,2914,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Cigna Medicare Advantage,Cigna Medicare Advantage,208946.9791,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Essence,Essence,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Humana Gold,Humana Gold,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Medica,Medica,2446,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Tricare,Tricare,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,208946.9791,"Per diem rate, all codes are bundled into service package"
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,UHC Medicare,UHC Medicare,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, orthopedic, length of stay is 14 days or more",A5102,HIPPS,,,,,,,,Inpatient,,,204849.9795,204849.9795,Wellcare,Wellcare,204849.9795,,,,,,,case rate,1241,208946.9791,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Aetna Medicare,Aetna Medicare,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Cigna,Cigna,2914,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Cigna Medicare Advantage,Cigna Medicare Advantage,93003.5907,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Essence,Essence,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Humana Gold,Humana Gold,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Medica,Medica,2446,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Tricare,Tricare,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,93003.5907,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,UHC Medicare,UHC Medicare,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 15 days or fewer",A5103,HIPPS,,,,,,,,Inpatient,,,91179.99088,91179.99088,Wellcare,Wellcare,91179.99088,,,,,,,case rate,1241,93003.5907,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2952,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Meritain Health PPO CPD,Meritain Health PPO CPD,2952,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Aetna/Commercial Product,Aetna/Commercial Product,2361,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Meritain Health CPD,Meritain Health CPD,2361,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Starmark CPD,Starmark CPD,2361,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Aetna Medicare,Aetna Medicare,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Ambetter ,Ambetter ,2619,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Anthem Blue Access,Anthem Blue Access,2491,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Anthem Blue Access Choice,Anthem Blue Access Choice,1630,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Anthem Blue Preferred,Anthem Blue Preferred,1347,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Anthem Pathway,Anthem Pathway,1241,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Anthem Alliance,Anthem Alliance,1500,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Cigna,Cigna,2914,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Cigna PPO,Cigna PPO,3305,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Cigna Medicare Advantage,Cigna Medicare Advantage,223186.1777,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Essence,Essence,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Healthlink HMO,Healthlink HMO,2131,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Healthlink PPO,Healthlink PPO,2579,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,HomeState Health Plan,HomeState Health Plan,1904.86,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Humana Gold,Humana Gold,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Medicaid MO,Medicaid MO,1763.76,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Medica,Medica,2446,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Tricare,Tricare,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,UHC All Payer,UHC All Payer,2763,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,UHC Exchange,UHC Exchange,2822,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,UHC Medicaid,UHC Medicaid,2028.32,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,UMR CPD,UMR CPD,2763,,,,,,,per diem,1241,223186.1777,"Per diem rate, all codes are bundled into service package"
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,UHC Medicare,UHC Medicare,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
"Expired, not orthopedic, length of stay is 16 days or more",A5104,HIPPS,,,,,,,,Inpatient,,,218809.9781,218809.9781,Wellcare,Wellcare,218809.9781,,,,,,,case rate,1241,223186.1777,Base Rate * Tier * Negotiated Percent
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Meritain Health PPO CPD,Meritain Health PPO CPD,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Aetna/Commercial Product,Aetna/Commercial Product,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Meritain Health CPD,Meritain Health CPD,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Starmark CPD,Starmark CPD,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Aetna Medicare,Aetna Medicare,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Ambetter ,Ambetter ,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Blue Access,Anthem Blue Access,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Blue Access Choice,Anthem Blue Access Choice,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Blue Preferred,Anthem Blue Preferred,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Pathway,Anthem Pathway,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Alliance,Anthem Alliance,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Anthem Medicare,Anthem Medicare,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Cigna,Cigna,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Cigna PPO,Cigna PPO,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Cigna Medicare Advantage,Cigna Medicare Advantage,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Essence,Essence,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Healthlink HMO,Healthlink HMO,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Healthlink PPO,Healthlink PPO,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,HomeState Health Plan,HomeState Health Plan,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Humana Gold,Humana Gold,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Medicaid MO,Medicaid MO,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Medica,Medica,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Tricare,Tricare,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,UHC All Payer,UHC All Payer,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,UHC Exchange,UHC Exchange,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,UHC Medicaid,UHC Medicaid,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,UMR CPD,UMR CPD,1458.43,,,,,,,per diem,1458.43,1458.43,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,UHC Medicare,UHC Medicare,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10600400,CDM,118,RC,,,,,,Inpatient,,,1458.43,1458.43,Wellcare,Wellcare,1458.43,,,,,,,case rate,1458.43,1458.43,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Meritain Health PPO CPD,Meritain Health PPO CPD,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Aetna/Commercial Product,Aetna/Commercial Product,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Meritain Health CPD,Meritain Health CPD,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Starmark CPD,Starmark CPD,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Aetna Medicare,Aetna Medicare,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Ambetter ,Ambetter ,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Blue Access,Anthem Blue Access,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Blue Access Choice,Anthem Blue Access Choice,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Blue Preferred,Anthem Blue Preferred,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Pathway,Anthem Pathway,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Alliance,Anthem Alliance,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Anthem Medicare,Anthem Medicare,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Cigna,Cigna,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Cigna PPO,Cigna PPO,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Cigna Medicare Advantage,Cigna Medicare Advantage,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Essence,Essence,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Healthlink HMO,Healthlink HMO,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Healthlink PPO,Healthlink PPO,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,HomeState Health Plan,HomeState Health Plan,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Humana Gold,Humana Gold,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Medicaid MO,Medicaid MO,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Medica,Medica,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Tricare,Tricare,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,UHC All Payer,UHC All Payer,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,UHC Exchange,UHC Exchange,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,UHC Medicaid,UHC Medicaid,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,UMR CPD,UMR CPD,1335.89,,,,,,,per diem,1335.89,1335.89,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,UHC Medicare,UHC Medicare,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10600450,CDM,128,RC,,,,,,Inpatient,,,1335.89,1335.89,Wellcare,Wellcare,1335.89,,,,,,,case rate,1335.89,1335.89,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Meritain Health PPO CPD,Meritain Health PPO CPD,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Aetna/Commercial Product,Aetna/Commercial Product,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Meritain Health CPD,Meritain Health CPD,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Starmark CPD,Starmark CPD,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Aetna Medicare,Aetna Medicare,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Ambetter ,Ambetter ,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Blue Access,Anthem Blue Access,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Blue Access Choice,Anthem Blue Access Choice,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Blue Preferred,Anthem Blue Preferred,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Pathway,Anthem Pathway,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Alliance,Anthem Alliance,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Anthem Medicare,Anthem Medicare,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Cigna,Cigna,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Cigna PPO,Cigna PPO,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Cigna Medicare Advantage,Cigna Medicare Advantage,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Essence,Essence,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Healthlink HMO,Healthlink HMO,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Healthlink PPO,Healthlink PPO,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,HomeState Health Plan,HomeState Health Plan,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Humana Gold,Humana Gold,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Medicaid MO,Medicaid MO,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Medica,Medica,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Tricare,Tricare,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,UHC All Payer,UHC All Payer,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,UHC Exchange,UHC Exchange,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,UHC Medicaid,UHC Medicaid,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,UMR CPD,UMR CPD,1284.5,,,,,,,per diem,1284.5,1284.5,"Per diem rate, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,UHC Medicare,UHC Medicare,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
3/4 BED REHAB SEMI-PRIVATE    ,10600460,CDM,138,RC,,,,,,Inpatient,,,1284.5,1284.5,Wellcare,Wellcare,1284.5,,,,,,,case rate,1284.5,1284.5,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Meritain Health PPO CPD,Meritain Health PPO CPD,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Aetna/Commercial Product,Aetna/Commercial Product,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Meritain Health CPD,Meritain Health CPD,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Starmark CPD,Starmark CPD,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Aetna Medicare,Aetna Medicare,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Ambetter ,Ambetter ,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Blue Access,Anthem Blue Access,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Blue Access Choice,Anthem Blue Access Choice,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Blue Preferred,Anthem Blue Preferred,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Pathway,Anthem Pathway,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Alliance,Anthem Alliance,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Anthem Medicare,Anthem Medicare,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Cigna,Cigna,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Cigna PPO,Cigna PPO,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Cigna Medicare Advantage,Cigna Medicare Advantage,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Essence,Essence,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Healthlink HMO,Healthlink HMO,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Healthlink PPO,Healthlink PPO,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,HomeState Health Plan,HomeState Health Plan,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Humana Gold,Humana Gold,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Medicaid MO,Medicaid MO,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Medica,Medica,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Tricare,Tricare,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,UHC All Payer,UHC All Payer,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,UHC Exchange,UHC Exchange,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,UHC Medicaid,UHC Medicaid,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,UMR CPD,UMR CPD,1302.8,,,,,,,per diem,1302.8,1302.8,"Per diem rate, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,UHC Medicare,UHC Medicare,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
DELUXE REHAB PRIVATE          ,10600470,CDM,148,RC,,,,,,Inpatient,,,1302.8,1302.8,Wellcare,Wellcare,1302.8,,,,,,,case rate,1302.8,1302.8,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Meritain Health PPO CPD,Meritain Health PPO CPD,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Aetna/Commercial Product,Aetna/Commercial Product,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Meritain Health CPD,Meritain Health CPD,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Starmark CPD,Starmark CPD,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Aetna Medicare,Aetna Medicare,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Ambetter ,Ambetter ,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Blue Access,Anthem Blue Access,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Blue Access Choice,Anthem Blue Access Choice,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Blue Preferred,Anthem Blue Preferred,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Pathway,Anthem Pathway,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Alliance,Anthem Alliance,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Anthem Medicare,Anthem Medicare,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Cigna,Cigna,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Cigna PPO,Cigna PPO,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Cigna Medicare Advantage,Cigna Medicare Advantage,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Essence,Essence,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Healthlink HMO,Healthlink HMO,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Healthlink PPO,Healthlink PPO,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,HomeState Health Plan,HomeState Health Plan,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Humana Gold,Humana Gold,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Medicaid MO,Medicaid MO,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Medica,Medica,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Tricare,Tricare,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,UHC All Payer,UHC All Payer,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,UHC Exchange,UHC Exchange,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,UHC Medicaid,UHC Medicaid,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,UMR CPD,UMR CPD,1193.33,,,,,,,per diem,1193.33,1193.33,"Per diem rate, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,UHC Medicare,UHC Medicare,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
WARD REHAB SEMI-PRIVATE       ,10600480,CDM,158,RC,,,,,,Inpatient,,,1193.33,1193.33,Wellcare,Wellcare,1193.33,,,,,,,case rate,1193.33,1193.33,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Meritain Health PPO CPD,Meritain Health PPO CPD,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Aetna/Commercial Product,Aetna/Commercial Product,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Meritain Health CPD,Meritain Health CPD,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Starmark CPD,Starmark CPD,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Aetna Medicare,Aetna Medicare,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Ambetter ,Ambetter ,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Blue Access,Anthem Blue Access,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Blue Access Choice,Anthem Blue Access Choice,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Blue Preferred,Anthem Blue Preferred,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Pathway,Anthem Pathway,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Alliance,Anthem Alliance,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Anthem Medicare,Anthem Medicare,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Cigna,Cigna,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Cigna PPO,Cigna PPO,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Cigna Medicare Advantage,Cigna Medicare Advantage,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Essence,Essence,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Healthlink HMO,Healthlink HMO,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Healthlink PPO,Healthlink PPO,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,HomeState Health Plan,HomeState Health Plan,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Humana Gold,Humana Gold,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Medicaid MO,Medicaid MO,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Medica,Medica,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Tricare,Tricare,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,UHC All Payer,UHC All Payer,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,UHC Exchange,UHC Exchange,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,UHC Medicaid,UHC Medicaid,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,UMR CPD,UMR CPD,1125.08,,,,,,,per diem,1125.08,1125.08,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,UHC Medicare,UHC Medicare,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB PRIVATE    ,10700400,CDM,118,RC,,,,,,Inpatient,,,1125.08,1125.08,Wellcare,Wellcare,1125.08,,,,,,,case rate,1125.08,1125.08,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Meritain Health PPO CPD,Meritain Health PPO CPD,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Aetna/Commercial Product,Aetna/Commercial Product,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Meritain Health CPD,Meritain Health CPD,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Starmark CPD,Starmark CPD,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Aetna Medicare,Aetna Medicare,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Ambetter ,Ambetter ,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Blue Access,Anthem Blue Access,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Blue Access Choice,Anthem Blue Access Choice,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Blue Preferred,Anthem Blue Preferred,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Pathway,Anthem Pathway,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Alliance,Anthem Alliance,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Anthem Medicare,Anthem Medicare,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Cigna,Cigna,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Cigna PPO,Cigna PPO,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Cigna Medicare Advantage,Cigna Medicare Advantage,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Essence,Essence,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Healthlink HMO,Healthlink HMO,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Healthlink PPO,Healthlink PPO,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,HomeState Health Plan,HomeState Health Plan,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Humana Gold,Humana Gold,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Medicaid MO,Medicaid MO,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Medica,Medica,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Tricare,Tricare,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,UHC All Payer,UHC All Payer,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,UHC Exchange,UHC Exchange,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,UHC Medicaid,UHC Medicaid,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,UMR CPD,UMR CPD,1117.67,,,,,,,per diem,1117.67,1117.67,"Per diem rate, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,UHC Medicare,UHC Medicare,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
INTERMEDIATE REHAB SEMI-PRIV  ,10700450,CDM,128,RC,,,,,,Inpatient,,,1117.67,1117.67,Wellcare,Wellcare,1117.67,,,,,,,case rate,1117.67,1117.67,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Meritain Health PPO CPD,Meritain Health PPO CPD,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Aetna/Commercial Product,Aetna/Commercial Product,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Meritain Health CPD,Meritain Health CPD,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Starmark CPD,Starmark CPD,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Aetna Medicare,Aetna Medicare,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Ambetter ,Ambetter ,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Blue Access,Anthem Blue Access,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Blue Access Choice,Anthem Blue Access Choice,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Blue Preferred,Anthem Blue Preferred,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Pathway,Anthem Pathway,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Alliance,Anthem Alliance,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Anthem Medicare,Anthem Medicare,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Cigna,Cigna,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Cigna PPO,Cigna PPO,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Cigna Medicare Advantage,Cigna Medicare Advantage,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Essence,Essence,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Healthlink HMO,Healthlink HMO,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Healthlink PPO,Healthlink PPO,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,HomeState Health Plan,HomeState Health Plan,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Humana Gold,Humana Gold,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Medicaid MO,Medicaid MO,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Medica,Medica,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Tricare,Tricare,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,UHC All Payer,UHC All Payer,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,UHC Exchange,UHC Exchange,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,UHC Medicaid,UHC Medicaid,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,UMR CPD,UMR CPD,2421.7,,,,,,,per diem,2421.7,2421.7,"Per diem rate, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,UHC Medicare,UHC Medicare,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HOSPITAL HOLD                 ,11000050,CDM,180,RC,,,,,,Inpatient,,,2421.7,2421.7,Wellcare,Wellcare,2421.7,,,,,,,case rate,2421.7,2421.7,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Meritain Health PPO CPD,Meritain Health PPO CPD,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Aetna/Commercial Product,Aetna/Commercial Product,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Meritain Health CPD,Meritain Health CPD,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Starmark CPD,Starmark CPD,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Aetna Medicare,Aetna Medicare,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Ambetter ,Ambetter ,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Blue Access,Anthem Blue Access,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Blue Access Choice,Anthem Blue Access Choice,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Blue Preferred,Anthem Blue Preferred,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Pathway,Anthem Pathway,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Alliance,Anthem Alliance,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Anthem Medicare,Anthem Medicare,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Cigna,Cigna,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Cigna PPO,Cigna PPO,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Cigna Medicare Advantage,Cigna Medicare Advantage,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Essence,Essence,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Healthlink HMO,Healthlink HMO,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Healthlink PPO,Healthlink PPO,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,HomeState Health Plan,HomeState Health Plan,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Humana Gold,Humana Gold,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Medicaid MO,Medicaid MO,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Medica,Medica,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Tricare,Tricare,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,UHC All Payer,UHC All Payer,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,UHC Exchange,UHC Exchange,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,UHC Medicaid,UHC Medicaid,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,UMR CPD,UMR CPD,122.57,,,,,,,per diem,122.57,122.57,"Per diem rate, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,UHC Medicare,UHC Medicare,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
HCHG EXTENDED RECOVERY PE     ,11400020,CDM,710,RC,,,,,,Inpatient,,,122.57,122.57,Wellcare,Wellcare,122.57,,,,,,,case rate,122.57,122.57,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Meritain Health PPO CPD,Meritain Health PPO CPD,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Aetna/Commercial Product,Aetna/Commercial Product,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Meritain Health CPD,Meritain Health CPD,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Starmark CPD,Starmark CPD,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Aetna Medicare,Aetna Medicare,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Ambetter ,Ambetter ,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Blue Access,Anthem Blue Access,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Blue Access Choice,Anthem Blue Access Choice,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Blue Preferred,Anthem Blue Preferred,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Pathway,Anthem Pathway,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Alliance,Anthem Alliance,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Anthem Medicare,Anthem Medicare,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Cigna,Cigna,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Cigna PPO,Cigna PPO,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Cigna Medicare Advantage,Cigna Medicare Advantage,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Essence,Essence,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Healthlink HMO,Healthlink HMO,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Healthlink PPO,Healthlink PPO,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,HomeState Health Plan,HomeState Health Plan,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Humana Gold,Humana Gold,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Medicaid MO,Medicaid MO,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Medica,Medica,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Tricare,Tricare,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,UHC All Payer,UHC All Payer,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,UHC Exchange,UHC Exchange,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,UHC Medicaid,UHC Medicaid,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,UMR CPD,UMR CPD,1686.11,,,,,,,per diem,1686.11,1686.11,"Per diem rate, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,UHC Medicare,UHC Medicare,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
CENTRAL LINE INSERTION        ,11600110,CDM,360,RC,36569,CPT,,,,Inpatient,,,1686.11,1686.11,Wellcare,Wellcare,1686.11,,,,,,,case rate,1686.11,1686.11,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Meritain Health PPO CPD,Meritain Health PPO CPD,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Aetna/Commercial Product,Aetna/Commercial Product,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Meritain Health CPD,Meritain Health CPD,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Starmark CPD,Starmark CPD,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Aetna Medicare,Aetna Medicare,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Ambetter ,Ambetter ,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Blue Access,Anthem Blue Access,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Blue Access Choice,Anthem Blue Access Choice,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Blue Preferred,Anthem Blue Preferred,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Pathway,Anthem Pathway,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Alliance,Anthem Alliance,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Anthem Medicare,Anthem Medicare,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Cigna,Cigna,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Cigna PPO,Cigna PPO,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Cigna Medicare Advantage,Cigna Medicare Advantage,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Essence,Essence,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Healthlink HMO,Healthlink HMO,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Healthlink PPO,Healthlink PPO,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,HomeState Health Plan,HomeState Health Plan,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Humana Gold,Humana Gold,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Medicaid MO,Medicaid MO,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Medica,Medica,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Tricare,Tricare,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,UHC All Payer,UHC All Payer,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,UHC Exchange,UHC Exchange,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,UHC Medicaid,UHC Medicaid,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,UMR CPD,UMR CPD,219.86,,,,,,,per diem,219.86,219.86,"Per diem rate, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,UHC Medicare,UHC Medicare,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
APPLY MULTI-LAYER VENOUS WND  ,11600806,CDM,361,RC,29581,CPT,,,,Inpatient,,,219.86,219.86,Wellcare,Wellcare,219.86,,,,,,,case rate,219.86,219.86,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Meritain Health PPO CPD,Meritain Health PPO CPD,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Aetna/Commercial Product,Aetna/Commercial Product,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Meritain Health CPD,Meritain Health CPD,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Starmark CPD,Starmark CPD,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Aetna Medicare,Aetna Medicare,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Ambetter ,Ambetter ,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Blue Access,Anthem Blue Access,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Blue Access Choice,Anthem Blue Access Choice,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Blue Preferred,Anthem Blue Preferred,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Pathway,Anthem Pathway,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Alliance,Anthem Alliance,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Anthem Medicare,Anthem Medicare,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Cigna,Cigna,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Cigna PPO,Cigna PPO,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Cigna Medicare Advantage,Cigna Medicare Advantage,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Essence,Essence,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Healthlink HMO,Healthlink HMO,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Healthlink PPO,Healthlink PPO,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,HomeState Health Plan,HomeState Health Plan,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Humana Gold,Humana Gold,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Medicaid MO,Medicaid MO,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Medica,Medica,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Tricare,Tricare,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,UHC All Payer,UHC All Payer,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,UHC Exchange,UHC Exchange,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,UHC Medicaid,UHC Medicaid,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,UMR CPD,UMR CPD,940.21,,,,,,,per diem,940.21,940.21,"Per diem rate, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,UHC Medicare,UHC Medicare,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
CYSTO W/REMOVE FB/CALCUL STENT,11600807,CDM,361,RC,52310,CPT,,,,Inpatient,,,940.21,940.21,Wellcare,Wellcare,940.21,,,,,,,case rate,940.21,940.21,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Meritain Health PPO CPD,Meritain Health PPO CPD,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Aetna/Commercial Product,Aetna/Commercial Product,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Meritain Health CPD,Meritain Health CPD,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Starmark CPD,Starmark CPD,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Aetna Medicare,Aetna Medicare,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Ambetter ,Ambetter ,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Blue Access,Anthem Blue Access,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Blue Access Choice,Anthem Blue Access Choice,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Blue Preferred,Anthem Blue Preferred,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Pathway,Anthem Pathway,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Alliance,Anthem Alliance,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Anthem Medicare,Anthem Medicare,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Cigna,Cigna,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Cigna PPO,Cigna PPO,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Cigna Medicare Advantage,Cigna Medicare Advantage,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Essence,Essence,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Healthlink HMO,Healthlink HMO,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Healthlink PPO,Healthlink PPO,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,HomeState Health Plan,HomeState Health Plan,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Humana Gold,Humana Gold,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Medicaid MO,Medicaid MO,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Medica,Medica,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Tricare,Tricare,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,UHC All Payer,UHC All Payer,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,UHC Exchange,UHC Exchange,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,UHC Medicaid,UHC Medicaid,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,UMR CPD,UMR CPD,1427.83,,,,,,,per diem,1427.83,1427.83,"Per diem rate, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,UHC Medicare,UHC Medicare,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
REMOVE TUNNELED CEN VEN CATH  ,11600808,CDM,261,RC,36589,CPT,,,,Inpatient,,,1427.83,1427.83,Wellcare,Wellcare,1427.83,,,,,,,case rate,1427.83,1427.83,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Meritain Health PPO CPD,Meritain Health PPO CPD,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Aetna/Commercial Product,Aetna/Commercial Product,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Meritain Health CPD,Meritain Health CPD,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Starmark CPD,Starmark CPD,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Aetna Medicare,Aetna Medicare,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Ambetter ,Ambetter ,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Blue Access,Anthem Blue Access,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Blue Access Choice,Anthem Blue Access Choice,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Blue Preferred,Anthem Blue Preferred,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Pathway,Anthem Pathway,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Alliance,Anthem Alliance,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Anthem Medicare,Anthem Medicare,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Cigna,Cigna,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Cigna PPO,Cigna PPO,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Cigna Medicare Advantage,Cigna Medicare Advantage,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Essence,Essence,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Healthlink HMO,Healthlink HMO,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Healthlink PPO,Healthlink PPO,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,HomeState Health Plan,HomeState Health Plan,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Humana Gold,Humana Gold,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Medicaid MO,Medicaid MO,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Medica,Medica,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Tricare,Tricare,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,UHC All Payer,UHC All Payer,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,UHC Exchange,UHC Exchange,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,UHC Medicaid,UHC Medicaid,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,UMR CPD,UMR CPD,1159.53,,,,,,,per diem,1159.53,1159.53,"Per diem rate, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,UHC Medicare,UHC Medicare,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
RENAL BIOPSY PERC             ,11600809,CDM,360,RC,50200,CPT,,,,Inpatient,,,1159.53,1159.53,Wellcare,Wellcare,1159.53,,,,,,,case rate,1159.53,1159.53,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Meritain Health PPO CPD,Meritain Health PPO CPD,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Aetna/Commercial Product,Aetna/Commercial Product,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Meritain Health CPD,Meritain Health CPD,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Starmark CPD,Starmark CPD,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Aetna Medicare,Aetna Medicare,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Ambetter ,Ambetter ,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Blue Access,Anthem Blue Access,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Blue Access Choice,Anthem Blue Access Choice,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Blue Preferred,Anthem Blue Preferred,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Pathway,Anthem Pathway,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Alliance,Anthem Alliance,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Anthem Medicare,Anthem Medicare,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Cigna,Cigna,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Cigna PPO,Cigna PPO,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Cigna Medicare Advantage,Cigna Medicare Advantage,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Essence,Essence,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Healthlink HMO,Healthlink HMO,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Healthlink PPO,Healthlink PPO,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,HomeState Health Plan,HomeState Health Plan,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Humana Gold,Humana Gold,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Medicaid MO,Medicaid MO,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Medica,Medica,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Tricare,Tricare,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,UHC All Payer,UHC All Payer,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,UHC Exchange,UHC Exchange,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,UHC Medicaid,UHC Medicaid,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,UMR CPD,UMR CPD,71.28,,,,,,,per diem,71.28,71.28,"Per diem rate, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,UHC Medicare,UHC Medicare,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
BOOT CASTING XL               ,33105807,CDM,270,RC,,,,,,Inpatient,,,71.28,71.28,Wellcare,Wellcare,71.28,,,,,,,case rate,71.28,71.28,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Meritain Health PPO CPD,Meritain Health PPO CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna/Commercial Product,Aetna/Commercial Product,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Meritain Health CPD,Meritain Health CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Starmark CPD,Starmark CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna Medicare,Aetna Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Ambetter ,Ambetter ,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access,Anthem Blue Access,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access Choice,Anthem Blue Access Choice,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Preferred,Anthem Blue Preferred,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Pathway,Anthem Pathway,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Alliance,Anthem Alliance,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Medicare,Anthem Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna,Cigna,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna PPO,Cigna PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna Medicare Advantage,Cigna Medicare Advantage,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Essence,Essence,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthlink HMO,Healthlink HMO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthlink PPO,Healthlink PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,HomeState Health Plan,HomeState Health Plan,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Humana Gold,Humana Gold,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Medicaid MO,Medicaid MO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Medica,Medica,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Tricare,Tricare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC All Payer,UHC All Payer,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Exchange,UHC Exchange,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Medicaid,UHC Medicaid,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,UMR CPD,UMR CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Medicare,UHC Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
SUPPORT HAND WRIST CARROT     ,33105844,CDM,270,RC,,,,,,Inpatient,,,63,63,Wellcare,Wellcare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health PPO CPD,Meritain Health PPO CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/Commercial Product,Aetna/Commercial Product,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health CPD,Meritain Health CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Starmark CPD,Starmark CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna Medicare,Aetna Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Ambetter ,Ambetter ,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access,Anthem Blue Access,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access Choice,Anthem Blue Access Choice,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Preferred,Anthem Blue Preferred,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Pathway,Anthem Pathway,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Alliance,Anthem Alliance,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Medicare,Anthem Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna,Cigna,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna PPO,Cigna PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna Medicare Advantage,Cigna Medicare Advantage,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Essence,Essence,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink HMO,Healthlink HMO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink PPO,Healthlink PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,HomeState Health Plan,HomeState Health Plan,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Humana Gold,Humana Gold,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Medicaid MO,Medicaid MO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Medica,Medica,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Tricare,Tricare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC All Payer,UHC All Payer,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Exchange,UHC Exchange,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicaid,UHC Medicaid,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,UMR CPD,UMR CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicare,UHC Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZAA2.25""",33105845,CDM,270,RC,,,,,,Inpatient,,,59,59,Wellcare,Wellcare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health PPO CPD,Meritain Health PPO CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/Commercial Product,Aetna/Commercial Product,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health CPD,Meritain Health CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Starmark CPD,Starmark CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna Medicare,Aetna Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Ambetter ,Ambetter ,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access,Anthem Blue Access,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access Choice,Anthem Blue Access Choice,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Preferred,Anthem Blue Preferred,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Pathway,Anthem Pathway,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Alliance,Anthem Alliance,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Medicare,Anthem Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna,Cigna,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna PPO,Cigna PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna Medicare Advantage,Cigna Medicare Advantage,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Essence,Essence,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink HMO,Healthlink HMO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink PPO,Healthlink PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,HomeState Health Plan,HomeState Health Plan,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Humana Gold,Humana Gold,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Medicaid MO,Medicaid MO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Medica,Medica,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Tricare,Tricare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC All Payer,UHC All Payer,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Exchange,UHC Exchange,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicaid,UHC Medicaid,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,UMR CPD,UMR CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicare,UHC Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZA2.625""",33105846,CDM,270,RC,,,,,,Inpatient,,,59,59,Wellcare,Wellcare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health PPO CPD,Meritain Health PPO CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/Commercial Product,Aetna/Commercial Product,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health CPD,Meritain Health CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Starmark CPD,Starmark CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna Medicare,Aetna Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Ambetter ,Ambetter ,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access,Anthem Blue Access,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access Choice,Anthem Blue Access Choice,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Preferred,Anthem Blue Preferred,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Pathway,Anthem Pathway,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Alliance,Anthem Alliance,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Medicare,Anthem Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna,Cigna,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna PPO,Cigna PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna Medicare Advantage,Cigna Medicare Advantage,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Essence,Essence,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink HMO,Healthlink HMO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink PPO,Healthlink PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,HomeState Health Plan,HomeState Health Plan,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Humana Gold,Humana Gold,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Medicaid MO,Medicaid MO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Medica,Medica,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Tricare,Tricare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC All Payer,UHC All Payer,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Exchange,UHC Exchange,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicaid,UHC Medicaid,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,UMR CPD,UMR CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicare,UHC Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
"SPLINT FNGR EXT ASST SZC3.125""",33105847,CDM,270,RC,,,,,,Inpatient,,,59,59,Wellcare,Wellcare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-SMALL  ,33105848,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE SMALL    ,33105849,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MEDIUM   ,33105850,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE MED/LG   ,33105851,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE LARGE    ,33105852,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST CLOSED TOE X-LARGE  ,33105853,CDM,270,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Meritain Health PPO CPD,Meritain Health PPO CPD,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Aetna/Commercial Product,Aetna/Commercial Product,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Meritain Health CPD,Meritain Health CPD,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Starmark CPD,Starmark CPD,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Aetna Medicare,Aetna Medicare,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Ambetter ,Ambetter ,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Blue Access,Anthem Blue Access,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Blue Access Choice,Anthem Blue Access Choice,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Blue Preferred,Anthem Blue Preferred,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Pathway,Anthem Pathway,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Alliance,Anthem Alliance,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Anthem Medicare,Anthem Medicare,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Cigna,Cigna,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Cigna PPO,Cigna PPO,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Cigna Medicare Advantage,Cigna Medicare Advantage,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Essence,Essence,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Healthlink HMO,Healthlink HMO,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Healthlink PPO,Healthlink PPO,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,HomeState Health Plan,HomeState Health Plan,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Humana Gold,Humana Gold,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Medicaid MO,Medicaid MO,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Medica,Medica,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Tricare,Tricare,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,UHC All Payer,UHC All Payer,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,UHC Exchange,UHC Exchange,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,UHC Medicaid,UHC Medicaid,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,UMR CPD,UMR CPD,41,,,,,,,per diem,41,41,"Per diem rate, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,UHC Medicare,UHC Medicare,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
SHOE CAST OPEN TOE MED/LG     ,33105854,CDM,270,RC,,,,,,Inpatient,,,41,41,Wellcare,Wellcare,41,,,,,,,case rate,41,41,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Meritain Health PPO CPD,Meritain Health PPO CPD,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Aetna/Commercial Product,Aetna/Commercial Product,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Meritain Health CPD,Meritain Health CPD,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Starmark CPD,Starmark CPD,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Aetna Medicare,Aetna Medicare,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Ambetter ,Ambetter ,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Blue Access,Anthem Blue Access,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Blue Access Choice,Anthem Blue Access Choice,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Blue Preferred,Anthem Blue Preferred,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Pathway,Anthem Pathway,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Alliance,Anthem Alliance,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Anthem Medicare,Anthem Medicare,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Cigna,Cigna,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Cigna PPO,Cigna PPO,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Cigna Medicare Advantage,Cigna Medicare Advantage,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Essence,Essence,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Healthlink HMO,Healthlink HMO,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Healthlink PPO,Healthlink PPO,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,HomeState Health Plan,HomeState Health Plan,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Humana Gold,Humana Gold,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Medicaid MO,Medicaid MO,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Medica,Medica,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Tricare,Tricare,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,UHC All Payer,UHC All Payer,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,UHC Exchange,UHC Exchange,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,UHC Medicaid,UHC Medicaid,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,UMR CPD,UMR CPD,92,,,,,,,per diem,92,92,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,UHC Medicare,UHC Medicare,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL OPPO PREM LG  ,33105855,CDM,270,RC,,,,,,Inpatient,,,92,92,Wellcare,Wellcare,92,,,,,,,case rate,92,92,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Meritain Health PPO CPD,Meritain Health PPO CPD,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Aetna/Commercial Product,Aetna/Commercial Product,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Meritain Health CPD,Meritain Health CPD,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Starmark CPD,Starmark CPD,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Aetna Medicare,Aetna Medicare,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Ambetter ,Ambetter ,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Blue Access,Anthem Blue Access,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Blue Access Choice,Anthem Blue Access Choice,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Blue Preferred,Anthem Blue Preferred,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Pathway,Anthem Pathway,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Alliance,Anthem Alliance,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Anthem Medicare,Anthem Medicare,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Cigna,Cigna,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Cigna PPO,Cigna PPO,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Cigna Medicare Advantage,Cigna Medicare Advantage,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Essence,Essence,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Healthlink HMO,Healthlink HMO,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Healthlink PPO,Healthlink PPO,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,HomeState Health Plan,HomeState Health Plan,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Humana Gold,Humana Gold,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Medicaid MO,Medicaid MO,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Medica,Medica,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Tricare,Tricare,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,UHC All Payer,UHC All Payer,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,UHC Exchange,UHC Exchange,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,UHC Medicaid,UHC Medicaid,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,UMR CPD,UMR CPD,539,,,,,,,per diem,539,539,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,UHC Medicare,UHC Medicare,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS ADULT   ,33106404,CDM,270,RC,,,,,,Inpatient,,,539,539,Wellcare,Wellcare,539,,,,,,,case rate,539,539,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Meritain Health PPO CPD,Meritain Health PPO CPD,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Aetna/Commercial Product,Aetna/Commercial Product,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Meritain Health CPD,Meritain Health CPD,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Starmark CPD,Starmark CPD,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Aetna Medicare,Aetna Medicare,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Ambetter ,Ambetter ,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Blue Access,Anthem Blue Access,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Blue Access Choice,Anthem Blue Access Choice,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Blue Preferred,Anthem Blue Preferred,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Pathway,Anthem Pathway,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Alliance,Anthem Alliance,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Anthem Medicare,Anthem Medicare,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Cigna,Cigna,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Cigna PPO,Cigna PPO,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Cigna Medicare Advantage,Cigna Medicare Advantage,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Essence,Essence,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Healthlink HMO,Healthlink HMO,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Healthlink PPO,Healthlink PPO,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,HomeState Health Plan,HomeState Health Plan,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Humana Gold,Humana Gold,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Medicaid MO,Medicaid MO,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Medica,Medica,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Tricare,Tricare,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,UHC All Payer,UHC All Payer,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,UHC Exchange,UHC Exchange,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,UHC Medicaid,UHC Medicaid,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,UMR CPD,UMR CPD,768,,,,,,,per diem,768,768,"Per diem rate, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,UHC Medicare,UHC Medicare,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
POSITIONER PATNT TRTS BARIATRC,33106405,CDM,270,RC,,,,,,Inpatient,,,768,768,Wellcare,Wellcare,768,,,,,,,case rate,768,768,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Meritain Health PPO CPD,Meritain Health PPO CPD,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Aetna/Commercial Product,Aetna/Commercial Product,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Meritain Health CPD,Meritain Health CPD,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Starmark CPD,Starmark CPD,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Aetna Medicare,Aetna Medicare,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Ambetter ,Ambetter ,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Blue Access,Anthem Blue Access,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Blue Access Choice,Anthem Blue Access Choice,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Blue Preferred,Anthem Blue Preferred,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Pathway,Anthem Pathway,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Alliance,Anthem Alliance,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Anthem Medicare,Anthem Medicare,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Cigna,Cigna,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Cigna PPO,Cigna PPO,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Cigna Medicare Advantage,Cigna Medicare Advantage,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Essence,Essence,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Healthlink HMO,Healthlink HMO,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Healthlink PPO,Healthlink PPO,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,HomeState Health Plan,HomeState Health Plan,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Humana Gold,Humana Gold,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Medicaid MO,Medicaid MO,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Medica,Medica,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Tricare,Tricare,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,UHC All Payer,UHC All Payer,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,UHC Exchange,UHC Exchange,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,UHC Medicaid,UHC Medicaid,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,UMR CPD,UMR CPD,18.42,,,,,,,per diem,18.42,18.42,"Per diem rate, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,UHC Medicare,UHC Medicare,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
DRESSING HYDROFERA BLUEFOAM4X5,33109273,CDM,270,RC,,,,,,Inpatient,,,18.42,18.42,Wellcare,Wellcare,18.42,,,,,,,case rate,18.42,18.42,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Meritain Health PPO CPD,Meritain Health PPO CPD,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Aetna/Commercial Product,Aetna/Commercial Product,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Meritain Health CPD,Meritain Health CPD,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Starmark CPD,Starmark CPD,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Aetna Medicare,Aetna Medicare,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Ambetter ,Ambetter ,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Blue Access,Anthem Blue Access,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Blue Access Choice,Anthem Blue Access Choice,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Blue Preferred,Anthem Blue Preferred,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Pathway,Anthem Pathway,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Alliance,Anthem Alliance,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Anthem Medicare,Anthem Medicare,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Cigna,Cigna,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Cigna PPO,Cigna PPO,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Cigna Medicare Advantage,Cigna Medicare Advantage,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Essence,Essence,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Healthlink HMO,Healthlink HMO,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Healthlink PPO,Healthlink PPO,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,HomeState Health Plan,HomeState Health Plan,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Humana Gold,Humana Gold,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Medicaid MO,Medicaid MO,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Medica,Medica,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Tricare,Tricare,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,UHC All Payer,UHC All Payer,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,UHC Exchange,UHC Exchange,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,UHC Medicaid,UHC Medicaid,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,UMR CPD,UMR CPD,28.14,,,,,,,per diem,28.14,28.14,"Per diem rate, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,UHC Medicare,UHC Medicare,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
BANDAGE COMP 4LAYER FOURFLEX  ,33111446,CDM,270,RC,,,,,,Inpatient,,,28.14,28.14,Wellcare,Wellcare,28.14,,,,,,,case rate,28.14,28.14,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Meritain Health PPO CPD,Meritain Health PPO CPD,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Aetna/Commercial Product,Aetna/Commercial Product,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Meritain Health CPD,Meritain Health CPD,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Starmark CPD,Starmark CPD,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Aetna Medicare,Aetna Medicare,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Ambetter ,Ambetter ,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Blue Access,Anthem Blue Access,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Blue Access Choice,Anthem Blue Access Choice,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Blue Preferred,Anthem Blue Preferred,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Pathway,Anthem Pathway,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Alliance,Anthem Alliance,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Anthem Medicare,Anthem Medicare,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Cigna,Cigna,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Cigna PPO,Cigna PPO,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Cigna Medicare Advantage,Cigna Medicare Advantage,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Essence,Essence,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Healthlink HMO,Healthlink HMO,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Healthlink PPO,Healthlink PPO,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,HomeState Health Plan,HomeState Health Plan,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Humana Gold,Humana Gold,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Medicaid MO,Medicaid MO,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Medica,Medica,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Tricare,Tricare,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,UHC All Payer,UHC All Payer,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,UHC Exchange,UHC Exchange,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,UHC Medicaid,UHC Medicaid,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,UMR CPD,UMR CPD,6.81,,,,,,,per diem,6.81,6.81,"Per diem rate, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,UHC Medicare,UHC Medicare,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
DRSG BIATAIN SOFT HOLD 4X4    ,33118600,CDM,270,RC,,,,,,Inpatient,,,6.81,6.81,Wellcare,Wellcare,6.81,,,,,,,case rate,6.81,6.81,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health PPO CPD,Meritain Health PPO CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/Commercial Product,Aetna/Commercial Product,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health CPD,Meritain Health CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Starmark CPD,Starmark CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna Medicare,Aetna Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Ambetter ,Ambetter ,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access,Anthem Blue Access,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access Choice,Anthem Blue Access Choice,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Preferred,Anthem Blue Preferred,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Pathway,Anthem Pathway,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Alliance,Anthem Alliance,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Medicare,Anthem Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna,Cigna,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna PPO,Cigna PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna Medicare Advantage,Cigna Medicare Advantage,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Essence,Essence,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink HMO,Healthlink HMO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink PPO,Healthlink PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,HomeState Health Plan,HomeState Health Plan,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Humana Gold,Humana Gold,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Medicaid MO,Medicaid MO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Medica,Medica,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Tricare,Tricare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC All Payer,UHC All Payer,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Exchange,UHC Exchange,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicaid,UHC Medicaid,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,UMR CPD,UMR CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicare,UHC Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE SM,33120101,CDM,270,RC,,,,,,Inpatient,,,540,540,Wellcare,Wellcare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health PPO CPD,Meritain Health PPO CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/Commercial Product,Aetna/Commercial Product,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health CPD,Meritain Health CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Starmark CPD,Starmark CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna Medicare,Aetna Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Ambetter ,Ambetter ,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access,Anthem Blue Access,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access Choice,Anthem Blue Access Choice,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Preferred,Anthem Blue Preferred,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Pathway,Anthem Pathway,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Alliance,Anthem Alliance,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Medicare,Anthem Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna,Cigna,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna PPO,Cigna PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna Medicare Advantage,Cigna Medicare Advantage,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Essence,Essence,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink HMO,Healthlink HMO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink PPO,Healthlink PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,HomeState Health Plan,HomeState Health Plan,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Humana Gold,Humana Gold,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Medicaid MO,Medicaid MO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Medica,Medica,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Tricare,Tricare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC All Payer,UHC All Payer,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Exchange,UHC Exchange,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicaid,UHC Medicaid,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,UMR CPD,UMR CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicare,UHC Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE LG,33120102,CDM,270,RC,,,,,,Inpatient,,,540,540,Wellcare,Wellcare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health PPO CPD,Meritain Health PPO CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna/Commercial Product,Aetna/Commercial Product,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Meritain Health CPD,Meritain Health CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Starmark CPD,Starmark CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Aetna Medicare,Aetna Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Ambetter ,Ambetter ,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access,Anthem Blue Access,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Access Choice,Anthem Blue Access Choice,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Blue Preferred,Anthem Blue Preferred,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Pathway,Anthem Pathway,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Alliance,Anthem Alliance,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Anthem Medicare,Anthem Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna,Cigna,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna PPO,Cigna PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Cigna Medicare Advantage,Cigna Medicare Advantage,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Essence,Essence,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink HMO,Healthlink HMO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Healthlink PPO,Healthlink PPO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,HomeState Health Plan,HomeState Health Plan,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Humana Gold,Humana Gold,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Medicaid MO,Medicaid MO,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Medica,Medica,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Tricare,Tricare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC All Payer,UHC All Payer,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Exchange,UHC Exchange,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicaid,UHC Medicaid,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,UMR CPD,UMR CPD,540,,,,,,,per diem,540,540,"Per diem rate, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,UHC Medicare,UHC Medicare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
ORTH KNEE SOFT ROM COMPLETE XL,33120103,CDM,270,RC,,,,,,Inpatient,,,540,540,Wellcare,Wellcare,540,,,,,,,case rate,540,540,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Meritain Health PPO CPD,Meritain Health PPO CPD,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Aetna/Commercial Product,Aetna/Commercial Product,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Meritain Health CPD,Meritain Health CPD,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Starmark CPD,Starmark CPD,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Aetna Medicare,Aetna Medicare,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Ambetter ,Ambetter ,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Blue Access,Anthem Blue Access,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Blue Access Choice,Anthem Blue Access Choice,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Blue Preferred,Anthem Blue Preferred,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Pathway,Anthem Pathway,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Alliance,Anthem Alliance,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Anthem Medicare,Anthem Medicare,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Cigna,Cigna,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Cigna PPO,Cigna PPO,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Cigna Medicare Advantage,Cigna Medicare Advantage,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Essence,Essence,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Healthlink HMO,Healthlink HMO,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Healthlink PPO,Healthlink PPO,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,HomeState Health Plan,HomeState Health Plan,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Humana Gold,Humana Gold,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Medicaid MO,Medicaid MO,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Medica,Medica,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Tricare,Tricare,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,UHC All Payer,UHC All Payer,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,UHC Exchange,UHC Exchange,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,UHC Medicaid,UHC Medicaid,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,UMR CPD,UMR CPD,35.64,,,,,,,per diem,35.64,35.64,"Per diem rate, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,UHC Medicare,UHC Medicare,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
DRESSING BARR SIL ACT 4X8     ,33123879,CDM,270,RC,,,,,,Inpatient,,,35.64,35.64,Wellcare,Wellcare,35.64,,,,,,,case rate,35.64,35.64,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Meritain Health PPO CPD,Meritain Health PPO CPD,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Aetna/Commercial Product,Aetna/Commercial Product,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Meritain Health CPD,Meritain Health CPD,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Starmark CPD,Starmark CPD,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Aetna Medicare,Aetna Medicare,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Ambetter ,Ambetter ,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Blue Access,Anthem Blue Access,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Blue Access Choice,Anthem Blue Access Choice,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Blue Preferred,Anthem Blue Preferred,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Pathway,Anthem Pathway,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Alliance,Anthem Alliance,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Anthem Medicare,Anthem Medicare,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Cigna,Cigna,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Cigna PPO,Cigna PPO,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Cigna Medicare Advantage,Cigna Medicare Advantage,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Essence,Essence,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Healthlink HMO,Healthlink HMO,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Healthlink PPO,Healthlink PPO,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,HomeState Health Plan,HomeState Health Plan,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Humana Gold,Humana Gold,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Medicaid MO,Medicaid MO,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Medica,Medica,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Tricare,Tricare,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,UHC All Payer,UHC All Payer,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,UHC Exchange,UHC Exchange,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,UHC Medicaid,UHC Medicaid,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,UMR CPD,UMR CPD,12.56,,,,,,,per diem,12.56,12.56,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,UHC Medicare,UHC Medicare,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL / ELBOW, KNIT ",33124721,CDM,270,RC,,,,,,Inpatient,,,12.56,12.56,Wellcare,Wellcare,12.56,,,,,,,case rate,12.56,12.56,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Meritain Health PPO CPD,Meritain Health PPO CPD,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Aetna/Commercial Product,Aetna/Commercial Product,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Meritain Health CPD,Meritain Health CPD,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Starmark CPD,Starmark CPD,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Aetna Medicare,Aetna Medicare,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Ambetter ,Ambetter ,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Blue Access,Anthem Blue Access,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Blue Access Choice,Anthem Blue Access Choice,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Blue Preferred,Anthem Blue Preferred,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Pathway,Anthem Pathway,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Alliance,Anthem Alliance,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Anthem Medicare,Anthem Medicare,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Cigna,Cigna,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Cigna PPO,Cigna PPO,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Cigna Medicare Advantage,Cigna Medicare Advantage,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Essence,Essence,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Healthlink HMO,Healthlink HMO,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Healthlink PPO,Healthlink PPO,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,HomeState Health Plan,HomeState Health Plan,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Humana Gold,Humana Gold,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Medicaid MO,Medicaid MO,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Medica,Medica,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Tricare,Tricare,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,UHC All Payer,UHC All Payer,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,UHC Exchange,UHC Exchange,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,UHC Medicaid,UHC Medicaid,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,UMR CPD,UMR CPD,53.79,,,,,,,per diem,53.79,53.79,"Per diem rate, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,UHC Medicare,UHC Medicare,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"CHAIR, SHOWER, W/BACK         ",33124728,CDM,279,RC,,,,,,Inpatient,,,53.79,53.79,Wellcare,Wellcare,53.79,,,,,,,case rate,53.79,53.79,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Meritain Health PPO CPD,Meritain Health PPO CPD,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Aetna/Commercial Product,Aetna/Commercial Product,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Meritain Health CPD,Meritain Health CPD,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Starmark CPD,Starmark CPD,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Aetna Medicare,Aetna Medicare,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Ambetter ,Ambetter ,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Blue Access,Anthem Blue Access,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Blue Access Choice,Anthem Blue Access Choice,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Blue Preferred,Anthem Blue Preferred,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Pathway,Anthem Pathway,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Alliance,Anthem Alliance,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Anthem Medicare,Anthem Medicare,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Cigna,Cigna,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Cigna PPO,Cigna PPO,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Cigna Medicare Advantage,Cigna Medicare Advantage,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Essence,Essence,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Healthlink HMO,Healthlink HMO,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Healthlink PPO,Healthlink PPO,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,HomeState Health Plan,HomeState Health Plan,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Humana Gold,Humana Gold,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Medicaid MO,Medicaid MO,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Medica,Medica,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Tricare,Tricare,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,UHC All Payer,UHC All Payer,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,UHC Exchange,UHC Exchange,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,UHC Medicaid,UHC Medicaid,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,UMR CPD,UMR CPD,23.77,,,,,,,per diem,23.77,23.77,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,UHC Medicare,UHC Medicare,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, MEDIUM",33124738,CDM,270,RC,,,,,,Inpatient,,,23.77,23.77,Wellcare,Wellcare,23.77,,,,,,,case rate,23.77,23.77,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NAVY    ",33124741,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health PPO CPD,Meritain Health PPO CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/Commercial Product,Aetna/Commercial Product,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health CPD,Meritain Health CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Starmark CPD,Starmark CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna Medicare,Aetna Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Ambetter ,Ambetter ,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access,Anthem Blue Access,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access Choice,Anthem Blue Access Choice,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Preferred,Anthem Blue Preferred,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Pathway,Anthem Pathway,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Alliance,Anthem Alliance,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Medicare,Anthem Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna,Cigna,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna PPO,Cigna PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna Medicare Advantage,Cigna Medicare Advantage,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Essence,Essence,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink HMO,Healthlink HMO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink PPO,Healthlink PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,HomeState Health Plan,HomeState Health Plan,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Humana Gold,Humana Gold,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medicaid MO,Medicaid MO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medica,Medica,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Tricare,Tricare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC All Payer,UHC All Payer,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Exchange,UHC Exchange,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicaid,UHC Medicaid,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UMR CPD,UMR CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicare,UHC Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"HOE, POST-OP, RIGID, NVY      ",33124742,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Wellcare,Wellcare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health PPO CPD,Meritain Health PPO CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/Commercial Product,Aetna/Commercial Product,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health CPD,Meritain Health CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Starmark CPD,Starmark CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna Medicare,Aetna Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Ambetter ,Ambetter ,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access,Anthem Blue Access,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access Choice,Anthem Blue Access Choice,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Preferred,Anthem Blue Preferred,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Pathway,Anthem Pathway,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Alliance,Anthem Alliance,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Medicare,Anthem Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna,Cigna,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna PPO,Cigna PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna Medicare Advantage,Cigna Medicare Advantage,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Essence,Essence,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink HMO,Healthlink HMO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink PPO,Healthlink PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,HomeState Health Plan,HomeState Health Plan,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Humana Gold,Humana Gold,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medicaid MO,Medicaid MO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medica,Medica,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Tricare,Tricare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC All Payer,UHC All Payer,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Exchange,UHC Exchange,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicaid,UHC Medicaid,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UMR CPD,UMR CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicare,UHC Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGID, NVY     ",33124743,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Wellcare,Wellcare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health PPO CPD,Meritain Health PPO CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna/Commercial Product,Aetna/Commercial Product,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Meritain Health CPD,Meritain Health CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Starmark CPD,Starmark CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Aetna Medicare,Aetna Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Ambetter ,Ambetter ,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access,Anthem Blue Access,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Access Choice,Anthem Blue Access Choice,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Blue Preferred,Anthem Blue Preferred,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Pathway,Anthem Pathway,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Alliance,Anthem Alliance,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Anthem Medicare,Anthem Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna,Cigna,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna PPO,Cigna PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Cigna Medicare Advantage,Cigna Medicare Advantage,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Essence,Essence,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink HMO,Healthlink HMO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Healthlink PPO,Healthlink PPO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,HomeState Health Plan,HomeState Health Plan,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Humana Gold,Humana Gold,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medicaid MO,Medicaid MO,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Medica,Medica,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Tricare,Tricare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC All Payer,UHC All Payer,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Exchange,UHC Exchange,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicaid,UHC Medicaid,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UMR CPD,UMR CPD,19.38,,,,,,,per diem,19.38,19.38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,UHC Medicare,UHC Medicare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP, RIGD, NVY      ",33124744,CDM,270,RC,,,,,,Inpatient,,,19.38,19.38,Wellcare,Wellcare,19.38,,,,,,,case rate,19.38,19.38,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Meritain Health PPO CPD,Meritain Health PPO CPD,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Aetna/Commercial Product,Aetna/Commercial Product,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Meritain Health CPD,Meritain Health CPD,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Starmark CPD,Starmark CPD,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Aetna Medicare,Aetna Medicare,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Ambetter ,Ambetter ,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Blue Access,Anthem Blue Access,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Blue Access Choice,Anthem Blue Access Choice,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Blue Preferred,Anthem Blue Preferred,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Pathway,Anthem Pathway,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Alliance,Anthem Alliance,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Anthem Medicare,Anthem Medicare,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Cigna,Cigna,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Cigna PPO,Cigna PPO,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Cigna Medicare Advantage,Cigna Medicare Advantage,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Essence,Essence,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Healthlink HMO,Healthlink HMO,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Healthlink PPO,Healthlink PPO,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,HomeState Health Plan,HomeState Health Plan,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Humana Gold,Humana Gold,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Medicaid MO,Medicaid MO,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Medica,Medica,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Tricare,Tricare,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,UHC All Payer,UHC All Payer,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,UHC Exchange,UHC Exchange,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,UHC Medicaid,UHC Medicaid,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,UMR CPD,UMR CPD,405,,,,,,,per diem,405,405,"Per diem rate, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,UHC Medicare,UHC Medicare,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
WHEELCHAIR                    ,33124759,CDM,279,RC,,,,,,Inpatient,,,405,405,Wellcare,Wellcare,405,,,,,,,case rate,405,405,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Meritain Health PPO CPD,Meritain Health PPO CPD,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Aetna/Commercial Product,Aetna/Commercial Product,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Meritain Health CPD,Meritain Health CPD,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Starmark CPD,Starmark CPD,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Aetna Medicare,Aetna Medicare,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Ambetter ,Ambetter ,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Blue Access,Anthem Blue Access,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Blue Access Choice,Anthem Blue Access Choice,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Blue Preferred,Anthem Blue Preferred,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Pathway,Anthem Pathway,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Alliance,Anthem Alliance,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Anthem Medicare,Anthem Medicare,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Cigna,Cigna,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Cigna PPO,Cigna PPO,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Cigna Medicare Advantage,Cigna Medicare Advantage,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Essence,Essence,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Healthlink HMO,Healthlink HMO,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Healthlink PPO,Healthlink PPO,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,HomeState Health Plan,HomeState Health Plan,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Humana Gold,Humana Gold,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Medicaid MO,Medicaid MO,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Medica,Medica,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Tricare,Tricare,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,UHC All Payer,UHC All Payer,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,UHC Exchange,UHC Exchange,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,UHC Medicaid,UHC Medicaid,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,UMR CPD,UMR CPD,28.52,,,,,,,per diem,28.52,28.52,"Per diem rate, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,UHC Medicare,UHC Medicare,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
"PROTECTOR, HEEL, ELBOW, WHT   ",33124776,CDM,270,RC,,,,,,Inpatient,,,28.52,28.52,Wellcare,Wellcare,28.52,,,,,,,case rate,28.52,28.52,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT LG    ,33124827,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT MED   ,33124828,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Meritain Health PPO CPD,Meritain Health PPO CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna/Commercial Product,Aetna/Commercial Product,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Meritain Health CPD,Meritain Health CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Starmark CPD,Starmark CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna Medicare,Aetna Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Ambetter ,Ambetter ,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Access,Anthem Blue Access,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Access Choice,Anthem Blue Access Choice,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Preferred,Anthem Blue Preferred,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Pathway,Anthem Pathway,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Alliance,Anthem Alliance,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Medicare,Anthem Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna,Cigna,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna PPO,Cigna PPO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna Medicare Advantage,Cigna Medicare Advantage,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Essence,Essence,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthlink HMO,Healthlink HMO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthlink PPO,Healthlink PPO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,HomeState Health Plan,HomeState Health Plan,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Humana Gold,Humana Gold,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Medicaid MO,Medicaid MO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Medica,Medica,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Tricare,Tricare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC All Payer,UHC All Payer,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Exchange,UHC Exchange,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Medicaid,UHC Medicaid,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UMR CPD,UMR CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Medicare,UHC Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPRO IN-BED AFO BOOT XL    ,33124829,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Wellcare,Wellcare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Meritain Health PPO CPD,Meritain Health PPO CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna/Commercial Product,Aetna/Commercial Product,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Meritain Health CPD,Meritain Health CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Starmark CPD,Starmark CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Aetna Medicare,Aetna Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Ambetter ,Ambetter ,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Access,Anthem Blue Access,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Access Choice,Anthem Blue Access Choice,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Blue Preferred,Anthem Blue Preferred,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Pathway,Anthem Pathway,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Alliance,Anthem Alliance,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Anthem Medicare,Anthem Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna,Cigna,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna PPO,Cigna PPO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Cigna Medicare Advantage,Cigna Medicare Advantage,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Essence,Essence,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthlink HMO,Healthlink HMO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Healthlink PPO,Healthlink PPO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,HomeState Health Plan,HomeState Health Plan,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Humana Gold,Humana Gold,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Medicaid MO,Medicaid MO,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Medica,Medica,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Tricare,Tricare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC All Payer,UHC All Payer,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Exchange,UHC Exchange,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Medicaid,UHC Medicaid,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UMR CPD,UMR CPD,103.47,,,,,,,per diem,103.47,103.47,"Per diem rate, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,UHC Medicare,UHC Medicare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
SOFTPROF IN-BED AFO BOOT SM   ,33124854,CDM,270,RC,,,,,,Inpatient,,,103.47,103.47,Wellcare,Wellcare,103.47,,,,,,,case rate,103.47,103.47,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO, LARGE, L    ",33124859,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM,L     ",33124860,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"LEEDER REST WHFO,MEDIUM, R    ",33124861,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Meritain Health PPO CPD,Meritain Health PPO CPD,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Aetna/Commercial Product,Aetna/Commercial Product,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Meritain Health CPD,Meritain Health CPD,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Starmark CPD,Starmark CPD,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Aetna Medicare,Aetna Medicare,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Ambetter ,Ambetter ,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Blue Access,Anthem Blue Access,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Blue Access Choice,Anthem Blue Access Choice,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Blue Preferred,Anthem Blue Preferred,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Pathway,Anthem Pathway,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Alliance,Anthem Alliance,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Anthem Medicare,Anthem Medicare,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Cigna,Cigna,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Cigna PPO,Cigna PPO,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Cigna Medicare Advantage,Cigna Medicare Advantage,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Essence,Essence,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Healthlink HMO,Healthlink HMO,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Healthlink PPO,Healthlink PPO,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,HomeState Health Plan,HomeState Health Plan,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Humana Gold,Humana Gold,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Medicaid MO,Medicaid MO,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Medica,Medica,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Tricare,Tricare,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,UHC All Payer,UHC All Payer,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,UHC Exchange,UHC Exchange,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,UHC Medicaid,UHC Medicaid,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,UMR CPD,UMR CPD,10.29,,,,,,,per diem,10.29,10.29,"Per diem rate, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,UHC Medicare,UHC Medicare,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
CPM - CHATANUGA REMOTE PENDANT,33124863,CDM,279,RC,,,,,,Inpatient,,,10.29,10.29,Wellcare,Wellcare,10.29,,,,,,,case rate,10.29,10.29,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Meritain Health PPO CPD,Meritain Health PPO CPD,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Aetna/Commercial Product,Aetna/Commercial Product,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Meritain Health CPD,Meritain Health CPD,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Starmark CPD,Starmark CPD,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Aetna Medicare,Aetna Medicare,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Ambetter ,Ambetter ,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Blue Access,Anthem Blue Access,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Blue Access Choice,Anthem Blue Access Choice,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Blue Preferred,Anthem Blue Preferred,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Pathway,Anthem Pathway,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Alliance,Anthem Alliance,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Anthem Medicare,Anthem Medicare,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Cigna,Cigna,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Cigna PPO,Cigna PPO,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Cigna Medicare Advantage,Cigna Medicare Advantage,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Essence,Essence,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Healthlink HMO,Healthlink HMO,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Healthlink PPO,Healthlink PPO,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,HomeState Health Plan,HomeState Health Plan,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Humana Gold,Humana Gold,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Medicaid MO,Medicaid MO,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Medica,Medica,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Tricare,Tricare,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,UHC All Payer,UHC All Payer,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,UHC Exchange,UHC Exchange,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,UHC Medicaid,UHC Medicaid,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,UMR CPD,UMR CPD,139.86,,,,,,,per diem,139.86,139.86,"Per diem rate, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,UHC Medicare,UHC Medicare,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
GIVMOHR SLING LARGE           ,33124871,CDM,270,RC,,,,,,Inpatient,,,139.86,139.86,Wellcare,Wellcare,139.86,,,,,,,case rate,139.86,139.86,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Meritain Health PPO CPD,Meritain Health PPO CPD,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Aetna/Commercial Product,Aetna/Commercial Product,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Meritain Health CPD,Meritain Health CPD,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Starmark CPD,Starmark CPD,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Aetna Medicare,Aetna Medicare,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Ambetter ,Ambetter ,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Blue Access,Anthem Blue Access,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Blue Access Choice,Anthem Blue Access Choice,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Blue Preferred,Anthem Blue Preferred,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Pathway,Anthem Pathway,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Alliance,Anthem Alliance,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Anthem Medicare,Anthem Medicare,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Cigna,Cigna,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Cigna PPO,Cigna PPO,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Cigna Medicare Advantage,Cigna Medicare Advantage,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Essence,Essence,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Healthlink HMO,Healthlink HMO,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Healthlink PPO,Healthlink PPO,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,HomeState Health Plan,HomeState Health Plan,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Humana Gold,Humana Gold,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Medicaid MO,Medicaid MO,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Medica,Medica,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Tricare,Tricare,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,UHC All Payer,UHC All Payer,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,UHC Exchange,UHC Exchange,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,UHC Medicaid,UHC Medicaid,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,UMR CPD,UMR CPD,65.63,,,,,,,per diem,65.63,65.63,"Per diem rate, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,UHC Medicare,UHC Medicare,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
BOOT HEEL PROT HEELMEXIX BASIC,33124894,CDM,270,RC,,,,,,Inpatient,,,65.63,65.63,Wellcare,Wellcare,65.63,,,,,,,case rate,65.63,65.63,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health PPO CPD,Meritain Health PPO CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/Commercial Product,Aetna/Commercial Product,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health CPD,Meritain Health CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Starmark CPD,Starmark CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna Medicare,Aetna Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Ambetter ,Ambetter ,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access,Anthem Blue Access,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access Choice,Anthem Blue Access Choice,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Preferred,Anthem Blue Preferred,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Pathway,Anthem Pathway,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Alliance,Anthem Alliance,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Medicare,Anthem Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna,Cigna,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna PPO,Cigna PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna Medicare Advantage,Cigna Medicare Advantage,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Essence,Essence,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink HMO,Healthlink HMO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink PPO,Healthlink PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,HomeState Health Plan,HomeState Health Plan,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Humana Gold,Humana Gold,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medicaid MO,Medicaid MO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medica,Medica,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Tricare,Tricare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC All Payer,UHC All Payer,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Exchange,UHC Exchange,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicaid,UHC Medicaid,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UMR CPD,UMR CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicare,UHC Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL L      ,33124901,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Wellcare,Wellcare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health PPO CPD,Meritain Health PPO CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/Commercial Product,Aetna/Commercial Product,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health CPD,Meritain Health CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Starmark CPD,Starmark CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna Medicare,Aetna Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Ambetter ,Ambetter ,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access,Anthem Blue Access,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access Choice,Anthem Blue Access Choice,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Preferred,Anthem Blue Preferred,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Pathway,Anthem Pathway,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Alliance,Anthem Alliance,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Medicare,Anthem Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna,Cigna,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna PPO,Cigna PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna Medicare Advantage,Cigna Medicare Advantage,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Essence,Essence,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink HMO,Healthlink HMO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink PPO,Healthlink PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,HomeState Health Plan,HomeState Health Plan,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Humana Gold,Humana Gold,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medicaid MO,Medicaid MO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medica,Medica,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Tricare,Tricare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC All Payer,UHC All Payer,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Exchange,UHC Exchange,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicaid,UHC Medicaid,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UMR CPD,UMR CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicare,UHC Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO SMALL R      ,33124902,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Wellcare,Wellcare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health PPO CPD,Meritain Health PPO CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna/Commercial Product,Aetna/Commercial Product,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Meritain Health CPD,Meritain Health CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Starmark CPD,Starmark CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Aetna Medicare,Aetna Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Ambetter ,Ambetter ,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access,Anthem Blue Access,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Access Choice,Anthem Blue Access Choice,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Blue Preferred,Anthem Blue Preferred,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Pathway,Anthem Pathway,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Alliance,Anthem Alliance,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Anthem Medicare,Anthem Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna,Cigna,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna PPO,Cigna PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Cigna Medicare Advantage,Cigna Medicare Advantage,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Essence,Essence,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink HMO,Healthlink HMO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Healthlink PPO,Healthlink PPO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,HomeState Health Plan,HomeState Health Plan,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Humana Gold,Humana Gold,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medicaid MO,Medicaid MO,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Medica,Medica,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Tricare,Tricare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC All Payer,UHC All Payer,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Exchange,UHC Exchange,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicaid,UHC Medicaid,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UMR CPD,UMR CPD,122.19,,,,,,,per diem,122.19,122.19,"Per diem rate, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,UHC Medicare,UHC Medicare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
LEEDER REST WHFO LARGE R      ,33124903,CDM,270,RC,,,,,,Inpatient,,,122.19,122.19,Wellcare,Wellcare,122.19,,,,,,,case rate,122.19,122.19,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN LEFT LR,33124909,CDM,270,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
SPLINT THUMB SPICA 6IN RT LG  ,33124910,CDM,270,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Meritain Health PPO CPD,Meritain Health PPO CPD,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Aetna/Commercial Product,Aetna/Commercial Product,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Meritain Health CPD,Meritain Health CPD,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Starmark CPD,Starmark CPD,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Aetna Medicare,Aetna Medicare,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Ambetter ,Ambetter ,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Blue Access,Anthem Blue Access,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Blue Access Choice,Anthem Blue Access Choice,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Blue Preferred,Anthem Blue Preferred,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Pathway,Anthem Pathway,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Alliance,Anthem Alliance,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Anthem Medicare,Anthem Medicare,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Cigna,Cigna,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Cigna PPO,Cigna PPO,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Cigna Medicare Advantage,Cigna Medicare Advantage,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Essence,Essence,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Healthlink HMO,Healthlink HMO,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Healthlink PPO,Healthlink PPO,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,HomeState Health Plan,HomeState Health Plan,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Humana Gold,Humana Gold,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Medicaid MO,Medicaid MO,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Medica,Medica,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Tricare,Tricare,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,UHC All Payer,UHC All Payer,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,UHC Exchange,UHC Exchange,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,UHC Medicaid,UHC Medicaid,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,UMR CPD,UMR CPD,149.91,,,,,,,per diem,149.91,149.91,"Per diem rate, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,UHC Medicare,UHC Medicare,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
OVERLAY WAFFLE EC PLS 76X34X3 ,33124913,CDM,279,RC,,,,,,Inpatient,,,149.91,149.91,Wellcare,Wellcare,149.91,,,,,,,case rate,149.91,149.91,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Meritain Health PPO CPD,Meritain Health PPO CPD,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Aetna/Commercial Product,Aetna/Commercial Product,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Meritain Health CPD,Meritain Health CPD,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Starmark CPD,Starmark CPD,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Aetna Medicare,Aetna Medicare,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Ambetter ,Ambetter ,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Blue Access,Anthem Blue Access,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Blue Access Choice,Anthem Blue Access Choice,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Blue Preferred,Anthem Blue Preferred,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Pathway,Anthem Pathway,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Alliance,Anthem Alliance,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Anthem Medicare,Anthem Medicare,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Cigna,Cigna,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Cigna PPO,Cigna PPO,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Cigna Medicare Advantage,Cigna Medicare Advantage,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Essence,Essence,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Healthlink HMO,Healthlink HMO,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Healthlink PPO,Healthlink PPO,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,HomeState Health Plan,HomeState Health Plan,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Humana Gold,Humana Gold,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Medicaid MO,Medicaid MO,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Medica,Medica,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Tricare,Tricare,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,UHC All Payer,UHC All Payer,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,UHC Exchange,UHC Exchange,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,UHC Medicaid,UHC Medicaid,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,UMR CPD,UMR CPD,389.98,,,,,,,per diem,389.98,389.98,"Per diem rate, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,UHC Medicare,UHC Medicare,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
VISION BIPAP MACHINE DAILY REN,33125233,CDM,279,RC,,,,,,Inpatient,,,389.98,389.98,Wellcare,Wellcare,389.98,,,,,,,case rate,389.98,389.98,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Meritain Health PPO CPD,Meritain Health PPO CPD,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Aetna/Commercial Product,Aetna/Commercial Product,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Meritain Health CPD,Meritain Health CPD,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Starmark CPD,Starmark CPD,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Aetna Medicare,Aetna Medicare,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Ambetter ,Ambetter ,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Blue Access,Anthem Blue Access,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Blue Access Choice,Anthem Blue Access Choice,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Blue Preferred,Anthem Blue Preferred,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Pathway,Anthem Pathway,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Alliance,Anthem Alliance,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Anthem Medicare,Anthem Medicare,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Cigna,Cigna,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Cigna PPO,Cigna PPO,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Cigna Medicare Advantage,Cigna Medicare Advantage,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Essence,Essence,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Healthlink HMO,Healthlink HMO,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Healthlink PPO,Healthlink PPO,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,HomeState Health Plan,HomeState Health Plan,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Humana Gold,Humana Gold,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Medicaid MO,Medicaid MO,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Medica,Medica,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Tricare,Tricare,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,UHC All Payer,UHC All Payer,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,UHC Exchange,UHC Exchange,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,UHC Medicaid,UHC Medicaid,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,UMR CPD,UMR CPD,943.49,,,,,,,per diem,943.49,943.49,"Per diem rate, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,UHC Medicare,UHC Medicare,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
RENASYS WOUND VAC GO PUMP DAIL,33125236,CDM,279,RC,,,,,,Inpatient,,,943.49,943.49,Wellcare,Wellcare,943.49,,,,,,,case rate,943.49,943.49,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Meritain Health PPO CPD,Meritain Health PPO CPD,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Aetna/Commercial Product,Aetna/Commercial Product,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Meritain Health CPD,Meritain Health CPD,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Starmark CPD,Starmark CPD,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Aetna Medicare,Aetna Medicare,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Ambetter ,Ambetter ,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Blue Access,Anthem Blue Access,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Blue Access Choice,Anthem Blue Access Choice,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Blue Preferred,Anthem Blue Preferred,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Pathway,Anthem Pathway,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Alliance,Anthem Alliance,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Anthem Medicare,Anthem Medicare,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Cigna,Cigna,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Cigna PPO,Cigna PPO,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Cigna Medicare Advantage,Cigna Medicare Advantage,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Essence,Essence,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Healthlink HMO,Healthlink HMO,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Healthlink PPO,Healthlink PPO,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,HomeState Health Plan,HomeState Health Plan,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Humana Gold,Humana Gold,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Medicaid MO,Medicaid MO,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Medica,Medica,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Tricare,Tricare,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,UHC All Payer,UHC All Payer,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,UHC Exchange,UHC Exchange,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,UHC Medicaid,UHC Medicaid,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,UMR CPD,UMR CPD,6.46,,,,,,,per diem,6.46,6.46,"Per diem rate, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,UHC Medicare,UHC Medicare,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
KANGAROO EXTERNAL FEEDING PUMP,33125237,CDM,279,RC,,,,,,Inpatient,,,6.46,6.46,Wellcare,Wellcare,6.46,,,,,,,case rate,6.46,6.46,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Meritain Health PPO CPD,Meritain Health PPO CPD,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Aetna/Commercial Product,Aetna/Commercial Product,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Meritain Health CPD,Meritain Health CPD,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Starmark CPD,Starmark CPD,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Aetna Medicare,Aetna Medicare,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Ambetter ,Ambetter ,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Blue Access,Anthem Blue Access,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Blue Access Choice,Anthem Blue Access Choice,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Blue Preferred,Anthem Blue Preferred,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Pathway,Anthem Pathway,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Alliance,Anthem Alliance,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Anthem Medicare,Anthem Medicare,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Cigna,Cigna,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Cigna PPO,Cigna PPO,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Cigna Medicare Advantage,Cigna Medicare Advantage,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Essence,Essence,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Healthlink HMO,Healthlink HMO,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Healthlink PPO,Healthlink PPO,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,HomeState Health Plan,HomeState Health Plan,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Humana Gold,Humana Gold,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Medicaid MO,Medicaid MO,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Medica,Medica,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Tricare,Tricare,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,UHC All Payer,UHC All Payer,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,UHC Exchange,UHC Exchange,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,UHC Medicaid,UHC Medicaid,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,UMR CPD,UMR CPD,1671.1,,,,,,,per diem,1671.1,1671.1,"Per diem rate, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,UHC Medicare,UHC Medicare,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED (1000LBS) DAILY ,33125238,CDM,279,RC,,,,,,Inpatient,,,1671.1,1671.1,Wellcare,Wellcare,1671.1,,,,,,,case rate,1671.1,1671.1,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Meritain Health PPO CPD,Meritain Health PPO CPD,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Aetna/Commercial Product,Aetna/Commercial Product,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Meritain Health CPD,Meritain Health CPD,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Starmark CPD,Starmark CPD,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Aetna Medicare,Aetna Medicare,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Ambetter ,Ambetter ,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Blue Access,Anthem Blue Access,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Blue Access Choice,Anthem Blue Access Choice,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Blue Preferred,Anthem Blue Preferred,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Pathway,Anthem Pathway,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Alliance,Anthem Alliance,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Anthem Medicare,Anthem Medicare,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Cigna,Cigna,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Cigna PPO,Cigna PPO,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Cigna Medicare Advantage,Cigna Medicare Advantage,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Essence,Essence,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Healthlink HMO,Healthlink HMO,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Healthlink PPO,Healthlink PPO,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,HomeState Health Plan,HomeState Health Plan,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Humana Gold,Humana Gold,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Medicaid MO,Medicaid MO,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Medica,Medica,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Tricare,Tricare,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,UHC All Payer,UHC All Payer,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,UHC Exchange,UHC Exchange,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,UHC Medicaid,UHC Medicaid,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,UMR CPD,UMR CPD,1965.6,,,,,,,per diem,1965.6,1965.6,"Per diem rate, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,UHC Medicare,UHC Medicare,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
STAGE IV 3000 LAL MATTRESS    ,33125239,CDM,279,RC,,,,,,Inpatient,,,1965.6,1965.6,Wellcare,Wellcare,1965.6,,,,,,,case rate,1965.6,1965.6,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Meritain Health PPO CPD,Meritain Health PPO CPD,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Aetna/Commercial Product,Aetna/Commercial Product,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Meritain Health CPD,Meritain Health CPD,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Starmark CPD,Starmark CPD,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Aetna Medicare,Aetna Medicare,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Ambetter ,Ambetter ,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Blue Access,Anthem Blue Access,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Blue Access Choice,Anthem Blue Access Choice,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Blue Preferred,Anthem Blue Preferred,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Pathway,Anthem Pathway,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Alliance,Anthem Alliance,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Anthem Medicare,Anthem Medicare,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Cigna,Cigna,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Cigna PPO,Cigna PPO,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Cigna Medicare Advantage,Cigna Medicare Advantage,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Essence,Essence,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Healthlink HMO,Healthlink HMO,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Healthlink PPO,Healthlink PPO,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,HomeState Health Plan,HomeState Health Plan,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Humana Gold,Humana Gold,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Medicaid MO,Medicaid MO,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Medica,Medica,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Tricare,Tricare,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,UHC All Payer,UHC All Payer,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,UHC Exchange,UHC Exchange,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,UHC Medicaid,UHC Medicaid,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,UMR CPD,UMR CPD,944.42,,,,,,,per diem,944.42,944.42,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,UHC Medicare,UHC Medicare,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS FOAM (500LB L,33125241,CDM,279,RC,,,,,,Inpatient,,,944.42,944.42,Wellcare,Wellcare,944.42,,,,,,,case rate,944.42,944.42,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Meritain Health PPO CPD,Meritain Health PPO CPD,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Aetna/Commercial Product,Aetna/Commercial Product,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Meritain Health CPD,Meritain Health CPD,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Starmark CPD,Starmark CPD,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Aetna Medicare,Aetna Medicare,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Ambetter ,Ambetter ,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Blue Access,Anthem Blue Access,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Blue Access Choice,Anthem Blue Access Choice,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Blue Preferred,Anthem Blue Preferred,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Pathway,Anthem Pathway,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Alliance,Anthem Alliance,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Anthem Medicare,Anthem Medicare,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Cigna,Cigna,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Cigna PPO,Cigna PPO,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Cigna Medicare Advantage,Cigna Medicare Advantage,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Essence,Essence,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Healthlink HMO,Healthlink HMO,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Healthlink PPO,Healthlink PPO,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,HomeState Health Plan,HomeState Health Plan,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Humana Gold,Humana Gold,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Medicaid MO,Medicaid MO,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Medica,Medica,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Tricare,Tricare,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,UHC All Payer,UHC All Payer,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,UHC Exchange,UHC Exchange,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,UHC Medicaid,UHC Medicaid,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,UMR CPD,UMR CPD,377.4,,,,,,,per diem,377.4,377.4,"Per diem rate, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,UHC Medicare,UHC Medicare,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
AIR 2 LAL PULSATE MATTRESS    ,33125242,CDM,279,RC,,,,,,Inpatient,,,377.4,377.4,Wellcare,Wellcare,377.4,,,,,,,case rate,377.4,377.4,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Meritain Health PPO CPD,Meritain Health PPO CPD,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Aetna/Commercial Product,Aetna/Commercial Product,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Meritain Health CPD,Meritain Health CPD,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Starmark CPD,Starmark CPD,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Aetna Medicare,Aetna Medicare,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Ambetter ,Ambetter ,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Blue Access,Anthem Blue Access,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Blue Access Choice,Anthem Blue Access Choice,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Blue Preferred,Anthem Blue Preferred,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Pathway,Anthem Pathway,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Alliance,Anthem Alliance,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Anthem Medicare,Anthem Medicare,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Cigna,Cigna,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Cigna PPO,Cigna PPO,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Cigna Medicare Advantage,Cigna Medicare Advantage,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Essence,Essence,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Healthlink HMO,Healthlink HMO,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Healthlink PPO,Healthlink PPO,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,HomeState Health Plan,HomeState Health Plan,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Humana Gold,Humana Gold,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Medicaid MO,Medicaid MO,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Medica,Medica,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Tricare,Tricare,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,UHC All Payer,UHC All Payer,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,UHC Exchange,UHC Exchange,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,UHC Medicaid,UHC Medicaid,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,UMR CPD,UMR CPD,11.65,,,,,,,per diem,11.65,11.65,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,UHC Medicare,UHC Medicare,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33125296,CDM,270,RC,,,,,,Inpatient,,,11.65,11.65,Wellcare,Wellcare,11.65,,,,,,,case rate,11.65,11.65,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Meritain Health PPO CPD,Meritain Health PPO CPD,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Aetna/Commercial Product,Aetna/Commercial Product,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Meritain Health CPD,Meritain Health CPD,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Starmark CPD,Starmark CPD,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Aetna Medicare,Aetna Medicare,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Ambetter ,Ambetter ,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Blue Access,Anthem Blue Access,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Blue Access Choice,Anthem Blue Access Choice,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Blue Preferred,Anthem Blue Preferred,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Pathway,Anthem Pathway,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Alliance,Anthem Alliance,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Anthem Medicare,Anthem Medicare,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Cigna,Cigna,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Cigna PPO,Cigna PPO,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Cigna Medicare Advantage,Cigna Medicare Advantage,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Essence,Essence,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Healthlink HMO,Healthlink HMO,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Healthlink PPO,Healthlink PPO,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,HomeState Health Plan,HomeState Health Plan,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Humana Gold,Humana Gold,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Medicaid MO,Medicaid MO,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Medica,Medica,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Tricare,Tricare,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,UHC All Payer,UHC All Payer,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,UHC Exchange,UHC Exchange,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,UHC Medicaid,UHC Medicaid,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,UMR CPD,UMR CPD,181.95,,,,,,,per diem,181.95,181.95,"Per diem rate, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,UHC Medicare,UHC Medicare,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
HEEL PRESSURE RELIEVING BOOT  ,33125298,CDM,270,RC,,,,,,Inpatient,,,181.95,181.95,Wellcare,Wellcare,181.95,,,,,,,case rate,181.95,181.95,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Meritain Health PPO CPD,Meritain Health PPO CPD,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Aetna/Commercial Product,Aetna/Commercial Product,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Meritain Health CPD,Meritain Health CPD,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Starmark CPD,Starmark CPD,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Aetna Medicare,Aetna Medicare,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Ambetter ,Ambetter ,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Blue Access,Anthem Blue Access,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Blue Access Choice,Anthem Blue Access Choice,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Blue Preferred,Anthem Blue Preferred,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Pathway,Anthem Pathway,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Alliance,Anthem Alliance,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Anthem Medicare,Anthem Medicare,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Cigna,Cigna,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Cigna PPO,Cigna PPO,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Cigna Medicare Advantage,Cigna Medicare Advantage,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Essence,Essence,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Healthlink HMO,Healthlink HMO,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Healthlink PPO,Healthlink PPO,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,HomeState Health Plan,HomeState Health Plan,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Humana Gold,Humana Gold,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Medicaid MO,Medicaid MO,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Medica,Medica,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Tricare,Tricare,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,UHC All Payer,UHC All Payer,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,UHC Exchange,UHC Exchange,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,UHC Medicaid,UHC Medicaid,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,UMR CPD,UMR CPD,49.82,,,,,,,per diem,49.82,49.82,"Per diem rate, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,UHC Medicare,UHC Medicare,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
PILLOW ABDUCT DSPB SM 6X12X18 ,33125320,CDM,270,RC,,,,,,Inpatient,,,49.82,49.82,Wellcare,Wellcare,49.82,,,,,,,case rate,49.82,49.82,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Meritain Health PPO CPD,Meritain Health PPO CPD,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Aetna/Commercial Product,Aetna/Commercial Product,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Meritain Health CPD,Meritain Health CPD,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Starmark CPD,Starmark CPD,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Aetna Medicare,Aetna Medicare,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Ambetter ,Ambetter ,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Blue Access,Anthem Blue Access,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Blue Access Choice,Anthem Blue Access Choice,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Blue Preferred,Anthem Blue Preferred,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Pathway,Anthem Pathway,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Alliance,Anthem Alliance,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Anthem Medicare,Anthem Medicare,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Cigna,Cigna,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Cigna PPO,Cigna PPO,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Cigna Medicare Advantage,Cigna Medicare Advantage,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Essence,Essence,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Healthlink HMO,Healthlink HMO,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Healthlink PPO,Healthlink PPO,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,HomeState Health Plan,HomeState Health Plan,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Humana Gold,Humana Gold,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Medicaid MO,Medicaid MO,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Medica,Medica,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Tricare,Tricare,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,UHC All Payer,UHC All Payer,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,UHC Exchange,UHC Exchange,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,UHC Medicaid,UHC Medicaid,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,UMR CPD,UMR CPD,97.34,,,,,,,per diem,97.34,97.34,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,UHC Medicare,UHC Medicare,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATTRESS         ,33125330,CDM,279,RC,,,,,,Inpatient,,,97.34,97.34,Wellcare,Wellcare,97.34,,,,,,,case rate,97.34,97.34,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Meritain Health PPO CPD,Meritain Health PPO CPD,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Aetna/Commercial Product,Aetna/Commercial Product,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Meritain Health CPD,Meritain Health CPD,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Starmark CPD,Starmark CPD,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Aetna Medicare,Aetna Medicare,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Ambetter ,Ambetter ,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Blue Access,Anthem Blue Access,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Blue Access Choice,Anthem Blue Access Choice,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Blue Preferred,Anthem Blue Preferred,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Pathway,Anthem Pathway,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Alliance,Anthem Alliance,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Anthem Medicare,Anthem Medicare,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Cigna,Cigna,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Cigna PPO,Cigna PPO,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Cigna Medicare Advantage,Cigna Medicare Advantage,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Essence,Essence,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Healthlink HMO,Healthlink HMO,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Healthlink PPO,Healthlink PPO,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,HomeState Health Plan,HomeState Health Plan,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Humana Gold,Humana Gold,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Medicaid MO,Medicaid MO,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Medica,Medica,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Tricare,Tricare,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,UHC All Payer,UHC All Payer,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,UHC Exchange,UHC Exchange,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,UHC Medicaid,UHC Medicaid,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,UMR CPD,UMR CPD,74.88,,,,,,,per diem,74.88,74.88,"Per diem rate, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,UHC Medicare,UHC Medicare,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
VISION BIPAP/CPAP             ,33125356,CDM,279,RC,,,,,,Inpatient,,,74.88,74.88,Wellcare,Wellcare,74.88,,,,,,,case rate,74.88,74.88,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Meritain Health PPO CPD,Meritain Health PPO CPD,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Aetna/Commercial Product,Aetna/Commercial Product,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Meritain Health CPD,Meritain Health CPD,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Starmark CPD,Starmark CPD,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Aetna Medicare,Aetna Medicare,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Ambetter ,Ambetter ,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Blue Access,Anthem Blue Access,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Blue Access Choice,Anthem Blue Access Choice,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Blue Preferred,Anthem Blue Preferred,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Pathway,Anthem Pathway,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Alliance,Anthem Alliance,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Anthem Medicare,Anthem Medicare,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Cigna,Cigna,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Cigna PPO,Cigna PPO,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Cigna Medicare Advantage,Cigna Medicare Advantage,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Essence,Essence,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Healthlink HMO,Healthlink HMO,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Healthlink PPO,Healthlink PPO,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,HomeState Health Plan,HomeState Health Plan,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Humana Gold,Humana Gold,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Medicaid MO,Medicaid MO,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Medica,Medica,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Tricare,Tricare,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,UHC All Payer,UHC All Payer,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,UHC Exchange,UHC Exchange,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,UHC Medicaid,UHC Medicaid,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,UMR CPD,UMR CPD,93.06,,,,,,,per diem,93.06,93.06,"Per diem rate, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,UHC Medicare,UHC Medicare,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
BARI BED                      ,33125357,CDM,279,RC,,,,,,Inpatient,,,93.06,93.06,Wellcare,Wellcare,93.06,,,,,,,case rate,93.06,93.06,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Meritain Health PPO CPD,Meritain Health PPO CPD,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Aetna/Commercial Product,Aetna/Commercial Product,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Meritain Health CPD,Meritain Health CPD,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Starmark CPD,Starmark CPD,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Aetna Medicare,Aetna Medicare,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Ambetter ,Ambetter ,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Blue Access,Anthem Blue Access,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Blue Access Choice,Anthem Blue Access Choice,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Blue Preferred,Anthem Blue Preferred,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Pathway,Anthem Pathway,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Alliance,Anthem Alliance,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Anthem Medicare,Anthem Medicare,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Cigna,Cigna,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Cigna PPO,Cigna PPO,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Cigna Medicare Advantage,Cigna Medicare Advantage,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Essence,Essence,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Healthlink HMO,Healthlink HMO,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Healthlink PPO,Healthlink PPO,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,HomeState Health Plan,HomeState Health Plan,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Humana Gold,Humana Gold,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Medicaid MO,Medicaid MO,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Medica,Medica,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Tricare,Tricare,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,UHC All Payer,UHC All Payer,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,UHC Exchange,UHC Exchange,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,UHC Medicaid,UHC Medicaid,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,UMR CPD,UMR CPD,37.44,,,,,,,per diem,37.44,37.44,"Per diem rate, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,UHC Medicare,UHC Medicare,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
CONTINUOUS POX - UHS          ,33125358,CDM,279,RC,,,,,,Inpatient,,,37.44,37.44,Wellcare,Wellcare,37.44,,,,,,,case rate,37.44,37.44,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Meritain Health PPO CPD,Meritain Health PPO CPD,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Aetna/Commercial Product,Aetna/Commercial Product,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Meritain Health CPD,Meritain Health CPD,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Starmark CPD,Starmark CPD,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Aetna Medicare,Aetna Medicare,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Ambetter ,Ambetter ,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Blue Access,Anthem Blue Access,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Blue Access Choice,Anthem Blue Access Choice,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Blue Preferred,Anthem Blue Preferred,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Pathway,Anthem Pathway,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Alliance,Anthem Alliance,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Anthem Medicare,Anthem Medicare,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Cigna,Cigna,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Cigna PPO,Cigna PPO,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Cigna Medicare Advantage,Cigna Medicare Advantage,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Essence,Essence,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Healthlink HMO,Healthlink HMO,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Healthlink PPO,Healthlink PPO,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,HomeState Health Plan,HomeState Health Plan,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Humana Gold,Humana Gold,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Medicaid MO,Medicaid MO,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Medica,Medica,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Tricare,Tricare,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,UHC All Payer,UHC All Payer,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,UHC Exchange,UHC Exchange,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,UHC Medicaid,UHC Medicaid,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,UMR CPD,UMR CPD,194.08,,,,,,,per diem,194.08,194.08,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,UHC Medicare,UHC Medicare,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33125360,CDM,279,RC,,,,,,Inpatient,,,194.08,194.08,Wellcare,Wellcare,194.08,,,,,,,case rate,194.08,194.08,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Meritain Health PPO CPD,Meritain Health PPO CPD,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Aetna/Commercial Product,Aetna/Commercial Product,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Meritain Health CPD,Meritain Health CPD,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Starmark CPD,Starmark CPD,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Aetna Medicare,Aetna Medicare,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Ambetter ,Ambetter ,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Blue Access,Anthem Blue Access,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Blue Access Choice,Anthem Blue Access Choice,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Blue Preferred,Anthem Blue Preferred,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Pathway,Anthem Pathway,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Alliance,Anthem Alliance,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Anthem Medicare,Anthem Medicare,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Cigna,Cigna,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Cigna PPO,Cigna PPO,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Cigna Medicare Advantage,Cigna Medicare Advantage,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Essence,Essence,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Healthlink HMO,Healthlink HMO,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Healthlink PPO,Healthlink PPO,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,HomeState Health Plan,HomeState Health Plan,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Humana Gold,Humana Gold,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Medicaid MO,Medicaid MO,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Medica,Medica,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Tricare,Tricare,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,UHC All Payer,UHC All Payer,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,UHC Exchange,UHC Exchange,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,UHC Medicaid,UHC Medicaid,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,UMR CPD,UMR CPD,27.52,,,,,,,per diem,27.52,27.52,"Per diem rate, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,UHC Medicare,UHC Medicare,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
SCD PUMP                      ,33125361,CDM,279,RC,,,,,,Inpatient,,,27.52,27.52,Wellcare,Wellcare,27.52,,,,,,,case rate,27.52,27.52,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Meritain Health PPO CPD,Meritain Health PPO CPD,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Aetna/Commercial Product,Aetna/Commercial Product,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Meritain Health CPD,Meritain Health CPD,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Starmark CPD,Starmark CPD,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Aetna Medicare,Aetna Medicare,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Ambetter ,Ambetter ,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Blue Access,Anthem Blue Access,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Blue Access Choice,Anthem Blue Access Choice,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Blue Preferred,Anthem Blue Preferred,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Pathway,Anthem Pathway,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Alliance,Anthem Alliance,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Anthem Medicare,Anthem Medicare,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Cigna,Cigna,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Cigna PPO,Cigna PPO,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Cigna Medicare Advantage,Cigna Medicare Advantage,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Essence,Essence,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Healthlink HMO,Healthlink HMO,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Healthlink PPO,Healthlink PPO,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,HomeState Health Plan,HomeState Health Plan,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Humana Gold,Humana Gold,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Medicaid MO,Medicaid MO,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Medica,Medica,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Tricare,Tricare,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,UHC All Payer,UHC All Payer,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,UHC Exchange,UHC Exchange,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,UHC Medicaid,UHC Medicaid,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,UMR CPD,UMR CPD,126.83,,,,,,,per diem,126.83,126.83,"Per diem rate, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,UHC Medicare,UHC Medicare,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
WOUND VAC VCOK11537           ,33125362,CDM,279,RC,,,,,,Inpatient,,,126.83,126.83,Wellcare,Wellcare,126.83,,,,,,,case rate,126.83,126.83,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Meritain Health PPO CPD,Meritain Health PPO CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Aetna/Commercial Product,Aetna/Commercial Product,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Meritain Health CPD,Meritain Health CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Starmark CPD,Starmark CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Aetna Medicare,Aetna Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Ambetter ,Ambetter ,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Access,Anthem Blue Access,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Access Choice,Anthem Blue Access Choice,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Preferred,Anthem Blue Preferred,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Pathway,Anthem Pathway,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Alliance,Anthem Alliance,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Medicare,Anthem Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Cigna,Cigna,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Cigna PPO,Cigna PPO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Cigna Medicare Advantage,Cigna Medicare Advantage,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Essence,Essence,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Healthlink HMO,Healthlink HMO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Healthlink PPO,Healthlink PPO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,HomeState Health Plan,HomeState Health Plan,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Humana Gold,Humana Gold,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Medicaid MO,Medicaid MO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Medica,Medica,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Tricare,Tricare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,UHC All Payer,UHC All Payer,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,UHC Exchange,UHC Exchange,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,UHC Medicaid,UHC Medicaid,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,UMR CPD,UMR CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,UHC Medicare,UHC Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARI MATTRESS                 ,33125363,CDM,279,RC,,,,,,Inpatient,,,36.05,36.05,Wellcare,Wellcare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Meritain Health PPO CPD,Meritain Health PPO CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna/Commercial Product,Aetna/Commercial Product,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Meritain Health CPD,Meritain Health CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Starmark CPD,Starmark CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna Medicare,Aetna Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Ambetter ,Ambetter ,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Access,Anthem Blue Access,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Access Choice,Anthem Blue Access Choice,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Preferred,Anthem Blue Preferred,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Pathway,Anthem Pathway,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Alliance,Anthem Alliance,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Medicare,Anthem Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna,Cigna,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna PPO,Cigna PPO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna Medicare Advantage,Cigna Medicare Advantage,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Essence,Essence,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthlink HMO,Healthlink HMO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthlink PPO,Healthlink PPO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,HomeState Health Plan,HomeState Health Plan,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Humana Gold,Humana Gold,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Medicaid MO,Medicaid MO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Medica,Medica,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Tricare,Tricare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC All Payer,UHC All Payer,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Exchange,UHC Exchange,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Medicaid,UHC Medicaid,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UMR CPD,UMR CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Medicare,UHC Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BARIMATT 1000 PLUS MATTRESS   ,33125364,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Wellcare,Wellcare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Meritain Health PPO CPD,Meritain Health PPO CPD,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Aetna/Commercial Product,Aetna/Commercial Product,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Meritain Health CPD,Meritain Health CPD,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Starmark CPD,Starmark CPD,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Aetna Medicare,Aetna Medicare,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Ambetter ,Ambetter ,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Blue Access,Anthem Blue Access,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Blue Access Choice,Anthem Blue Access Choice,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Blue Preferred,Anthem Blue Preferred,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Pathway,Anthem Pathway,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Alliance,Anthem Alliance,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Anthem Medicare,Anthem Medicare,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Cigna,Cigna,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Cigna PPO,Cigna PPO,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Cigna Medicare Advantage,Cigna Medicare Advantage,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Essence,Essence,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Healthlink HMO,Healthlink HMO,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Healthlink PPO,Healthlink PPO,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,HomeState Health Plan,HomeState Health Plan,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Humana Gold,Humana Gold,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Medicaid MO,Medicaid MO,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Medica,Medica,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Tricare,Tricare,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,UHC All Payer,UHC All Payer,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,UHC Exchange,UHC Exchange,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,UHC Medicaid,UHC Medicaid,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,UMR CPD,UMR CPD,216.23,,,,,,,per diem,216.23,216.23,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,UHC Medicare,UHC Medicare,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33125365,CDM,270,RC,,,,,,Inpatient,,,216.23,216.23,Wellcare,Wellcare,216.23,,,,,,,case rate,216.23,216.23,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Meritain Health PPO CPD,Meritain Health PPO CPD,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Aetna/Commercial Product,Aetna/Commercial Product,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Meritain Health CPD,Meritain Health CPD,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Starmark CPD,Starmark CPD,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Aetna Medicare,Aetna Medicare,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Ambetter ,Ambetter ,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Blue Access,Anthem Blue Access,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Blue Access Choice,Anthem Blue Access Choice,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Blue Preferred,Anthem Blue Preferred,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Pathway,Anthem Pathway,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Alliance,Anthem Alliance,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Anthem Medicare,Anthem Medicare,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Cigna,Cigna,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Cigna PPO,Cigna PPO,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Cigna Medicare Advantage,Cigna Medicare Advantage,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Essence,Essence,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Healthlink HMO,Healthlink HMO,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Healthlink PPO,Healthlink PPO,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,HomeState Health Plan,HomeState Health Plan,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Humana Gold,Humana Gold,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Medicaid MO,Medicaid MO,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Medica,Medica,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Tricare,Tricare,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,UHC All Payer,UHC All Payer,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,UHC Exchange,UHC Exchange,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,UHC Medicaid,UHC Medicaid,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,UMR CPD,UMR CPD,164.99,,,,,,,per diem,164.99,164.99,"Per diem rate, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,UHC Medicare,UHC Medicare,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
FREEDOM VAC                   ,33125366,CDM,279,RC,,,,,,Inpatient,,,164.99,164.99,Wellcare,Wellcare,164.99,,,,,,,case rate,164.99,164.99,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Meritain Health PPO CPD,Meritain Health PPO CPD,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Aetna/Commercial Product,Aetna/Commercial Product,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Meritain Health CPD,Meritain Health CPD,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Starmark CPD,Starmark CPD,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Aetna Medicare,Aetna Medicare,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Ambetter ,Ambetter ,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Blue Access,Anthem Blue Access,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Blue Access Choice,Anthem Blue Access Choice,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Blue Preferred,Anthem Blue Preferred,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Pathway,Anthem Pathway,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Alliance,Anthem Alliance,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Anthem Medicare,Anthem Medicare,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Cigna,Cigna,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Cigna PPO,Cigna PPO,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Cigna Medicare Advantage,Cigna Medicare Advantage,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Essence,Essence,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Healthlink HMO,Healthlink HMO,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Healthlink PPO,Healthlink PPO,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,HomeState Health Plan,HomeState Health Plan,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Humana Gold,Humana Gold,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Medicaid MO,Medicaid MO,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Medica,Medica,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Tricare,Tricare,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,UHC All Payer,UHC All Payer,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,UHC Exchange,UHC Exchange,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,UHC Medicaid,UHC Medicaid,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,UMR CPD,UMR CPD,238.65,,,,,,,per diem,238.65,238.65,"Per diem rate, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,UHC Medicare,UHC Medicare,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
LIFEVEST WEARABLE DEFIB       ,33125369,CDM,279,RC,,,,,,Inpatient,,,238.65,238.65,Wellcare,Wellcare,238.65,,,,,,,case rate,238.65,238.65,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Meritain Health PPO CPD,Meritain Health PPO CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Aetna/Commercial Product,Aetna/Commercial Product,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Meritain Health CPD,Meritain Health CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Starmark CPD,Starmark CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Aetna Medicare,Aetna Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Ambetter ,Ambetter ,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access,Anthem Blue Access,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access Choice,Anthem Blue Access Choice,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Blue Preferred,Anthem Blue Preferred,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Pathway,Anthem Pathway,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Alliance,Anthem Alliance,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Anthem Medicare,Anthem Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Cigna,Cigna,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Cigna PPO,Cigna PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Cigna Medicare Advantage,Cigna Medicare Advantage,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Essence,Essence,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Healthlink HMO,Healthlink HMO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Healthlink PPO,Healthlink PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,HomeState Health Plan,HomeState Health Plan,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Humana Gold,Humana Gold,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Medicaid MO,Medicaid MO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Medica,Medica,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Tricare,Tricare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,UHC All Payer,UHC All Payer,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,UHC Exchange,UHC Exchange,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,UHC Medicaid,UHC Medicaid,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,UMR CPD,UMR CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,UHC Medicare,UHC Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI SHUTTLE CHAIR            ,33125776,CDM,279,RC,,,,,,Inpatient,,,152,152,Wellcare,Wellcare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Meritain Health PPO CPD,Meritain Health PPO CPD,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Aetna/Commercial Product,Aetna/Commercial Product,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Meritain Health CPD,Meritain Health CPD,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Starmark CPD,Starmark CPD,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Aetna Medicare,Aetna Medicare,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Ambetter ,Ambetter ,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Blue Access,Anthem Blue Access,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Blue Access Choice,Anthem Blue Access Choice,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Blue Preferred,Anthem Blue Preferred,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Pathway,Anthem Pathway,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Alliance,Anthem Alliance,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Anthem Medicare,Anthem Medicare,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Cigna,Cigna,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Cigna PPO,Cigna PPO,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Cigna Medicare Advantage,Cigna Medicare Advantage,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Essence,Essence,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Healthlink HMO,Healthlink HMO,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Healthlink PPO,Healthlink PPO,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,HomeState Health Plan,HomeState Health Plan,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Humana Gold,Humana Gold,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Medicaid MO,Medicaid MO,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Medica,Medica,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Tricare,Tricare,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,UHC All Payer,UHC All Payer,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,UHC Exchange,UHC Exchange,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,UHC Medicaid,UHC Medicaid,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,UMR CPD,UMR CPD,91.2,,,,,,,per diem,91.2,91.2,"Per diem rate, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,UHC Medicare,UHC Medicare,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI HOYER LIFT WITH SCALE    ,33125777,CDM,279,RC,,,,,,Inpatient,,,91.2,91.2,Wellcare,Wellcare,91.2,,,,,,,case rate,91.2,91.2,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Meritain Health PPO CPD,Meritain Health PPO CPD,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Aetna/Commercial Product,Aetna/Commercial Product,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Meritain Health CPD,Meritain Health CPD,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Starmark CPD,Starmark CPD,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Aetna Medicare,Aetna Medicare,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Ambetter ,Ambetter ,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Blue Access,Anthem Blue Access,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Blue Access Choice,Anthem Blue Access Choice,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Blue Preferred,Anthem Blue Preferred,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Pathway,Anthem Pathway,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Alliance,Anthem Alliance,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Anthem Medicare,Anthem Medicare,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Cigna,Cigna,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Cigna PPO,Cigna PPO,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Cigna Medicare Advantage,Cigna Medicare Advantage,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Essence,Essence,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Healthlink HMO,Healthlink HMO,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Healthlink PPO,Healthlink PPO,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,HomeState Health Plan,HomeState Health Plan,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Humana Gold,Humana Gold,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Medicaid MO,Medicaid MO,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Medica,Medica,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Tricare,Tricare,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,UHC All Payer,UHC All Payer,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,UHC Exchange,UHC Exchange,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,UHC Medicaid,UHC Medicaid,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,UMR CPD,UMR CPD,21.28,,,,,,,per diem,21.28,21.28,"Per diem rate, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,UHC Medicare,UHC Medicare,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARI BEDSIDE COMMODE          ,33125778,CDM,279,RC,,,,,,Inpatient,,,21.28,21.28,Wellcare,Wellcare,21.28,,,,,,,case rate,21.28,21.28,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Meritain Health PPO CPD,Meritain Health PPO CPD,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Aetna/Commercial Product,Aetna/Commercial Product,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Meritain Health CPD,Meritain Health CPD,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Starmark CPD,Starmark CPD,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Aetna Medicare,Aetna Medicare,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Ambetter ,Ambetter ,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Blue Access,Anthem Blue Access,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Blue Access Choice,Anthem Blue Access Choice,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Blue Preferred,Anthem Blue Preferred,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Pathway,Anthem Pathway,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Alliance,Anthem Alliance,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Anthem Medicare,Anthem Medicare,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Cigna,Cigna,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Cigna PPO,Cigna PPO,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Cigna Medicare Advantage,Cigna Medicare Advantage,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Essence,Essence,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Healthlink HMO,Healthlink HMO,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Healthlink PPO,Healthlink PPO,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,HomeState Health Plan,HomeState Health Plan,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Humana Gold,Humana Gold,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Medicaid MO,Medicaid MO,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Medica,Medica,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Tricare,Tricare,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,UHC All Payer,UHC All Payer,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,UHC Exchange,UHC Exchange,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,UHC Medicaid,UHC Medicaid,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,UMR CPD,UMR CPD,22.92,,,,,,,per diem,22.92,22.92,"Per diem rate, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,UHC Medicare,UHC Medicare,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
BARIATRIC STAND-ALONE TRAPEZE ,33125864,CDM,279,RC,,,,,,Inpatient,,,22.92,22.92,Wellcare,Wellcare,22.92,,,,,,,case rate,22.92,22.92,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Meritain Health PPO CPD,Meritain Health PPO CPD,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Aetna/Commercial Product,Aetna/Commercial Product,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Meritain Health CPD,Meritain Health CPD,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Starmark CPD,Starmark CPD,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Aetna Medicare,Aetna Medicare,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Ambetter ,Ambetter ,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Blue Access,Anthem Blue Access,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Blue Access Choice,Anthem Blue Access Choice,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Blue Preferred,Anthem Blue Preferred,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Pathway,Anthem Pathway,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Alliance,Anthem Alliance,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Anthem Medicare,Anthem Medicare,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Cigna,Cigna,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Cigna PPO,Cigna PPO,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Cigna Medicare Advantage,Cigna Medicare Advantage,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Essence,Essence,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Healthlink HMO,Healthlink HMO,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Healthlink PPO,Healthlink PPO,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,HomeState Health Plan,HomeState Health Plan,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Humana Gold,Humana Gold,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Medicaid MO,Medicaid MO,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Medica,Medica,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Tricare,Tricare,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,UHC All Payer,UHC All Payer,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,UHC Exchange,UHC Exchange,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,UHC Medicaid,UHC Medicaid,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,UMR CPD,UMR CPD,0.35,,,,,,,per diem,0.35,0.35,"Per diem rate, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,UHC Medicare,UHC Medicare,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
ABDOMINAL PAD 5X9             ,33126010,CDM,270,RC,,,,,,Inpatient,,,0.35,0.35,Wellcare,Wellcare,0.35,,,,,,,case rate,0.35,0.35,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Meritain Health PPO CPD,Meritain Health PPO CPD,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Aetna/Commercial Product,Aetna/Commercial Product,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Meritain Health CPD,Meritain Health CPD,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Starmark CPD,Starmark CPD,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Aetna Medicare,Aetna Medicare,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Ambetter ,Ambetter ,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Blue Access,Anthem Blue Access,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Blue Access Choice,Anthem Blue Access Choice,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Blue Preferred,Anthem Blue Preferred,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Pathway,Anthem Pathway,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Alliance,Anthem Alliance,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Anthem Medicare,Anthem Medicare,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Cigna,Cigna,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Cigna PPO,Cigna PPO,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Cigna Medicare Advantage,Cigna Medicare Advantage,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Essence,Essence,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Healthlink HMO,Healthlink HMO,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Healthlink PPO,Healthlink PPO,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,HomeState Health Plan,HomeState Health Plan,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Humana Gold,Humana Gold,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Medicaid MO,Medicaid MO,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Medica,Medica,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Tricare,Tricare,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,UHC All Payer,UHC All Payer,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,UHC Exchange,UHC Exchange,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,UHC Medicaid,UHC Medicaid,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,UMR CPD,UMR CPD,18.8,,,,,,,per diem,18.8,18.8,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,UHC Medicare,UHC Medicare,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33127208,CDM,270,RC,,,,,,Inpatient,,,18.8,18.8,Wellcare,Wellcare,18.8,,,,,,,case rate,18.8,18.8,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health PPO CPD,Meritain Health PPO CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/Commercial Product,Aetna/Commercial Product,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health CPD,Meritain Health CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Starmark CPD,Starmark CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Aetna Medicare,Aetna Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Ambetter ,Ambetter ,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access,Anthem Blue Access,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access Choice,Anthem Blue Access Choice,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Preferred,Anthem Blue Preferred,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Pathway,Anthem Pathway,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Alliance,Anthem Alliance,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Medicare,Anthem Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Cigna,Cigna,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Cigna PPO,Cigna PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Cigna Medicare Advantage,Cigna Medicare Advantage,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Essence,Essence,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink HMO,Healthlink HMO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink PPO,Healthlink PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,HomeState Health Plan,HomeState Health Plan,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Humana Gold,Humana Gold,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Medicaid MO,Medicaid MO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Medica,Medica,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Tricare,Tricare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,UHC All Payer,UHC All Payer,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,UHC Exchange,UHC Exchange,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicaid,UHC Medicaid,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,UMR CPD,UMR CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicare,UHC Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33127342,CDM,270,RC,,,,,,Inpatient,,,40.95,40.95,Wellcare,Wellcare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Meritain Health PPO CPD,Meritain Health PPO CPD,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Aetna/Commercial Product,Aetna/Commercial Product,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Meritain Health CPD,Meritain Health CPD,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Starmark CPD,Starmark CPD,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Aetna Medicare,Aetna Medicare,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Ambetter ,Ambetter ,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Blue Access,Anthem Blue Access,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Blue Access Choice,Anthem Blue Access Choice,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Blue Preferred,Anthem Blue Preferred,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Pathway,Anthem Pathway,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Alliance,Anthem Alliance,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Anthem Medicare,Anthem Medicare,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Cigna,Cigna,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Cigna PPO,Cigna PPO,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Cigna Medicare Advantage,Cigna Medicare Advantage,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Essence,Essence,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Healthlink HMO,Healthlink HMO,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Healthlink PPO,Healthlink PPO,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,HomeState Health Plan,HomeState Health Plan,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Humana Gold,Humana Gold,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Medicaid MO,Medicaid MO,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Medica,Medica,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Tricare,Tricare,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,UHC All Payer,UHC All Payer,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,UHC Exchange,UHC Exchange,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,UHC Medicaid,UHC Medicaid,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,UMR CPD,UMR CPD,105.83,,,,,,,per diem,105.83,105.83,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,UHC Medicare,UHC Medicare,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33127451,CDM,279,RC,,,,,,Inpatient,,,105.83,105.83,Wellcare,Wellcare,105.83,,,,,,,case rate,105.83,105.83,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Meritain Health PPO CPD,Meritain Health PPO CPD,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Aetna/Commercial Product,Aetna/Commercial Product,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Meritain Health CPD,Meritain Health CPD,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Starmark CPD,Starmark CPD,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Aetna Medicare,Aetna Medicare,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Ambetter ,Ambetter ,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Blue Access,Anthem Blue Access,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Blue Access Choice,Anthem Blue Access Choice,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Blue Preferred,Anthem Blue Preferred,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Pathway,Anthem Pathway,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Alliance,Anthem Alliance,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Anthem Medicare,Anthem Medicare,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Cigna,Cigna,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Cigna PPO,Cigna PPO,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Cigna Medicare Advantage,Cigna Medicare Advantage,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Essence,Essence,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Healthlink HMO,Healthlink HMO,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Healthlink PPO,Healthlink PPO,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,HomeState Health Plan,HomeState Health Plan,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Humana Gold,Humana Gold,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Medicaid MO,Medicaid MO,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Medica,Medica,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Tricare,Tricare,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,UHC All Payer,UHC All Payer,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,UHC Exchange,UHC Exchange,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,UHC Medicaid,UHC Medicaid,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,UMR CPD,UMR CPD,216.04,,,,,,,per diem,216.04,216.04,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,UHC Medicare,UHC Medicare,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33127456,CDM,279,RC,,,,,,Inpatient,,,216.04,216.04,Wellcare,Wellcare,216.04,,,,,,,case rate,216.04,216.04,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Meritain Health PPO CPD,Meritain Health PPO CPD,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Aetna/Commercial Product,Aetna/Commercial Product,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Meritain Health CPD,Meritain Health CPD,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Starmark CPD,Starmark CPD,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Aetna Medicare,Aetna Medicare,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Ambetter ,Ambetter ,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Blue Access,Anthem Blue Access,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Blue Access Choice,Anthem Blue Access Choice,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Blue Preferred,Anthem Blue Preferred,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Pathway,Anthem Pathway,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Alliance,Anthem Alliance,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Anthem Medicare,Anthem Medicare,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Cigna,Cigna,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Cigna PPO,Cigna PPO,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Cigna Medicare Advantage,Cigna Medicare Advantage,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Essence,Essence,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Healthlink HMO,Healthlink HMO,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Healthlink PPO,Healthlink PPO,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,HomeState Health Plan,HomeState Health Plan,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Humana Gold,Humana Gold,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Medicaid MO,Medicaid MO,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Medica,Medica,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Tricare,Tricare,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,UHC All Payer,UHC All Payer,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,UHC Exchange,UHC Exchange,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,UHC Medicaid,UHC Medicaid,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,UMR CPD,UMR CPD,91.41,,,,,,,per diem,91.41,91.41,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,UHC Medicare,UHC Medicare,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33127462,CDM,279,RC,,,,,,Inpatient,,,91.41,91.41,Wellcare,Wellcare,91.41,,,,,,,case rate,91.41,91.41,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Meritain Health PPO CPD,Meritain Health PPO CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Aetna/Commercial Product,Aetna/Commercial Product,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Meritain Health CPD,Meritain Health CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Starmark CPD,Starmark CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Aetna Medicare,Aetna Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Ambetter ,Ambetter ,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Blue Access,Anthem Blue Access,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Blue Access Choice,Anthem Blue Access Choice,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Blue Preferred,Anthem Blue Preferred,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Pathway,Anthem Pathway,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Alliance,Anthem Alliance,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Anthem Medicare,Anthem Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Cigna,Cigna,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Cigna PPO,Cigna PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Cigna Medicare Advantage,Cigna Medicare Advantage,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Essence,Essence,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Healthlink HMO,Healthlink HMO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Healthlink PPO,Healthlink PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,HomeState Health Plan,HomeState Health Plan,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Humana Gold,Humana Gold,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Medicaid MO,Medicaid MO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Medica,Medica,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Tricare,Tricare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,UHC All Payer,UHC All Payer,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,UHC Exchange,UHC Exchange,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,UHC Medicaid,UHC Medicaid,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,UMR CPD,UMR CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,UHC Medicare,UHC Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33127464,CDM,279,RC,,,,,,Inpatient,,,273.98,273.98,Wellcare,Wellcare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33127465,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Meritain Health PPO CPD,Meritain Health PPO CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna/Commercial Product,Aetna/Commercial Product,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Meritain Health CPD,Meritain Health CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Starmark CPD,Starmark CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna Medicare,Aetna Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Ambetter ,Ambetter ,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Access,Anthem Blue Access,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Access Choice,Anthem Blue Access Choice,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Preferred,Anthem Blue Preferred,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Pathway,Anthem Pathway,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Alliance,Anthem Alliance,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Medicare,Anthem Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna,Cigna,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna PPO,Cigna PPO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna Medicare Advantage,Cigna Medicare Advantage,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Essence,Essence,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthlink HMO,Healthlink HMO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthlink PPO,Healthlink PPO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,HomeState Health Plan,HomeState Health Plan,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Humana Gold,Humana Gold,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Medicaid MO,Medicaid MO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Medica,Medica,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Tricare,Tricare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC All Payer,UHC All Payer,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Exchange,UHC Exchange,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Medicaid,UHC Medicaid,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UMR CPD,UMR CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Medicare,UHC Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33127466,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Wellcare,Wellcare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health PPO CPD,Meritain Health PPO CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/Commercial Product,Aetna/Commercial Product,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health CPD,Meritain Health CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Starmark CPD,Starmark CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna Medicare,Aetna Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Ambetter ,Ambetter ,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access,Anthem Blue Access,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access Choice,Anthem Blue Access Choice,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Preferred,Anthem Blue Preferred,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Pathway,Anthem Pathway,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Alliance,Anthem Alliance,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Medicare,Anthem Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna,Cigna,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna PPO,Cigna PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna Medicare Advantage,Cigna Medicare Advantage,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Essence,Essence,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink HMO,Healthlink HMO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink PPO,Healthlink PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,HomeState Health Plan,HomeState Health Plan,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Humana Gold,Humana Gold,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Medicaid MO,Medicaid MO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Medica,Medica,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Tricare,Tricare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC All Payer,UHC All Payer,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Exchange,UHC Exchange,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicaid,UHC Medicaid,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,UMR CPD,UMR CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicare,UHC Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33127467,CDM,279,RC,,,,,,Inpatient,,,12,12,Wellcare,Wellcare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health PPO CPD,Meritain Health PPO CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/Commercial Product,Aetna/Commercial Product,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health CPD,Meritain Health CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Starmark CPD,Starmark CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna Medicare,Aetna Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Ambetter ,Ambetter ,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access,Anthem Blue Access,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access Choice,Anthem Blue Access Choice,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Preferred,Anthem Blue Preferred,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Pathway,Anthem Pathway,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Alliance,Anthem Alliance,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Medicare,Anthem Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna,Cigna,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna PPO,Cigna PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna Medicare Advantage,Cigna Medicare Advantage,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Essence,Essence,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink HMO,Healthlink HMO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink PPO,Healthlink PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,HomeState Health Plan,HomeState Health Plan,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Humana Gold,Humana Gold,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Medicaid MO,Medicaid MO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Medica,Medica,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Tricare,Tricare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC All Payer,UHC All Payer,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Exchange,UHC Exchange,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicaid,UHC Medicaid,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UMR CPD,UMR CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicare,UHC Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33127482,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Wellcare,Wellcare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health PPO CPD,Meritain Health PPO CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/Commercial Product,Aetna/Commercial Product,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health CPD,Meritain Health CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Starmark CPD,Starmark CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Aetna Medicare,Aetna Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Ambetter ,Ambetter ,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access,Anthem Blue Access,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access Choice,Anthem Blue Access Choice,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Preferred,Anthem Blue Preferred,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Pathway,Anthem Pathway,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Alliance,Anthem Alliance,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Medicare,Anthem Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Cigna,Cigna,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Cigna PPO,Cigna PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Cigna Medicare Advantage,Cigna Medicare Advantage,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Essence,Essence,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink HMO,Healthlink HMO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink PPO,Healthlink PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,HomeState Health Plan,HomeState Health Plan,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Humana Gold,Humana Gold,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Medicaid MO,Medicaid MO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Medica,Medica,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Tricare,Tricare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,UHC All Payer,UHC All Payer,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,UHC Exchange,UHC Exchange,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicaid,UHC Medicaid,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,UMR CPD,UMR CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicare,UHC Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33127489,CDM,279,RC,,,,,,Inpatient,,,27.5,27.5,Wellcare,Wellcare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Meritain Health PPO CPD,Meritain Health PPO CPD,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Aetna/Commercial Product,Aetna/Commercial Product,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Meritain Health CPD,Meritain Health CPD,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Starmark CPD,Starmark CPD,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Aetna Medicare,Aetna Medicare,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Ambetter ,Ambetter ,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Blue Access,Anthem Blue Access,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Blue Access Choice,Anthem Blue Access Choice,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Blue Preferred,Anthem Blue Preferred,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Pathway,Anthem Pathway,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Alliance,Anthem Alliance,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Anthem Medicare,Anthem Medicare,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Cigna,Cigna,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Cigna PPO,Cigna PPO,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Cigna Medicare Advantage,Cigna Medicare Advantage,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Essence,Essence,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Healthlink HMO,Healthlink HMO,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Healthlink PPO,Healthlink PPO,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,HomeState Health Plan,HomeState Health Plan,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Humana Gold,Humana Gold,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Medicaid MO,Medicaid MO,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Medica,Medica,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Tricare,Tricare,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,UHC All Payer,UHC All Payer,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,UHC Exchange,UHC Exchange,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,UHC Medicaid,UHC Medicaid,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,UMR CPD,UMR CPD,79,,,,,,,per diem,79,79,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,UHC Medicare,UHC Medicare,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33127490,CDM,279,RC,,,,,,Inpatient,,,79,79,Wellcare,Wellcare,79,,,,,,,case rate,79,79,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33127518,CDM,279,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Meritain Health PPO CPD,Meritain Health PPO CPD,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Aetna/Commercial Product,Aetna/Commercial Product,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Meritain Health CPD,Meritain Health CPD,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Starmark CPD,Starmark CPD,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Aetna Medicare,Aetna Medicare,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Ambetter ,Ambetter ,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Blue Access,Anthem Blue Access,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Blue Access Choice,Anthem Blue Access Choice,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Blue Preferred,Anthem Blue Preferred,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Pathway,Anthem Pathway,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Alliance,Anthem Alliance,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Anthem Medicare,Anthem Medicare,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Cigna,Cigna,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Cigna PPO,Cigna PPO,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Cigna Medicare Advantage,Cigna Medicare Advantage,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Essence,Essence,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Healthlink HMO,Healthlink HMO,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Healthlink PPO,Healthlink PPO,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,HomeState Health Plan,HomeState Health Plan,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Humana Gold,Humana Gold,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Medicaid MO,Medicaid MO,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Medica,Medica,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Tricare,Tricare,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,UHC All Payer,UHC All Payer,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,UHC Exchange,UHC Exchange,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,UHC Medicaid,UHC Medicaid,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,UMR CPD,UMR CPD,73.25,,,,,,,per diem,73.25,73.25,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,UHC Medicare,UHC Medicare,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE) DA,33127520,CDM,279,RC,,,,,,Inpatient,,,73.25,73.25,Wellcare,Wellcare,73.25,,,,,,,case rate,73.25,73.25,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Meritain Health PPO CPD,Meritain Health PPO CPD,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Aetna/Commercial Product,Aetna/Commercial Product,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Meritain Health CPD,Meritain Health CPD,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Starmark CPD,Starmark CPD,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Aetna Medicare,Aetna Medicare,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Ambetter ,Ambetter ,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Blue Access,Anthem Blue Access,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Blue Access Choice,Anthem Blue Access Choice,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Blue Preferred,Anthem Blue Preferred,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Pathway,Anthem Pathway,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Alliance,Anthem Alliance,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Anthem Medicare,Anthem Medicare,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Cigna,Cigna,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Cigna PPO,Cigna PPO,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Cigna Medicare Advantage,Cigna Medicare Advantage,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Essence,Essence,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Healthlink HMO,Healthlink HMO,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Healthlink PPO,Healthlink PPO,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,HomeState Health Plan,HomeState Health Plan,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Humana Gold,Humana Gold,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Medicaid MO,Medicaid MO,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Medica,Medica,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Tricare,Tricare,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,UHC All Payer,UHC All Payer,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,UHC Exchange,UHC Exchange,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,UHC Medicaid,UHC Medicaid,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,UMR CPD,UMR CPD,9.93,,,,,,,per diem,9.93,9.93,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,UHC Medicare,UHC Medicare,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33127521,CDM,279,RC,,,,,,Inpatient,,,9.93,9.93,Wellcare,Wellcare,9.93,,,,,,,case rate,9.93,9.93,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Meritain Health PPO CPD,Meritain Health PPO CPD,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Aetna/Commercial Product,Aetna/Commercial Product,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Meritain Health CPD,Meritain Health CPD,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Starmark CPD,Starmark CPD,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Aetna Medicare,Aetna Medicare,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Ambetter ,Ambetter ,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Blue Access,Anthem Blue Access,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Blue Access Choice,Anthem Blue Access Choice,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Blue Preferred,Anthem Blue Preferred,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Pathway,Anthem Pathway,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Alliance,Anthem Alliance,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Anthem Medicare,Anthem Medicare,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Cigna,Cigna,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Cigna PPO,Cigna PPO,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Cigna Medicare Advantage,Cigna Medicare Advantage,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Essence,Essence,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Healthlink HMO,Healthlink HMO,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Healthlink PPO,Healthlink PPO,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,HomeState Health Plan,HomeState Health Plan,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Humana Gold,Humana Gold,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Medicaid MO,Medicaid MO,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Medica,Medica,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Tricare,Tricare,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,UHC All Payer,UHC All Payer,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,UHC Exchange,UHC Exchange,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,UHC Medicaid,UHC Medicaid,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,UMR CPD,UMR CPD,11.75,,,,,,,per diem,11.75,11.75,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,UHC Medicare,UHC Medicare,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33127523,CDM,279,RC,,,,,,Inpatient,,,11.75,11.75,Wellcare,Wellcare,11.75,,,,,,,case rate,11.75,11.75,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Meritain Health PPO CPD,Meritain Health PPO CPD,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Aetna/Commercial Product,Aetna/Commercial Product,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Meritain Health CPD,Meritain Health CPD,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Starmark CPD,Starmark CPD,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Aetna Medicare,Aetna Medicare,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Ambetter ,Ambetter ,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Blue Access,Anthem Blue Access,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Blue Access Choice,Anthem Blue Access Choice,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Blue Preferred,Anthem Blue Preferred,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Pathway,Anthem Pathway,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Alliance,Anthem Alliance,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Anthem Medicare,Anthem Medicare,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Cigna,Cigna,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Cigna PPO,Cigna PPO,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Cigna Medicare Advantage,Cigna Medicare Advantage,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Essence,Essence,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Healthlink HMO,Healthlink HMO,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Healthlink PPO,Healthlink PPO,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,HomeState Health Plan,HomeState Health Plan,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Humana Gold,Humana Gold,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Medicaid MO,Medicaid MO,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Medica,Medica,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Tricare,Tricare,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,UHC All Payer,UHC All Payer,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,UHC Exchange,UHC Exchange,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,UHC Medicaid,UHC Medicaid,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,UMR CPD,UMR CPD,6.25,,,,,,,per diem,6.25,6.25,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,UHC Medicare,UHC Medicare,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33127527,CDM,279,RC,,,,,,Inpatient,,,6.25,6.25,Wellcare,Wellcare,6.25,,,,,,,case rate,6.25,6.25,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Meritain Health PPO CPD,Meritain Health PPO CPD,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Aetna/Commercial Product,Aetna/Commercial Product,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Meritain Health CPD,Meritain Health CPD,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Starmark CPD,Starmark CPD,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Aetna Medicare,Aetna Medicare,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Ambetter ,Ambetter ,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Blue Access,Anthem Blue Access,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Blue Access Choice,Anthem Blue Access Choice,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Blue Preferred,Anthem Blue Preferred,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Pathway,Anthem Pathway,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Alliance,Anthem Alliance,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Anthem Medicare,Anthem Medicare,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Cigna,Cigna,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Cigna PPO,Cigna PPO,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Cigna Medicare Advantage,Cigna Medicare Advantage,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Essence,Essence,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Healthlink HMO,Healthlink HMO,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Healthlink PPO,Healthlink PPO,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,HomeState Health Plan,HomeState Health Plan,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Humana Gold,Humana Gold,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Medicaid MO,Medicaid MO,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Medica,Medica,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Tricare,Tricare,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,UHC All Payer,UHC All Payer,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,UHC Exchange,UHC Exchange,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,UHC Medicaid,UHC Medicaid,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,UMR CPD,UMR CPD,63.5,,,,,,,per diem,63.5,63.5,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,UHC Medicare,UHC Medicare,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33127533,CDM,279,RC,,,,,,Inpatient,,,63.5,63.5,Wellcare,Wellcare,63.5,,,,,,,case rate,63.5,63.5,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Meritain Health PPO CPD,Meritain Health PPO CPD,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Aetna/Commercial Product,Aetna/Commercial Product,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Meritain Health CPD,Meritain Health CPD,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Starmark CPD,Starmark CPD,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Aetna Medicare,Aetna Medicare,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Ambetter ,Ambetter ,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Blue Access,Anthem Blue Access,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Blue Access Choice,Anthem Blue Access Choice,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Blue Preferred,Anthem Blue Preferred,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Pathway,Anthem Pathway,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Alliance,Anthem Alliance,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Anthem Medicare,Anthem Medicare,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Cigna,Cigna,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Cigna PPO,Cigna PPO,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Cigna Medicare Advantage,Cigna Medicare Advantage,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Essence,Essence,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Healthlink HMO,Healthlink HMO,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Healthlink PPO,Healthlink PPO,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,HomeState Health Plan,HomeState Health Plan,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Humana Gold,Humana Gold,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Medicaid MO,Medicaid MO,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Medica,Medica,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Tricare,Tricare,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,UHC All Payer,UHC All Payer,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,UHC Exchange,UHC Exchange,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,UHC Medicaid,UHC Medicaid,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,UMR CPD,UMR CPD,111.25,,,,,,,per diem,111.25,111.25,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,UHC Medicare,UHC Medicare,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33127534,CDM,279,RC,,,,,,Inpatient,,,111.25,111.25,Wellcare,Wellcare,111.25,,,,,,,case rate,111.25,111.25,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Meritain Health PPO CPD,Meritain Health PPO CPD,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Aetna/Commercial Product,Aetna/Commercial Product,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Meritain Health CPD,Meritain Health CPD,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Starmark CPD,Starmark CPD,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Aetna Medicare,Aetna Medicare,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Ambetter ,Ambetter ,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Blue Access,Anthem Blue Access,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Blue Access Choice,Anthem Blue Access Choice,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Blue Preferred,Anthem Blue Preferred,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Pathway,Anthem Pathway,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Alliance,Anthem Alliance,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Anthem Medicare,Anthem Medicare,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Cigna,Cigna,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Cigna PPO,Cigna PPO,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Cigna Medicare Advantage,Cigna Medicare Advantage,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Essence,Essence,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Healthlink HMO,Healthlink HMO,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Healthlink PPO,Healthlink PPO,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,HomeState Health Plan,HomeState Health Plan,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Humana Gold,Humana Gold,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Medicaid MO,Medicaid MO,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Medica,Medica,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Tricare,Tricare,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,UHC All Payer,UHC All Payer,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,UHC Exchange,UHC Exchange,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,UHC Medicaid,UHC Medicaid,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,UMR CPD,UMR CPD,132.36,,,,,,,per diem,132.36,132.36,"Per diem rate, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,UHC Medicare,UHC Medicare,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
COLLAR UNIVERSAL ASPEN # 5255-,33129235,CDM,270,RC,,,,,,Inpatient,,,132.36,132.36,Wellcare,Wellcare,132.36,,,,,,,case rate,132.36,132.36,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Meritain Health PPO CPD,Meritain Health PPO CPD,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Aetna/Commercial Product,Aetna/Commercial Product,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Meritain Health CPD,Meritain Health CPD,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Starmark CPD,Starmark CPD,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Aetna Medicare,Aetna Medicare,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Ambetter ,Ambetter ,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Blue Access,Anthem Blue Access,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Blue Access Choice,Anthem Blue Access Choice,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Blue Preferred,Anthem Blue Preferred,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Pathway,Anthem Pathway,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Alliance,Anthem Alliance,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Anthem Medicare,Anthem Medicare,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Cigna,Cigna,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Cigna PPO,Cigna PPO,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Cigna Medicare Advantage,Cigna Medicare Advantage,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Essence,Essence,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Healthlink HMO,Healthlink HMO,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Healthlink PPO,Healthlink PPO,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,HomeState Health Plan,HomeState Health Plan,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Humana Gold,Humana Gold,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Medicaid MO,Medicaid MO,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Medica,Medica,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Tricare,Tricare,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,UHC All Payer,UHC All Payer,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,UHC Exchange,UHC Exchange,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,UHC Medicaid,UHC Medicaid,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,UMR CPD,UMR CPD,16.95,,,,,,,per diem,16.95,16.95,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,UHC Medicare,UHC Medicare,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN TO 45I,33129236,CDM,270,RC,,,,,,Inpatient,,,16.95,16.95,Wellcare,Wellcare,16.95,,,,,,,case rate,16.95,16.95,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Meritain Health PPO CPD,Meritain Health PPO CPD,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Aetna/Commercial Product,Aetna/Commercial Product,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Meritain Health CPD,Meritain Health CPD,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Starmark CPD,Starmark CPD,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Aetna Medicare,Aetna Medicare,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Ambetter ,Ambetter ,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Blue Access,Anthem Blue Access,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Blue Access Choice,Anthem Blue Access Choice,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Blue Preferred,Anthem Blue Preferred,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Pathway,Anthem Pathway,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Alliance,Anthem Alliance,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Anthem Medicare,Anthem Medicare,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Cigna,Cigna,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Cigna PPO,Cigna PPO,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Cigna Medicare Advantage,Cigna Medicare Advantage,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Essence,Essence,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Healthlink HMO,Healthlink HMO,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Healthlink PPO,Healthlink PPO,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,HomeState Health Plan,HomeState Health Plan,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Humana Gold,Humana Gold,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Medicaid MO,Medicaid MO,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Medica,Medica,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Tricare,Tricare,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,UHC All Payer,UHC All Payer,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,UHC Exchange,UHC Exchange,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,UHC Medicaid,UHC Medicaid,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,UMR CPD,UMR CPD,15.19,,,,,,,per diem,15.19,15.19,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,UHC Medicare,UHC Medicare,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33129237,CDM,270,RC,,,,,,Inpatient,,,15.19,15.19,Wellcare,Wellcare,15.19,,,,,,,case rate,15.19,15.19,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Meritain Health PPO CPD,Meritain Health PPO CPD,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Aetna/Commercial Product,Aetna/Commercial Product,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Meritain Health CPD,Meritain Health CPD,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Starmark CPD,Starmark CPD,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Aetna Medicare,Aetna Medicare,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Ambetter ,Ambetter ,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Blue Access,Anthem Blue Access,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Blue Access Choice,Anthem Blue Access Choice,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Blue Preferred,Anthem Blue Preferred,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Pathway,Anthem Pathway,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Alliance,Anthem Alliance,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Anthem Medicare,Anthem Medicare,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Cigna,Cigna,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Cigna PPO,Cigna PPO,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Cigna Medicare Advantage,Cigna Medicare Advantage,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Essence,Essence,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Healthlink HMO,Healthlink HMO,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Healthlink PPO,Healthlink PPO,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,HomeState Health Plan,HomeState Health Plan,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Humana Gold,Humana Gold,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Medicaid MO,Medicaid MO,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Medica,Medica,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Tricare,Tricare,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,UHC All Payer,UHC All Payer,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,UHC Exchange,UHC Exchange,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,UHC Medicaid,UHC Medicaid,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,UMR CPD,UMR CPD,8.1,,,,,,,per diem,8.1,8.1,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,UHC Medicare,UHC Medicare,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33129250,CDM,270,RC,,,,,,Inpatient,,,8.1,8.1,Wellcare,Wellcare,8.1,,,,,,,case rate,8.1,8.1,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Meritain Health PPO CPD,Meritain Health PPO CPD,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Aetna/Commercial Product,Aetna/Commercial Product,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Meritain Health CPD,Meritain Health CPD,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Starmark CPD,Starmark CPD,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Aetna Medicare,Aetna Medicare,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Ambetter ,Ambetter ,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Blue Access,Anthem Blue Access,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Blue Access Choice,Anthem Blue Access Choice,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Blue Preferred,Anthem Blue Preferred,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Pathway,Anthem Pathway,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Alliance,Anthem Alliance,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Anthem Medicare,Anthem Medicare,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Cigna,Cigna,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Cigna PPO,Cigna PPO,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Cigna Medicare Advantage,Cigna Medicare Advantage,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Essence,Essence,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Healthlink HMO,Healthlink HMO,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Healthlink PPO,Healthlink PPO,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,HomeState Health Plan,HomeState Health Plan,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Humana Gold,Humana Gold,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Medicaid MO,Medicaid MO,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Medica,Medica,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Tricare,Tricare,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,UHC All Payer,UHC All Payer,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,UHC Exchange,UHC Exchange,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,UHC Medicaid,UHC Medicaid,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,UMR CPD,UMR CPD,39.39,,,,,,,per diem,39.39,39.39,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,UHC Medicare,UHC Medicare,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR LG 3 1/4 # 79-,33129258,CDM,270,RC,,,,,,Inpatient,,,39.39,39.39,Wellcare,Wellcare,39.39,,,,,,,case rate,39.39,39.39,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Meritain Health PPO CPD,Meritain Health PPO CPD,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Aetna/Commercial Product,Aetna/Commercial Product,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Meritain Health CPD,Meritain Health CPD,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Starmark CPD,Starmark CPD,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Aetna Medicare,Aetna Medicare,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Ambetter ,Ambetter ,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Blue Access,Anthem Blue Access,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Blue Access Choice,Anthem Blue Access Choice,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Blue Preferred,Anthem Blue Preferred,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Pathway,Anthem Pathway,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Alliance,Anthem Alliance,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Anthem Medicare,Anthem Medicare,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Cigna,Cigna,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Cigna PPO,Cigna PPO,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Cigna Medicare Advantage,Cigna Medicare Advantage,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Essence,Essence,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Healthlink HMO,Healthlink HMO,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Healthlink PPO,Healthlink PPO,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,HomeState Health Plan,HomeState Health Plan,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Humana Gold,Humana Gold,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Medicaid MO,Medicaid MO,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Medica,Medica,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Tricare,Tricare,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,UHC All Payer,UHC All Payer,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,UHC Exchange,UHC Exchange,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,UHC Medicaid,UHC Medicaid,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,UMR CPD,UMR CPD,39.54,,,,,,,per diem,39.54,39.54,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,UHC Medicare,UHC Medicare,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR SMALL 4 1/4 # ,33129259,CDM,270,RC,,,,,,Inpatient,,,39.54,39.54,Wellcare,Wellcare,39.54,,,,,,,case rate,39.54,39.54,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Meritain Health PPO CPD,Meritain Health PPO CPD,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Aetna/Commercial Product,Aetna/Commercial Product,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Meritain Health CPD,Meritain Health CPD,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Starmark CPD,Starmark CPD,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Aetna Medicare,Aetna Medicare,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Ambetter ,Ambetter ,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Blue Access,Anthem Blue Access,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Blue Access Choice,Anthem Blue Access Choice,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Blue Preferred,Anthem Blue Preferred,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Pathway,Anthem Pathway,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Alliance,Anthem Alliance,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Anthem Medicare,Anthem Medicare,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Cigna,Cigna,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Cigna PPO,Cigna PPO,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Cigna Medicare Advantage,Cigna Medicare Advantage,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Essence,Essence,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Healthlink HMO,Healthlink HMO,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Healthlink PPO,Healthlink PPO,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,HomeState Health Plan,HomeState Health Plan,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Humana Gold,Humana Gold,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Medicaid MO,Medicaid MO,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Medica,Medica,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Tricare,Tricare,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,UHC All Payer,UHC All Payer,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,UHC Exchange,UHC Exchange,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,UHC Medicaid,UHC Medicaid,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,UMR CPD,UMR CPD,68.58,,,,,,,per diem,68.58,68.58,"Per diem rate, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,UHC Medicare,UHC Medicare,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
KNEE SEPARATOR W/ POLYESTER CO,33129261,CDM,270,RC,,,,,,Inpatient,,,68.58,68.58,Wellcare,Wellcare,68.58,,,,,,,case rate,68.58,68.58,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Meritain Health PPO CPD,Meritain Health PPO CPD,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Aetna/Commercial Product,Aetna/Commercial Product,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Meritain Health CPD,Meritain Health CPD,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Starmark CPD,Starmark CPD,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Aetna Medicare,Aetna Medicare,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Ambetter ,Ambetter ,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Blue Access,Anthem Blue Access,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Blue Access Choice,Anthem Blue Access Choice,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Blue Preferred,Anthem Blue Preferred,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Pathway,Anthem Pathway,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Alliance,Anthem Alliance,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Anthem Medicare,Anthem Medicare,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Cigna,Cigna,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Cigna PPO,Cigna PPO,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Cigna Medicare Advantage,Cigna Medicare Advantage,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Essence,Essence,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Healthlink HMO,Healthlink HMO,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Healthlink PPO,Healthlink PPO,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,HomeState Health Plan,HomeState Health Plan,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Humana Gold,Humana Gold,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Medicaid MO,Medicaid MO,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Medica,Medica,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Tricare,Tricare,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,UHC All Payer,UHC All Payer,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,UHC Exchange,UHC Exchange,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,UHC Medicaid,UHC Medicaid,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,UMR CPD,UMR CPD,18.75,,,,,,,per diem,18.75,18.75,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,UHC Medicare,UHC Medicare,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER MED # A545,33129263,CDM,270,RC,,,,,,Inpatient,,,18.75,18.75,Wellcare,Wellcare,18.75,,,,,,,case rate,18.75,18.75,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Meritain Health PPO CPD,Meritain Health PPO CPD,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Aetna/Commercial Product,Aetna/Commercial Product,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Meritain Health CPD,Meritain Health CPD,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Starmark CPD,Starmark CPD,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Aetna Medicare,Aetna Medicare,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Ambetter ,Ambetter ,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Blue Access,Anthem Blue Access,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Blue Access Choice,Anthem Blue Access Choice,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Blue Preferred,Anthem Blue Preferred,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Pathway,Anthem Pathway,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Alliance,Anthem Alliance,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Anthem Medicare,Anthem Medicare,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Cigna,Cigna,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Cigna PPO,Cigna PPO,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Cigna Medicare Advantage,Cigna Medicare Advantage,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Essence,Essence,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Healthlink HMO,Healthlink HMO,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Healthlink PPO,Healthlink PPO,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,HomeState Health Plan,HomeState Health Plan,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Humana Gold,Humana Gold,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Medicaid MO,Medicaid MO,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Medica,Medica,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Tricare,Tricare,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,UHC All Payer,UHC All Payer,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,UHC Exchange,UHC Exchange,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,UHC Medicaid,UHC Medicaid,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,UMR CPD,UMR CPD,51.91,,,,,,,per diem,51.91,51.91,"Per diem rate, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,UHC Medicare,UHC Medicare,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SHOULDER IMMOBILZER LARGE # A5,33129264,CDM,270,RC,,,,,,Inpatient,,,51.91,51.91,Wellcare,Wellcare,51.91,,,,,,,case rate,51.91,51.91,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Meritain Health PPO CPD,Meritain Health PPO CPD,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Aetna/Commercial Product,Aetna/Commercial Product,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Meritain Health CPD,Meritain Health CPD,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Starmark CPD,Starmark CPD,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Aetna Medicare,Aetna Medicare,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Ambetter ,Ambetter ,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Blue Access,Anthem Blue Access,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Blue Access Choice,Anthem Blue Access Choice,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Blue Preferred,Anthem Blue Preferred,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Pathway,Anthem Pathway,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Alliance,Anthem Alliance,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Anthem Medicare,Anthem Medicare,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Cigna,Cigna,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Cigna PPO,Cigna PPO,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Cigna Medicare Advantage,Cigna Medicare Advantage,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Essence,Essence,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Healthlink HMO,Healthlink HMO,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Healthlink PPO,Healthlink PPO,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,HomeState Health Plan,HomeState Health Plan,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Humana Gold,Humana Gold,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Medicaid MO,Medicaid MO,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Medica,Medica,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Tricare,Tricare,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,UHC All Payer,UHC All Payer,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,UHC Exchange,UHC Exchange,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,UHC Medicaid,UHC Medicaid,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,UMR CPD,UMR CPD,5.45,,,,,,,per diem,5.45,5.45,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,UHC Medicare,UHC Medicare,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33129303,CDM,279,RC,,,,,,Inpatient,,,5.45,5.45,Wellcare,Wellcare,5.45,,,,,,,case rate,5.45,5.45,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Meritain Health PPO CPD,Meritain Health PPO CPD,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Aetna/Commercial Product,Aetna/Commercial Product,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Meritain Health CPD,Meritain Health CPD,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Starmark CPD,Starmark CPD,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Aetna Medicare,Aetna Medicare,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Ambetter ,Ambetter ,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Blue Access,Anthem Blue Access,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Blue Access Choice,Anthem Blue Access Choice,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Blue Preferred,Anthem Blue Preferred,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Pathway,Anthem Pathway,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Alliance,Anthem Alliance,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Anthem Medicare,Anthem Medicare,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Cigna,Cigna,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Cigna PPO,Cigna PPO,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Cigna Medicare Advantage,Cigna Medicare Advantage,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Essence,Essence,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Healthlink HMO,Healthlink HMO,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Healthlink PPO,Healthlink PPO,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,HomeState Health Plan,HomeState Health Plan,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Humana Gold,Humana Gold,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Medicaid MO,Medicaid MO,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Medica,Medica,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Tricare,Tricare,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,UHC All Payer,UHC All Payer,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,UHC Exchange,UHC Exchange,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,UHC Medicaid,UHC Medicaid,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,UMR CPD,UMR CPD,115.4,,,,,,,per diem,115.4,115.4,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,UHC Medicare,UHC Medicare,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33129317,CDM,279,RC,,,,,,Inpatient,,,115.4,115.4,Wellcare,Wellcare,115.4,,,,,,,case rate,115.4,115.4,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Meritain Health PPO CPD,Meritain Health PPO CPD,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Aetna/Commercial Product,Aetna/Commercial Product,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Meritain Health CPD,Meritain Health CPD,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Starmark CPD,Starmark CPD,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Aetna Medicare,Aetna Medicare,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Ambetter ,Ambetter ,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Blue Access,Anthem Blue Access,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Blue Access Choice,Anthem Blue Access Choice,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Blue Preferred,Anthem Blue Preferred,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Pathway,Anthem Pathway,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Alliance,Anthem Alliance,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Anthem Medicare,Anthem Medicare,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Cigna,Cigna,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Cigna PPO,Cigna PPO,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Cigna Medicare Advantage,Cigna Medicare Advantage,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Essence,Essence,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Healthlink HMO,Healthlink HMO,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Healthlink PPO,Healthlink PPO,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,HomeState Health Plan,HomeState Health Plan,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Humana Gold,Humana Gold,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Medicaid MO,Medicaid MO,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Medica,Medica,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Tricare,Tricare,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,UHC All Payer,UHC All Payer,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,UHC Exchange,UHC Exchange,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,UHC Medicaid,UHC Medicaid,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,UMR CPD,UMR CPD,151,,,,,,,per diem,151,151,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,UHC Medicare,UHC Medicare,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33129320,CDM,270,RC,,,,,,Inpatient,,,151,151,Wellcare,Wellcare,151,,,,,,,case rate,151,151,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Meritain Health PPO CPD,Meritain Health PPO CPD,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Aetna/Commercial Product,Aetna/Commercial Product,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Meritain Health CPD,Meritain Health CPD,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Starmark CPD,Starmark CPD,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Aetna Medicare,Aetna Medicare,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Ambetter ,Ambetter ,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Blue Access,Anthem Blue Access,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Blue Access Choice,Anthem Blue Access Choice,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Blue Preferred,Anthem Blue Preferred,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Pathway,Anthem Pathway,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Alliance,Anthem Alliance,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Anthem Medicare,Anthem Medicare,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Cigna,Cigna,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Cigna PPO,Cigna PPO,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Cigna Medicare Advantage,Cigna Medicare Advantage,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Essence,Essence,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Healthlink HMO,Healthlink HMO,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Healthlink PPO,Healthlink PPO,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,HomeState Health Plan,HomeState Health Plan,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Humana Gold,Humana Gold,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Medicaid MO,Medicaid MO,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Medica,Medica,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Tricare,Tricare,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,UHC All Payer,UHC All Payer,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,UHC Exchange,UHC Exchange,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,UHC Medicaid,UHC Medicaid,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,UMR CPD,UMR CPD,98.8,,,,,,,per diem,98.8,98.8,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,UHC Medicare,UHC Medicare,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33129383,CDM,270,RC,,,,,,Inpatient,,,98.8,98.8,Wellcare,Wellcare,98.8,,,,,,,case rate,98.8,98.8,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Meritain Health PPO CPD,Meritain Health PPO CPD,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Aetna/Commercial Product,Aetna/Commercial Product,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Meritain Health CPD,Meritain Health CPD,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Starmark CPD,Starmark CPD,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Aetna Medicare,Aetna Medicare,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Ambetter ,Ambetter ,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Blue Access,Anthem Blue Access,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Blue Access Choice,Anthem Blue Access Choice,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Blue Preferred,Anthem Blue Preferred,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Pathway,Anthem Pathway,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Alliance,Anthem Alliance,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Anthem Medicare,Anthem Medicare,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Cigna,Cigna,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Cigna PPO,Cigna PPO,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Cigna Medicare Advantage,Cigna Medicare Advantage,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Essence,Essence,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Healthlink HMO,Healthlink HMO,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Healthlink PPO,Healthlink PPO,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,HomeState Health Plan,HomeState Health Plan,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Humana Gold,Humana Gold,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Medicaid MO,Medicaid MO,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Medica,Medica,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Tricare,Tricare,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,UHC All Payer,UHC All Payer,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,UHC Exchange,UHC Exchange,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,UHC Medicaid,UHC Medicaid,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,UMR CPD,UMR CPD,74.3,,,,,,,per diem,74.3,74.3,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,UHC Medicare,UHC Medicare,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33129385,CDM,270,RC,,,,,,Inpatient,,,74.3,74.3,Wellcare,Wellcare,74.3,,,,,,,case rate,74.3,74.3,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Meritain Health PPO CPD,Meritain Health PPO CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna/Commercial Product,Aetna/Commercial Product,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Meritain Health CPD,Meritain Health CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Starmark CPD,Starmark CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna Medicare,Aetna Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Ambetter ,Ambetter ,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Access,Anthem Blue Access,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Access Choice,Anthem Blue Access Choice,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Preferred,Anthem Blue Preferred,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Pathway,Anthem Pathway,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Alliance,Anthem Alliance,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Medicare,Anthem Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna,Cigna,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna PPO,Cigna PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna Medicare Advantage,Cigna Medicare Advantage,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Essence,Essence,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthlink HMO,Healthlink HMO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthlink PPO,Healthlink PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,HomeState Health Plan,HomeState Health Plan,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Humana Gold,Humana Gold,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Medicaid MO,Medicaid MO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Medica,Medica,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Tricare,Tricare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC All Payer,UHC All Payer,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Exchange,UHC Exchange,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Medicaid,UHC Medicaid,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UMR CPD,UMR CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Medicare,UHC Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
BARIATRIC DEOP ARM COMMODE    ,33129507,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Wellcare,Wellcare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Meritain Health PPO CPD,Meritain Health PPO CPD,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Aetna/Commercial Product,Aetna/Commercial Product,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Meritain Health CPD,Meritain Health CPD,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Starmark CPD,Starmark CPD,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Aetna Medicare,Aetna Medicare,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Ambetter ,Ambetter ,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Blue Access,Anthem Blue Access,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Blue Access Choice,Anthem Blue Access Choice,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Blue Preferred,Anthem Blue Preferred,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Pathway,Anthem Pathway,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Alliance,Anthem Alliance,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Anthem Medicare,Anthem Medicare,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Cigna,Cigna,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Cigna PPO,Cigna PPO,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Cigna Medicare Advantage,Cigna Medicare Advantage,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Essence,Essence,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Healthlink HMO,Healthlink HMO,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Healthlink PPO,Healthlink PPO,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,HomeState Health Plan,HomeState Health Plan,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Humana Gold,Humana Gold,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Medicaid MO,Medicaid MO,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Medica,Medica,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Tricare,Tricare,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,UHC All Payer,UHC All Payer,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,UHC Exchange,UHC Exchange,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,UHC Medicaid,UHC Medicaid,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,UMR CPD,UMR CPD,549.9,,,,,,,per diem,549.9,549.9,"Per diem rate, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,UHC Medicare,UHC Medicare,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ICEMAN COOLER # 11-0494       ,33129536,CDM,279,RC,,,,,,Inpatient,,,549.9,549.9,Wellcare,Wellcare,549.9,,,,,,,case rate,549.9,549.9,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Meritain Health PPO CPD,Meritain Health PPO CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna/Commercial Product,Aetna/Commercial Product,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Meritain Health CPD,Meritain Health CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Starmark CPD,Starmark CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna Medicare,Aetna Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Ambetter ,Ambetter ,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Access,Anthem Blue Access,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Access Choice,Anthem Blue Access Choice,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Preferred,Anthem Blue Preferred,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Pathway,Anthem Pathway,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Alliance,Anthem Alliance,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Medicare,Anthem Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna,Cigna,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna PPO,Cigna PPO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna Medicare Advantage,Cigna Medicare Advantage,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Essence,Essence,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthlink HMO,Healthlink HMO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthlink PPO,Healthlink PPO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,HomeState Health Plan,HomeState Health Plan,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Humana Gold,Humana Gold,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Medicaid MO,Medicaid MO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Medica,Medica,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Tricare,Tricare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC All Payer,UHC All Payer,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Exchange,UHC Exchange,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Medicaid,UHC Medicaid,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UMR CPD,UMR CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Medicare,UHC Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129556,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Wellcare,Wellcare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Meritain Health PPO CPD,Meritain Health PPO CPD,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Aetna/Commercial Product,Aetna/Commercial Product,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Meritain Health CPD,Meritain Health CPD,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Starmark CPD,Starmark CPD,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Aetna Medicare,Aetna Medicare,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Ambetter ,Ambetter ,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Blue Access,Anthem Blue Access,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Blue Access Choice,Anthem Blue Access Choice,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Blue Preferred,Anthem Blue Preferred,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Pathway,Anthem Pathway,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Alliance,Anthem Alliance,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Anthem Medicare,Anthem Medicare,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Cigna,Cigna,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Cigna PPO,Cigna PPO,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Cigna Medicare Advantage,Cigna Medicare Advantage,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Essence,Essence,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Healthlink HMO,Healthlink HMO,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Healthlink PPO,Healthlink PPO,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,HomeState Health Plan,HomeState Health Plan,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Humana Gold,Humana Gold,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Medicaid MO,Medicaid MO,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Medica,Medica,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Tricare,Tricare,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,UHC All Payer,UHC All Payer,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,UHC Exchange,UHC Exchange,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,UHC Medicaid,UHC Medicaid,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,UMR CPD,UMR CPD,230.61,,,,,,,per diem,230.61,230.61,"Per diem rate, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,UHC Medicare,UHC Medicare,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
ROYLAM DURABLE UNIVERSAL BOOT ,33129558,CDM,270,RC,,,,,,Inpatient,,,230.61,230.61,Wellcare,Wellcare,230.61,,,,,,,case rate,230.61,230.61,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Meritain Health PPO CPD,Meritain Health PPO CPD,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Aetna/Commercial Product,Aetna/Commercial Product,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Meritain Health CPD,Meritain Health CPD,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Starmark CPD,Starmark CPD,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Aetna Medicare,Aetna Medicare,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Ambetter ,Ambetter ,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Blue Access,Anthem Blue Access,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Blue Access Choice,Anthem Blue Access Choice,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Blue Preferred,Anthem Blue Preferred,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Pathway,Anthem Pathway,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Alliance,Anthem Alliance,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Anthem Medicare,Anthem Medicare,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Cigna,Cigna,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Cigna PPO,Cigna PPO,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Cigna Medicare Advantage,Cigna Medicare Advantage,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Essence,Essence,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Healthlink HMO,Healthlink HMO,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Healthlink PPO,Healthlink PPO,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,HomeState Health Plan,HomeState Health Plan,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Humana Gold,Humana Gold,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Medicaid MO,Medicaid MO,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Medica,Medica,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Tricare,Tricare,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,UHC All Payer,UHC All Payer,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,UHC Exchange,UHC Exchange,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,UHC Medicaid,UHC Medicaid,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,UMR CPD,UMR CPD,84.57,,,,,,,per diem,84.57,84.57,"Per diem rate, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,UHC Medicare,UHC Medicare,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
TRI PANEL KNEE IMMOBILIZER #55,33129572,CDM,270,RC,,,,,,Inpatient,,,84.57,84.57,Wellcare,Wellcare,84.57,,,,,,,case rate,84.57,84.57,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Meritain Health PPO CPD,Meritain Health PPO CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna/Commercial Product,Aetna/Commercial Product,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Meritain Health CPD,Meritain Health CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Starmark CPD,Starmark CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Aetna Medicare,Aetna Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Ambetter ,Ambetter ,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Access,Anthem Blue Access,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Access Choice,Anthem Blue Access Choice,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Blue Preferred,Anthem Blue Preferred,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Pathway,Anthem Pathway,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Alliance,Anthem Alliance,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Anthem Medicare,Anthem Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna,Cigna,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna PPO,Cigna PPO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Cigna Medicare Advantage,Cigna Medicare Advantage,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Essence,Essence,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthlink HMO,Healthlink HMO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Healthlink PPO,Healthlink PPO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,HomeState Health Plan,HomeState Health Plan,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Humana Gold,Humana Gold,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Medicaid MO,Medicaid MO,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Medica,Medica,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Tricare,Tricare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC All Payer,UHC All Payer,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Exchange,UHC Exchange,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Medicaid,UHC Medicaid,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UMR CPD,UMR CPD,72.21,,,,,,,per diem,72.21,72.21,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,UHC Medicare,UHC Medicare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129573,CDM,270,RC,,,,,,Inpatient,,,72.21,72.21,Wellcare,Wellcare,72.21,,,,,,,case rate,72.21,72.21,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Meritain Health PPO CPD,Meritain Health PPO CPD,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Aetna/Commercial Product,Aetna/Commercial Product,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Meritain Health CPD,Meritain Health CPD,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Starmark CPD,Starmark CPD,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Aetna Medicare,Aetna Medicare,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Ambetter ,Ambetter ,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Blue Access,Anthem Blue Access,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Blue Access Choice,Anthem Blue Access Choice,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Blue Preferred,Anthem Blue Preferred,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Pathway,Anthem Pathway,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Alliance,Anthem Alliance,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Anthem Medicare,Anthem Medicare,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Cigna,Cigna,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Cigna PPO,Cigna PPO,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Cigna Medicare Advantage,Cigna Medicare Advantage,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Essence,Essence,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Healthlink HMO,Healthlink HMO,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Healthlink PPO,Healthlink PPO,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,HomeState Health Plan,HomeState Health Plan,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Humana Gold,Humana Gold,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Medicaid MO,Medicaid MO,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Medica,Medica,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Tricare,Tricare,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,UHC All Payer,UHC All Payer,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,UHC Exchange,UHC Exchange,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,UHC Medicaid,UHC Medicaid,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,UMR CPD,UMR CPD,81.54,,,,,,,per diem,81.54,81.54,"Per diem rate, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,UHC Medicare,UHC Medicare,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
ROLYAN UNIVERSAL KNEE IMMOBILI,33129574,CDM,270,RC,,,,,,Inpatient,,,81.54,81.54,Wellcare,Wellcare,81.54,,,,,,,case rate,81.54,81.54,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Meritain Health PPO CPD,Meritain Health PPO CPD,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Aetna/Commercial Product,Aetna/Commercial Product,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Meritain Health CPD,Meritain Health CPD,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Starmark CPD,Starmark CPD,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Aetna Medicare,Aetna Medicare,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Ambetter ,Ambetter ,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Blue Access,Anthem Blue Access,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Blue Access Choice,Anthem Blue Access Choice,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Blue Preferred,Anthem Blue Preferred,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Pathway,Anthem Pathway,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Alliance,Anthem Alliance,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Anthem Medicare,Anthem Medicare,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Cigna,Cigna,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Cigna PPO,Cigna PPO,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Cigna Medicare Advantage,Cigna Medicare Advantage,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Essence,Essence,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Healthlink HMO,Healthlink HMO,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Healthlink PPO,Healthlink PPO,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,HomeState Health Plan,HomeState Health Plan,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Humana Gold,Humana Gold,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Medicaid MO,Medicaid MO,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Medica,Medica,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Tricare,Tricare,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,UHC All Payer,UHC All Payer,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,UHC Exchange,UHC Exchange,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,UHC Medicaid,UHC Medicaid,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,UMR CPD,UMR CPD,63.72,,,,,,,per diem,63.72,63.72,"Per diem rate, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,UHC Medicare,UHC Medicare,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
SI BACK BELT MEDIUM #56298602 ,33129575,CDM,270,RC,,,,,,Inpatient,,,63.72,63.72,Wellcare,Wellcare,63.72,,,,,,,case rate,63.72,63.72,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Meritain Health PPO CPD,Meritain Health PPO CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna/Commercial Product,Aetna/Commercial Product,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Meritain Health CPD,Meritain Health CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Starmark CPD,Starmark CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna Medicare,Aetna Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Ambetter ,Ambetter ,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Access,Anthem Blue Access,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Access Choice,Anthem Blue Access Choice,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Preferred,Anthem Blue Preferred,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Pathway,Anthem Pathway,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Alliance,Anthem Alliance,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Medicare,Anthem Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna,Cigna,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna PPO,Cigna PPO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna Medicare Advantage,Cigna Medicare Advantage,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Essence,Essence,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthlink HMO,Healthlink HMO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthlink PPO,Healthlink PPO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,HomeState Health Plan,HomeState Health Plan,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Humana Gold,Humana Gold,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Medicaid MO,Medicaid MO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Medica,Medica,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Tricare,Tricare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC All Payer,UHC All Payer,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Exchange,UHC Exchange,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Medicaid,UHC Medicaid,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UMR CPD,UMR CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Medicare,UHC Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT X LARGE # 56,33129576,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Wellcare,Wellcare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Meritain Health PPO CPD,Meritain Health PPO CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna/Commercial Product,Aetna/Commercial Product,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Meritain Health CPD,Meritain Health CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Starmark CPD,Starmark CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Aetna Medicare,Aetna Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Ambetter ,Ambetter ,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Access,Anthem Blue Access,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Access Choice,Anthem Blue Access Choice,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Blue Preferred,Anthem Blue Preferred,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Pathway,Anthem Pathway,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Alliance,Anthem Alliance,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Anthem Medicare,Anthem Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna,Cigna,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna PPO,Cigna PPO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Cigna Medicare Advantage,Cigna Medicare Advantage,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Essence,Essence,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthlink HMO,Healthlink HMO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Healthlink PPO,Healthlink PPO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,HomeState Health Plan,HomeState Health Plan,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Humana Gold,Humana Gold,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Medicaid MO,Medicaid MO,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Medica,Medica,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Tricare,Tricare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC All Payer,UHC All Payer,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Exchange,UHC Exchange,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Medicaid,UHC Medicaid,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UMR CPD,UMR CPD,175.71,,,,,,,per diem,175.71,175.71,"Per diem rate, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,UHC Medicare,UHC Medicare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
ROYLAN PODUS BOOT STANDARD # 5,33129577,CDM,270,RC,,,,,,Inpatient,,,175.71,175.71,Wellcare,Wellcare,175.71,,,,,,,case rate,175.71,175.71,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Meritain Health PPO CPD,Meritain Health PPO CPD,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Aetna/Commercial Product,Aetna/Commercial Product,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Meritain Health CPD,Meritain Health CPD,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Starmark CPD,Starmark CPD,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Aetna Medicare,Aetna Medicare,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Ambetter ,Ambetter ,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Blue Access,Anthem Blue Access,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Blue Access Choice,Anthem Blue Access Choice,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Blue Preferred,Anthem Blue Preferred,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Pathway,Anthem Pathway,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Alliance,Anthem Alliance,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Anthem Medicare,Anthem Medicare,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Cigna,Cigna,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Cigna PPO,Cigna PPO,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Cigna Medicare Advantage,Cigna Medicare Advantage,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Essence,Essence,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Healthlink HMO,Healthlink HMO,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Healthlink PPO,Healthlink PPO,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,HomeState Health Plan,HomeState Health Plan,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Humana Gold,Humana Gold,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Medicaid MO,Medicaid MO,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Medica,Medica,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Tricare,Tricare,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,UHC All Payer,UHC All Payer,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,UHC Exchange,UHC Exchange,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,UHC Medicaid,UHC Medicaid,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,UMR CPD,UMR CPD,3.96,,,,,,,per diem,3.96,3.96,"Per diem rate, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,UHC Medicare,UHC Medicare,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
COLLAR TRACH LARGE 3 1/4 # 525,33129579,CDM,270,RC,,,,,,Inpatient,,,3.96,3.96,Wellcare,Wellcare,3.96,,,,,,,case rate,3.96,3.96,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health PPO CPD,Meritain Health PPO CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/Commercial Product,Aetna/Commercial Product,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health CPD,Meritain Health CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Starmark CPD,Starmark CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna Medicare,Aetna Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Ambetter ,Ambetter ,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access,Anthem Blue Access,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access Choice,Anthem Blue Access Choice,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Preferred,Anthem Blue Preferred,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Pathway,Anthem Pathway,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Alliance,Anthem Alliance,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Medicare,Anthem Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna,Cigna,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna PPO,Cigna PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna Medicare Advantage,Cigna Medicare Advantage,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Essence,Essence,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink HMO,Healthlink HMO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink PPO,Healthlink PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,HomeState Health Plan,HomeState Health Plan,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Humana Gold,Humana Gold,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Medicaid MO,Medicaid MO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Medica,Medica,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Tricare,Tricare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC All Payer,UHC All Payer,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Exchange,UHC Exchange,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicaid,UHC Medicaid,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,UMR CPD,UMR CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicare,UHC Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
POSEY VAIL BED DAILY RENTAL   ,33129588,CDM,279,RC,,,,,,Inpatient,,,180,180,Wellcare,Wellcare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health PPO CPD,Meritain Health PPO CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/Commercial Product,Aetna/Commercial Product,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health CPD,Meritain Health CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Starmark CPD,Starmark CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna Medicare,Aetna Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Ambetter ,Ambetter ,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access,Anthem Blue Access,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access Choice,Anthem Blue Access Choice,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Preferred,Anthem Blue Preferred,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Pathway,Anthem Pathway,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Alliance,Anthem Alliance,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Medicare,Anthem Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna,Cigna,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna PPO,Cigna PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna Medicare Advantage,Cigna Medicare Advantage,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Essence,Essence,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink HMO,Healthlink HMO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink PPO,Healthlink PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,HomeState Health Plan,HomeState Health Plan,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Humana Gold,Humana Gold,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medicaid MO,Medicaid MO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medica,Medica,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Tricare,Tricare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC All Payer,UHC All Payer,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Exchange,UHC Exchange,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicaid,UHC Medicaid,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UMR CPD,UMR CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicare,UHC Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33129589,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Wellcare,Wellcare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33129590,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Meritain Health PPO CPD,Meritain Health PPO CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna/Commercial Product,Aetna/Commercial Product,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Meritain Health CPD,Meritain Health CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Starmark CPD,Starmark CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna Medicare,Aetna Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Ambetter ,Ambetter ,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Access,Anthem Blue Access,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Access Choice,Anthem Blue Access Choice,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Preferred,Anthem Blue Preferred,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Pathway,Anthem Pathway,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Alliance,Anthem Alliance,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Medicare,Anthem Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna,Cigna,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna PPO,Cigna PPO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna Medicare Advantage,Cigna Medicare Advantage,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Essence,Essence,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthlink HMO,Healthlink HMO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthlink PPO,Healthlink PPO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,HomeState Health Plan,HomeState Health Plan,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Humana Gold,Humana Gold,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Medicaid MO,Medicaid MO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Medica,Medica,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Tricare,Tricare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC All Payer,UHC All Payer,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Exchange,UHC Exchange,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Medicaid,UHC Medicaid,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UMR CPD,UMR CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Medicare,UHC Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 700lb RENT  ,33129591,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Wellcare,Wellcare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Meritain Health PPO CPD,Meritain Health PPO CPD,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Aetna/Commercial Product,Aetna/Commercial Product,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Meritain Health CPD,Meritain Health CPD,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Starmark CPD,Starmark CPD,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Aetna Medicare,Aetna Medicare,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Ambetter ,Ambetter ,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Blue Access,Anthem Blue Access,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Blue Access Choice,Anthem Blue Access Choice,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Blue Preferred,Anthem Blue Preferred,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Pathway,Anthem Pathway,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Alliance,Anthem Alliance,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Anthem Medicare,Anthem Medicare,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Cigna,Cigna,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Cigna PPO,Cigna PPO,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Cigna Medicare Advantage,Cigna Medicare Advantage,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Essence,Essence,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Healthlink HMO,Healthlink HMO,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Healthlink PPO,Healthlink PPO,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,HomeState Health Plan,HomeState Health Plan,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Humana Gold,Humana Gold,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Medicaid MO,Medicaid MO,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Medica,Medica,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Tricare,Tricare,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,UHC All Payer,UHC All Payer,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,UHC Exchange,UHC Exchange,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,UHC Medicaid,UHC Medicaid,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,UMR CPD,UMR CPD,136,,,,,,,per diem,136,136,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,UHC Medicare,UHC Medicare,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33129592,CDM,279,RC,,,,,,Inpatient,,,136,136,Wellcare,Wellcare,136,,,,,,,case rate,136,136,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Meritain Health PPO CPD,Meritain Health PPO CPD,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Aetna/Commercial Product,Aetna/Commercial Product,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Meritain Health CPD,Meritain Health CPD,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Starmark CPD,Starmark CPD,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Aetna Medicare,Aetna Medicare,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Ambetter ,Ambetter ,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Blue Access,Anthem Blue Access,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Blue Access Choice,Anthem Blue Access Choice,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Blue Preferred,Anthem Blue Preferred,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Pathway,Anthem Pathway,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Alliance,Anthem Alliance,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Anthem Medicare,Anthem Medicare,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Cigna,Cigna,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Cigna PPO,Cigna PPO,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Cigna Medicare Advantage,Cigna Medicare Advantage,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Essence,Essence,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Healthlink HMO,Healthlink HMO,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Healthlink PPO,Healthlink PPO,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,HomeState Health Plan,HomeState Health Plan,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Humana Gold,Humana Gold,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Medicaid MO,Medicaid MO,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Medica,Medica,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Tricare,Tricare,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,UHC All Payer,UHC All Payer,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,UHC Exchange,UHC Exchange,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,UHC Medicaid,UHC Medicaid,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,UMR CPD,UMR CPD,79.3,,,,,,,per diem,79.3,79.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,UHC Medicare,UHC Medicare,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33129593,CDM,279,RC,,,,,,Inpatient,,,79.3,79.3,Wellcare,Wellcare,79.3,,,,,,,case rate,79.3,79.3,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health PPO CPD,Meritain Health PPO CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/Commercial Product,Aetna/Commercial Product,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health CPD,Meritain Health CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Starmark CPD,Starmark CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna Medicare,Aetna Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Ambetter ,Ambetter ,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access,Anthem Blue Access,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access Choice,Anthem Blue Access Choice,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Preferred,Anthem Blue Preferred,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Pathway,Anthem Pathway,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Alliance,Anthem Alliance,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Medicare,Anthem Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna,Cigna,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna PPO,Cigna PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna Medicare Advantage,Cigna Medicare Advantage,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Essence,Essence,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink HMO,Healthlink HMO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink PPO,Healthlink PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,HomeState Health Plan,HomeState Health Plan,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Humana Gold,Humana Gold,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medicaid MO,Medicaid MO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medica,Medica,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Tricare,Tricare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC All Payer,UHC All Payer,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Exchange,UHC Exchange,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicaid,UHC Medicaid,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UMR CPD,UMR CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicare,UHC Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33129594,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Wellcare,Wellcare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Meritain Health PPO CPD,Meritain Health PPO CPD,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Aetna/Commercial Product,Aetna/Commercial Product,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Meritain Health CPD,Meritain Health CPD,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Starmark CPD,Starmark CPD,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Aetna Medicare,Aetna Medicare,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Ambetter ,Ambetter ,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Blue Access,Anthem Blue Access,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Blue Access Choice,Anthem Blue Access Choice,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Blue Preferred,Anthem Blue Preferred,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Pathway,Anthem Pathway,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Alliance,Anthem Alliance,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Anthem Medicare,Anthem Medicare,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Cigna,Cigna,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Cigna PPO,Cigna PPO,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Cigna Medicare Advantage,Cigna Medicare Advantage,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Essence,Essence,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Healthlink HMO,Healthlink HMO,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Healthlink PPO,Healthlink PPO,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,HomeState Health Plan,HomeState Health Plan,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Humana Gold,Humana Gold,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Medicaid MO,Medicaid MO,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Medica,Medica,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Tricare,Tricare,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,UHC All Payer,UHC All Payer,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,UHC Exchange,UHC Exchange,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,UHC Medicaid,UHC Medicaid,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,UMR CPD,UMR CPD,160.15,,,,,,,per diem,160.15,160.15,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,UHC Medicare,UHC Medicare,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33129595,CDM,279,RC,,,,,,Inpatient,,,160.15,160.15,Wellcare,Wellcare,160.15,,,,,,,case rate,160.15,160.15,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Meritain Health PPO CPD,Meritain Health PPO CPD,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Aetna/Commercial Product,Aetna/Commercial Product,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Meritain Health CPD,Meritain Health CPD,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Starmark CPD,Starmark CPD,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Aetna Medicare,Aetna Medicare,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Ambetter ,Ambetter ,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Blue Access,Anthem Blue Access,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Blue Access Choice,Anthem Blue Access Choice,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Blue Preferred,Anthem Blue Preferred,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Pathway,Anthem Pathway,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Alliance,Anthem Alliance,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Anthem Medicare,Anthem Medicare,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Cigna,Cigna,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Cigna PPO,Cigna PPO,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Cigna Medicare Advantage,Cigna Medicare Advantage,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Essence,Essence,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Healthlink HMO,Healthlink HMO,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Healthlink PPO,Healthlink PPO,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,HomeState Health Plan,HomeState Health Plan,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Humana Gold,Humana Gold,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Medicaid MO,Medicaid MO,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Medica,Medica,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Tricare,Tricare,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,UHC All Payer,UHC All Payer,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,UHC Exchange,UHC Exchange,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,UHC Medicaid,UHC Medicaid,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,UMR CPD,UMR CPD,37.6,,,,,,,per diem,37.6,37.6,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,UHC Medicare,UHC Medicare,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33129596,CDM,279,RC,,,,,,Inpatient,,,37.6,37.6,Wellcare,Wellcare,37.6,,,,,,,case rate,37.6,37.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Meritain Health PPO CPD,Meritain Health PPO CPD,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Aetna/Commercial Product,Aetna/Commercial Product,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Meritain Health CPD,Meritain Health CPD,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Starmark CPD,Starmark CPD,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Aetna Medicare,Aetna Medicare,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Ambetter ,Ambetter ,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Blue Access,Anthem Blue Access,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Blue Access Choice,Anthem Blue Access Choice,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Blue Preferred,Anthem Blue Preferred,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Pathway,Anthem Pathway,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Alliance,Anthem Alliance,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Anthem Medicare,Anthem Medicare,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Cigna,Cigna,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Cigna PPO,Cigna PPO,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Cigna Medicare Advantage,Cigna Medicare Advantage,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Essence,Essence,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Healthlink HMO,Healthlink HMO,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Healthlink PPO,Healthlink PPO,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,HomeState Health Plan,HomeState Health Plan,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Humana Gold,Humana Gold,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Medicaid MO,Medicaid MO,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Medica,Medica,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Tricare,Tricare,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,UHC All Payer,UHC All Payer,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,UHC Exchange,UHC Exchange,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,UHC Medicaid,UHC Medicaid,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,UMR CPD,UMR CPD,12.6,,,,,,,per diem,12.6,12.6,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,UHC Medicare,UHC Medicare,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33129597,CDM,279,RC,,,,,,Inpatient,,,12.6,12.6,Wellcare,Wellcare,12.6,,,,,,,case rate,12.6,12.6,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33129598,CDM,279,RC,,,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health PPO CPD,Meritain Health PPO CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/Commercial Product,Aetna/Commercial Product,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health CPD,Meritain Health CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Starmark CPD,Starmark CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna Medicare,Aetna Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Ambetter ,Ambetter ,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access,Anthem Blue Access,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access Choice,Anthem Blue Access Choice,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Preferred,Anthem Blue Preferred,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Pathway,Anthem Pathway,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Alliance,Anthem Alliance,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Medicare,Anthem Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna,Cigna,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna PPO,Cigna PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna Medicare Advantage,Cigna Medicare Advantage,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Essence,Essence,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink HMO,Healthlink HMO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink PPO,Healthlink PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,HomeState Health Plan,HomeState Health Plan,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Humana Gold,Humana Gold,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medicaid MO,Medicaid MO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medica,Medica,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Tricare,Tricare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC All Payer,UHC All Payer,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Exchange,UHC Exchange,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicaid,UHC Medicaid,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UMR CPD,UMR CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicare,UHC Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33129599,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Wellcare,Wellcare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Meritain Health PPO CPD,Meritain Health PPO CPD,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Aetna/Commercial Product,Aetna/Commercial Product,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Meritain Health CPD,Meritain Health CPD,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Starmark CPD,Starmark CPD,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Aetna Medicare,Aetna Medicare,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Ambetter ,Ambetter ,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Blue Access,Anthem Blue Access,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Blue Access Choice,Anthem Blue Access Choice,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Blue Preferred,Anthem Blue Preferred,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Pathway,Anthem Pathway,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Alliance,Anthem Alliance,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Anthem Medicare,Anthem Medicare,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Cigna,Cigna,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Cigna PPO,Cigna PPO,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Cigna Medicare Advantage,Cigna Medicare Advantage,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Essence,Essence,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Healthlink HMO,Healthlink HMO,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Healthlink PPO,Healthlink PPO,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,HomeState Health Plan,HomeState Health Plan,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Humana Gold,Humana Gold,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Medicaid MO,Medicaid MO,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Medica,Medica,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Tricare,Tricare,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,UHC All Payer,UHC All Payer,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,UHC Exchange,UHC Exchange,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,UHC Medicaid,UHC Medicaid,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,UMR CPD,UMR CPD,90.85,,,,,,,per diem,90.85,90.85,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,UHC Medicare,UHC Medicare,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33129600,CDM,279,RC,,,,,,Inpatient,,,90.85,90.85,Wellcare,Wellcare,90.85,,,,,,,case rate,90.85,90.85,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Meritain Health PPO CPD,Meritain Health PPO CPD,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Aetna/Commercial Product,Aetna/Commercial Product,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Meritain Health CPD,Meritain Health CPD,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Starmark CPD,Starmark CPD,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Aetna Medicare,Aetna Medicare,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Ambetter ,Ambetter ,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Blue Access,Anthem Blue Access,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Blue Access Choice,Anthem Blue Access Choice,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Blue Preferred,Anthem Blue Preferred,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Pathway,Anthem Pathway,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Alliance,Anthem Alliance,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Anthem Medicare,Anthem Medicare,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Cigna,Cigna,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Cigna PPO,Cigna PPO,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Cigna Medicare Advantage,Cigna Medicare Advantage,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Essence,Essence,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Healthlink HMO,Healthlink HMO,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Healthlink PPO,Healthlink PPO,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,HomeState Health Plan,HomeState Health Plan,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Humana Gold,Humana Gold,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Medicaid MO,Medicaid MO,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Medica,Medica,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Tricare,Tricare,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,UHC All Payer,UHC All Payer,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,UHC Exchange,UHC Exchange,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,UHC Medicaid,UHC Medicaid,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,UMR CPD,UMR CPD,181.65,,,,,,,per diem,181.65,181.65,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,UHC Medicare,UHC Medicare,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33129602,CDM,279,RC,,,,,,Inpatient,,,181.65,181.65,Wellcare,Wellcare,181.65,,,,,,,case rate,181.65,181.65,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Meritain Health PPO CPD,Meritain Health PPO CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna/Commercial Product,Aetna/Commercial Product,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Meritain Health CPD,Meritain Health CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Starmark CPD,Starmark CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna Medicare,Aetna Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Ambetter ,Ambetter ,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Access,Anthem Blue Access,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Access Choice,Anthem Blue Access Choice,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Preferred,Anthem Blue Preferred,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Pathway,Anthem Pathway,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Alliance,Anthem Alliance,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Medicare,Anthem Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna,Cigna,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna PPO,Cigna PPO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna Medicare Advantage,Cigna Medicare Advantage,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Essence,Essence,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthlink HMO,Healthlink HMO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthlink PPO,Healthlink PPO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,HomeState Health Plan,HomeState Health Plan,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Humana Gold,Humana Gold,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Medicaid MO,Medicaid MO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Medica,Medica,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Tricare,Tricare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC All Payer,UHC All Payer,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Exchange,UHC Exchange,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Medicaid,UHC Medicaid,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UMR CPD,UMR CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Medicare,UHC Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33129603,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Wellcare,Wellcare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Meritain Health PPO CPD,Meritain Health PPO CPD,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Aetna/Commercial Product,Aetna/Commercial Product,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Meritain Health CPD,Meritain Health CPD,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Starmark CPD,Starmark CPD,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Aetna Medicare,Aetna Medicare,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Ambetter ,Ambetter ,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Blue Access,Anthem Blue Access,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Blue Access Choice,Anthem Blue Access Choice,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Blue Preferred,Anthem Blue Preferred,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Pathway,Anthem Pathway,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Alliance,Anthem Alliance,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Anthem Medicare,Anthem Medicare,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Cigna,Cigna,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Cigna PPO,Cigna PPO,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Cigna Medicare Advantage,Cigna Medicare Advantage,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Essence,Essence,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Healthlink HMO,Healthlink HMO,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Healthlink PPO,Healthlink PPO,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,HomeState Health Plan,HomeState Health Plan,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Humana Gold,Humana Gold,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Medicaid MO,Medicaid MO,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Medica,Medica,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Tricare,Tricare,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,UHC All Payer,UHC All Payer,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,UHC Exchange,UHC Exchange,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,UHC Medicaid,UHC Medicaid,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,UMR CPD,UMR CPD,22.6,,,,,,,per diem,22.6,22.6,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,UHC Medicare,UHC Medicare,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33129604,CDM,279,RC,,,,,,Inpatient,,,22.6,22.6,Wellcare,Wellcare,22.6,,,,,,,case rate,22.6,22.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Meritain Health PPO CPD,Meritain Health PPO CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna/Commercial Product,Aetna/Commercial Product,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Meritain Health CPD,Meritain Health CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Starmark CPD,Starmark CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna Medicare,Aetna Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Ambetter ,Ambetter ,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Access,Anthem Blue Access,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Access Choice,Anthem Blue Access Choice,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Preferred,Anthem Blue Preferred,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Pathway,Anthem Pathway,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Alliance,Anthem Alliance,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Medicare,Anthem Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna,Cigna,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna PPO,Cigna PPO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna Medicare Advantage,Cigna Medicare Advantage,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Essence,Essence,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthlink HMO,Healthlink HMO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthlink PPO,Healthlink PPO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,HomeState Health Plan,HomeState Health Plan,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Humana Gold,Humana Gold,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Medicaid MO,Medicaid MO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Medica,Medica,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Tricare,Tricare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC All Payer,UHC All Payer,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Exchange,UHC Exchange,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Medicaid,UHC Medicaid,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UMR CPD,UMR CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Medicare,UHC Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33129605,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Wellcare,Wellcare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33129606,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Meritain Health PPO CPD,Meritain Health PPO CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna/Commercial Product,Aetna/Commercial Product,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Meritain Health CPD,Meritain Health CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Starmark CPD,Starmark CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Aetna Medicare,Aetna Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Ambetter ,Ambetter ,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Access,Anthem Blue Access,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Access Choice,Anthem Blue Access Choice,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Blue Preferred,Anthem Blue Preferred,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Pathway,Anthem Pathway,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Alliance,Anthem Alliance,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Anthem Medicare,Anthem Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna,Cigna,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna PPO,Cigna PPO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Cigna Medicare Advantage,Cigna Medicare Advantage,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Essence,Essence,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthlink HMO,Healthlink HMO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Healthlink PPO,Healthlink PPO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,HomeState Health Plan,HomeState Health Plan,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Humana Gold,Humana Gold,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Medicaid MO,Medicaid MO,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Medica,Medica,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Tricare,Tricare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC All Payer,UHC All Payer,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Exchange,UHC Exchange,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Medicaid,UHC Medicaid,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UMR CPD,UMR CPD,54.6,,,,,,,per diem,54.6,54.6,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,UHC Medicare,UHC Medicare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33129607,CDM,279,RC,,,,,,Inpatient,,,54.6,54.6,Wellcare,Wellcare,54.6,,,,,,,case rate,54.6,54.6,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Meritain Health PPO CPD,Meritain Health PPO CPD,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Aetna/Commercial Product,Aetna/Commercial Product,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Meritain Health CPD,Meritain Health CPD,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Starmark CPD,Starmark CPD,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Aetna Medicare,Aetna Medicare,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Ambetter ,Ambetter ,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Blue Access,Anthem Blue Access,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Blue Access Choice,Anthem Blue Access Choice,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Blue Preferred,Anthem Blue Preferred,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Pathway,Anthem Pathway,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Alliance,Anthem Alliance,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Anthem Medicare,Anthem Medicare,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Cigna,Cigna,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Cigna PPO,Cigna PPO,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Cigna Medicare Advantage,Cigna Medicare Advantage,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Essence,Essence,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Healthlink HMO,Healthlink HMO,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Healthlink PPO,Healthlink PPO,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,HomeState Health Plan,HomeState Health Plan,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Humana Gold,Humana Gold,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Medicaid MO,Medicaid MO,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Medica,Medica,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Tricare,Tricare,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,UHC All Payer,UHC All Payer,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,UHC Exchange,UHC Exchange,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,UHC Medicaid,UHC Medicaid,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,UMR CPD,UMR CPD,68.25,,,,,,,per diem,68.25,68.25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,UHC Medicare,UHC Medicare,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33129608,CDM,279,RC,,,,,,Inpatient,,,68.25,68.25,Wellcare,Wellcare,68.25,,,,,,,case rate,68.25,68.25,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Meritain Health PPO CPD,Meritain Health PPO CPD,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Aetna/Commercial Product,Aetna/Commercial Product,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Meritain Health CPD,Meritain Health CPD,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Starmark CPD,Starmark CPD,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Aetna Medicare,Aetna Medicare,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Ambetter ,Ambetter ,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Blue Access,Anthem Blue Access,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Blue Access Choice,Anthem Blue Access Choice,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Blue Preferred,Anthem Blue Preferred,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Pathway,Anthem Pathway,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Alliance,Anthem Alliance,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Anthem Medicare,Anthem Medicare,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Cigna,Cigna,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Cigna PPO,Cigna PPO,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Cigna Medicare Advantage,Cigna Medicare Advantage,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Essence,Essence,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Healthlink HMO,Healthlink HMO,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Healthlink PPO,Healthlink PPO,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,HomeState Health Plan,HomeState Health Plan,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Humana Gold,Humana Gold,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Medicaid MO,Medicaid MO,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Medica,Medica,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Tricare,Tricare,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,UHC All Payer,UHC All Payer,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,UHC Exchange,UHC Exchange,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,UHC Medicaid,UHC Medicaid,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,UMR CPD,UMR CPD,170.1,,,,,,,per diem,170.1,170.1,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,UHC Medicare,UHC Medicare,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33129610,CDM,279,RC,,,,,,Inpatient,,,170.1,170.1,Wellcare,Wellcare,170.1,,,,,,,case rate,170.1,170.1,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health PPO CPD,Meritain Health PPO CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/Commercial Product,Aetna/Commercial Product,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health CPD,Meritain Health CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Starmark CPD,Starmark CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna Medicare,Aetna Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Ambetter ,Ambetter ,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access,Anthem Blue Access,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access Choice,Anthem Blue Access Choice,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Preferred,Anthem Blue Preferred,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Pathway,Anthem Pathway,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Alliance,Anthem Alliance,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Medicare,Anthem Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna,Cigna,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna PPO,Cigna PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna Medicare Advantage,Cigna Medicare Advantage,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Essence,Essence,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink HMO,Healthlink HMO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink PPO,Healthlink PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,HomeState Health Plan,HomeState Health Plan,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Humana Gold,Humana Gold,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medicaid MO,Medicaid MO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medica,Medica,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Tricare,Tricare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC All Payer,UHC All Payer,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Exchange,UHC Exchange,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicaid,UHC Medicaid,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UMR CPD,UMR CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicare,UHC Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33129611,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Wellcare,Wellcare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Meritain Health PPO CPD,Meritain Health PPO CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna/Commercial Product,Aetna/Commercial Product,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Meritain Health CPD,Meritain Health CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Starmark CPD,Starmark CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Aetna Medicare,Aetna Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Ambetter ,Ambetter ,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Access,Anthem Blue Access,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Access Choice,Anthem Blue Access Choice,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Blue Preferred,Anthem Blue Preferred,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Pathway,Anthem Pathway,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Alliance,Anthem Alliance,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Anthem Medicare,Anthem Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna,Cigna,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna PPO,Cigna PPO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Cigna Medicare Advantage,Cigna Medicare Advantage,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Essence,Essence,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthlink HMO,Healthlink HMO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Healthlink PPO,Healthlink PPO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,HomeState Health Plan,HomeState Health Plan,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Humana Gold,Humana Gold,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Medicaid MO,Medicaid MO,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Medica,Medica,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Tricare,Tricare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC All Payer,UHC All Payer,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Exchange,UHC Exchange,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Medicaid,UHC Medicaid,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UMR CPD,UMR CPD,18.4,,,,,,,per diem,18.4,18.4,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,UHC Medicare,UHC Medicare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33129612,CDM,279,RC,,,,,,Inpatient,,,18.4,18.4,Wellcare,Wellcare,18.4,,,,,,,case rate,18.4,18.4,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health PPO CPD,Meritain Health PPO CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/Commercial Product,Aetna/Commercial Product,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health CPD,Meritain Health CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Starmark CPD,Starmark CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna Medicare,Aetna Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Ambetter ,Ambetter ,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access,Anthem Blue Access,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access Choice,Anthem Blue Access Choice,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Preferred,Anthem Blue Preferred,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Pathway,Anthem Pathway,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Alliance,Anthem Alliance,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Medicare,Anthem Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna,Cigna,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna PPO,Cigna PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna Medicare Advantage,Cigna Medicare Advantage,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Essence,Essence,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink HMO,Healthlink HMO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink PPO,Healthlink PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,HomeState Health Plan,HomeState Health Plan,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Humana Gold,Humana Gold,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medicaid MO,Medicaid MO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medica,Medica,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Tricare,Tricare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC All Payer,UHC All Payer,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Exchange,UHC Exchange,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicaid,UHC Medicaid,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UMR CPD,UMR CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicare,UHC Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33129613,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Wellcare,Wellcare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Meritain Health PPO CPD,Meritain Health PPO CPD,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Aetna/Commercial Product,Aetna/Commercial Product,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Meritain Health CPD,Meritain Health CPD,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Starmark CPD,Starmark CPD,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Aetna Medicare,Aetna Medicare,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Ambetter ,Ambetter ,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Blue Access,Anthem Blue Access,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Blue Access Choice,Anthem Blue Access Choice,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Blue Preferred,Anthem Blue Preferred,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Pathway,Anthem Pathway,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Alliance,Anthem Alliance,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Anthem Medicare,Anthem Medicare,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Cigna,Cigna,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Cigna PPO,Cigna PPO,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Cigna Medicare Advantage,Cigna Medicare Advantage,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Essence,Essence,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Healthlink HMO,Healthlink HMO,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Healthlink PPO,Healthlink PPO,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,HomeState Health Plan,HomeState Health Plan,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Humana Gold,Humana Gold,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Medicaid MO,Medicaid MO,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Medica,Medica,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Tricare,Tricare,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,UHC All Payer,UHC All Payer,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,UHC Exchange,UHC Exchange,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,UHC Medicaid,UHC Medicaid,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,UMR CPD,UMR CPD,7.9,,,,,,,per diem,7.9,7.9,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,UHC Medicare,UHC Medicare,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33129614,CDM,279,RC,,,,,,Inpatient,,,7.9,7.9,Wellcare,Wellcare,7.9,,,,,,,case rate,7.9,7.9,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Meritain Health PPO CPD,Meritain Health PPO CPD,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Aetna/Commercial Product,Aetna/Commercial Product,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Meritain Health CPD,Meritain Health CPD,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Starmark CPD,Starmark CPD,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Aetna Medicare,Aetna Medicare,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Ambetter ,Ambetter ,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Blue Access,Anthem Blue Access,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Blue Access Choice,Anthem Blue Access Choice,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Blue Preferred,Anthem Blue Preferred,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Pathway,Anthem Pathway,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Alliance,Anthem Alliance,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Anthem Medicare,Anthem Medicare,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Cigna,Cigna,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Cigna PPO,Cigna PPO,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Cigna Medicare Advantage,Cigna Medicare Advantage,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Essence,Essence,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Healthlink HMO,Healthlink HMO,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Healthlink PPO,Healthlink PPO,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,HomeState Health Plan,HomeState Health Plan,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Humana Gold,Humana Gold,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Medicaid MO,Medicaid MO,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Medica,Medica,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Tricare,Tricare,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,UHC All Payer,UHC All Payer,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,UHC Exchange,UHC Exchange,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,UHC Medicaid,UHC Medicaid,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,UMR CPD,UMR CPD,174.85,,,,,,,per diem,174.85,174.85,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,UHC Medicare,UHC Medicare,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33129616,CDM,279,RC,,,,,,Inpatient,,,174.85,174.85,Wellcare,Wellcare,174.85,,,,,,,case rate,174.85,174.85,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health PPO CPD,Meritain Health PPO CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/Commercial Product,Aetna/Commercial Product,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health CPD,Meritain Health CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Starmark CPD,Starmark CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna Medicare,Aetna Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Ambetter ,Ambetter ,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access,Anthem Blue Access,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access Choice,Anthem Blue Access Choice,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Preferred,Anthem Blue Preferred,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Pathway,Anthem Pathway,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Alliance,Anthem Alliance,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Medicare,Anthem Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna,Cigna,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna PPO,Cigna PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna Medicare Advantage,Cigna Medicare Advantage,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Essence,Essence,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink HMO,Healthlink HMO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink PPO,Healthlink PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,HomeState Health Plan,HomeState Health Plan,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Humana Gold,Humana Gold,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medicaid MO,Medicaid MO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medica,Medica,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Tricare,Tricare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC All Payer,UHC All Payer,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Exchange,UHC Exchange,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicaid,UHC Medicaid,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UMR CPD,UMR CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicare,UHC Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33129617,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Wellcare,Wellcare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Meritain Health PPO CPD,Meritain Health PPO CPD,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Aetna/Commercial Product,Aetna/Commercial Product,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Meritain Health CPD,Meritain Health CPD,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Starmark CPD,Starmark CPD,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Aetna Medicare,Aetna Medicare,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Ambetter ,Ambetter ,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Blue Access,Anthem Blue Access,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Blue Access Choice,Anthem Blue Access Choice,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Blue Preferred,Anthem Blue Preferred,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Pathway,Anthem Pathway,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Alliance,Anthem Alliance,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Anthem Medicare,Anthem Medicare,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Cigna,Cigna,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Cigna PPO,Cigna PPO,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Cigna Medicare Advantage,Cigna Medicare Advantage,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Essence,Essence,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Healthlink HMO,Healthlink HMO,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Healthlink PPO,Healthlink PPO,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,HomeState Health Plan,HomeState Health Plan,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Humana Gold,Humana Gold,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Medicaid MO,Medicaid MO,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Medica,Medica,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Tricare,Tricare,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,UHC All Payer,UHC All Payer,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,UHC Exchange,UHC Exchange,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,UHC Medicaid,UHC Medicaid,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,UMR CPD,UMR CPD,36,,,,,,,per diem,36,36,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,UHC Medicare,UHC Medicare,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33129618,CDM,279,RC,,,,,,Inpatient,,,36,36,Wellcare,Wellcare,36,,,,,,,case rate,36,36,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Meritain Health PPO CPD,Meritain Health PPO CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna/Commercial Product,Aetna/Commercial Product,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Meritain Health CPD,Meritain Health CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Starmark CPD,Starmark CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna Medicare,Aetna Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Ambetter ,Ambetter ,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Access,Anthem Blue Access,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Access Choice,Anthem Blue Access Choice,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Preferred,Anthem Blue Preferred,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Pathway,Anthem Pathway,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Alliance,Anthem Alliance,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Medicare,Anthem Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna,Cigna,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna PPO,Cigna PPO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna Medicare Advantage,Cigna Medicare Advantage,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Essence,Essence,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthlink HMO,Healthlink HMO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthlink PPO,Healthlink PPO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,HomeState Health Plan,HomeState Health Plan,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Humana Gold,Humana Gold,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Medicaid MO,Medicaid MO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Medica,Medica,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Tricare,Tricare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC All Payer,UHC All Payer,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Exchange,UHC Exchange,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Medicaid,UHC Medicaid,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UMR CPD,UMR CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Medicare,UHC Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33129619,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Wellcare,Wellcare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health PPO CPD,Meritain Health PPO CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/Commercial Product,Aetna/Commercial Product,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health CPD,Meritain Health CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Starmark CPD,Starmark CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna Medicare,Aetna Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Ambetter ,Ambetter ,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access,Anthem Blue Access,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access Choice,Anthem Blue Access Choice,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Preferred,Anthem Blue Preferred,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Pathway,Anthem Pathway,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Alliance,Anthem Alliance,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Medicare,Anthem Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna,Cigna,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna PPO,Cigna PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna Medicare Advantage,Cigna Medicare Advantage,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Essence,Essence,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink HMO,Healthlink HMO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink PPO,Healthlink PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,HomeState Health Plan,HomeState Health Plan,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Humana Gold,Humana Gold,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medicaid MO,Medicaid MO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medica,Medica,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Tricare,Tricare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC All Payer,UHC All Payer,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Exchange,UHC Exchange,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicaid,UHC Medicaid,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UMR CPD,UMR CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicare,UHC Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33129621,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Wellcare,Wellcare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health PPO CPD,Meritain Health PPO CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna/Commercial Product,Aetna/Commercial Product,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Meritain Health CPD,Meritain Health CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Starmark CPD,Starmark CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Aetna Medicare,Aetna Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Ambetter ,Ambetter ,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access,Anthem Blue Access,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Access Choice,Anthem Blue Access Choice,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Blue Preferred,Anthem Blue Preferred,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Pathway,Anthem Pathway,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Alliance,Anthem Alliance,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Anthem Medicare,Anthem Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna,Cigna,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna PPO,Cigna PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Cigna Medicare Advantage,Cigna Medicare Advantage,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Essence,Essence,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink HMO,Healthlink HMO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Healthlink PPO,Healthlink PPO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,HomeState Health Plan,HomeState Health Plan,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Humana Gold,Humana Gold,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medicaid MO,Medicaid MO,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Medica,Medica,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Tricare,Tricare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC All Payer,UHC All Payer,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Exchange,UHC Exchange,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicaid,UHC Medicaid,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UMR CPD,UMR CPD,34.15,,,,,,,per diem,34.15,34.15,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,UHC Medicare,UHC Medicare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33129622,CDM,279,RC,,,,,,Inpatient,,,34.15,34.15,Wellcare,Wellcare,34.15,,,,,,,case rate,34.15,34.15,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Meritain Health PPO CPD,Meritain Health PPO CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna/Commercial Product,Aetna/Commercial Product,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Meritain Health CPD,Meritain Health CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Starmark CPD,Starmark CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Aetna Medicare,Aetna Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Ambetter ,Ambetter ,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Access,Anthem Blue Access,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Access Choice,Anthem Blue Access Choice,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Blue Preferred,Anthem Blue Preferred,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Pathway,Anthem Pathway,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Alliance,Anthem Alliance,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Anthem Medicare,Anthem Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna,Cigna,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna PPO,Cigna PPO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Cigna Medicare Advantage,Cigna Medicare Advantage,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Essence,Essence,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthlink HMO,Healthlink HMO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Healthlink PPO,Healthlink PPO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,HomeState Health Plan,HomeState Health Plan,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Humana Gold,Humana Gold,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Medicaid MO,Medicaid MO,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Medica,Medica,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Tricare,Tricare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC All Payer,UHC All Payer,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Exchange,UHC Exchange,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Medicaid,UHC Medicaid,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UMR CPD,UMR CPD,36.25,,,,,,,per diem,36.25,36.25,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,UHC Medicare,UHC Medicare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33129623,CDM,279,RC,,,,,,Inpatient,,,36.25,36.25,Wellcare,Wellcare,36.25,,,,,,,case rate,36.25,36.25,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Meritain Health PPO CPD,Meritain Health PPO CPD,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Aetna/Commercial Product,Aetna/Commercial Product,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Meritain Health CPD,Meritain Health CPD,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Starmark CPD,Starmark CPD,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Aetna Medicare,Aetna Medicare,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Ambetter ,Ambetter ,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Blue Access,Anthem Blue Access,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Blue Access Choice,Anthem Blue Access Choice,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Blue Preferred,Anthem Blue Preferred,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Pathway,Anthem Pathway,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Alliance,Anthem Alliance,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Anthem Medicare,Anthem Medicare,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Cigna,Cigna,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Cigna PPO,Cigna PPO,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Cigna Medicare Advantage,Cigna Medicare Advantage,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Essence,Essence,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Healthlink HMO,Healthlink HMO,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Healthlink PPO,Healthlink PPO,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,HomeState Health Plan,HomeState Health Plan,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Humana Gold,Humana Gold,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Medicaid MO,Medicaid MO,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Medica,Medica,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Tricare,Tricare,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,UHC All Payer,UHC All Payer,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,UHC Exchange,UHC Exchange,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,UHC Medicaid,UHC Medicaid,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,UMR CPD,UMR CPD,4.75,,,,,,,per diem,4.75,4.75,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,UHC Medicare,UHC Medicare,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33129624,CDM,279,RC,,,,,,Inpatient,,,4.75,4.75,Wellcare,Wellcare,4.75,,,,,,,case rate,4.75,4.75,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Meritain Health PPO CPD,Meritain Health PPO CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna/Commercial Product,Aetna/Commercial Product,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Meritain Health CPD,Meritain Health CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Starmark CPD,Starmark CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Aetna Medicare,Aetna Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Ambetter ,Ambetter ,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Access,Anthem Blue Access,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Access Choice,Anthem Blue Access Choice,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Blue Preferred,Anthem Blue Preferred,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Pathway,Anthem Pathway,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Alliance,Anthem Alliance,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Anthem Medicare,Anthem Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna,Cigna,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna PPO,Cigna PPO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Cigna Medicare Advantage,Cigna Medicare Advantage,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Essence,Essence,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthlink HMO,Healthlink HMO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Healthlink PPO,Healthlink PPO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,HomeState Health Plan,HomeState Health Plan,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Humana Gold,Humana Gold,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Medicaid MO,Medicaid MO,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Medica,Medica,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Tricare,Tricare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC All Payer,UHC All Payer,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Exchange,UHC Exchange,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Medicaid,UHC Medicaid,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UMR CPD,UMR CPD,271.95,,,,,,,per diem,271.95,271.95,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,UHC Medicare,UHC Medicare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33129625,CDM,279,RC,,,,,,Inpatient,,,271.95,271.95,Wellcare,Wellcare,271.95,,,,,,,case rate,271.95,271.95,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Meritain Health PPO CPD,Meritain Health PPO CPD,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Aetna/Commercial Product,Aetna/Commercial Product,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Meritain Health CPD,Meritain Health CPD,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Starmark CPD,Starmark CPD,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Aetna Medicare,Aetna Medicare,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Ambetter ,Ambetter ,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Blue Access,Anthem Blue Access,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Blue Access Choice,Anthem Blue Access Choice,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Blue Preferred,Anthem Blue Preferred,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Pathway,Anthem Pathway,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Alliance,Anthem Alliance,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Anthem Medicare,Anthem Medicare,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Cigna,Cigna,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Cigna PPO,Cigna PPO,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Cigna Medicare Advantage,Cigna Medicare Advantage,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Essence,Essence,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Healthlink HMO,Healthlink HMO,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Healthlink PPO,Healthlink PPO,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,HomeState Health Plan,HomeState Health Plan,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Humana Gold,Humana Gold,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Medicaid MO,Medicaid MO,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Medica,Medica,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Tricare,Tricare,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,UHC All Payer,UHC All Payer,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,UHC Exchange,UHC Exchange,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,UHC Medicaid,UHC Medicaid,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,UMR CPD,UMR CPD,57.75,,,,,,,per diem,57.75,57.75,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,UHC Medicare,UHC Medicare,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33129626,CDM,279,RC,,,,,,Inpatient,,,57.75,57.75,Wellcare,Wellcare,57.75,,,,,,,case rate,57.75,57.75,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Meritain Health PPO CPD,Meritain Health PPO CPD,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Aetna/Commercial Product,Aetna/Commercial Product,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Meritain Health CPD,Meritain Health CPD,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Starmark CPD,Starmark CPD,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Aetna Medicare,Aetna Medicare,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Ambetter ,Ambetter ,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Blue Access,Anthem Blue Access,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Blue Access Choice,Anthem Blue Access Choice,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Blue Preferred,Anthem Blue Preferred,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Pathway,Anthem Pathway,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Alliance,Anthem Alliance,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Anthem Medicare,Anthem Medicare,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Cigna,Cigna,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Cigna PPO,Cigna PPO,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Cigna Medicare Advantage,Cigna Medicare Advantage,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Essence,Essence,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Healthlink HMO,Healthlink HMO,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Healthlink PPO,Healthlink PPO,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,HomeState Health Plan,HomeState Health Plan,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Humana Gold,Humana Gold,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Medicaid MO,Medicaid MO,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Medica,Medica,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Tricare,Tricare,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,UHC All Payer,UHC All Payer,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,UHC Exchange,UHC Exchange,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,UHC Medicaid,UHC Medicaid,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,UMR CPD,UMR CPD,544.45,,,,,,,per diem,544.45,544.45,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,UHC Medicare,UHC Medicare,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33129627,CDM,279,RC,,,,,,Inpatient,,,544.45,544.45,Wellcare,Wellcare,544.45,,,,,,,case rate,544.45,544.45,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health PPO CPD,Meritain Health PPO CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/Commercial Product,Aetna/Commercial Product,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health CPD,Meritain Health CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Starmark CPD,Starmark CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna Medicare,Aetna Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Ambetter ,Ambetter ,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access,Anthem Blue Access,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access Choice,Anthem Blue Access Choice,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Preferred,Anthem Blue Preferred,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Pathway,Anthem Pathway,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Alliance,Anthem Alliance,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Medicare,Anthem Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna,Cigna,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna PPO,Cigna PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna Medicare Advantage,Cigna Medicare Advantage,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Essence,Essence,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink HMO,Healthlink HMO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink PPO,Healthlink PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,HomeState Health Plan,HomeState Health Plan,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Humana Gold,Humana Gold,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medicaid MO,Medicaid MO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medica,Medica,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Tricare,Tricare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC All Payer,UHC All Payer,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Exchange,UHC Exchange,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicaid,UHC Medicaid,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UMR CPD,UMR CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicare,UHC Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33129628,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Wellcare,Wellcare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Meritain Health PPO CPD,Meritain Health PPO CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna/Commercial Product,Aetna/Commercial Product,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Meritain Health CPD,Meritain Health CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Starmark CPD,Starmark CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna Medicare,Aetna Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Ambetter ,Ambetter ,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Access,Anthem Blue Access,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Access Choice,Anthem Blue Access Choice,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Preferred,Anthem Blue Preferred,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Pathway,Anthem Pathway,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Alliance,Anthem Alliance,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Medicare,Anthem Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna,Cigna,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna PPO,Cigna PPO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna Medicare Advantage,Cigna Medicare Advantage,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Essence,Essence,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthlink HMO,Healthlink HMO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthlink PPO,Healthlink PPO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,HomeState Health Plan,HomeState Health Plan,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Humana Gold,Humana Gold,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Medicaid MO,Medicaid MO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Medica,Medica,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Tricare,Tricare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC All Payer,UHC All Payer,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Exchange,UHC Exchange,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Medicaid,UHC Medicaid,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UMR CPD,UMR CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Medicare,UHC Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33129629,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Wellcare,Wellcare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Meritain Health PPO CPD,Meritain Health PPO CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Aetna/Commercial Product,Aetna/Commercial Product,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Meritain Health CPD,Meritain Health CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Starmark CPD,Starmark CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Aetna Medicare,Aetna Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Ambetter ,Ambetter ,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Access,Anthem Blue Access,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Access Choice,Anthem Blue Access Choice,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Preferred,Anthem Blue Preferred,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Pathway,Anthem Pathway,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Alliance,Anthem Alliance,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Medicare,Anthem Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Cigna,Cigna,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Cigna PPO,Cigna PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Cigna Medicare Advantage,Cigna Medicare Advantage,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Essence,Essence,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Healthlink HMO,Healthlink HMO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Healthlink PPO,Healthlink PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,HomeState Health Plan,HomeState Health Plan,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Humana Gold,Humana Gold,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Medicaid MO,Medicaid MO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Medica,Medica,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Tricare,Tricare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,UHC All Payer,UHC All Payer,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,UHC Exchange,UHC Exchange,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,UHC Medicaid,UHC Medicaid,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,UMR CPD,UMR CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,UHC Medicare,UHC Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33129630,CDM,279,RC,,,,,,Inpatient,,,133.9,133.9,Wellcare,Wellcare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Meritain Health PPO CPD,Meritain Health PPO CPD,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Aetna/Commercial Product,Aetna/Commercial Product,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Meritain Health CPD,Meritain Health CPD,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Starmark CPD,Starmark CPD,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Aetna Medicare,Aetna Medicare,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Ambetter ,Ambetter ,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Blue Access,Anthem Blue Access,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Blue Access Choice,Anthem Blue Access Choice,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Blue Preferred,Anthem Blue Preferred,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Pathway,Anthem Pathway,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Alliance,Anthem Alliance,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Anthem Medicare,Anthem Medicare,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Cigna,Cigna,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Cigna PPO,Cigna PPO,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Cigna Medicare Advantage,Cigna Medicare Advantage,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Essence,Essence,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Healthlink HMO,Healthlink HMO,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Healthlink PPO,Healthlink PPO,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,HomeState Health Plan,HomeState Health Plan,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Humana Gold,Humana Gold,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Medicaid MO,Medicaid MO,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Medica,Medica,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Tricare,Tricare,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,UHC All Payer,UHC All Payer,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,UHC Exchange,UHC Exchange,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,UHC Medicaid,UHC Medicaid,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,UMR CPD,UMR CPD,61.45,,,,,,,per diem,61.45,61.45,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,UHC Medicare,UHC Medicare,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33129631,CDM,279,RC,,,,,,Inpatient,,,61.45,61.45,Wellcare,Wellcare,61.45,,,,,,,case rate,61.45,61.45,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Meritain Health PPO CPD,Meritain Health PPO CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna/Commercial Product,Aetna/Commercial Product,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Meritain Health CPD,Meritain Health CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Starmark CPD,Starmark CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna Medicare,Aetna Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Ambetter ,Ambetter ,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Access,Anthem Blue Access,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Access Choice,Anthem Blue Access Choice,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Preferred,Anthem Blue Preferred,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Pathway,Anthem Pathway,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Alliance,Anthem Alliance,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Medicare,Anthem Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna,Cigna,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna PPO,Cigna PPO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna Medicare Advantage,Cigna Medicare Advantage,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Essence,Essence,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthlink HMO,Healthlink HMO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthlink PPO,Healthlink PPO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,HomeState Health Plan,HomeState Health Plan,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Humana Gold,Humana Gold,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Medicaid MO,Medicaid MO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Medica,Medica,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Tricare,Tricare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC All Payer,UHC All Payer,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Exchange,UHC Exchange,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Medicaid,UHC Medicaid,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,UMR CPD,UMR CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Medicare,UHC Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33129632,CDM,279,RC,,,,,,Inpatient,,,52,52,Wellcare,Wellcare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Meritain Health PPO CPD,Meritain Health PPO CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna/Commercial Product,Aetna/Commercial Product,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Meritain Health CPD,Meritain Health CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Starmark CPD,Starmark CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna Medicare,Aetna Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Ambetter ,Ambetter ,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Access,Anthem Blue Access,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Access Choice,Anthem Blue Access Choice,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Preferred,Anthem Blue Preferred,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Pathway,Anthem Pathway,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Alliance,Anthem Alliance,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Medicare,Anthem Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna,Cigna,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna PPO,Cigna PPO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna Medicare Advantage,Cigna Medicare Advantage,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Essence,Essence,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthlink HMO,Healthlink HMO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthlink PPO,Healthlink PPO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,HomeState Health Plan,HomeState Health Plan,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Humana Gold,Humana Gold,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Medicaid MO,Medicaid MO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Medica,Medica,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Tricare,Tricare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC All Payer,UHC All Payer,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Exchange,UHC Exchange,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Medicaid,UHC Medicaid,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UMR CPD,UMR CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Medicare,UHC Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129633,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Wellcare,Wellcare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health PPO CPD,Meritain Health PPO CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna/Commercial Product,Aetna/Commercial Product,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Meritain Health CPD,Meritain Health CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Starmark CPD,Starmark CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Aetna Medicare,Aetna Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Ambetter ,Ambetter ,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access,Anthem Blue Access,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Access Choice,Anthem Blue Access Choice,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Blue Preferred,Anthem Blue Preferred,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Pathway,Anthem Pathway,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Alliance,Anthem Alliance,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Anthem Medicare,Anthem Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna,Cigna,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna PPO,Cigna PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Cigna Medicare Advantage,Cigna Medicare Advantage,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Essence,Essence,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink HMO,Healthlink HMO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Healthlink PPO,Healthlink PPO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,HomeState Health Plan,HomeState Health Plan,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Humana Gold,Humana Gold,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medicaid MO,Medicaid MO,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Medica,Medica,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Tricare,Tricare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC All Payer,UHC All Payer,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Exchange,UHC Exchange,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicaid,UHC Medicaid,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UMR CPD,UMR CPD,40.95,,,,,,,per diem,40.95,40.95,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,UHC Medicare,UHC Medicare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129634,CDM,279,RC,,,,,,Inpatient,,,40.95,40.95,Wellcare,Wellcare,40.95,,,,,,,case rate,40.95,40.95,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health PPO CPD,Meritain Health PPO CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/Commercial Product,Aetna/Commercial Product,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health CPD,Meritain Health CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Starmark CPD,Starmark CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Aetna Medicare,Aetna Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Ambetter ,Ambetter ,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access,Anthem Blue Access,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access Choice,Anthem Blue Access Choice,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Preferred,Anthem Blue Preferred,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Pathway,Anthem Pathway,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Alliance,Anthem Alliance,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Medicare,Anthem Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna,Cigna,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna PPO,Cigna PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Cigna Medicare Advantage,Cigna Medicare Advantage,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Essence,Essence,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink HMO,Healthlink HMO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink PPO,Healthlink PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,HomeState Health Plan,HomeState Health Plan,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Humana Gold,Humana Gold,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medicaid MO,Medicaid MO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Medica,Medica,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Tricare,Tricare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC All Payer,UHC All Payer,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Exchange,UHC Exchange,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicaid,UHC Medicaid,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UMR CPD,UMR CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicare,UHC Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33129636,CDM,279,RC,,,,,,Inpatient,,,27.3,27.3,Wellcare,Wellcare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Meritain Health PPO CPD,Meritain Health PPO CPD,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Aetna/Commercial Product,Aetna/Commercial Product,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Meritain Health CPD,Meritain Health CPD,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Starmark CPD,Starmark CPD,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Aetna Medicare,Aetna Medicare,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Ambetter ,Ambetter ,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Blue Access,Anthem Blue Access,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Blue Access Choice,Anthem Blue Access Choice,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Blue Preferred,Anthem Blue Preferred,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Pathway,Anthem Pathway,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Alliance,Anthem Alliance,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Anthem Medicare,Anthem Medicare,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Cigna,Cigna,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Cigna PPO,Cigna PPO,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Cigna Medicare Advantage,Cigna Medicare Advantage,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Essence,Essence,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Healthlink HMO,Healthlink HMO,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Healthlink PPO,Healthlink PPO,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,HomeState Health Plan,HomeState Health Plan,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Humana Gold,Humana Gold,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Medicaid MO,Medicaid MO,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Medica,Medica,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Tricare,Tricare,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,UHC All Payer,UHC All Payer,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,UHC Exchange,UHC Exchange,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,UHC Medicaid,UHC Medicaid,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,UMR CPD,UMR CPD,85.05,,,,,,,per diem,85.05,85.05,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,UHC Medicare,UHC Medicare,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33129637,CDM,279,RC,,,,,,Inpatient,,,85.05,85.05,Wellcare,Wellcare,85.05,,,,,,,case rate,85.05,85.05,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Meritain Health PPO CPD,Meritain Health PPO CPD,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Aetna/Commercial Product,Aetna/Commercial Product,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Meritain Health CPD,Meritain Health CPD,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Starmark CPD,Starmark CPD,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Aetna Medicare,Aetna Medicare,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Ambetter ,Ambetter ,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Blue Access,Anthem Blue Access,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Blue Access Choice,Anthem Blue Access Choice,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Blue Preferred,Anthem Blue Preferred,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Pathway,Anthem Pathway,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Alliance,Anthem Alliance,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Anthem Medicare,Anthem Medicare,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Cigna,Cigna,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Cigna PPO,Cigna PPO,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Cigna Medicare Advantage,Cigna Medicare Advantage,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Essence,Essence,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Healthlink HMO,Healthlink HMO,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Healthlink PPO,Healthlink PPO,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,HomeState Health Plan,HomeState Health Plan,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Humana Gold,Humana Gold,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Medicaid MO,Medicaid MO,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Medica,Medica,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Tricare,Tricare,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,UHC All Payer,UHC All Payer,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,UHC Exchange,UHC Exchange,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,UHC Medicaid,UHC Medicaid,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,UMR CPD,UMR CPD,58.8,,,,,,,per diem,58.8,58.8,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,UHC Medicare,UHC Medicare,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33129638,CDM,279,RC,,,,,,Inpatient,,,58.8,58.8,Wellcare,Wellcare,58.8,,,,,,,case rate,58.8,58.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Meritain Health PPO CPD,Meritain Health PPO CPD,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Aetna/Commercial Product,Aetna/Commercial Product,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Meritain Health CPD,Meritain Health CPD,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Starmark CPD,Starmark CPD,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Aetna Medicare,Aetna Medicare,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Ambetter ,Ambetter ,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Blue Access,Anthem Blue Access,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Blue Access Choice,Anthem Blue Access Choice,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Blue Preferred,Anthem Blue Preferred,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Pathway,Anthem Pathway,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Alliance,Anthem Alliance,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Anthem Medicare,Anthem Medicare,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Cigna,Cigna,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Cigna PPO,Cigna PPO,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Cigna Medicare Advantage,Cigna Medicare Advantage,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Essence,Essence,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Healthlink HMO,Healthlink HMO,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Healthlink PPO,Healthlink PPO,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,HomeState Health Plan,HomeState Health Plan,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Humana Gold,Humana Gold,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Medicaid MO,Medicaid MO,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Medica,Medica,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Tricare,Tricare,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,UHC All Payer,UHC All Payer,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,UHC Exchange,UHC Exchange,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,UHC Medicaid,UHC Medicaid,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,UMR CPD,UMR CPD,84,,,,,,,per diem,84,84,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,UHC Medicare,UHC Medicare,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33129639,CDM,279,RC,,,,,,Inpatient,,,84,84,Wellcare,Wellcare,84,,,,,,,case rate,84,84,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Meritain Health PPO CPD,Meritain Health PPO CPD,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Aetna/Commercial Product,Aetna/Commercial Product,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Meritain Health CPD,Meritain Health CPD,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Starmark CPD,Starmark CPD,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Aetna Medicare,Aetna Medicare,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Ambetter ,Ambetter ,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Blue Access,Anthem Blue Access,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Blue Access Choice,Anthem Blue Access Choice,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Blue Preferred,Anthem Blue Preferred,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Pathway,Anthem Pathway,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Alliance,Anthem Alliance,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Anthem Medicare,Anthem Medicare,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Cigna,Cigna,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Cigna PPO,Cigna PPO,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Cigna Medicare Advantage,Cigna Medicare Advantage,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Essence,Essence,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Healthlink HMO,Healthlink HMO,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Healthlink PPO,Healthlink PPO,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,HomeState Health Plan,HomeState Health Plan,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Humana Gold,Humana Gold,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Medicaid MO,Medicaid MO,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Medica,Medica,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Tricare,Tricare,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,UHC All Payer,UHC All Payer,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,UHC Exchange,UHC Exchange,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,UHC Medicaid,UHC Medicaid,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,UMR CPD,UMR CPD,47.8,,,,,,,per diem,47.8,47.8,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,UHC Medicare,UHC Medicare,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33129640,CDM,279,RC,,,,,,Inpatient,,,47.8,47.8,Wellcare,Wellcare,47.8,,,,,,,case rate,47.8,47.8,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Meritain Health PPO CPD,Meritain Health PPO CPD,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Aetna/Commercial Product,Aetna/Commercial Product,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Meritain Health CPD,Meritain Health CPD,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Starmark CPD,Starmark CPD,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Aetna Medicare,Aetna Medicare,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Ambetter ,Ambetter ,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Blue Access,Anthem Blue Access,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Blue Access Choice,Anthem Blue Access Choice,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Blue Preferred,Anthem Blue Preferred,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Pathway,Anthem Pathway,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Alliance,Anthem Alliance,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Anthem Medicare,Anthem Medicare,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Cigna,Cigna,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Cigna PPO,Cigna PPO,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Cigna Medicare Advantage,Cigna Medicare Advantage,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Essence,Essence,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Healthlink HMO,Healthlink HMO,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Healthlink PPO,Healthlink PPO,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,HomeState Health Plan,HomeState Health Plan,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Humana Gold,Humana Gold,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Medicaid MO,Medicaid MO,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Medica,Medica,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Tricare,Tricare,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,UHC All Payer,UHC All Payer,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,UHC Exchange,UHC Exchange,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,UHC Medicaid,UHC Medicaid,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,UMR CPD,UMR CPD,39.9,,,,,,,per diem,39.9,39.9,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,UHC Medicare,UHC Medicare,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33129642,CDM,279,RC,,,,,,Inpatient,,,39.9,39.9,Wellcare,Wellcare,39.9,,,,,,,case rate,39.9,39.9,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Meritain Health PPO CPD,Meritain Health PPO CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna/Commercial Product,Aetna/Commercial Product,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Meritain Health CPD,Meritain Health CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Starmark CPD,Starmark CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Aetna Medicare,Aetna Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Ambetter ,Ambetter ,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Access,Anthem Blue Access,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Access Choice,Anthem Blue Access Choice,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Blue Preferred,Anthem Blue Preferred,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Pathway,Anthem Pathway,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Alliance,Anthem Alliance,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Anthem Medicare,Anthem Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna,Cigna,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna PPO,Cigna PPO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Cigna Medicare Advantage,Cigna Medicare Advantage,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Essence,Essence,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthlink HMO,Healthlink HMO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Healthlink PPO,Healthlink PPO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,HomeState Health Plan,HomeState Health Plan,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Humana Gold,Humana Gold,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Medicaid MO,Medicaid MO,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Medica,Medica,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Tricare,Tricare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC All Payer,UHC All Payer,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Exchange,UHC Exchange,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Medicaid,UHC Medicaid,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,UMR CPD,UMR CPD,52,,,,,,,per diem,52,52,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,UHC Medicare,UHC Medicare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33129643,CDM,279,RC,,,,,,Inpatient,,,52,52,Wellcare,Wellcare,52,,,,,,,case rate,52,52,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Meritain Health PPO CPD,Meritain Health PPO CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna/Commercial Product,Aetna/Commercial Product,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Meritain Health CPD,Meritain Health CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Starmark CPD,Starmark CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Aetna Medicare,Aetna Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Ambetter ,Ambetter ,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Access,Anthem Blue Access,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Access Choice,Anthem Blue Access Choice,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Blue Preferred,Anthem Blue Preferred,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Pathway,Anthem Pathway,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Alliance,Anthem Alliance,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Anthem Medicare,Anthem Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna,Cigna,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna PPO,Cigna PPO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Cigna Medicare Advantage,Cigna Medicare Advantage,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Essence,Essence,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthlink HMO,Healthlink HMO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Healthlink PPO,Healthlink PPO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,HomeState Health Plan,HomeState Health Plan,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Humana Gold,Humana Gold,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Medicaid MO,Medicaid MO,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Medica,Medica,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Tricare,Tricare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC All Payer,UHC All Payer,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Exchange,UHC Exchange,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Medicaid,UHC Medicaid,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UMR CPD,UMR CPD,137.05,,,,,,,per diem,137.05,137.05,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,UHC Medicare,UHC Medicare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33129644,CDM,279,RC,,,,,,Inpatient,,,137.05,137.05,Wellcare,Wellcare,137.05,,,,,,,case rate,137.05,137.05,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Meritain Health PPO CPD,Meritain Health PPO CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna/Commercial Product,Aetna/Commercial Product,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Meritain Health CPD,Meritain Health CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Starmark CPD,Starmark CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Aetna Medicare,Aetna Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Ambetter ,Ambetter ,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Access,Anthem Blue Access,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Access Choice,Anthem Blue Access Choice,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Blue Preferred,Anthem Blue Preferred,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Pathway,Anthem Pathway,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Alliance,Anthem Alliance,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Anthem Medicare,Anthem Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna,Cigna,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna PPO,Cigna PPO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Cigna Medicare Advantage,Cigna Medicare Advantage,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Essence,Essence,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthlink HMO,Healthlink HMO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Healthlink PPO,Healthlink PPO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,HomeState Health Plan,HomeState Health Plan,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Humana Gold,Humana Gold,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Medicaid MO,Medicaid MO,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Medica,Medica,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Tricare,Tricare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC All Payer,UHC All Payer,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Exchange,UHC Exchange,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Medicaid,UHC Medicaid,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UMR CPD,UMR CPD,78.25,,,,,,,per diem,78.25,78.25,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,UHC Medicare,UHC Medicare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33129646,CDM,279,RC,,,,,,Inpatient,,,78.25,78.25,Wellcare,Wellcare,78.25,,,,,,,case rate,78.25,78.25,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Meritain Health PPO CPD,Meritain Health PPO CPD,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Aetna/Commercial Product,Aetna/Commercial Product,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Meritain Health CPD,Meritain Health CPD,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Starmark CPD,Starmark CPD,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Aetna Medicare,Aetna Medicare,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Ambetter ,Ambetter ,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Blue Access,Anthem Blue Access,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Blue Access Choice,Anthem Blue Access Choice,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Blue Preferred,Anthem Blue Preferred,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Pathway,Anthem Pathway,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Alliance,Anthem Alliance,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Anthem Medicare,Anthem Medicare,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Cigna,Cigna,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Cigna PPO,Cigna PPO,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Cigna Medicare Advantage,Cigna Medicare Advantage,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Essence,Essence,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Healthlink HMO,Healthlink HMO,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Healthlink PPO,Healthlink PPO,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,HomeState Health Plan,HomeState Health Plan,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Humana Gold,Humana Gold,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Medicaid MO,Medicaid MO,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Medica,Medica,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Tricare,Tricare,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,UHC All Payer,UHC All Payer,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,UHC Exchange,UHC Exchange,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,UHC Medicaid,UHC Medicaid,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,UMR CPD,UMR CPD,30.45,,,,,,,per diem,30.45,30.45,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,UHC Medicare,UHC Medicare,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33129647,CDM,279,RC,,,,,,Inpatient,,,30.45,30.45,Wellcare,Wellcare,30.45,,,,,,,case rate,30.45,30.45,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Meritain Health PPO CPD,Meritain Health PPO CPD,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Aetna/Commercial Product,Aetna/Commercial Product,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Meritain Health CPD,Meritain Health CPD,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Starmark CPD,Starmark CPD,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Aetna Medicare,Aetna Medicare,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Ambetter ,Ambetter ,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Blue Access,Anthem Blue Access,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Blue Access Choice,Anthem Blue Access Choice,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Blue Preferred,Anthem Blue Preferred,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Pathway,Anthem Pathway,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Alliance,Anthem Alliance,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Anthem Medicare,Anthem Medicare,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Cigna,Cigna,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Cigna PPO,Cigna PPO,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Cigna Medicare Advantage,Cigna Medicare Advantage,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Essence,Essence,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Healthlink HMO,Healthlink HMO,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Healthlink PPO,Healthlink PPO,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,HomeState Health Plan,HomeState Health Plan,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Humana Gold,Humana Gold,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Medicaid MO,Medicaid MO,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Medica,Medica,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Tricare,Tricare,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,UHC All Payer,UHC All Payer,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,UHC Exchange,UHC Exchange,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,UHC Medicaid,UHC Medicaid,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,UMR CPD,UMR CPD,218.4,,,,,,,per diem,218.4,218.4,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,UHC Medicare,UHC Medicare,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33129650,CDM,279,RC,,,,,,Inpatient,,,218.4,218.4,Wellcare,Wellcare,218.4,,,,,,,case rate,218.4,218.4,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health PPO CPD,Meritain Health PPO CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna/Commercial Product,Aetna/Commercial Product,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Meritain Health CPD,Meritain Health CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Starmark CPD,Starmark CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Aetna Medicare,Aetna Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Ambetter ,Ambetter ,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access,Anthem Blue Access,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Access Choice,Anthem Blue Access Choice,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Blue Preferred,Anthem Blue Preferred,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Pathway,Anthem Pathway,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Alliance,Anthem Alliance,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Anthem Medicare,Anthem Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna,Cigna,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna PPO,Cigna PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Cigna Medicare Advantage,Cigna Medicare Advantage,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Essence,Essence,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink HMO,Healthlink HMO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Healthlink PPO,Healthlink PPO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,HomeState Health Plan,HomeState Health Plan,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Humana Gold,Humana Gold,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medicaid MO,Medicaid MO,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Medica,Medica,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Tricare,Tricare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC All Payer,UHC All Payer,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Exchange,UHC Exchange,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicaid,UHC Medicaid,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UMR CPD,UMR CPD,45.15,,,,,,,per diem,45.15,45.15,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,UHC Medicare,UHC Medicare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33129651,CDM,279,RC,,,,,,Inpatient,,,45.15,45.15,Wellcare,Wellcare,45.15,,,,,,,case rate,45.15,45.15,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Meritain Health PPO CPD,Meritain Health PPO CPD,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Aetna/Commercial Product,Aetna/Commercial Product,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Meritain Health CPD,Meritain Health CPD,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Starmark CPD,Starmark CPD,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Aetna Medicare,Aetna Medicare,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Ambetter ,Ambetter ,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Blue Access,Anthem Blue Access,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Blue Access Choice,Anthem Blue Access Choice,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Blue Preferred,Anthem Blue Preferred,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Pathway,Anthem Pathway,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Alliance,Anthem Alliance,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Anthem Medicare,Anthem Medicare,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Cigna,Cigna,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Cigna PPO,Cigna PPO,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Cigna Medicare Advantage,Cigna Medicare Advantage,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Essence,Essence,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Healthlink HMO,Healthlink HMO,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Healthlink PPO,Healthlink PPO,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,HomeState Health Plan,HomeState Health Plan,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Humana Gold,Humana Gold,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Medicaid MO,Medicaid MO,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Medica,Medica,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Tricare,Tricare,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,UHC All Payer,UHC All Payer,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,UHC Exchange,UHC Exchange,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,UHC Medicaid,UHC Medicaid,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,UMR CPD,UMR CPD,139.65,,,,,,,per diem,139.65,139.65,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,UHC Medicare,UHC Medicare,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33129653,CDM,279,RC,,,,,,Inpatient,,,139.65,139.65,Wellcare,Wellcare,139.65,,,,,,,case rate,139.65,139.65,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Meritain Health PPO CPD,Meritain Health PPO CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna/Commercial Product,Aetna/Commercial Product,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Meritain Health CPD,Meritain Health CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Starmark CPD,Starmark CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna Medicare,Aetna Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Ambetter ,Ambetter ,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Access,Anthem Blue Access,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Access Choice,Anthem Blue Access Choice,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Preferred,Anthem Blue Preferred,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Pathway,Anthem Pathway,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Alliance,Anthem Alliance,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Medicare,Anthem Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna,Cigna,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna PPO,Cigna PPO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna Medicare Advantage,Cigna Medicare Advantage,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Essence,Essence,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthlink HMO,Healthlink HMO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthlink PPO,Healthlink PPO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,HomeState Health Plan,HomeState Health Plan,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Humana Gold,Humana Gold,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Medicaid MO,Medicaid MO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Medica,Medica,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Tricare,Tricare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC All Payer,UHC All Payer,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Exchange,UHC Exchange,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Medicaid,UHC Medicaid,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UMR CPD,UMR CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Medicare,UHC Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33129654,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Wellcare,Wellcare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health PPO CPD,Meritain Health PPO CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/Commercial Product,Aetna/Commercial Product,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health CPD,Meritain Health CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Starmark CPD,Starmark CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna Medicare,Aetna Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Ambetter ,Ambetter ,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access,Anthem Blue Access,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access Choice,Anthem Blue Access Choice,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Preferred,Anthem Blue Preferred,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Pathway,Anthem Pathway,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Alliance,Anthem Alliance,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Medicare,Anthem Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna,Cigna,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna PPO,Cigna PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna Medicare Advantage,Cigna Medicare Advantage,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Essence,Essence,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink HMO,Healthlink HMO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink PPO,Healthlink PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,HomeState Health Plan,HomeState Health Plan,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Humana Gold,Humana Gold,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medicaid MO,Medicaid MO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medica,Medica,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Tricare,Tricare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC All Payer,UHC All Payer,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Exchange,UHC Exchange,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicaid,UHC Medicaid,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UMR CPD,UMR CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicare,UHC Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33129655,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Wellcare,Wellcare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Meritain Health PPO CPD,Meritain Health PPO CPD,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Aetna/Commercial Product,Aetna/Commercial Product,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Meritain Health CPD,Meritain Health CPD,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Starmark CPD,Starmark CPD,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Aetna Medicare,Aetna Medicare,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Ambetter ,Ambetter ,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Blue Access,Anthem Blue Access,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Blue Access Choice,Anthem Blue Access Choice,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Blue Preferred,Anthem Blue Preferred,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Pathway,Anthem Pathway,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Alliance,Anthem Alliance,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Anthem Medicare,Anthem Medicare,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Cigna,Cigna,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Cigna PPO,Cigna PPO,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Cigna Medicare Advantage,Cigna Medicare Advantage,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Essence,Essence,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Healthlink HMO,Healthlink HMO,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Healthlink PPO,Healthlink PPO,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,HomeState Health Plan,HomeState Health Plan,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Humana Gold,Humana Gold,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Medicaid MO,Medicaid MO,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Medica,Medica,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Tricare,Tricare,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,UHC All Payer,UHC All Payer,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,UHC Exchange,UHC Exchange,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,UHC Medicaid,UHC Medicaid,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,UMR CPD,UMR CPD,180.39,,,,,,,per diem,180.39,180.39,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,UHC Medicare,UHC Medicare,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33129656,CDM,279,RC,,,,,,Inpatient,,,180.39,180.39,Wellcare,Wellcare,180.39,,,,,,,case rate,180.39,180.39,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Meritain Health PPO CPD,Meritain Health PPO CPD,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Aetna/Commercial Product,Aetna/Commercial Product,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Meritain Health CPD,Meritain Health CPD,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Starmark CPD,Starmark CPD,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Aetna Medicare,Aetna Medicare,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Ambetter ,Ambetter ,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Blue Access,Anthem Blue Access,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Blue Access Choice,Anthem Blue Access Choice,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Blue Preferred,Anthem Blue Preferred,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Pathway,Anthem Pathway,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Alliance,Anthem Alliance,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Anthem Medicare,Anthem Medicare,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Cigna,Cigna,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Cigna PPO,Cigna PPO,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Cigna Medicare Advantage,Cigna Medicare Advantage,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Essence,Essence,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Healthlink HMO,Healthlink HMO,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Healthlink PPO,Healthlink PPO,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,HomeState Health Plan,HomeState Health Plan,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Humana Gold,Humana Gold,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Medicaid MO,Medicaid MO,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Medica,Medica,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Tricare,Tricare,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,UHC All Payer,UHC All Payer,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,UHC Exchange,UHC Exchange,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,UHC Medicaid,UHC Medicaid,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,UMR CPD,UMR CPD,147.55,,,,,,,per diem,147.55,147.55,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,UHC Medicare,UHC Medicare,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33129657,CDM,279,RC,,,,,,Inpatient,,,147.55,147.55,Wellcare,Wellcare,147.55,,,,,,,case rate,147.55,147.55,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33129658,CDM,279,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Meritain Health PPO CPD,Meritain Health PPO CPD,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Aetna/Commercial Product,Aetna/Commercial Product,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Meritain Health CPD,Meritain Health CPD,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Starmark CPD,Starmark CPD,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Aetna Medicare,Aetna Medicare,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Ambetter ,Ambetter ,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Blue Access,Anthem Blue Access,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Blue Access Choice,Anthem Blue Access Choice,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Blue Preferred,Anthem Blue Preferred,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Pathway,Anthem Pathway,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Alliance,Anthem Alliance,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Anthem Medicare,Anthem Medicare,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Cigna,Cigna,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Cigna PPO,Cigna PPO,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Cigna Medicare Advantage,Cigna Medicare Advantage,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Essence,Essence,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Healthlink HMO,Healthlink HMO,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Healthlink PPO,Healthlink PPO,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,HomeState Health Plan,HomeState Health Plan,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Humana Gold,Humana Gold,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Medicaid MO,Medicaid MO,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Medica,Medica,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Tricare,Tricare,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,UHC All Payer,UHC All Payer,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,UHC Exchange,UHC Exchange,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,UHC Medicaid,UHC Medicaid,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,UMR CPD,UMR CPD,72.45,,,,,,,per diem,72.45,72.45,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,UHC Medicare,UHC Medicare,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY MEDPULSE DA  ,33129660,CDM,279,RC,,,,,,Inpatient,,,72.45,72.45,Wellcare,Wellcare,72.45,,,,,,,case rate,72.45,72.45,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Meritain Health PPO CPD,Meritain Health PPO CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna/Commercial Product,Aetna/Commercial Product,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Meritain Health CPD,Meritain Health CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Starmark CPD,Starmark CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna Medicare,Aetna Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Ambetter ,Ambetter ,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Access,Anthem Blue Access,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Access Choice,Anthem Blue Access Choice,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Preferred,Anthem Blue Preferred,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Pathway,Anthem Pathway,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Alliance,Anthem Alliance,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Medicare,Anthem Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna,Cigna,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna PPO,Cigna PPO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna Medicare Advantage,Cigna Medicare Advantage,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Essence,Essence,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthlink HMO,Healthlink HMO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthlink PPO,Healthlink PPO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,HomeState Health Plan,HomeState Health Plan,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Humana Gold,Humana Gold,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Medicaid MO,Medicaid MO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Medica,Medica,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Tricare,Tricare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC All Payer,UHC All Payer,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Exchange,UHC Exchange,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Medicaid,UHC Medicaid,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UMR CPD,UMR CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Medicare,UHC Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION DE,33129661,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Wellcare,Wellcare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Meritain Health PPO CPD,Meritain Health PPO CPD,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Aetna/Commercial Product,Aetna/Commercial Product,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Meritain Health CPD,Meritain Health CPD,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Starmark CPD,Starmark CPD,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Aetna Medicare,Aetna Medicare,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Ambetter ,Ambetter ,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Blue Access,Anthem Blue Access,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Blue Access Choice,Anthem Blue Access Choice,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Blue Preferred,Anthem Blue Preferred,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Pathway,Anthem Pathway,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Alliance,Anthem Alliance,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Anthem Medicare,Anthem Medicare,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Cigna,Cigna,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Cigna PPO,Cigna PPO,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Cigna Medicare Advantage,Cigna Medicare Advantage,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Essence,Essence,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Healthlink HMO,Healthlink HMO,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Healthlink PPO,Healthlink PPO,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,HomeState Health Plan,HomeState Health Plan,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Humana Gold,Humana Gold,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Medicaid MO,Medicaid MO,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Medica,Medica,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Tricare,Tricare,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,UHC All Payer,UHC All Payer,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,UHC Exchange,UHC Exchange,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,UHC Medicaid,UHC Medicaid,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,UMR CPD,UMR CPD,708.75,,,,,,,per diem,708.75,708.75,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,UHC Medicare,UHC Medicare,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33129662,CDM,279,RC,,,,,,Inpatient,,,708.75,708.75,Wellcare,Wellcare,708.75,,,,,,,case rate,708.75,708.75,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Meritain Health PPO CPD,Meritain Health PPO CPD,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Aetna/Commercial Product,Aetna/Commercial Product,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Meritain Health CPD,Meritain Health CPD,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Starmark CPD,Starmark CPD,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Aetna Medicare,Aetna Medicare,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Ambetter ,Ambetter ,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Blue Access,Anthem Blue Access,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Blue Access Choice,Anthem Blue Access Choice,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Blue Preferred,Anthem Blue Preferred,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Pathway,Anthem Pathway,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Alliance,Anthem Alliance,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Anthem Medicare,Anthem Medicare,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Cigna,Cigna,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Cigna PPO,Cigna PPO,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Cigna Medicare Advantage,Cigna Medicare Advantage,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Essence,Essence,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Healthlink HMO,Healthlink HMO,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Healthlink PPO,Healthlink PPO,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,HomeState Health Plan,HomeState Health Plan,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Humana Gold,Humana Gold,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Medicaid MO,Medicaid MO,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Medica,Medica,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Tricare,Tricare,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,UHC All Payer,UHC All Payer,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,UHC Exchange,UHC Exchange,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,UHC Medicaid,UHC Medicaid,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,UMR CPD,UMR CPD,11.55,,,,,,,per diem,11.55,11.55,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,UHC Medicare,UHC Medicare,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33129663,CDM,279,RC,,,,,,Inpatient,,,11.55,11.55,Wellcare,Wellcare,11.55,,,,,,,case rate,11.55,11.55,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Meritain Health PPO CPD,Meritain Health PPO CPD,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Aetna/Commercial Product,Aetna/Commercial Product,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Meritain Health CPD,Meritain Health CPD,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Starmark CPD,Starmark CPD,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Aetna Medicare,Aetna Medicare,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Ambetter ,Ambetter ,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Blue Access,Anthem Blue Access,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Blue Access Choice,Anthem Blue Access Choice,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Blue Preferred,Anthem Blue Preferred,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Pathway,Anthem Pathway,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Alliance,Anthem Alliance,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Anthem Medicare,Anthem Medicare,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Cigna,Cigna,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Cigna PPO,Cigna PPO,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Cigna Medicare Advantage,Cigna Medicare Advantage,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Essence,Essence,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Healthlink HMO,Healthlink HMO,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Healthlink PPO,Healthlink PPO,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,HomeState Health Plan,HomeState Health Plan,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Humana Gold,Humana Gold,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Medicaid MO,Medicaid MO,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Medica,Medica,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Tricare,Tricare,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,UHC All Payer,UHC All Payer,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,UHC Exchange,UHC Exchange,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,UHC Medicaid,UHC Medicaid,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,UMR CPD,UMR CPD,3.7,,,,,,,per diem,3.7,3.7,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,UHC Medicare,UHC Medicare,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33129664,CDM,279,RC,,,,,,Inpatient,,,3.7,3.7,Wellcare,Wellcare,3.7,,,,,,,case rate,3.7,3.7,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Meritain Health PPO CPD,Meritain Health PPO CPD,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Aetna/Commercial Product,Aetna/Commercial Product,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Meritain Health CPD,Meritain Health CPD,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Starmark CPD,Starmark CPD,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Aetna Medicare,Aetna Medicare,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Ambetter ,Ambetter ,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Blue Access,Anthem Blue Access,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Blue Access Choice,Anthem Blue Access Choice,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Blue Preferred,Anthem Blue Preferred,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Pathway,Anthem Pathway,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Alliance,Anthem Alliance,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Anthem Medicare,Anthem Medicare,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Cigna,Cigna,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Cigna PPO,Cigna PPO,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Cigna Medicare Advantage,Cigna Medicare Advantage,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Essence,Essence,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Healthlink HMO,Healthlink HMO,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Healthlink PPO,Healthlink PPO,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,HomeState Health Plan,HomeState Health Plan,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Humana Gold,Humana Gold,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Medicaid MO,Medicaid MO,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Medica,Medica,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Tricare,Tricare,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,UHC All Payer,UHC All Payer,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,UHC Exchange,UHC Exchange,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,UHC Medicaid,UHC Medicaid,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,UMR CPD,UMR CPD,158.55,,,,,,,per diem,158.55,158.55,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,UHC Medicare,UHC Medicare,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33129665,CDM,279,RC,,,,,,Inpatient,,,158.55,158.55,Wellcare,Wellcare,158.55,,,,,,,case rate,158.55,158.55,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Meritain Health PPO CPD,Meritain Health PPO CPD,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Aetna/Commercial Product,Aetna/Commercial Product,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Meritain Health CPD,Meritain Health CPD,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Starmark CPD,Starmark CPD,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Aetna Medicare,Aetna Medicare,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Ambetter ,Ambetter ,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Blue Access,Anthem Blue Access,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Blue Access Choice,Anthem Blue Access Choice,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Blue Preferred,Anthem Blue Preferred,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Pathway,Anthem Pathway,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Alliance,Anthem Alliance,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Anthem Medicare,Anthem Medicare,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Cigna,Cigna,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Cigna PPO,Cigna PPO,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Cigna Medicare Advantage,Cigna Medicare Advantage,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Essence,Essence,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Healthlink HMO,Healthlink HMO,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Healthlink PPO,Healthlink PPO,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,HomeState Health Plan,HomeState Health Plan,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Humana Gold,Humana Gold,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Medicaid MO,Medicaid MO,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Medica,Medica,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Tricare,Tricare,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,UHC All Payer,UHC All Payer,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,UHC Exchange,UHC Exchange,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,UHC Medicaid,UHC Medicaid,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,UMR CPD,UMR CPD,6.3,,,,,,,per diem,6.3,6.3,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,UHC Medicare,UHC Medicare,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33129667,CDM,279,RC,,,,,,Inpatient,,,6.3,6.3,Wellcare,Wellcare,6.3,,,,,,,case rate,6.3,6.3,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health PPO CPD,Meritain Health PPO CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/Commercial Product,Aetna/Commercial Product,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health CPD,Meritain Health CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Starmark CPD,Starmark CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna Medicare,Aetna Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Ambetter ,Ambetter ,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access,Anthem Blue Access,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access Choice,Anthem Blue Access Choice,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Preferred,Anthem Blue Preferred,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Pathway,Anthem Pathway,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Alliance,Anthem Alliance,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Medicare,Anthem Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna,Cigna,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna PPO,Cigna PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna Medicare Advantage,Cigna Medicare Advantage,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Essence,Essence,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink HMO,Healthlink HMO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink PPO,Healthlink PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,HomeState Health Plan,HomeState Health Plan,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Humana Gold,Humana Gold,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Medicaid MO,Medicaid MO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Medica,Medica,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Tricare,Tricare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC All Payer,UHC All Payer,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Exchange,UHC Exchange,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicaid,UHC Medicaid,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,UMR CPD,UMR CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicare,UHC Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33129668,CDM,279,RC,,,,,,Inpatient,,,105,105,Wellcare,Wellcare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health PPO CPD,Meritain Health PPO CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/Commercial Product,Aetna/Commercial Product,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health CPD,Meritain Health CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Starmark CPD,Starmark CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna Medicare,Aetna Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Ambetter ,Ambetter ,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access,Anthem Blue Access,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access Choice,Anthem Blue Access Choice,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Preferred,Anthem Blue Preferred,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Pathway,Anthem Pathway,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Alliance,Anthem Alliance,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Medicare,Anthem Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna,Cigna,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna PPO,Cigna PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna Medicare Advantage,Cigna Medicare Advantage,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Essence,Essence,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink HMO,Healthlink HMO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink PPO,Healthlink PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,HomeState Health Plan,HomeState Health Plan,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Humana Gold,Humana Gold,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Medicaid MO,Medicaid MO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Medica,Medica,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Tricare,Tricare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC All Payer,UHC All Payer,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Exchange,UHC Exchange,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicaid,UHC Medicaid,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,UMR CPD,UMR CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicare,UHC Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
ALTERNATE AIR MATTRESS # SFCT3,33129673,CDM,279,RC,,,,,,Inpatient,,,75,75,Wellcare,Wellcare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Meritain Health PPO CPD,Meritain Health PPO CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Aetna/Commercial Product,Aetna/Commercial Product,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Meritain Health CPD,Meritain Health CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Starmark CPD,Starmark CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Aetna Medicare,Aetna Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Ambetter ,Ambetter ,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Blue Access,Anthem Blue Access,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Blue Access Choice,Anthem Blue Access Choice,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Blue Preferred,Anthem Blue Preferred,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Pathway,Anthem Pathway,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Alliance,Anthem Alliance,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Anthem Medicare,Anthem Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Cigna,Cigna,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Cigna PPO,Cigna PPO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Cigna Medicare Advantage,Cigna Medicare Advantage,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Essence,Essence,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Healthlink HMO,Healthlink HMO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Healthlink PPO,Healthlink PPO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,HomeState Health Plan,HomeState Health Plan,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Humana Gold,Humana Gold,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Medicaid MO,Medicaid MO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Medica,Medica,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Tricare,Tricare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,UHC All Payer,UHC All Payer,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,UHC Exchange,UHC Exchange,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,UHC Medicaid,UHC Medicaid,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,UMR CPD,UMR CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,UHC Medicare,UHC Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC BED DAILY ,33129674,CDM,279,RC,,,,,,Inpatient,,,120,120,Wellcare,Wellcare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health PPO CPD,Meritain Health PPO CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/Commercial Product,Aetna/Commercial Product,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health CPD,Meritain Health CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Starmark CPD,Starmark CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna Medicare,Aetna Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Ambetter ,Ambetter ,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access,Anthem Blue Access,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access Choice,Anthem Blue Access Choice,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Preferred,Anthem Blue Preferred,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Pathway,Anthem Pathway,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Alliance,Anthem Alliance,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Medicare,Anthem Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna,Cigna,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna PPO,Cigna PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna Medicare Advantage,Cigna Medicare Advantage,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Essence,Essence,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink HMO,Healthlink HMO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink PPO,Healthlink PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,HomeState Health Plan,HomeState Health Plan,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Humana Gold,Humana Gold,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Medicaid MO,Medicaid MO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Medica,Medica,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Tricare,Tricare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC All Payer,UHC All Payer,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Exchange,UHC Exchange,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicaid,UHC Medicaid,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,UMR CPD,UMR CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicare,UHC Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
SIZE WISE BARIATRIC PULSE MATT,33129675,CDM,279,RC,,,,,,Inpatient,,,144,144,Wellcare,Wellcare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Meritain Health PPO CPD,Meritain Health PPO CPD,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Aetna/Commercial Product,Aetna/Commercial Product,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Meritain Health CPD,Meritain Health CPD,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Starmark CPD,Starmark CPD,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Aetna Medicare,Aetna Medicare,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Ambetter ,Ambetter ,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Blue Access,Anthem Blue Access,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Blue Access Choice,Anthem Blue Access Choice,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Blue Preferred,Anthem Blue Preferred,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Pathway,Anthem Pathway,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Alliance,Anthem Alliance,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Anthem Medicare,Anthem Medicare,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Cigna,Cigna,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Cigna PPO,Cigna PPO,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Cigna Medicare Advantage,Cigna Medicare Advantage,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Essence,Essence,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Healthlink HMO,Healthlink HMO,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Healthlink PPO,Healthlink PPO,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,HomeState Health Plan,HomeState Health Plan,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Humana Gold,Humana Gold,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Medicaid MO,Medicaid MO,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Medica,Medica,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Tricare,Tricare,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,UHC All Payer,UHC All Payer,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,UHC Exchange,UHC Exchange,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,UHC Medicaid,UHC Medicaid,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,UMR CPD,UMR CPD,10.3,,,,,,,per diem,10.3,10.3,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,UHC Medicare,UHC Medicare,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33129686,CDM,270,RC,,,,,,Inpatient,,,10.3,10.3,Wellcare,Wellcare,10.3,,,,,,,case rate,10.3,10.3,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Meritain Health PPO CPD,Meritain Health PPO CPD,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Aetna/Commercial Product,Aetna/Commercial Product,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Meritain Health CPD,Meritain Health CPD,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Starmark CPD,Starmark CPD,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Aetna Medicare,Aetna Medicare,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Ambetter ,Ambetter ,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Blue Access,Anthem Blue Access,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Blue Access Choice,Anthem Blue Access Choice,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Blue Preferred,Anthem Blue Preferred,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Pathway,Anthem Pathway,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Alliance,Anthem Alliance,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Anthem Medicare,Anthem Medicare,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Cigna,Cigna,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Cigna PPO,Cigna PPO,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Cigna Medicare Advantage,Cigna Medicare Advantage,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Essence,Essence,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Healthlink HMO,Healthlink HMO,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Healthlink PPO,Healthlink PPO,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,HomeState Health Plan,HomeState Health Plan,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Humana Gold,Humana Gold,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Medicaid MO,Medicaid MO,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Medica,Medica,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Tricare,Tricare,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,UHC All Payer,UHC All Payer,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,UHC Exchange,UHC Exchange,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,UHC Medicaid,UHC Medicaid,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,UMR CPD,UMR CPD,59.65,,,,,,,per diem,59.65,59.65,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,UHC Medicare,UHC Medicare,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC           ,33129692,CDM,270,RC,,,,,,Inpatient,,,59.65,59.65,Wellcare,Wellcare,59.65,,,,,,,case rate,59.65,59.65,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health PPO CPD,Meritain Health PPO CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Aetna/Commercial Product,Aetna/Commercial Product,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Meritain Health CPD,Meritain Health CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Starmark CPD,Starmark CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Aetna Medicare,Aetna Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Ambetter ,Ambetter ,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access,Anthem Blue Access,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Access Choice,Anthem Blue Access Choice,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Blue Preferred,Anthem Blue Preferred,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Pathway,Anthem Pathway,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Alliance,Anthem Alliance,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Anthem Medicare,Anthem Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Cigna,Cigna,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Cigna PPO,Cigna PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Cigna Medicare Advantage,Cigna Medicare Advantage,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Essence,Essence,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink HMO,Healthlink HMO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Healthlink PPO,Healthlink PPO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,HomeState Health Plan,HomeState Health Plan,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Humana Gold,Humana Gold,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Medicaid MO,Medicaid MO,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Medica,Medica,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Tricare,Tricare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,UHC All Payer,UHC All Payer,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,UHC Exchange,UHC Exchange,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicaid,UHC Medicaid,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,UMR CPD,UMR CPD,27.3,,,,,,,per diem,27.3,27.3,"Per diem rate, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,UHC Medicare,UHC Medicare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHO FINGER SPLINT-A/S       ,33129728,CDM,270,RC,,,,,,Inpatient,,,27.3,27.3,Wellcare,Wellcare,27.3,,,,,,,case rate,27.3,27.3,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Meritain Health PPO CPD,Meritain Health PPO CPD,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Aetna/Commercial Product,Aetna/Commercial Product,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Meritain Health CPD,Meritain Health CPD,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Starmark CPD,Starmark CPD,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Aetna Medicare,Aetna Medicare,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Ambetter ,Ambetter ,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Blue Access,Anthem Blue Access,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Blue Access Choice,Anthem Blue Access Choice,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Blue Preferred,Anthem Blue Preferred,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Pathway,Anthem Pathway,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Alliance,Anthem Alliance,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Anthem Medicare,Anthem Medicare,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Cigna,Cigna,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Cigna PPO,Cigna PPO,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Cigna Medicare Advantage,Cigna Medicare Advantage,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Essence,Essence,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Healthlink HMO,Healthlink HMO,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Healthlink PPO,Healthlink PPO,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,HomeState Health Plan,HomeState Health Plan,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Humana Gold,Humana Gold,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Medicaid MO,Medicaid MO,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Medica,Medica,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Tricare,Tricare,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,UHC All Payer,UHC All Payer,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,UHC Exchange,UHC Exchange,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,UHC Medicaid,UHC Medicaid,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,UMR CPD,UMR CPD,638.95,,,,,,,per diem,638.95,638.95,"Per diem rate, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,UHC Medicare,UHC Medicare,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
ORTHOSIS BRACE                ,33129729,CDM,270,RC,,,,,,Inpatient,,,638.95,638.95,Wellcare,Wellcare,638.95,,,,,,,case rate,638.95,638.95,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health PPO CPD,Meritain Health PPO CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/Commercial Product,Aetna/Commercial Product,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health CPD,Meritain Health CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Starmark CPD,Starmark CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Aetna Medicare,Aetna Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Ambetter ,Ambetter ,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access,Anthem Blue Access,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access Choice,Anthem Blue Access Choice,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Preferred,Anthem Blue Preferred,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Pathway,Anthem Pathway,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Alliance,Anthem Alliance,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Medicare,Anthem Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Cigna,Cigna,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Cigna PPO,Cigna PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Cigna Medicare Advantage,Cigna Medicare Advantage,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Essence,Essence,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink HMO,Healthlink HMO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink PPO,Healthlink PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,HomeState Health Plan,HomeState Health Plan,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Humana Gold,Humana Gold,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Medicaid MO,Medicaid MO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Medica,Medica,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Tricare,Tricare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,UHC All Payer,UHC All Payer,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,UHC Exchange,UHC Exchange,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicaid,UHC Medicaid,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,UMR CPD,UMR CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicare,UHC Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
WRIST SPLINT FORM-FIT         ,33129731,CDM,270,RC,,,,,,Inpatient,,,31.5,31.5,Wellcare,Wellcare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health PPO CPD,Meritain Health PPO CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/Commercial Product,Aetna/Commercial Product,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health CPD,Meritain Health CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Starmark CPD,Starmark CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Aetna Medicare,Aetna Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Ambetter ,Ambetter ,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access,Anthem Blue Access,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access Choice,Anthem Blue Access Choice,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Preferred,Anthem Blue Preferred,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Pathway,Anthem Pathway,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Alliance,Anthem Alliance,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Medicare,Anthem Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Cigna,Cigna,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Cigna PPO,Cigna PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Cigna Medicare Advantage,Cigna Medicare Advantage,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Essence,Essence,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink HMO,Healthlink HMO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink PPO,Healthlink PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,HomeState Health Plan,HomeState Health Plan,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Humana Gold,Humana Gold,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Medicaid MO,Medicaid MO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Medica,Medica,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Tricare,Tricare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,UHC All Payer,UHC All Payer,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,UHC Exchange,UHC Exchange,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicaid,UHC Medicaid,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,UMR CPD,UMR CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicare,UHC Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HAND HELP II                  ,33129735,CDM,270,RC,,,,,,Inpatient,,,44.29,44.29,Wellcare,Wellcare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Meritain Health PPO CPD,Meritain Health PPO CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna/Commercial Product,Aetna/Commercial Product,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Meritain Health CPD,Meritain Health CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Starmark CPD,Starmark CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna Medicare,Aetna Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Ambetter ,Ambetter ,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Access,Anthem Blue Access,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Access Choice,Anthem Blue Access Choice,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Preferred,Anthem Blue Preferred,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Pathway,Anthem Pathway,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Alliance,Anthem Alliance,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Medicare,Anthem Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna,Cigna,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna PPO,Cigna PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna Medicare Advantage,Cigna Medicare Advantage,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Essence,Essence,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthlink HMO,Healthlink HMO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthlink PPO,Healthlink PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,HomeState Health Plan,HomeState Health Plan,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Humana Gold,Humana Gold,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Medicaid MO,Medicaid MO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Medica,Medica,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Tricare,Tricare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC All Payer,UHC All Payer,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Exchange,UHC Exchange,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Medicaid,UHC Medicaid,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UMR CPD,UMR CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Medicare,UHC Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33129736,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Wellcare,Wellcare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health PPO CPD,Meritain Health PPO CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/Commercial Product,Aetna/Commercial Product,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health CPD,Meritain Health CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Starmark CPD,Starmark CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Aetna Medicare,Aetna Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Ambetter ,Ambetter ,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access,Anthem Blue Access,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access Choice,Anthem Blue Access Choice,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Preferred,Anthem Blue Preferred,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Pathway,Anthem Pathway,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Alliance,Anthem Alliance,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Medicare,Anthem Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Cigna,Cigna,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Cigna PPO,Cigna PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Cigna Medicare Advantage,Cigna Medicare Advantage,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Essence,Essence,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink HMO,Healthlink HMO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink PPO,Healthlink PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,HomeState Health Plan,HomeState Health Plan,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Humana Gold,Humana Gold,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Medicaid MO,Medicaid MO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Medica,Medica,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Tricare,Tricare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,UHC All Payer,UHC All Payer,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,UHC Exchange,UHC Exchange,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicaid,UHC Medicaid,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,UMR CPD,UMR CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicare,UHC Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WRIST HAND FNGR ORTHOSIS      ,33129756,CDM,274,RC,,,,,,Inpatient,,,277.2,277.2,Wellcare,Wellcare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Meritain Health PPO CPD,Meritain Health PPO CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna/Commercial Product,Aetna/Commercial Product,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Meritain Health CPD,Meritain Health CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Starmark CPD,Starmark CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna Medicare,Aetna Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Ambetter ,Ambetter ,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Access,Anthem Blue Access,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Access Choice,Anthem Blue Access Choice,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Preferred,Anthem Blue Preferred,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Pathway,Anthem Pathway,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Alliance,Anthem Alliance,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Medicare,Anthem Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna,Cigna,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna PPO,Cigna PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna Medicare Advantage,Cigna Medicare Advantage,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Essence,Essence,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthlink HMO,Healthlink HMO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthlink PPO,Healthlink PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,HomeState Health Plan,HomeState Health Plan,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Humana Gold,Humana Gold,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Medicaid MO,Medicaid MO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Medica,Medica,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Tricare,Tricare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC All Payer,UHC All Payer,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Exchange,UHC Exchange,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Medicaid,UHC Medicaid,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UMR CPD,UMR CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Medicare,UHC Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB                   ,33129757,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Wellcare,Wellcare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Meritain Health PPO CPD,Meritain Health PPO CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna/Commercial Product,Aetna/Commercial Product,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Meritain Health CPD,Meritain Health CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Starmark CPD,Starmark CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Aetna Medicare,Aetna Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Ambetter ,Ambetter ,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Access,Anthem Blue Access,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Access Choice,Anthem Blue Access Choice,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Blue Preferred,Anthem Blue Preferred,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Pathway,Anthem Pathway,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Alliance,Anthem Alliance,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Anthem Medicare,Anthem Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna,Cigna,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna PPO,Cigna PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Cigna Medicare Advantage,Cigna Medicare Advantage,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Essence,Essence,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthlink HMO,Healthlink HMO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Healthlink PPO,Healthlink PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,HomeState Health Plan,HomeState Health Plan,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Humana Gold,Humana Gold,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Medicaid MO,Medicaid MO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Medica,Medica,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Tricare,Tricare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC All Payer,UHC All Payer,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Exchange,UHC Exchange,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Medicaid,UHC Medicaid,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UMR CPD,UMR CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,UHC Medicare,UHC Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHO                           ,33129758,CDM,274,RC,,,,,,Inpatient,,,130.2,130.2,Wellcare,Wellcare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO PIP/DIP FLEX/EXT           ,33129759,CDM,274,RC,,,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Meritain Health PPO CPD,Meritain Health PPO CPD,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Aetna/Commercial Product,Aetna/Commercial Product,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Meritain Health CPD,Meritain Health CPD,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Starmark CPD,Starmark CPD,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Aetna Medicare,Aetna Medicare,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Ambetter ,Ambetter ,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Blue Access,Anthem Blue Access,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Blue Access Choice,Anthem Blue Access Choice,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Blue Preferred,Anthem Blue Preferred,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Pathway,Anthem Pathway,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Alliance,Anthem Alliance,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Anthem Medicare,Anthem Medicare,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Cigna,Cigna,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Cigna PPO,Cigna PPO,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Cigna Medicare Advantage,Cigna Medicare Advantage,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Essence,Essence,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Healthlink HMO,Healthlink HMO,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Healthlink PPO,Healthlink PPO,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,HomeState Health Plan,HomeState Health Plan,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Humana Gold,Humana Gold,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Medicaid MO,Medicaid MO,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Medica,Medica,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Tricare,Tricare,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,UHC All Payer,UHC All Payer,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,UHC Exchange,UHC Exchange,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,UHC Medicaid,UHC Medicaid,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,UMR CPD,UMR CPD,226.8,,,,,,,per diem,226.8,226.8,"Per diem rate, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,UHC Medicare,UHC Medicare,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
"WHO, STATIC                   ",33129760,CDM,274,RC,,,,,,Inpatient,,,226.8,226.8,Wellcare,Wellcare,226.8,,,,,,,case rate,226.8,226.8,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Meritain Health PPO CPD,Meritain Health PPO CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Aetna/Commercial Product,Aetna/Commercial Product,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Meritain Health CPD,Meritain Health CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Starmark CPD,Starmark CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Aetna Medicare,Aetna Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Ambetter ,Ambetter ,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Blue Access,Anthem Blue Access,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Blue Access Choice,Anthem Blue Access Choice,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Blue Preferred,Anthem Blue Preferred,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Pathway,Anthem Pathway,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Alliance,Anthem Alliance,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Anthem Medicare,Anthem Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Cigna,Cigna,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Cigna PPO,Cigna PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Cigna Medicare Advantage,Cigna Medicare Advantage,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Essence,Essence,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Healthlink HMO,Healthlink HMO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Healthlink PPO,Healthlink PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,HomeState Health Plan,HomeState Health Plan,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Humana Gold,Humana Gold,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Medicaid MO,Medicaid MO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Medica,Medica,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Tricare,Tricare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,UHC All Payer,UHC All Payer,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,UHC Exchange,UHC Exchange,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,UHC Medicaid,UHC Medicaid,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,UMR CPD,UMR CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,UHC Medicare,UHC Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HFO                           ,33129761,CDM,274,RC,,,,,,Inpatient,,,210,210,Wellcare,Wellcare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Meritain Health PPO CPD,Meritain Health PPO CPD,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Aetna/Commercial Product,Aetna/Commercial Product,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Meritain Health CPD,Meritain Health CPD,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Starmark CPD,Starmark CPD,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Aetna Medicare,Aetna Medicare,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Ambetter ,Ambetter ,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Blue Access,Anthem Blue Access,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Blue Access Choice,Anthem Blue Access Choice,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Blue Preferred,Anthem Blue Preferred,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Pathway,Anthem Pathway,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Alliance,Anthem Alliance,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Anthem Medicare,Anthem Medicare,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Cigna,Cigna,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Cigna PPO,Cigna PPO,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Cigna Medicare Advantage,Cigna Medicare Advantage,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Essence,Essence,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Healthlink HMO,Healthlink HMO,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Healthlink PPO,Healthlink PPO,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,HomeState Health Plan,HomeState Health Plan,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Humana Gold,Humana Gold,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Medicaid MO,Medicaid MO,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Medica,Medica,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Tricare,Tricare,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,UHC All Payer,UHC All Payer,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,UHC Exchange,UHC Exchange,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,UHC Medicaid,UHC Medicaid,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,UMR CPD,UMR CPD,153.3,,,,,,,per diem,153.3,153.3,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,UHC Medicare,UHC Medicare,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33129762,CDM,270,RC,,,,,,Inpatient,,,153.3,153.3,Wellcare,Wellcare,153.3,,,,,,,case rate,153.3,153.3,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Meritain Health PPO CPD,Meritain Health PPO CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna/Commercial Product,Aetna/Commercial Product,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Meritain Health CPD,Meritain Health CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Starmark CPD,Starmark CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Aetna Medicare,Aetna Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Ambetter ,Ambetter ,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Access,Anthem Blue Access,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Access Choice,Anthem Blue Access Choice,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Blue Preferred,Anthem Blue Preferred,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Pathway,Anthem Pathway,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Alliance,Anthem Alliance,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Anthem Medicare,Anthem Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna,Cigna,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna PPO,Cigna PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Cigna Medicare Advantage,Cigna Medicare Advantage,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Essence,Essence,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthlink HMO,Healthlink HMO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Healthlink PPO,Healthlink PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,HomeState Health Plan,HomeState Health Plan,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Humana Gold,Humana Gold,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Medicaid MO,Medicaid MO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Medica,Medica,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Tricare,Tricare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC All Payer,UHC All Payer,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Exchange,UHC Exchange,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Medicaid,UHC Medicaid,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UMR CPD,UMR CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,UHC Medicare,UHC Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
LONG ARM STATIC PREFAB        ,33129763,CDM,270,RC,,,,,,Inpatient,,,340.2,340.2,Wellcare,Wellcare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Meritain Health PPO CPD,Meritain Health PPO CPD,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Aetna/Commercial Product,Aetna/Commercial Product,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Meritain Health CPD,Meritain Health CPD,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Starmark CPD,Starmark CPD,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Aetna Medicare,Aetna Medicare,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Ambetter ,Ambetter ,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Blue Access,Anthem Blue Access,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Blue Access Choice,Anthem Blue Access Choice,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Blue Preferred,Anthem Blue Preferred,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Pathway,Anthem Pathway,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Alliance,Anthem Alliance,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Anthem Medicare,Anthem Medicare,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Cigna,Cigna,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Cigna PPO,Cigna PPO,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Cigna Medicare Advantage,Cigna Medicare Advantage,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Essence,Essence,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Healthlink HMO,Healthlink HMO,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Healthlink PPO,Healthlink PPO,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,HomeState Health Plan,HomeState Health Plan,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Humana Gold,Humana Gold,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Medicaid MO,Medicaid MO,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Medica,Medica,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Tricare,Tricare,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,UHC All Payer,UHC All Payer,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,UHC Exchange,UHC Exchange,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,UHC Medicaid,UHC Medicaid,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,UMR CPD,UMR CPD,369.6,,,,,,,per diem,369.6,369.6,"Per diem rate, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,UHC Medicare,UHC Medicare,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
HUMERAL FX PREFAB             ,33129764,CDM,270,RC,,,,,,Inpatient,,,369.6,369.6,Wellcare,Wellcare,369.6,,,,,,,case rate,369.6,369.6,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
ORTH FINGER SPLINT A/S        ,33129767,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health PPO CPD,Meritain Health PPO CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/Commercial Product,Aetna/Commercial Product,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health CPD,Meritain Health CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Starmark CPD,Starmark CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna Medicare,Aetna Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Ambetter ,Ambetter ,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access,Anthem Blue Access,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access Choice,Anthem Blue Access Choice,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Preferred,Anthem Blue Preferred,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Pathway,Anthem Pathway,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Alliance,Anthem Alliance,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Medicare,Anthem Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna,Cigna,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna PPO,Cigna PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna Medicare Advantage,Cigna Medicare Advantage,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Essence,Essence,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink HMO,Healthlink HMO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink PPO,Healthlink PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,HomeState Health Plan,HomeState Health Plan,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Humana Gold,Humana Gold,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Medicaid MO,Medicaid MO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Medica,Medica,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Tricare,Tricare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC All Payer,UHC All Payer,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Exchange,UHC Exchange,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicaid,UHC Medicaid,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UMR CPD,UMR CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicare,UHC Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
WHFO WRIST THUMB SPICA        ,33129768,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Wellcare,Wellcare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Meritain Health PPO CPD,Meritain Health PPO CPD,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Aetna/Commercial Product,Aetna/Commercial Product,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Meritain Health CPD,Meritain Health CPD,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Starmark CPD,Starmark CPD,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Aetna Medicare,Aetna Medicare,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Ambetter ,Ambetter ,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Blue Access,Anthem Blue Access,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Blue Access Choice,Anthem Blue Access Choice,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Blue Preferred,Anthem Blue Preferred,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Pathway,Anthem Pathway,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Alliance,Anthem Alliance,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Anthem Medicare,Anthem Medicare,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Cigna,Cigna,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Cigna PPO,Cigna PPO,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Cigna Medicare Advantage,Cigna Medicare Advantage,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Essence,Essence,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Healthlink HMO,Healthlink HMO,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Healthlink PPO,Healthlink PPO,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,HomeState Health Plan,HomeState Health Plan,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Humana Gold,Humana Gold,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Medicaid MO,Medicaid MO,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Medica,Medica,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Tricare,Tricare,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,UHC All Payer,UHC All Payer,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,UHC Exchange,UHC Exchange,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,UHC Medicaid,UHC Medicaid,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,UMR CPD,UMR CPD,110.75,,,,,,,per diem,110.75,110.75,"Per diem rate, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,UHC Medicare,UHC Medicare,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
FUNCTIONAL POSITION SPLINT    ,33129769,CDM,270,RC,,,,,,Inpatient,,,110.75,110.75,Wellcare,Wellcare,110.75,,,,,,,case rate,110.75,110.75,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Meritain Health PPO CPD,Meritain Health PPO CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Aetna/Commercial Product,Aetna/Commercial Product,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Meritain Health CPD,Meritain Health CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Starmark CPD,Starmark CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Aetna Medicare,Aetna Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Ambetter ,Ambetter ,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Access,Anthem Blue Access,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Access Choice,Anthem Blue Access Choice,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Preferred,Anthem Blue Preferred,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Pathway,Anthem Pathway,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Alliance,Anthem Alliance,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Anthem Medicare,Anthem Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Cigna,Cigna,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Cigna PPO,Cigna PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Cigna Medicare Advantage,Cigna Medicare Advantage,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Essence,Essence,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Healthlink HMO,Healthlink HMO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Healthlink PPO,Healthlink PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,HomeState Health Plan,HomeState Health Plan,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Humana Gold,Humana Gold,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Medicaid MO,Medicaid MO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Medica,Medica,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Tricare,Tricare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,UHC All Payer,UHC All Payer,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,UHC Exchange,UHC Exchange,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,UHC Medicaid,UHC Medicaid,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,UMR CPD,UMR CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,UHC Medicare,UHC Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WHFO PREFAB STATIC ORTHO      ,33129770,CDM,274,RC,L3807,CPT,,,,Inpatient,,,130.2,130.2,Wellcare,Wellcare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HFO STATIC PREFAB ORTHO       ,33129771,CDM,274,RC,L3923,CPT,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Meritain Health PPO CPD,Meritain Health PPO CPD,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Aetna/Commercial Product,Aetna/Commercial Product,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Meritain Health CPD,Meritain Health CPD,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Starmark CPD,Starmark CPD,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Aetna Medicare,Aetna Medicare,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Ambetter ,Ambetter ,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Blue Access,Anthem Blue Access,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Blue Access Choice,Anthem Blue Access Choice,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Blue Preferred,Anthem Blue Preferred,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Pathway,Anthem Pathway,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Alliance,Anthem Alliance,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Anthem Medicare,Anthem Medicare,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Cigna,Cigna,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Cigna PPO,Cigna PPO,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Cigna Medicare Advantage,Cigna Medicare Advantage,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Essence,Essence,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Healthlink HMO,Healthlink HMO,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Healthlink PPO,Healthlink PPO,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,HomeState Health Plan,HomeState Health Plan,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Humana Gold,Humana Gold,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Medicaid MO,Medicaid MO,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Medica,Medica,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Tricare,Tricare,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,UHC All Payer,UHC All Payer,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,UHC Exchange,UHC Exchange,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,UHC Medicaid,UHC Medicaid,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,UMR CPD,UMR CPD,368.55,,,,,,,per diem,368.55,368.55,"Per diem rate, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,UHC Medicare,UHC Medicare,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
HUMERAL FRACTURE PREFAB ORTHO ,33129772,CDM,274,RC,L3980,CPT,,,,Inpatient,,,368.55,368.55,Wellcare,Wellcare,368.55,,,,,,,case rate,368.55,368.55,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Meritain Health PPO CPD,Meritain Health PPO CPD,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Aetna/Commercial Product,Aetna/Commercial Product,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Meritain Health CPD,Meritain Health CPD,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Starmark CPD,Starmark CPD,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Aetna Medicare,Aetna Medicare,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Ambetter ,Ambetter ,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Blue Access,Anthem Blue Access,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Blue Access Choice,Anthem Blue Access Choice,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Blue Preferred,Anthem Blue Preferred,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Pathway,Anthem Pathway,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Alliance,Anthem Alliance,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Anthem Medicare,Anthem Medicare,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Cigna,Cigna,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Cigna PPO,Cigna PPO,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Cigna Medicare Advantage,Cigna Medicare Advantage,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Essence,Essence,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Healthlink HMO,Healthlink HMO,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Healthlink PPO,Healthlink PPO,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,HomeState Health Plan,HomeState Health Plan,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Humana Gold,Humana Gold,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Medicaid MO,Medicaid MO,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Medica,Medica,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Tricare,Tricare,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,UHC All Payer,UHC All Payer,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,UHC Exchange,UHC Exchange,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,UHC Medicaid,UHC Medicaid,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,UMR CPD,UMR CPD,292.32,,,,,,,per diem,292.32,292.32,"Per diem rate, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,UHC Medicare,UHC Medicare,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
M-BRACE LG PELVIS 33-45CM     ,33129773,CDM,270,RC,,,,,,Inpatient,,,292.32,292.32,Wellcare,Wellcare,292.32,,,,,,,case rate,292.32,292.32,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Meritain Health PPO CPD,Meritain Health PPO CPD,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Aetna/Commercial Product,Aetna/Commercial Product,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Meritain Health CPD,Meritain Health CPD,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Starmark CPD,Starmark CPD,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Aetna Medicare,Aetna Medicare,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Ambetter ,Ambetter ,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Blue Access,Anthem Blue Access,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Blue Access Choice,Anthem Blue Access Choice,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Blue Preferred,Anthem Blue Preferred,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Pathway,Anthem Pathway,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Alliance,Anthem Alliance,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Anthem Medicare,Anthem Medicare,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Cigna,Cigna,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Cigna PPO,Cigna PPO,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Cigna Medicare Advantage,Cigna Medicare Advantage,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Essence,Essence,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Healthlink HMO,Healthlink HMO,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Healthlink PPO,Healthlink PPO,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,HomeState Health Plan,HomeState Health Plan,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Humana Gold,Humana Gold,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Medicaid MO,Medicaid MO,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Medica,Medica,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Tricare,Tricare,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,UHC All Payer,UHC All Payer,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,UHC Exchange,UHC Exchange,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,UHC Medicaid,UHC Medicaid,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,UMR CPD,UMR CPD,212.64,,,,,,,per diem,212.64,212.64,"Per diem rate, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,UHC Medicare,UHC Medicare,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
RESTING PLATFORM SPLINT       ,33129783,CDM,270,RC,,,,,,Inpatient,,,212.64,212.64,Wellcare,Wellcare,212.64,,,,,,,case rate,212.64,212.64,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Meritain Health PPO CPD,Meritain Health PPO CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna/Commercial Product,Aetna/Commercial Product,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Meritain Health CPD,Meritain Health CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Starmark CPD,Starmark CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna Medicare,Aetna Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Ambetter ,Ambetter ,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Access,Anthem Blue Access,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Access Choice,Anthem Blue Access Choice,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Preferred,Anthem Blue Preferred,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Pathway,Anthem Pathway,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Alliance,Anthem Alliance,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Medicare,Anthem Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna,Cigna,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna PPO,Cigna PPO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna Medicare Advantage,Cigna Medicare Advantage,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Essence,Essence,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthlink HMO,Healthlink HMO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthlink PPO,Healthlink PPO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,HomeState Health Plan,HomeState Health Plan,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Humana Gold,Humana Gold,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Medicaid MO,Medicaid MO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Medica,Medica,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Tricare,Tricare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC All Payer,UHC All Payer,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Exchange,UHC Exchange,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Medicaid,UHC Medicaid,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UMR CPD,UMR CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Medicare,UHC Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - RIGHT LARGE  ,33129785,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Wellcare,Wellcare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Meritain Health PPO CPD,Meritain Health PPO CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna/Commercial Product,Aetna/Commercial Product,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Meritain Health CPD,Meritain Health CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Starmark CPD,Starmark CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Aetna Medicare,Aetna Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Ambetter ,Ambetter ,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Access,Anthem Blue Access,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Access Choice,Anthem Blue Access Choice,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Blue Preferred,Anthem Blue Preferred,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Pathway,Anthem Pathway,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Alliance,Anthem Alliance,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Anthem Medicare,Anthem Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna,Cigna,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna PPO,Cigna PPO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Cigna Medicare Advantage,Cigna Medicare Advantage,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Essence,Essence,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthlink HMO,Healthlink HMO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Healthlink PPO,Healthlink PPO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,HomeState Health Plan,HomeState Health Plan,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Humana Gold,Humana Gold,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Medicaid MO,Medicaid MO,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Medica,Medica,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Tricare,Tricare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC All Payer,UHC All Payer,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Exchange,UHC Exchange,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Medicaid,UHC Medicaid,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UMR CPD,UMR CPD,88.89,,,,,,,per diem,88.89,88.89,"Per diem rate, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,UHC Medicare,UHC Medicare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
ANKLE ORTHOSIS - LEFT LARGE   ,33129786,CDM,270,RC,,,,,,Inpatient,,,88.89,88.89,Wellcare,Wellcare,88.89,,,,,,,case rate,88.89,88.89,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Meritain Health PPO CPD,Meritain Health PPO CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Aetna/Commercial Product,Aetna/Commercial Product,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Meritain Health CPD,Meritain Health CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Starmark CPD,Starmark CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Aetna Medicare,Aetna Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Ambetter ,Ambetter ,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Blue Access,Anthem Blue Access,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Blue Access Choice,Anthem Blue Access Choice,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Blue Preferred,Anthem Blue Preferred,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Pathway,Anthem Pathway,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Alliance,Anthem Alliance,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Anthem Medicare,Anthem Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Cigna,Cigna,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Cigna PPO,Cigna PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Cigna Medicare Advantage,Cigna Medicare Advantage,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Essence,Essence,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Healthlink HMO,Healthlink HMO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Healthlink PPO,Healthlink PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,HomeState Health Plan,HomeState Health Plan,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Humana Gold,Humana Gold,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Medicaid MO,Medicaid MO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Medica,Medica,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Tricare,Tricare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,UHC All Payer,UHC All Payer,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,UHC Exchange,UHC Exchange,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,UHC Medicaid,UHC Medicaid,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,UMR CPD,UMR CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,UHC Medicare,UHC Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
FO PIP/DIP STATIC OR RING TYPE,33129787,CDM,274,RC,L3927,CPT,,,,Inpatient,,,54,54,Wellcare,Wellcare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Meritain Health PPO CPD,Meritain Health PPO CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Aetna/Commercial Product,Aetna/Commercial Product,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Meritain Health CPD,Meritain Health CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Starmark CPD,Starmark CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Aetna Medicare,Aetna Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Ambetter ,Ambetter ,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Access,Anthem Blue Access,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Access Choice,Anthem Blue Access Choice,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Preferred,Anthem Blue Preferred,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Pathway,Anthem Pathway,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Alliance,Anthem Alliance,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Anthem Medicare,Anthem Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Cigna,Cigna,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Cigna PPO,Cigna PPO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Cigna Medicare Advantage,Cigna Medicare Advantage,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Essence,Essence,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Healthlink HMO,Healthlink HMO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Healthlink PPO,Healthlink PPO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,HomeState Health Plan,HomeState Health Plan,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Humana Gold,Humana Gold,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Medicaid MO,Medicaid MO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Medica,Medica,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Tricare,Tricare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,UHC All Payer,UHC All Payer,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,UHC Exchange,UHC Exchange,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,UHC Medicaid,UHC Medicaid,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,UMR CPD,UMR CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,UHC Medicare,UHC Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB FITTED         ,33129788,CDM,274,RC,L3929,HCPCS,,,,Inpatient,,,150,150,Wellcare,Wellcare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Meritain Health PPO CPD,Meritain Health PPO CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Aetna/Commercial Product,Aetna/Commercial Product,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Meritain Health CPD,Meritain Health CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Starmark CPD,Starmark CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Aetna Medicare,Aetna Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Ambetter ,Ambetter ,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Access,Anthem Blue Access,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Access Choice,Anthem Blue Access Choice,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Blue Preferred,Anthem Blue Preferred,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Pathway,Anthem Pathway,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Alliance,Anthem Alliance,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Anthem Medicare,Anthem Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Cigna,Cigna,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Cigna PPO,Cigna PPO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Cigna Medicare Advantage,Cigna Medicare Advantage,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Essence,Essence,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Healthlink HMO,Healthlink HMO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Healthlink PPO,Healthlink PPO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,HomeState Health Plan,HomeState Health Plan,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Humana Gold,Humana Gold,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Medicaid MO,Medicaid MO,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Medica,Medica,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Tricare,Tricare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,UHC All Payer,UHC All Payer,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,UHC Exchange,UHC Exchange,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,UHC Medicaid,UHC Medicaid,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,UMR CPD,UMR CPD,150,,,,,,,per diem,150,150,"Per diem rate, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,UHC Medicare,UHC Medicare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HFO DYN PREFAB NON FITTED     ,33129789,CDM,274,RC,L3930,HCPCS,,,,Inpatient,,,150,150,Wellcare,Wellcare,150,,,,,,,case rate,150,150,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Meritain Health PPO CPD,Meritain Health PPO CPD,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Aetna/Commercial Product,Aetna/Commercial Product,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Meritain Health CPD,Meritain Health CPD,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Starmark CPD,Starmark CPD,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Aetna Medicare,Aetna Medicare,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Ambetter ,Ambetter ,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Blue Access,Anthem Blue Access,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Blue Access Choice,Anthem Blue Access Choice,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Blue Preferred,Anthem Blue Preferred,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Pathway,Anthem Pathway,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Alliance,Anthem Alliance,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Anthem Medicare,Anthem Medicare,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Cigna,Cigna,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Cigna PPO,Cigna PPO,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Cigna Medicare Advantage,Cigna Medicare Advantage,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Essence,Essence,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Healthlink HMO,Healthlink HMO,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Healthlink PPO,Healthlink PPO,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,HomeState Health Plan,HomeState Health Plan,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Humana Gold,Humana Gold,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Medicaid MO,Medicaid MO,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Medica,Medica,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Tricare,Tricare,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,UHC All Payer,UHC All Payer,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,UHC Exchange,UHC Exchange,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,UHC Medicaid,UHC Medicaid,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,UMR CPD,UMR CPD,6.75,,,,,,,per diem,6.75,6.75,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,UHC Medicare,UHC Medicare,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33129799,CDM,270,RC,,,,,,Inpatient,,,6.75,6.75,Wellcare,Wellcare,6.75,,,,,,,case rate,6.75,6.75,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Meritain Health PPO CPD,Meritain Health PPO CPD,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Aetna/Commercial Product,Aetna/Commercial Product,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Meritain Health CPD,Meritain Health CPD,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Starmark CPD,Starmark CPD,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Aetna Medicare,Aetna Medicare,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Ambetter ,Ambetter ,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Blue Access,Anthem Blue Access,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Blue Access Choice,Anthem Blue Access Choice,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Blue Preferred,Anthem Blue Preferred,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Pathway,Anthem Pathway,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Alliance,Anthem Alliance,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Anthem Medicare,Anthem Medicare,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Cigna,Cigna,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Cigna PPO,Cigna PPO,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Cigna Medicare Advantage,Cigna Medicare Advantage,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Essence,Essence,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Healthlink HMO,Healthlink HMO,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Healthlink PPO,Healthlink PPO,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,HomeState Health Plan,HomeState Health Plan,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Humana Gold,Humana Gold,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Medicaid MO,Medicaid MO,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Medica,Medica,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Tricare,Tricare,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,UHC All Payer,UHC All Payer,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,UHC Exchange,UHC Exchange,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,UHC Medicaid,UHC Medicaid,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,UMR CPD,UMR CPD,27.18,,,,,,,per diem,27.18,27.18,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,UHC Medicare,UHC Medicare,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 36IN WIDE   ,33130001,CDM,279,RC,,,,,,Inpatient,,,27.18,27.18,Wellcare,Wellcare,27.18,,,,,,,case rate,27.18,27.18,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Meritain Health PPO CPD,Meritain Health PPO CPD,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Aetna/Commercial Product,Aetna/Commercial Product,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Meritain Health CPD,Meritain Health CPD,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Starmark CPD,Starmark CPD,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Aetna Medicare,Aetna Medicare,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Ambetter ,Ambetter ,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Blue Access,Anthem Blue Access,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Blue Access Choice,Anthem Blue Access Choice,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Blue Preferred,Anthem Blue Preferred,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Pathway,Anthem Pathway,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Alliance,Anthem Alliance,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Anthem Medicare,Anthem Medicare,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Cigna,Cigna,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Cigna PPO,Cigna PPO,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Cigna Medicare Advantage,Cigna Medicare Advantage,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Essence,Essence,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Healthlink HMO,Healthlink HMO,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Healthlink PPO,Healthlink PPO,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,HomeState Health Plan,HomeState Health Plan,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Humana Gold,Humana Gold,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Medicaid MO,Medicaid MO,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Medica,Medica,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Tricare,Tricare,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,UHC All Payer,UHC All Payer,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,UHC Exchange,UHC Exchange,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,UHC Medicaid,UHC Medicaid,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,UMR CPD,UMR CPD,34.61,,,,,,,per diem,34.61,34.61,"Per diem rate, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,UHC Medicare,UHC Medicare,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
LOW AIR LOSS MATT 42IN WIDE   ,33130002,CDM,279,RC,,,,,,Inpatient,,,34.61,34.61,Wellcare,Wellcare,34.61,,,,,,,case rate,34.61,34.61,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Meritain Health PPO CPD,Meritain Health PPO CPD,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Aetna/Commercial Product,Aetna/Commercial Product,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Meritain Health CPD,Meritain Health CPD,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Starmark CPD,Starmark CPD,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Aetna Medicare,Aetna Medicare,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Ambetter ,Ambetter ,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Blue Access,Anthem Blue Access,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Blue Access Choice,Anthem Blue Access Choice,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Blue Preferred,Anthem Blue Preferred,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Pathway,Anthem Pathway,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Alliance,Anthem Alliance,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Anthem Medicare,Anthem Medicare,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Cigna,Cigna,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Cigna PPO,Cigna PPO,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Cigna Medicare Advantage,Cigna Medicare Advantage,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Essence,Essence,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Healthlink HMO,Healthlink HMO,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Healthlink PPO,Healthlink PPO,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,HomeState Health Plan,HomeState Health Plan,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Humana Gold,Humana Gold,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Medicaid MO,Medicaid MO,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Medica,Medica,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Tricare,Tricare,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,UHC All Payer,UHC All Payer,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,UHC Exchange,UHC Exchange,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,UHC Medicaid,UHC Medicaid,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,UMR CPD,UMR CPD,26.2,,,,,,,per diem,26.2,26.2,"Per diem rate, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,UHC Medicare,UHC Medicare,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC BED WITH SCALE      ,33130003,CDM,279,RC,,,,,,Inpatient,,,26.2,26.2,Wellcare,Wellcare,26.2,,,,,,,case rate,26.2,26.2,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Meritain Health PPO CPD,Meritain Health PPO CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna/Commercial Product,Aetna/Commercial Product,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Meritain Health CPD,Meritain Health CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Starmark CPD,Starmark CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Aetna Medicare,Aetna Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Ambetter ,Ambetter ,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Access,Anthem Blue Access,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Access Choice,Anthem Blue Access Choice,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Blue Preferred,Anthem Blue Preferred,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Pathway,Anthem Pathway,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Alliance,Anthem Alliance,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Anthem Medicare,Anthem Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna,Cigna,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna PPO,Cigna PPO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Cigna Medicare Advantage,Cigna Medicare Advantage,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Essence,Essence,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthlink HMO,Healthlink HMO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Healthlink PPO,Healthlink PPO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,HomeState Health Plan,HomeState Health Plan,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Humana Gold,Humana Gold,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Medicaid MO,Medicaid MO,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Medica,Medica,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Tricare,Tricare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC All Payer,UHC All Payer,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Exchange,UHC Exchange,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Medicaid,UHC Medicaid,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UMR CPD,UMR CPD,190.04,,,,,,,per diem,190.04,190.04,"Per diem rate, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,UHC Medicare,UHC Medicare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC LOW BED             ,33130004,CDM,279,RC,,,,,,Inpatient,,,190.04,190.04,Wellcare,Wellcare,190.04,,,,,,,case rate,190.04,190.04,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Meritain Health PPO CPD,Meritain Health PPO CPD,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Aetna/Commercial Product,Aetna/Commercial Product,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Meritain Health CPD,Meritain Health CPD,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Starmark CPD,Starmark CPD,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Aetna Medicare,Aetna Medicare,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Ambetter ,Ambetter ,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Blue Access,Anthem Blue Access,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Blue Access Choice,Anthem Blue Access Choice,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Blue Preferred,Anthem Blue Preferred,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Pathway,Anthem Pathway,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Alliance,Anthem Alliance,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Anthem Medicare,Anthem Medicare,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Cigna,Cigna,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Cigna PPO,Cigna PPO,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Cigna Medicare Advantage,Cigna Medicare Advantage,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Essence,Essence,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Healthlink HMO,Healthlink HMO,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Healthlink PPO,Healthlink PPO,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,HomeState Health Plan,HomeState Health Plan,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Humana Gold,Humana Gold,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Medicaid MO,Medicaid MO,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Medica,Medica,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Tricare,Tricare,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,UHC All Payer,UHC All Payer,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,UHC Exchange,UHC Exchange,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,UHC Medicaid,UHC Medicaid,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,UMR CPD,UMR CPD,7.56,,,,,,,per diem,7.56,7.56,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,UHC Medicare,UHC Medicare,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER 500-750 LBS  ,33130005,CDM,279,RC,,,,,,Inpatient,,,7.56,7.56,Wellcare,Wellcare,7.56,,,,,,,case rate,7.56,7.56,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Meritain Health PPO CPD,Meritain Health PPO CPD,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Aetna/Commercial Product,Aetna/Commercial Product,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Meritain Health CPD,Meritain Health CPD,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Starmark CPD,Starmark CPD,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Aetna Medicare,Aetna Medicare,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Ambetter ,Ambetter ,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Blue Access,Anthem Blue Access,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Blue Access Choice,Anthem Blue Access Choice,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Blue Preferred,Anthem Blue Preferred,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Pathway,Anthem Pathway,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Alliance,Anthem Alliance,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Anthem Medicare,Anthem Medicare,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Cigna,Cigna,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Cigna PPO,Cigna PPO,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Cigna Medicare Advantage,Cigna Medicare Advantage,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Essence,Essence,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Healthlink HMO,Healthlink HMO,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Healthlink PPO,Healthlink PPO,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,HomeState Health Plan,HomeState Health Plan,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Humana Gold,Humana Gold,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Medicaid MO,Medicaid MO,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Medica,Medica,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Tricare,Tricare,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,UHC All Payer,UHC All Payer,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,UHC Exchange,UHC Exchange,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,UHC Medicaid,UHC Medicaid,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,UMR CPD,UMR CPD,30.9,,,,,,,per diem,30.9,30.9,"Per diem rate, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,UHC Medicare,UHC Medicare,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
FOAM MATTRESS                 ,33130006,CDM,279,RC,,,,,,Inpatient,,,30.9,30.9,Wellcare,Wellcare,30.9,,,,,,,case rate,30.9,30.9,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Meritain Health PPO CPD,Meritain Health PPO CPD,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Aetna/Commercial Product,Aetna/Commercial Product,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Meritain Health CPD,Meritain Health CPD,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Starmark CPD,Starmark CPD,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Aetna Medicare,Aetna Medicare,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Ambetter ,Ambetter ,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Blue Access,Anthem Blue Access,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Blue Access Choice,Anthem Blue Access Choice,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Blue Preferred,Anthem Blue Preferred,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Pathway,Anthem Pathway,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Alliance,Anthem Alliance,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Anthem Medicare,Anthem Medicare,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Cigna,Cigna,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Cigna PPO,Cigna PPO,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Cigna Medicare Advantage,Cigna Medicare Advantage,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Essence,Essence,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Healthlink HMO,Healthlink HMO,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Healthlink PPO,Healthlink PPO,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,HomeState Health Plan,HomeState Health Plan,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Humana Gold,Humana Gold,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Medicaid MO,Medicaid MO,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Medica,Medica,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Tricare,Tricare,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,UHC All Payer,UHC All Payer,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,UHC Exchange,UHC Exchange,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,UHC Medicaid,UHC Medicaid,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,UMR CPD,UMR CPD,17.99,,,,,,,per diem,17.99,17.99,"Per diem rate, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,UHC Medicare,UHC Medicare,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
C-PAP MACHINE - AUTO SET SPIRI,33130008,CDM,279,RC,,,,,,Inpatient,,,17.99,17.99,Wellcare,Wellcare,17.99,,,,,,,case rate,17.99,17.99,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Meritain Health PPO CPD,Meritain Health PPO CPD,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Aetna/Commercial Product,Aetna/Commercial Product,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Meritain Health CPD,Meritain Health CPD,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Starmark CPD,Starmark CPD,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Aetna Medicare,Aetna Medicare,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Ambetter ,Ambetter ,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Blue Access,Anthem Blue Access,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Blue Access Choice,Anthem Blue Access Choice,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Blue Preferred,Anthem Blue Preferred,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Pathway,Anthem Pathway,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Alliance,Anthem Alliance,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Anthem Medicare,Anthem Medicare,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Cigna,Cigna,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Cigna PPO,Cigna PPO,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Cigna Medicare Advantage,Cigna Medicare Advantage,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Essence,Essence,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Healthlink HMO,Healthlink HMO,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Healthlink PPO,Healthlink PPO,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,HomeState Health Plan,HomeState Health Plan,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Humana Gold,Humana Gold,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Medicaid MO,Medicaid MO,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Medica,Medica,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Tricare,Tricare,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,UHC All Payer,UHC All Payer,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,UHC Exchange,UHC Exchange,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,UHC Medicaid,UHC Medicaid,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,UMR CPD,UMR CPD,37.2,,,,,,,per diem,37.2,37.2,"Per diem rate, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,UHC Medicare,UHC Medicare,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAP MACHINE - FOCUS        ,33130009,CDM,279,RC,,,,,,Inpatient,,,37.2,37.2,Wellcare,Wellcare,37.2,,,,,,,case rate,37.2,37.2,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Meritain Health PPO CPD,Meritain Health PPO CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Aetna/Commercial Product,Aetna/Commercial Product,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Meritain Health CPD,Meritain Health CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Starmark CPD,Starmark CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Aetna Medicare,Aetna Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Ambetter ,Ambetter ,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Blue Access,Anthem Blue Access,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Blue Access Choice,Anthem Blue Access Choice,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Blue Preferred,Anthem Blue Preferred,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Pathway,Anthem Pathway,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Alliance,Anthem Alliance,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Anthem Medicare,Anthem Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Cigna,Cigna,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Cigna PPO,Cigna PPO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Cigna Medicare Advantage,Cigna Medicare Advantage,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Essence,Essence,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Healthlink HMO,Healthlink HMO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Healthlink PPO,Healthlink PPO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,HomeState Health Plan,HomeState Health Plan,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Humana Gold,Humana Gold,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Medicaid MO,Medicaid MO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Medica,Medica,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Tricare,Tricare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,UHC All Payer,UHC All Payer,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,UHC Exchange,UHC Exchange,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,UHC Medicaid,UHC Medicaid,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,UMR CPD,UMR CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,UHC Medicare,UHC Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
BI PAT MACHINE - VISION       ,33130010,CDM,279,RC,,,,,,Inpatient,,,22.68,22.68,Wellcare,Wellcare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health PPO CPD,Meritain Health PPO CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/Commercial Product,Aetna/Commercial Product,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health CPD,Meritain Health CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Starmark CPD,Starmark CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Aetna Medicare,Aetna Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Ambetter ,Ambetter ,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access,Anthem Blue Access,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access Choice,Anthem Blue Access Choice,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Preferred,Anthem Blue Preferred,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Pathway,Anthem Pathway,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Alliance,Anthem Alliance,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Medicare,Anthem Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Cigna,Cigna,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Cigna PPO,Cigna PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Cigna Medicare Advantage,Cigna Medicare Advantage,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Essence,Essence,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink HMO,Healthlink HMO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink PPO,Healthlink PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,HomeState Health Plan,HomeState Health Plan,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Humana Gold,Humana Gold,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Medicaid MO,Medicaid MO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Medica,Medica,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Tricare,Tricare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,UHC All Payer,UHC All Payer,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,UHC Exchange,UHC Exchange,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicaid,UHC Medicaid,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,UMR CPD,UMR CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicare,UHC Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
CONTINUOUS PULSE OX MACHINE   ,33130012,CDM,279,RC,,,,,,Inpatient,,,40.82,40.82,Wellcare,Wellcare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Meritain Health PPO CPD,Meritain Health PPO CPD,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Aetna/Commercial Product,Aetna/Commercial Product,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Meritain Health CPD,Meritain Health CPD,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Starmark CPD,Starmark CPD,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Aetna Medicare,Aetna Medicare,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Ambetter ,Ambetter ,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Blue Access,Anthem Blue Access,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Blue Access Choice,Anthem Blue Access Choice,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Blue Preferred,Anthem Blue Preferred,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Pathway,Anthem Pathway,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Alliance,Anthem Alliance,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Anthem Medicare,Anthem Medicare,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Cigna,Cigna,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Cigna PPO,Cigna PPO,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Cigna Medicare Advantage,Cigna Medicare Advantage,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Essence,Essence,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Healthlink HMO,Healthlink HMO,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Healthlink PPO,Healthlink PPO,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,HomeState Health Plan,HomeState Health Plan,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Humana Gold,Humana Gold,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Medicaid MO,Medicaid MO,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Medica,Medica,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Tricare,Tricare,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,UHC All Payer,UHC All Payer,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,UHC Exchange,UHC Exchange,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,UHC Medicaid,UHC Medicaid,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,UMR CPD,UMR CPD,170.12,,,,,,,per diem,170.12,170.12,"Per diem rate, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,UHC Medicare,UHC Medicare,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - FREEDOM RENTAL    ,33130014,CDM,279,RC,,,,,,Inpatient,,,170.12,170.12,Wellcare,Wellcare,170.12,,,,,,,case rate,170.12,170.12,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Meritain Health PPO CPD,Meritain Health PPO CPD,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Aetna/Commercial Product,Aetna/Commercial Product,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Meritain Health CPD,Meritain Health CPD,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Starmark CPD,Starmark CPD,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Aetna Medicare,Aetna Medicare,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Ambetter ,Ambetter ,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Blue Access,Anthem Blue Access,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Blue Access Choice,Anthem Blue Access Choice,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Blue Preferred,Anthem Blue Preferred,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Pathway,Anthem Pathway,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Alliance,Anthem Alliance,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Anthem Medicare,Anthem Medicare,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Cigna,Cigna,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Cigna PPO,Cigna PPO,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Cigna Medicare Advantage,Cigna Medicare Advantage,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Essence,Essence,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Healthlink HMO,Healthlink HMO,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Healthlink PPO,Healthlink PPO,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,HomeState Health Plan,HomeState Health Plan,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Humana Gold,Humana Gold,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Medicaid MO,Medicaid MO,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Medica,Medica,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Tricare,Tricare,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,UHC All Payer,UHC All Payer,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,UHC Exchange,UHC Exchange,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,UHC Medicaid,UHC Medicaid,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,UMR CPD,UMR CPD,85.02,,,,,,,per diem,85.02,85.02,"Per diem rate, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,UHC Medicare,UHC Medicare,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
WOUND VAC - ULTA RENTAL       ,33130015,CDM,279,RC,,,,,,Inpatient,,,85.02,85.02,Wellcare,Wellcare,85.02,,,,,,,case rate,85.02,85.02,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Meritain Health PPO CPD,Meritain Health PPO CPD,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Aetna/Commercial Product,Aetna/Commercial Product,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Meritain Health CPD,Meritain Health CPD,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Starmark CPD,Starmark CPD,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Aetna Medicare,Aetna Medicare,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Ambetter ,Ambetter ,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Blue Access,Anthem Blue Access,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Blue Access Choice,Anthem Blue Access Choice,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Blue Preferred,Anthem Blue Preferred,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Pathway,Anthem Pathway,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Alliance,Anthem Alliance,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Anthem Medicare,Anthem Medicare,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Cigna,Cigna,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Cigna PPO,Cigna PPO,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Cigna Medicare Advantage,Cigna Medicare Advantage,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Essence,Essence,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Healthlink HMO,Healthlink HMO,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Healthlink PPO,Healthlink PPO,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,HomeState Health Plan,HomeState Health Plan,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Humana Gold,Humana Gold,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Medicaid MO,Medicaid MO,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Medica,Medica,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Tricare,Tricare,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,UHC All Payer,UHC All Payer,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,UHC Exchange,UHC Exchange,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,UHC Medicaid,UHC Medicaid,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,UMR CPD,UMR CPD,70.8,,,,,,,per diem,70.8,70.8,"Per diem rate, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,UHC Medicare,UHC Medicare,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
MATTRESS UMS 36X84X8-10       ,33130016,CDM,279,RC,,,,,,Inpatient,,,70.8,70.8,Wellcare,Wellcare,70.8,,,,,,,case rate,70.8,70.8,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Meritain Health PPO CPD,Meritain Health PPO CPD,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Aetna/Commercial Product,Aetna/Commercial Product,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Meritain Health CPD,Meritain Health CPD,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Starmark CPD,Starmark CPD,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Aetna Medicare,Aetna Medicare,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Ambetter ,Ambetter ,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Blue Access,Anthem Blue Access,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Blue Access Choice,Anthem Blue Access Choice,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Blue Preferred,Anthem Blue Preferred,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Pathway,Anthem Pathway,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Alliance,Anthem Alliance,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Anthem Medicare,Anthem Medicare,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Cigna,Cigna,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Cigna PPO,Cigna PPO,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Cigna Medicare Advantage,Cigna Medicare Advantage,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Essence,Essence,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Healthlink HMO,Healthlink HMO,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Healthlink PPO,Healthlink PPO,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,HomeState Health Plan,HomeState Health Plan,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Humana Gold,Humana Gold,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Medicaid MO,Medicaid MO,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Medica,Medica,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Tricare,Tricare,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,UHC All Payer,UHC All Payer,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,UHC Exchange,UHC Exchange,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,UHC Medicaid,UHC Medicaid,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,UMR CPD,UMR CPD,186.36,,,,,,,per diem,186.36,186.36,"Per diem rate, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,UHC Medicare,UHC Medicare,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
ROTEC 1100SE BARIATRIC LOW BED,33130017,CDM,279,RC,,,,,,Inpatient,,,186.36,186.36,Wellcare,Wellcare,186.36,,,,,,,case rate,186.36,186.36,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Meritain Health PPO CPD,Meritain Health PPO CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Aetna/Commercial Product,Aetna/Commercial Product,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Meritain Health CPD,Meritain Health CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Starmark CPD,Starmark CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Aetna Medicare,Aetna Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Ambetter ,Ambetter ,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Access,Anthem Blue Access,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Access Choice,Anthem Blue Access Choice,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Preferred,Anthem Blue Preferred,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Pathway,Anthem Pathway,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Alliance,Anthem Alliance,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Medicare,Anthem Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Cigna,Cigna,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Cigna PPO,Cigna PPO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Cigna Medicare Advantage,Cigna Medicare Advantage,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Essence,Essence,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Healthlink HMO,Healthlink HMO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Healthlink PPO,Healthlink PPO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,HomeState Health Plan,HomeState Health Plan,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Humana Gold,Humana Gold,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Medicaid MO,Medicaid MO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Medica,Medica,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Tricare,Tricare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,UHC All Payer,UHC All Payer,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,UHC Exchange,UHC Exchange,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,UHC Medicaid,UHC Medicaid,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,UMR CPD,UMR CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,UHC Medicare,UHC Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
RESIRONICS BIPAP AUTO RR      ,33130019,CDM,279,RC,,,,,,Inpatient,,,21.48,21.48,Wellcare,Wellcare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Meritain Health PPO CPD,Meritain Health PPO CPD,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Aetna/Commercial Product,Aetna/Commercial Product,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Meritain Health CPD,Meritain Health CPD,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Starmark CPD,Starmark CPD,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Aetna Medicare,Aetna Medicare,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Ambetter ,Ambetter ,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Blue Access,Anthem Blue Access,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Blue Access Choice,Anthem Blue Access Choice,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Blue Preferred,Anthem Blue Preferred,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Pathway,Anthem Pathway,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Alliance,Anthem Alliance,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Anthem Medicare,Anthem Medicare,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Cigna,Cigna,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Cigna PPO,Cigna PPO,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Cigna Medicare Advantage,Cigna Medicare Advantage,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Essence,Essence,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Healthlink HMO,Healthlink HMO,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Healthlink PPO,Healthlink PPO,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,HomeState Health Plan,HomeState Health Plan,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Humana Gold,Humana Gold,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Medicaid MO,Medicaid MO,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Medica,Medica,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Tricare,Tricare,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,UHC All Payer,UHC All Payer,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,UHC Exchange,UHC Exchange,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,UHC Medicaid,UHC Medicaid,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,UMR CPD,UMR CPD,76.26,,,,,,,per diem,76.26,76.26,"Per diem rate, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,UHC Medicare,UHC Medicare,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
WAVE MATTREXX 48X80X10        ,33130020,CDM,279,RC,,,,,,Inpatient,,,76.26,76.26,Wellcare,Wellcare,76.26,,,,,,,case rate,76.26,76.26,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Meritain Health PPO CPD,Meritain Health PPO CPD,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Aetna/Commercial Product,Aetna/Commercial Product,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Meritain Health CPD,Meritain Health CPD,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Starmark CPD,Starmark CPD,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Aetna Medicare,Aetna Medicare,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Ambetter ,Ambetter ,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Blue Access,Anthem Blue Access,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Blue Access Choice,Anthem Blue Access Choice,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Blue Preferred,Anthem Blue Preferred,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Pathway,Anthem Pathway,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Alliance,Anthem Alliance,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Anthem Medicare,Anthem Medicare,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Cigna,Cigna,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Cigna PPO,Cigna PPO,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Cigna Medicare Advantage,Cigna Medicare Advantage,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Essence,Essence,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Healthlink HMO,Healthlink HMO,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Healthlink PPO,Healthlink PPO,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,HomeState Health Plan,HomeState Health Plan,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Humana Gold,Humana Gold,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Medicaid MO,Medicaid MO,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Medica,Medica,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Tricare,Tricare,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,UHC All Payer,UHC All Payer,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,UHC Exchange,UHC Exchange,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,UHC Medicaid,UHC Medicaid,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,UMR CPD,UMR CPD,90.63,,,,,,,per diem,90.63,90.63,"Per diem rate, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,UHC Medicare,UHC Medicare,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
ROTEC V600- SE LOW BED        ,33130021,CDM,279,RC,,,,,,Inpatient,,,90.63,90.63,Wellcare,Wellcare,90.63,,,,,,,case rate,90.63,90.63,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Meritain Health PPO CPD,Meritain Health PPO CPD,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Aetna/Commercial Product,Aetna/Commercial Product,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Meritain Health CPD,Meritain Health CPD,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Starmark CPD,Starmark CPD,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Aetna Medicare,Aetna Medicare,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Ambetter ,Ambetter ,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Blue Access,Anthem Blue Access,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Blue Access Choice,Anthem Blue Access Choice,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Blue Preferred,Anthem Blue Preferred,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Pathway,Anthem Pathway,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Alliance,Anthem Alliance,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Anthem Medicare,Anthem Medicare,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Cigna,Cigna,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Cigna PPO,Cigna PPO,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Cigna Medicare Advantage,Cigna Medicare Advantage,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Essence,Essence,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Healthlink HMO,Healthlink HMO,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Healthlink PPO,Healthlink PPO,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,HomeState Health Plan,HomeState Health Plan,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Humana Gold,Humana Gold,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Medicaid MO,Medicaid MO,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Medica,Medica,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Tricare,Tricare,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,UHC All Payer,UHC All Payer,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,UHC Exchange,UHC Exchange,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,UHC Medicaid,UHC Medicaid,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,UMR CPD,UMR CPD,255.66,,,,,,,per diem,255.66,255.66,"Per diem rate, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,UHC Medicare,UHC Medicare,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
WOUND VAC                     ,33130023,CDM,279,RC,,,,,,Inpatient,,,255.66,255.66,Wellcare,Wellcare,255.66,,,,,,,case rate,255.66,255.66,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Meritain Health PPO CPD,Meritain Health PPO CPD,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Aetna/Commercial Product,Aetna/Commercial Product,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Meritain Health CPD,Meritain Health CPD,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Starmark CPD,Starmark CPD,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Aetna Medicare,Aetna Medicare,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Ambetter ,Ambetter ,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Blue Access,Anthem Blue Access,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Blue Access Choice,Anthem Blue Access Choice,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Blue Preferred,Anthem Blue Preferred,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Pathway,Anthem Pathway,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Alliance,Anthem Alliance,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Anthem Medicare,Anthem Medicare,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Cigna,Cigna,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Cigna PPO,Cigna PPO,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Cigna Medicare Advantage,Cigna Medicare Advantage,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Essence,Essence,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Healthlink HMO,Healthlink HMO,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Healthlink PPO,Healthlink PPO,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,HomeState Health Plan,HomeState Health Plan,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Humana Gold,Humana Gold,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Medicaid MO,Medicaid MO,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Medica,Medica,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Tricare,Tricare,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,UHC All Payer,UHC All Payer,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,UHC Exchange,UHC Exchange,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,UHC Medicaid,UHC Medicaid,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,UMR CPD,UMR CPD,42.88,,,,,,,per diem,42.88,42.88,"Per diem rate, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,UHC Medicare,UHC Medicare,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
LONG BED EXTENDED             ,33130025,CDM,279,RC,,,,,,Inpatient,,,42.88,42.88,Wellcare,Wellcare,42.88,,,,,,,case rate,42.88,42.88,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RENTAL             ,33130026,CDM,279,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Meritain Health PPO CPD,Meritain Health PPO CPD,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Aetna/Commercial Product,Aetna/Commercial Product,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Meritain Health CPD,Meritain Health CPD,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Starmark CPD,Starmark CPD,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Aetna Medicare,Aetna Medicare,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Ambetter ,Ambetter ,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Blue Access,Anthem Blue Access,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Blue Access Choice,Anthem Blue Access Choice,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Blue Preferred,Anthem Blue Preferred,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Pathway,Anthem Pathway,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Alliance,Anthem Alliance,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Anthem Medicare,Anthem Medicare,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Cigna,Cigna,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Cigna PPO,Cigna PPO,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Cigna Medicare Advantage,Cigna Medicare Advantage,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Essence,Essence,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Healthlink HMO,Healthlink HMO,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Healthlink PPO,Healthlink PPO,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,HomeState Health Plan,HomeState Health Plan,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Humana Gold,Humana Gold,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Medicaid MO,Medicaid MO,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Medica,Medica,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Tricare,Tricare,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,UHC All Payer,UHC All Payer,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,UHC Exchange,UHC Exchange,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,UHC Medicaid,UHC Medicaid,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,UMR CPD,UMR CPD,117.94,,,,,,,per diem,117.94,117.94,"Per diem rate, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,UHC Medicare,UHC Medicare,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
LAL MATTRESS                  ,33130032,CDM,279,RC,,,,,,Inpatient,,,117.94,117.94,Wellcare,Wellcare,117.94,,,,,,,case rate,117.94,117.94,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Meritain Health PPO CPD,Meritain Health PPO CPD,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Aetna/Commercial Product,Aetna/Commercial Product,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Meritain Health CPD,Meritain Health CPD,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Starmark CPD,Starmark CPD,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Aetna Medicare,Aetna Medicare,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Ambetter ,Ambetter ,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Blue Access,Anthem Blue Access,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Blue Access Choice,Anthem Blue Access Choice,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Blue Preferred,Anthem Blue Preferred,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Pathway,Anthem Pathway,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Alliance,Anthem Alliance,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Anthem Medicare,Anthem Medicare,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Cigna,Cigna,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Cigna PPO,Cigna PPO,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Cigna Medicare Advantage,Cigna Medicare Advantage,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Essence,Essence,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Healthlink HMO,Healthlink HMO,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Healthlink PPO,Healthlink PPO,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,HomeState Health Plan,HomeState Health Plan,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Humana Gold,Humana Gold,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Medicaid MO,Medicaid MO,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Medica,Medica,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Tricare,Tricare,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,UHC All Payer,UHC All Payer,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,UHC Exchange,UHC Exchange,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,UHC Medicaid,UHC Medicaid,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,UMR CPD,UMR CPD,38.51,,,,,,,per diem,38.51,38.51,"Per diem rate, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,UHC Medicare,UHC Medicare,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
BOOT AIR WALKER               ,33130037,CDM,270,RC,,,,,,Inpatient,,,38.51,38.51,Wellcare,Wellcare,38.51,,,,,,,case rate,38.51,38.51,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Meritain Health PPO CPD,Meritain Health PPO CPD,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Aetna/Commercial Product,Aetna/Commercial Product,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Meritain Health CPD,Meritain Health CPD,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Starmark CPD,Starmark CPD,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Aetna Medicare,Aetna Medicare,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Ambetter ,Ambetter ,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Blue Access,Anthem Blue Access,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Blue Access Choice,Anthem Blue Access Choice,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Blue Preferred,Anthem Blue Preferred,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Pathway,Anthem Pathway,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Alliance,Anthem Alliance,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Anthem Medicare,Anthem Medicare,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Cigna,Cigna,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Cigna PPO,Cigna PPO,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Cigna Medicare Advantage,Cigna Medicare Advantage,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Essence,Essence,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Healthlink HMO,Healthlink HMO,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Healthlink PPO,Healthlink PPO,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,HomeState Health Plan,HomeState Health Plan,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Humana Gold,Humana Gold,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Medicaid MO,Medicaid MO,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Medica,Medica,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Tricare,Tricare,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,UHC All Payer,UHC All Payer,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,UHC Exchange,UHC Exchange,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,UHC Medicaid,UHC Medicaid,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,UMR CPD,UMR CPD,8.28,,,,,,,per diem,8.28,8.28,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,UHC Medicare,UHC Medicare,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER XXL 86-105   ,33130038,CDM,270,RC,,,,,,Inpatient,,,8.28,8.28,Wellcare,Wellcare,8.28,,,,,,,case rate,8.28,8.28,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Meritain Health PPO CPD,Meritain Health PPO CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Aetna/Commercial Product,Aetna/Commercial Product,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Meritain Health CPD,Meritain Health CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Starmark CPD,Starmark CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Aetna Medicare,Aetna Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Ambetter ,Ambetter ,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Access,Anthem Blue Access,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Access Choice,Anthem Blue Access Choice,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Blue Preferred,Anthem Blue Preferred,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Pathway,Anthem Pathway,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Alliance,Anthem Alliance,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Anthem Medicare,Anthem Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Cigna,Cigna,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Cigna PPO,Cigna PPO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Cigna Medicare Advantage,Cigna Medicare Advantage,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Essence,Essence,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Healthlink HMO,Healthlink HMO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Healthlink PPO,Healthlink PPO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,HomeState Health Plan,HomeState Health Plan,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Humana Gold,Humana Gold,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Medicaid MO,Medicaid MO,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Medica,Medica,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Tricare,Tricare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,UHC All Payer,UHC All Payer,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,UHC Exchange,UHC Exchange,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,UHC Medicaid,UHC Medicaid,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,UMR CPD,UMR CPD,36.05,,,,,,,per diem,36.05,36.05,"Per diem rate, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,UHC Medicare,UHC Medicare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
WRAPAROUND HINGED KNEE BR - L ,33130039,CDM,270,RC,,,,,,Inpatient,,,36.05,36.05,Wellcare,Wellcare,36.05,,,,,,,case rate,36.05,36.05,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Meritain Health PPO CPD,Meritain Health PPO CPD,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Aetna/Commercial Product,Aetna/Commercial Product,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Meritain Health CPD,Meritain Health CPD,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Starmark CPD,Starmark CPD,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Aetna Medicare,Aetna Medicare,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Ambetter ,Ambetter ,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Blue Access,Anthem Blue Access,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Blue Access Choice,Anthem Blue Access Choice,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Blue Preferred,Anthem Blue Preferred,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Pathway,Anthem Pathway,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Alliance,Anthem Alliance,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Anthem Medicare,Anthem Medicare,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Cigna,Cigna,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Cigna PPO,Cigna PPO,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Cigna Medicare Advantage,Cigna Medicare Advantage,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Essence,Essence,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Healthlink HMO,Healthlink HMO,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Healthlink PPO,Healthlink PPO,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,HomeState Health Plan,HomeState Health Plan,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Humana Gold,Humana Gold,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Medicaid MO,Medicaid MO,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Medica,Medica,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Tricare,Tricare,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,UHC All Payer,UHC All Payer,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,UHC Exchange,UHC Exchange,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,UHC Medicaid,UHC Medicaid,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,UMR CPD,UMR CPD,656.37,,,,,,,per diem,656.37,656.37,"Per diem rate, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,UHC Medicare,UHC Medicare,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
FLOOR CUSHION                 ,33132031,CDM,279,RC,,,,,,Inpatient,,,656.37,656.37,Wellcare,Wellcare,656.37,,,,,,,case rate,656.37,656.37,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Meritain Health PPO CPD,Meritain Health PPO CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna/Commercial Product,Aetna/Commercial Product,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Meritain Health CPD,Meritain Health CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Starmark CPD,Starmark CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna Medicare,Aetna Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Ambetter ,Ambetter ,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Access,Anthem Blue Access,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Access Choice,Anthem Blue Access Choice,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Preferred,Anthem Blue Preferred,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Pathway,Anthem Pathway,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Alliance,Anthem Alliance,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Medicare,Anthem Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna,Cigna,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna PPO,Cigna PPO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna Medicare Advantage,Cigna Medicare Advantage,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Essence,Essence,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthlink HMO,Healthlink HMO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthlink PPO,Healthlink PPO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,HomeState Health Plan,HomeState Health Plan,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Humana Gold,Humana Gold,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Medicaid MO,Medicaid MO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Medica,Medica,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Tricare,Tricare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC All Payer,UHC All Payer,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Exchange,UHC Exchange,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Medicaid,UHC Medicaid,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UMR CPD,UMR CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Medicare,UHC Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL    ,33132070,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Wellcare,Wellcare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Meritain Health PPO CPD,Meritain Health PPO CPD,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Aetna/Commercial Product,Aetna/Commercial Product,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Meritain Health CPD,Meritain Health CPD,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Starmark CPD,Starmark CPD,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Aetna Medicare,Aetna Medicare,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Ambetter ,Ambetter ,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Blue Access,Anthem Blue Access,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Blue Access Choice,Anthem Blue Access Choice,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Blue Preferred,Anthem Blue Preferred,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Pathway,Anthem Pathway,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Alliance,Anthem Alliance,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Anthem Medicare,Anthem Medicare,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Cigna,Cigna,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Cigna PPO,Cigna PPO,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Cigna Medicare Advantage,Cigna Medicare Advantage,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Essence,Essence,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Healthlink HMO,Healthlink HMO,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Healthlink PPO,Healthlink PPO,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,HomeState Health Plan,HomeState Health Plan,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Humana Gold,Humana Gold,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Medicaid MO,Medicaid MO,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Medica,Medica,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Tricare,Tricare,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,UHC All Payer,UHC All Payer,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,UHC Exchange,UHC Exchange,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,UHC Medicaid,UHC Medicaid,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,UMR CPD,UMR CPD,290.96,,,,,,,per diem,290.96,290.96,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,UHC Medicare,UHC Medicare,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL KNITTED GEL XL ,33132071,CDM,270,RC,,,,,,Inpatient,,,290.96,290.96,Wellcare,Wellcare,290.96,,,,,,,case rate,290.96,290.96,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Meritain Health PPO CPD,Meritain Health PPO CPD,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Aetna/Commercial Product,Aetna/Commercial Product,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Meritain Health CPD,Meritain Health CPD,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Starmark CPD,Starmark CPD,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Aetna Medicare,Aetna Medicare,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Ambetter ,Ambetter ,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Blue Access,Anthem Blue Access,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Blue Access Choice,Anthem Blue Access Choice,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Blue Preferred,Anthem Blue Preferred,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Pathway,Anthem Pathway,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Alliance,Anthem Alliance,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Anthem Medicare,Anthem Medicare,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Cigna,Cigna,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Cigna PPO,Cigna PPO,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Cigna Medicare Advantage,Cigna Medicare Advantage,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Essence,Essence,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Healthlink HMO,Healthlink HMO,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Healthlink PPO,Healthlink PPO,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,HomeState Health Plan,HomeState Health Plan,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Humana Gold,Humana Gold,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Medicaid MO,Medicaid MO,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Medica,Medica,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Tricare,Tricare,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,UHC All Payer,UHC All Payer,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,UHC Exchange,UHC Exchange,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,UHC Medicaid,UHC Medicaid,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,UMR CPD,UMR CPD,1368.33,,,,,,,per diem,1368.33,1368.33,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,UHC Medicare,UHC Medicare,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE FOR SEIZURE P,33132072,CDM,279,RC,,,,,,Inpatient,,,1368.33,1368.33,Wellcare,Wellcare,1368.33,,,,,,,case rate,1368.33,1368.33,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Meritain Health PPO CPD,Meritain Health PPO CPD,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Aetna/Commercial Product,Aetna/Commercial Product,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Meritain Health CPD,Meritain Health CPD,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Starmark CPD,Starmark CPD,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Aetna Medicare,Aetna Medicare,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Ambetter ,Ambetter ,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Blue Access,Anthem Blue Access,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Blue Access Choice,Anthem Blue Access Choice,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Blue Preferred,Anthem Blue Preferred,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Pathway,Anthem Pathway,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Alliance,Anthem Alliance,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Anthem Medicare,Anthem Medicare,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Cigna,Cigna,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Cigna PPO,Cigna PPO,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Cigna Medicare Advantage,Cigna Medicare Advantage,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Essence,Essence,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Healthlink HMO,Healthlink HMO,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Healthlink PPO,Healthlink PPO,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,HomeState Health Plan,HomeState Health Plan,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Humana Gold,Humana Gold,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Medicaid MO,Medicaid MO,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Medica,Medica,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Tricare,Tricare,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,UHC All Payer,UHC All Payer,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,UHC Exchange,UHC Exchange,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,UHC Medicaid,UHC Medicaid,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,UMR CPD,UMR CPD,3.83,,,,,,,per diem,3.83,3.83,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,UHC Medicare,UHC Medicare,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33132158,CDM,270,RC,,,,,,Inpatient,,,3.83,3.83,Wellcare,Wellcare,3.83,,,,,,,case rate,3.83,3.83,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Meritain Health PPO CPD,Meritain Health PPO CPD,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Aetna/Commercial Product,Aetna/Commercial Product,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Meritain Health CPD,Meritain Health CPD,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Starmark CPD,Starmark CPD,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Aetna Medicare,Aetna Medicare,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Ambetter ,Ambetter ,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Blue Access,Anthem Blue Access,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Blue Access Choice,Anthem Blue Access Choice,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Blue Preferred,Anthem Blue Preferred,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Pathway,Anthem Pathway,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Alliance,Anthem Alliance,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Anthem Medicare,Anthem Medicare,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Cigna,Cigna,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Cigna PPO,Cigna PPO,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Cigna Medicare Advantage,Cigna Medicare Advantage,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Essence,Essence,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Healthlink HMO,Healthlink HMO,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Healthlink PPO,Healthlink PPO,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,HomeState Health Plan,HomeState Health Plan,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Humana Gold,Humana Gold,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Medicaid MO,Medicaid MO,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Medica,Medica,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Tricare,Tricare,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,UHC All Payer,UHC All Payer,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,UHC Exchange,UHC Exchange,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,UHC Medicaid,UHC Medicaid,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,UMR CPD,UMR CPD,5.61,,,,,,,per diem,5.61,5.61,"Per diem rate, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,UHC Medicare,UHC Medicare,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
CAST PADDING 4X4              ,33132239,CDM,270,RC,,,,,,Inpatient,,,5.61,5.61,Wellcare,Wellcare,5.61,,,,,,,case rate,5.61,5.61,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Meritain Health PPO CPD,Meritain Health PPO CPD,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Aetna/Commercial Product,Aetna/Commercial Product,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Meritain Health CPD,Meritain Health CPD,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Starmark CPD,Starmark CPD,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Aetna Medicare,Aetna Medicare,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Ambetter ,Ambetter ,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Blue Access,Anthem Blue Access,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Blue Access Choice,Anthem Blue Access Choice,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Blue Preferred,Anthem Blue Preferred,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Pathway,Anthem Pathway,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Alliance,Anthem Alliance,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Anthem Medicare,Anthem Medicare,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Cigna,Cigna,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Cigna PPO,Cigna PPO,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Cigna Medicare Advantage,Cigna Medicare Advantage,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Essence,Essence,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Healthlink HMO,Healthlink HMO,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Healthlink PPO,Healthlink PPO,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,HomeState Health Plan,HomeState Health Plan,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Humana Gold,Humana Gold,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Medicaid MO,Medicaid MO,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Medica,Medica,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Tricare,Tricare,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,UHC All Payer,UHC All Payer,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,UHC Exchange,UHC Exchange,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,UHC Medicaid,UHC Medicaid,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,UMR CPD,UMR CPD,122.15,,,,,,,per diem,122.15,122.15,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,UHC Medicare,UHC Medicare,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33132258,CDM,270,RC,,,,,,Inpatient,,,122.15,122.15,Wellcare,Wellcare,122.15,,,,,,,case rate,122.15,122.15,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Meritain Health PPO CPD,Meritain Health PPO CPD,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Aetna/Commercial Product,Aetna/Commercial Product,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Meritain Health CPD,Meritain Health CPD,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Starmark CPD,Starmark CPD,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Aetna Medicare,Aetna Medicare,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Ambetter ,Ambetter ,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Blue Access,Anthem Blue Access,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Blue Access Choice,Anthem Blue Access Choice,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Blue Preferred,Anthem Blue Preferred,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Pathway,Anthem Pathway,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Alliance,Anthem Alliance,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Anthem Medicare,Anthem Medicare,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Cigna,Cigna,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Cigna PPO,Cigna PPO,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Cigna Medicare Advantage,Cigna Medicare Advantage,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Essence,Essence,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Healthlink HMO,Healthlink HMO,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Healthlink PPO,Healthlink PPO,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,HomeState Health Plan,HomeState Health Plan,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Humana Gold,Humana Gold,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Medicaid MO,Medicaid MO,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Medica,Medica,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Tricare,Tricare,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,UHC All Payer,UHC All Payer,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,UHC Exchange,UHC Exchange,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,UHC Medicaid,UHC Medicaid,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,UMR CPD,UMR CPD,235.11,,,,,,,per diem,235.11,235.11,"Per diem rate, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,UHC Medicare,UHC Medicare,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
E-Z BOOT # 6188               ,33132263,CDM,270,RC,,,,,,Inpatient,,,235.11,235.11,Wellcare,Wellcare,235.11,,,,,,,case rate,235.11,235.11,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Meritain Health PPO CPD,Meritain Health PPO CPD,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Aetna/Commercial Product,Aetna/Commercial Product,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Meritain Health CPD,Meritain Health CPD,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Starmark CPD,Starmark CPD,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Aetna Medicare,Aetna Medicare,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Ambetter ,Ambetter ,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Blue Access,Anthem Blue Access,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Blue Access Choice,Anthem Blue Access Choice,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Blue Preferred,Anthem Blue Preferred,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Pathway,Anthem Pathway,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Alliance,Anthem Alliance,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Anthem Medicare,Anthem Medicare,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Cigna,Cigna,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Cigna PPO,Cigna PPO,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Cigna Medicare Advantage,Cigna Medicare Advantage,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Essence,Essence,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Healthlink HMO,Healthlink HMO,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Healthlink PPO,Healthlink PPO,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,HomeState Health Plan,HomeState Health Plan,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Humana Gold,Humana Gold,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Medicaid MO,Medicaid MO,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Medica,Medica,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Tricare,Tricare,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,UHC All Payer,UHC All Payer,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,UHC Exchange,UHC Exchange,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,UHC Medicaid,UHC Medicaid,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,UMR CPD,UMR CPD,158.82,,,,,,,per diem,158.82,158.82,"Per diem rate, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,UHC Medicare,UHC Medicare,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
COMMODE                       ,33132275,CDM,279,RC,,,,,,Inpatient,,,158.82,158.82,Wellcare,Wellcare,158.82,,,,,,,case rate,158.82,158.82,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Meritain Health PPO CPD,Meritain Health PPO CPD,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Aetna/Commercial Product,Aetna/Commercial Product,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Meritain Health CPD,Meritain Health CPD,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Starmark CPD,Starmark CPD,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Aetna Medicare,Aetna Medicare,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Ambetter ,Ambetter ,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Blue Access,Anthem Blue Access,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Blue Access Choice,Anthem Blue Access Choice,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Blue Preferred,Anthem Blue Preferred,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Pathway,Anthem Pathway,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Alliance,Anthem Alliance,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Anthem Medicare,Anthem Medicare,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Cigna,Cigna,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Cigna PPO,Cigna PPO,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Cigna Medicare Advantage,Cigna Medicare Advantage,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Essence,Essence,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Healthlink HMO,Healthlink HMO,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Healthlink PPO,Healthlink PPO,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,HomeState Health Plan,HomeState Health Plan,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Humana Gold,Humana Gold,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Medicaid MO,Medicaid MO,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Medica,Medica,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Tricare,Tricare,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,UHC All Payer,UHC All Payer,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,UHC Exchange,UHC Exchange,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,UHC Medicaid,UHC Medicaid,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,UMR CPD,UMR CPD,23.97,,,,,,,per diem,23.97,23.97,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,UHC Medicare,UHC Medicare,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER              ,33132283,CDM,270,RC,,,,,,Inpatient,,,23.97,23.97,Wellcare,Wellcare,23.97,,,,,,,case rate,23.97,23.97,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Meritain Health PPO CPD,Meritain Health PPO CPD,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Aetna/Commercial Product,Aetna/Commercial Product,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Meritain Health CPD,Meritain Health CPD,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Starmark CPD,Starmark CPD,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Aetna Medicare,Aetna Medicare,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Ambetter ,Ambetter ,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Blue Access,Anthem Blue Access,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Blue Access Choice,Anthem Blue Access Choice,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Blue Preferred,Anthem Blue Preferred,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Pathway,Anthem Pathway,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Alliance,Anthem Alliance,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Anthem Medicare,Anthem Medicare,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Cigna,Cigna,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Cigna PPO,Cigna PPO,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Cigna Medicare Advantage,Cigna Medicare Advantage,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Essence,Essence,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Healthlink HMO,Healthlink HMO,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Healthlink PPO,Healthlink PPO,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,HomeState Health Plan,HomeState Health Plan,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Humana Gold,Humana Gold,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Medicaid MO,Medicaid MO,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Medica,Medica,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Tricare,Tricare,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,UHC All Payer,UHC All Payer,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,UHC Exchange,UHC Exchange,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,UHC Medicaid,UHC Medicaid,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,UMR CPD,UMR CPD,12.75,,,,,,,per diem,12.75,12.75,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,UHC Medicare,UHC Medicare,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33132320,CDM,270,RC,,,,,,Inpatient,,,12.75,12.75,Wellcare,Wellcare,12.75,,,,,,,case rate,12.75,12.75,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Meritain Health PPO CPD,Meritain Health PPO CPD,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Aetna/Commercial Product,Aetna/Commercial Product,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Meritain Health CPD,Meritain Health CPD,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Starmark CPD,Starmark CPD,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Aetna Medicare,Aetna Medicare,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Ambetter ,Ambetter ,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Blue Access,Anthem Blue Access,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Blue Access Choice,Anthem Blue Access Choice,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Blue Preferred,Anthem Blue Preferred,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Pathway,Anthem Pathway,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Alliance,Anthem Alliance,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Anthem Medicare,Anthem Medicare,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Cigna,Cigna,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Cigna PPO,Cigna PPO,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Cigna Medicare Advantage,Cigna Medicare Advantage,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Essence,Essence,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Healthlink HMO,Healthlink HMO,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Healthlink PPO,Healthlink PPO,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,HomeState Health Plan,HomeState Health Plan,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Humana Gold,Humana Gold,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Medicaid MO,Medicaid MO,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Medica,Medica,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Tricare,Tricare,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,UHC All Payer,UHC All Payer,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,UHC Exchange,UHC Exchange,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,UHC Medicaid,UHC Medicaid,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,UMR CPD,UMR CPD,127.25,,,,,,,per diem,127.25,127.25,"Per diem rate, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,UHC Medicare,UHC Medicare,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
FOOT SCD # DJ3046             ,33132336,CDM,279,RC,,,,,,Inpatient,,,127.25,127.25,Wellcare,Wellcare,127.25,,,,,,,case rate,127.25,127.25,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Meritain Health PPO CPD,Meritain Health PPO CPD,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Aetna/Commercial Product,Aetna/Commercial Product,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Meritain Health CPD,Meritain Health CPD,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Starmark CPD,Starmark CPD,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Aetna Medicare,Aetna Medicare,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Ambetter ,Ambetter ,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Blue Access,Anthem Blue Access,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Blue Access Choice,Anthem Blue Access Choice,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Blue Preferred,Anthem Blue Preferred,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Pathway,Anthem Pathway,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Alliance,Anthem Alliance,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Anthem Medicare,Anthem Medicare,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Cigna,Cigna,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Cigna PPO,Cigna PPO,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Cigna Medicare Advantage,Cigna Medicare Advantage,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Essence,Essence,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Healthlink HMO,Healthlink HMO,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Healthlink PPO,Healthlink PPO,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,HomeState Health Plan,HomeState Health Plan,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Humana Gold,Humana Gold,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Medicaid MO,Medicaid MO,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Medica,Medica,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Tricare,Tricare,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,UHC All Payer,UHC All Payer,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,UHC Exchange,UHC Exchange,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,UHC Medicaid,UHC Medicaid,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,UMR CPD,UMR CPD,205.28,,,,,,,per diem,205.28,205.28,"Per diem rate, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,UHC Medicare,UHC Medicare,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
BOOT PREVALON W/STABILIZER    ,33132349,CDM,270,RC,,,,,,Inpatient,,,205.28,205.28,Wellcare,Wellcare,205.28,,,,,,,case rate,205.28,205.28,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Meritain Health PPO CPD,Meritain Health PPO CPD,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Aetna/Commercial Product,Aetna/Commercial Product,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Meritain Health CPD,Meritain Health CPD,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Starmark CPD,Starmark CPD,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Aetna Medicare,Aetna Medicare,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Ambetter ,Ambetter ,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Blue Access,Anthem Blue Access,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Blue Access Choice,Anthem Blue Access Choice,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Blue Preferred,Anthem Blue Preferred,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Pathway,Anthem Pathway,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Alliance,Anthem Alliance,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Anthem Medicare,Anthem Medicare,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Cigna,Cigna,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Cigna PPO,Cigna PPO,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Cigna Medicare Advantage,Cigna Medicare Advantage,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Essence,Essence,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Healthlink HMO,Healthlink HMO,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Healthlink PPO,Healthlink PPO,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,HomeState Health Plan,HomeState Health Plan,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Humana Gold,Humana Gold,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Medicaid MO,Medicaid MO,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Medica,Medica,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Tricare,Tricare,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,UHC All Payer,UHC All Payer,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,UHC Exchange,UHC Exchange,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,UHC Medicaid,UHC Medicaid,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,UMR CPD,UMR CPD,43.61,,,,,,,per diem,43.61,43.61,"Per diem rate, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,UHC Medicare,UHC Medicare,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
PILLOW REUSABLE CLOUD NINE    ,33132364,CDM,270,RC,,,,,,Inpatient,,,43.61,43.61,Wellcare,Wellcare,43.61,,,,,,,case rate,43.61,43.61,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Meritain Health PPO CPD,Meritain Health PPO CPD,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Aetna/Commercial Product,Aetna/Commercial Product,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Meritain Health CPD,Meritain Health CPD,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Starmark CPD,Starmark CPD,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Aetna Medicare,Aetna Medicare,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Ambetter ,Ambetter ,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Blue Access,Anthem Blue Access,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Blue Access Choice,Anthem Blue Access Choice,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Blue Preferred,Anthem Blue Preferred,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Pathway,Anthem Pathway,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Alliance,Anthem Alliance,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Anthem Medicare,Anthem Medicare,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Cigna,Cigna,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Cigna PPO,Cigna PPO,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Cigna Medicare Advantage,Cigna Medicare Advantage,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Essence,Essence,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Healthlink HMO,Healthlink HMO,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Healthlink PPO,Healthlink PPO,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,HomeState Health Plan,HomeState Health Plan,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Humana Gold,Humana Gold,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Medicaid MO,Medicaid MO,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Medica,Medica,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Tricare,Tricare,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,UHC All Payer,UHC All Payer,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,UHC Exchange,UHC Exchange,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,UHC Medicaid,UHC Medicaid,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,UMR CPD,UMR CPD,330.74,,,,,,,per diem,330.74,330.74,"Per diem rate, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,UHC Medicare,UHC Medicare,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
ROOKE BOOT # HFS 102          ,33132365,CDM,270,RC,,,,,,Inpatient,,,330.74,330.74,Wellcare,Wellcare,330.74,,,,,,,case rate,330.74,330.74,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Meritain Health PPO CPD,Meritain Health PPO CPD,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Aetna/Commercial Product,Aetna/Commercial Product,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Meritain Health CPD,Meritain Health CPD,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Starmark CPD,Starmark CPD,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Aetna Medicare,Aetna Medicare,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Ambetter ,Ambetter ,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Blue Access,Anthem Blue Access,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Blue Access Choice,Anthem Blue Access Choice,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Blue Preferred,Anthem Blue Preferred,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Pathway,Anthem Pathway,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Alliance,Anthem Alliance,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Anthem Medicare,Anthem Medicare,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Cigna,Cigna,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Cigna PPO,Cigna PPO,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Cigna Medicare Advantage,Cigna Medicare Advantage,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Essence,Essence,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Healthlink HMO,Healthlink HMO,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Healthlink PPO,Healthlink PPO,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,HomeState Health Plan,HomeState Health Plan,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Humana Gold,Humana Gold,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Medicaid MO,Medicaid MO,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Medica,Medica,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Tricare,Tricare,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,UHC All Payer,UHC All Payer,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,UHC Exchange,UHC Exchange,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,UHC Medicaid,UHC Medicaid,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,UMR CPD,UMR CPD,197.37,,,,,,,per diem,197.37,197.37,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,UHC Medicare,UHC Medicare,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33132456,CDM,279,RC,,,,,,Inpatient,,,197.37,197.37,Wellcare,Wellcare,197.37,,,,,,,case rate,197.37,197.37,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Meritain Health PPO CPD,Meritain Health PPO CPD,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Aetna/Commercial Product,Aetna/Commercial Product,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Meritain Health CPD,Meritain Health CPD,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Starmark CPD,Starmark CPD,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Aetna Medicare,Aetna Medicare,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Ambetter ,Ambetter ,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Blue Access,Anthem Blue Access,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Blue Access Choice,Anthem Blue Access Choice,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Blue Preferred,Anthem Blue Preferred,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Pathway,Anthem Pathway,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Alliance,Anthem Alliance,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Anthem Medicare,Anthem Medicare,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Cigna,Cigna,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Cigna PPO,Cigna PPO,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Cigna Medicare Advantage,Cigna Medicare Advantage,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Essence,Essence,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Healthlink HMO,Healthlink HMO,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Healthlink PPO,Healthlink PPO,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,HomeState Health Plan,HomeState Health Plan,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Humana Gold,Humana Gold,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Medicaid MO,Medicaid MO,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Medica,Medica,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Tricare,Tricare,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,UHC All Payer,UHC All Payer,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,UHC Exchange,UHC Exchange,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,UHC Medicaid,UHC Medicaid,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,UMR CPD,UMR CPD,242.4,,,,,,,per diem,242.4,242.4,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,UHC Medicare,UHC Medicare,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33132468,CDM,279,RC,,,,,,Inpatient,,,242.4,242.4,Wellcare,Wellcare,242.4,,,,,,,case rate,242.4,242.4,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Meritain Health PPO CPD,Meritain Health PPO CPD,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Aetna/Commercial Product,Aetna/Commercial Product,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Meritain Health CPD,Meritain Health CPD,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Starmark CPD,Starmark CPD,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Aetna Medicare,Aetna Medicare,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Ambetter ,Ambetter ,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Blue Access,Anthem Blue Access,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Blue Access Choice,Anthem Blue Access Choice,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Blue Preferred,Anthem Blue Preferred,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Pathway,Anthem Pathway,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Alliance,Anthem Alliance,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Anthem Medicare,Anthem Medicare,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Cigna,Cigna,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Cigna PPO,Cigna PPO,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Cigna Medicare Advantage,Cigna Medicare Advantage,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Essence,Essence,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Healthlink HMO,Healthlink HMO,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Healthlink PPO,Healthlink PPO,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,HomeState Health Plan,HomeState Health Plan,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Humana Gold,Humana Gold,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Medicaid MO,Medicaid MO,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Medica,Medica,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Tricare,Tricare,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,UHC All Payer,UHC All Payer,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,UHC Exchange,UHC Exchange,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,UHC Medicaid,UHC Medicaid,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,UMR CPD,UMR CPD,31.11,,,,,,,per diem,31.11,31.11,"Per diem rate, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,UHC Medicare,UHC Medicare,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
CPM APPLICATION DAILY RENTAL  ,33132472,CDM,279,RC,,,,,,Inpatient,,,31.11,31.11,Wellcare,Wellcare,31.11,,,,,,,case rate,31.11,31.11,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SPECIAL ORDER BEDS/MATTRESS   ,33132494,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Meritain Health PPO CPD,Meritain Health PPO CPD,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Aetna/Commercial Product,Aetna/Commercial Product,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Meritain Health CPD,Meritain Health CPD,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Starmark CPD,Starmark CPD,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Aetna Medicare,Aetna Medicare,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Ambetter ,Ambetter ,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Blue Access,Anthem Blue Access,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Blue Access Choice,Anthem Blue Access Choice,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Blue Preferred,Anthem Blue Preferred,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Pathway,Anthem Pathway,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Alliance,Anthem Alliance,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Anthem Medicare,Anthem Medicare,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Cigna,Cigna,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Cigna PPO,Cigna PPO,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Cigna Medicare Advantage,Cigna Medicare Advantage,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Essence,Essence,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Healthlink HMO,Healthlink HMO,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Healthlink PPO,Healthlink PPO,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,HomeState Health Plan,HomeState Health Plan,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Humana Gold,Humana Gold,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Medicaid MO,Medicaid MO,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Medica,Medica,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Tricare,Tricare,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,UHC All Payer,UHC All Payer,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,UHC Exchange,UHC Exchange,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,UHC Medicaid,UHC Medicaid,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,UMR CPD,UMR CPD,31.66,,,,,,,per diem,31.66,31.66,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,UHC Medicare,UHC Medicare,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33132506,CDM,279,RC,,,,,,Inpatient,,,31.66,31.66,Wellcare,Wellcare,31.66,,,,,,,case rate,31.66,31.66,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Meritain Health PPO CPD,Meritain Health PPO CPD,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Aetna/Commercial Product,Aetna/Commercial Product,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Meritain Health CPD,Meritain Health CPD,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Starmark CPD,Starmark CPD,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Aetna Medicare,Aetna Medicare,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Ambetter ,Ambetter ,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Blue Access,Anthem Blue Access,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Blue Access Choice,Anthem Blue Access Choice,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Blue Preferred,Anthem Blue Preferred,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Pathway,Anthem Pathway,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Alliance,Anthem Alliance,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Anthem Medicare,Anthem Medicare,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Cigna,Cigna,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Cigna PPO,Cigna PPO,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Cigna Medicare Advantage,Cigna Medicare Advantage,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Essence,Essence,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Healthlink HMO,Healthlink HMO,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Healthlink PPO,Healthlink PPO,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,HomeState Health Plan,HomeState Health Plan,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Humana Gold,Humana Gold,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Medicaid MO,Medicaid MO,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Medica,Medica,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Tricare,Tricare,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,UHC All Payer,UHC All Payer,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,UHC Exchange,UHC Exchange,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,UHC Medicaid,UHC Medicaid,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,UMR CPD,UMR CPD,177.48,,,,,,,per diem,177.48,177.48,"Per diem rate, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,UHC Medicare,UHC Medicare,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
SHORT ARM STATIC SPLINT       ,33132571,CDM,270,RC,,,,,,Inpatient,,,177.48,177.48,Wellcare,Wellcare,177.48,,,,,,,case rate,177.48,177.48,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Meritain Health PPO CPD,Meritain Health PPO CPD,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Aetna/Commercial Product,Aetna/Commercial Product,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Meritain Health CPD,Meritain Health CPD,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Starmark CPD,Starmark CPD,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Aetna Medicare,Aetna Medicare,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Ambetter ,Ambetter ,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Blue Access,Anthem Blue Access,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Blue Access Choice,Anthem Blue Access Choice,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Blue Preferred,Anthem Blue Preferred,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Pathway,Anthem Pathway,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Alliance,Anthem Alliance,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Anthem Medicare,Anthem Medicare,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Cigna,Cigna,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Cigna PPO,Cigna PPO,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Cigna Medicare Advantage,Cigna Medicare Advantage,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Essence,Essence,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Healthlink HMO,Healthlink HMO,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Healthlink PPO,Healthlink PPO,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,HomeState Health Plan,HomeState Health Plan,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Humana Gold,Humana Gold,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Medicaid MO,Medicaid MO,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Medica,Medica,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Tricare,Tricare,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,UHC All Payer,UHC All Payer,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,UHC Exchange,UHC Exchange,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,UHC Medicaid,UHC Medicaid,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,UMR CPD,UMR CPD,80.58,,,,,,,per diem,80.58,80.58,"Per diem rate, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,UHC Medicare,UHC Medicare,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
ORTHO WEDGE SHOE LARGE        ,33132572,CDM,270,RC,,,,,,Inpatient,,,80.58,80.58,Wellcare,Wellcare,80.58,,,,,,,case rate,80.58,80.58,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Meritain Health PPO CPD,Meritain Health PPO CPD,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Aetna/Commercial Product,Aetna/Commercial Product,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Meritain Health CPD,Meritain Health CPD,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Starmark CPD,Starmark CPD,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Aetna Medicare,Aetna Medicare,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Ambetter ,Ambetter ,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Blue Access,Anthem Blue Access,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Blue Access Choice,Anthem Blue Access Choice,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Blue Preferred,Anthem Blue Preferred,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Pathway,Anthem Pathway,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Alliance,Anthem Alliance,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Anthem Medicare,Anthem Medicare,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Cigna,Cigna,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Cigna PPO,Cigna PPO,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Cigna Medicare Advantage,Cigna Medicare Advantage,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Essence,Essence,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Healthlink HMO,Healthlink HMO,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Healthlink PPO,Healthlink PPO,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,HomeState Health Plan,HomeState Health Plan,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Humana Gold,Humana Gold,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Medicaid MO,Medicaid MO,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Medica,Medica,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Tricare,Tricare,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,UHC All Payer,UHC All Payer,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,UHC Exchange,UHC Exchange,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,UHC Medicaid,UHC Medicaid,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,UMR CPD,UMR CPD,237.92,,,,,,,per diem,237.92,237.92,"Per diem rate, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,UHC Medicare,UHC Medicare,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT REGULAR            ,33132582,CDM,270,RC,,,,,,Inpatient,,,237.92,237.92,Wellcare,Wellcare,237.92,,,,,,,case rate,237.92,237.92,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Meritain Health PPO CPD,Meritain Health PPO CPD,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Aetna/Commercial Product,Aetna/Commercial Product,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Meritain Health CPD,Meritain Health CPD,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Starmark CPD,Starmark CPD,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Aetna Medicare,Aetna Medicare,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Ambetter ,Ambetter ,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Blue Access,Anthem Blue Access,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Blue Access Choice,Anthem Blue Access Choice,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Blue Preferred,Anthem Blue Preferred,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Pathway,Anthem Pathway,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Alliance,Anthem Alliance,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Anthem Medicare,Anthem Medicare,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Cigna,Cigna,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Cigna PPO,Cigna PPO,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Cigna Medicare Advantage,Cigna Medicare Advantage,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Essence,Essence,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Healthlink HMO,Healthlink HMO,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Healthlink PPO,Healthlink PPO,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,HomeState Health Plan,HomeState Health Plan,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Humana Gold,Humana Gold,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Medicaid MO,Medicaid MO,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Medica,Medica,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Tricare,Tricare,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,UHC All Payer,UHC All Payer,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,UHC Exchange,UHC Exchange,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,UHC Medicaid,UHC Medicaid,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,UMR CPD,UMR CPD,268.52,,,,,,,per diem,268.52,268.52,"Per diem rate, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,UHC Medicare,UHC Medicare,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
MULTI BOOT XLARGE             ,33132583,CDM,270,RC,,,,,,Inpatient,,,268.52,268.52,Wellcare,Wellcare,268.52,,,,,,,case rate,268.52,268.52,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Meritain Health PPO CPD,Meritain Health PPO CPD,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Aetna/Commercial Product,Aetna/Commercial Product,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Meritain Health CPD,Meritain Health CPD,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Starmark CPD,Starmark CPD,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Aetna Medicare,Aetna Medicare,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Ambetter ,Ambetter ,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Blue Access,Anthem Blue Access,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Blue Access Choice,Anthem Blue Access Choice,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Blue Preferred,Anthem Blue Preferred,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Pathway,Anthem Pathway,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Alliance,Anthem Alliance,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Anthem Medicare,Anthem Medicare,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Cigna,Cigna,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Cigna PPO,Cigna PPO,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Cigna Medicare Advantage,Cigna Medicare Advantage,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Essence,Essence,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Healthlink HMO,Healthlink HMO,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Healthlink PPO,Healthlink PPO,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,HomeState Health Plan,HomeState Health Plan,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Humana Gold,Humana Gold,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Medicaid MO,Medicaid MO,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Medica,Medica,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Tricare,Tricare,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,UHC All Payer,UHC All Payer,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,UHC Exchange,UHC Exchange,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,UHC Medicaid,UHC Medicaid,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,UMR CPD,UMR CPD,32.7,,,,,,,per diem,32.7,32.7,"Per diem rate, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,UHC Medicare,UHC Medicare,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
POSEY WRAP-AROUND             ,33132590,CDM,279,RC,,,,,,Inpatient,,,32.7,32.7,Wellcare,Wellcare,32.7,,,,,,,case rate,32.7,32.7,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Meritain Health PPO CPD,Meritain Health PPO CPD,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Aetna/Commercial Product,Aetna/Commercial Product,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Meritain Health CPD,Meritain Health CPD,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Starmark CPD,Starmark CPD,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Aetna Medicare,Aetna Medicare,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Ambetter ,Ambetter ,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Blue Access,Anthem Blue Access,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Blue Access Choice,Anthem Blue Access Choice,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Blue Preferred,Anthem Blue Preferred,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Pathway,Anthem Pathway,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Alliance,Anthem Alliance,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Anthem Medicare,Anthem Medicare,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Cigna,Cigna,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Cigna PPO,Cigna PPO,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Cigna Medicare Advantage,Cigna Medicare Advantage,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Essence,Essence,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Healthlink HMO,Healthlink HMO,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Healthlink PPO,Healthlink PPO,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,HomeState Health Plan,HomeState Health Plan,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Humana Gold,Humana Gold,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Medicaid MO,Medicaid MO,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Medica,Medica,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Tricare,Tricare,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,UHC All Payer,UHC All Payer,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,UHC Exchange,UHC Exchange,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,UHC Medicaid,UHC Medicaid,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,UMR CPD,UMR CPD,33.18,,,,,,,per diem,33.18,33.18,"Per diem rate, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,UHC Medicare,UHC Medicare,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
SENTRY 1400 AIR MATTR AND PUMP,33132591,CDM,279,RC,,,,,,Inpatient,,,33.18,33.18,Wellcare,Wellcare,33.18,,,,,,,case rate,33.18,33.18,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Meritain Health PPO CPD,Meritain Health PPO CPD,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Aetna/Commercial Product,Aetna/Commercial Product,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Meritain Health CPD,Meritain Health CPD,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Starmark CPD,Starmark CPD,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Aetna Medicare,Aetna Medicare,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Ambetter ,Ambetter ,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Blue Access,Anthem Blue Access,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Blue Access Choice,Anthem Blue Access Choice,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Blue Preferred,Anthem Blue Preferred,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Pathway,Anthem Pathway,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Alliance,Anthem Alliance,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Anthem Medicare,Anthem Medicare,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Cigna,Cigna,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Cigna PPO,Cigna PPO,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Cigna Medicare Advantage,Cigna Medicare Advantage,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Essence,Essence,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Healthlink HMO,Healthlink HMO,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Healthlink PPO,Healthlink PPO,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,HomeState Health Plan,HomeState Health Plan,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Humana Gold,Humana Gold,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Medicaid MO,Medicaid MO,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Medica,Medica,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Tricare,Tricare,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,UHC All Payer,UHC All Payer,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,UHC Exchange,UHC Exchange,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,UHC Medicaid,UHC Medicaid,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,UMR CPD,UMR CPD,124.98,,,,,,,per diem,124.98,124.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,UHC Medicare,UHC Medicare,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED W AIR MATT/PUMP ,33132592,CDM,270,RC,,,,,,Inpatient,,,124.98,124.98,Wellcare,Wellcare,124.98,,,,,,,case rate,124.98,124.98,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health PPO CPD,Meritain Health PPO CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/Commercial Product,Aetna/Commercial Product,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health CPD,Meritain Health CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Starmark CPD,Starmark CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna Medicare,Aetna Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Ambetter ,Ambetter ,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access,Anthem Blue Access,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access Choice,Anthem Blue Access Choice,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Preferred,Anthem Blue Preferred,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Pathway,Anthem Pathway,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Alliance,Anthem Alliance,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Medicare,Anthem Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna,Cigna,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna PPO,Cigna PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna Medicare Advantage,Cigna Medicare Advantage,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Essence,Essence,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink HMO,Healthlink HMO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink PPO,Healthlink PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,HomeState Health Plan,HomeState Health Plan,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Humana Gold,Humana Gold,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Medicaid MO,Medicaid MO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Medica,Medica,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Tricare,Tricare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC All Payer,UHC All Payer,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Exchange,UHC Exchange,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicaid,UHC Medicaid,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,UMR CPD,UMR CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicare,UHC Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LOW BED LTC                   ,33132593,CDM,279,RC,,,,,,Inpatient,,,24,24,Wellcare,Wellcare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Meritain Health PPO CPD,Meritain Health PPO CPD,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Aetna/Commercial Product,Aetna/Commercial Product,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Meritain Health CPD,Meritain Health CPD,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Starmark CPD,Starmark CPD,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Aetna Medicare,Aetna Medicare,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Ambetter ,Ambetter ,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Blue Access,Anthem Blue Access,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Blue Access Choice,Anthem Blue Access Choice,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Blue Preferred,Anthem Blue Preferred,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Pathway,Anthem Pathway,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Alliance,Anthem Alliance,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Anthem Medicare,Anthem Medicare,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Cigna,Cigna,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Cigna PPO,Cigna PPO,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Cigna Medicare Advantage,Cigna Medicare Advantage,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Essence,Essence,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Healthlink HMO,Healthlink HMO,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Healthlink PPO,Healthlink PPO,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,HomeState Health Plan,HomeState Health Plan,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Humana Gold,Humana Gold,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Medicaid MO,Medicaid MO,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Medica,Medica,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Tricare,Tricare,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,UHC All Payer,UHC All Payer,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,UHC Exchange,UHC Exchange,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,UHC Medicaid,UHC Medicaid,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,UMR CPD,UMR CPD,16.16,,,,,,,per diem,16.16,16.16,"Per diem rate, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,UHC Medicare,UHC Medicare,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
SHOE CAST SOFTIE              ,33132594,CDM,270,RC,,,,,,Inpatient,,,16.16,16.16,Wellcare,Wellcare,16.16,,,,,,,case rate,16.16,16.16,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Meritain Health PPO CPD,Meritain Health PPO CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna/Commercial Product,Aetna/Commercial Product,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Meritain Health CPD,Meritain Health CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Starmark CPD,Starmark CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna Medicare,Aetna Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Ambetter ,Ambetter ,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Access,Anthem Blue Access,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Access Choice,Anthem Blue Access Choice,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Preferred,Anthem Blue Preferred,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Pathway,Anthem Pathway,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Alliance,Anthem Alliance,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Medicare,Anthem Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna,Cigna,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna PPO,Cigna PPO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna Medicare Advantage,Cigna Medicare Advantage,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Essence,Essence,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthlink HMO,Healthlink HMO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthlink PPO,Healthlink PPO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,HomeState Health Plan,HomeState Health Plan,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Humana Gold,Humana Gold,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Medicaid MO,Medicaid MO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Medica,Medica,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Tricare,Tricare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC All Payer,UHC All Payer,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Exchange,UHC Exchange,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Medicaid,UHC Medicaid,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UMR CPD,UMR CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Medicare,UHC Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - MEDIUM   ,33132595,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Wellcare,Wellcare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Meritain Health PPO CPD,Meritain Health PPO CPD,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Aetna/Commercial Product,Aetna/Commercial Product,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Meritain Health CPD,Meritain Health CPD,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Starmark CPD,Starmark CPD,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Aetna Medicare,Aetna Medicare,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Ambetter ,Ambetter ,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Blue Access,Anthem Blue Access,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Blue Access Choice,Anthem Blue Access Choice,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Blue Preferred,Anthem Blue Preferred,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Pathway,Anthem Pathway,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Alliance,Anthem Alliance,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Anthem Medicare,Anthem Medicare,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Cigna,Cigna,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Cigna PPO,Cigna PPO,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Cigna Medicare Advantage,Cigna Medicare Advantage,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Essence,Essence,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Healthlink HMO,Healthlink HMO,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Healthlink PPO,Healthlink PPO,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,HomeState Health Plan,HomeState Health Plan,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Humana Gold,Humana Gold,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Medicaid MO,Medicaid MO,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Medica,Medica,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Tricare,Tricare,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,UHC All Payer,UHC All Payer,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,UHC Exchange,UHC Exchange,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,UHC Medicaid,UHC Medicaid,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,UMR CPD,UMR CPD,17.4,,,,,,,per diem,17.4,17.4,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,UHC Medicare,UHC Medicare,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - X LARGE  ,33132596,CDM,270,RC,,,,,,Inpatient,,,17.4,17.4,Wellcare,Wellcare,17.4,,,,,,,case rate,17.4,17.4,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Meritain Health PPO CPD,Meritain Health PPO CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna/Commercial Product,Aetna/Commercial Product,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Meritain Health CPD,Meritain Health CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Starmark CPD,Starmark CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Aetna Medicare,Aetna Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Ambetter ,Ambetter ,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Access,Anthem Blue Access,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Access Choice,Anthem Blue Access Choice,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Blue Preferred,Anthem Blue Preferred,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Pathway,Anthem Pathway,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Alliance,Anthem Alliance,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Anthem Medicare,Anthem Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna,Cigna,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna PPO,Cigna PPO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Cigna Medicare Advantage,Cigna Medicare Advantage,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Essence,Essence,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthlink HMO,Healthlink HMO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Healthlink PPO,Healthlink PPO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,HomeState Health Plan,HomeState Health Plan,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Humana Gold,Humana Gold,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Medicaid MO,Medicaid MO,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Medica,Medica,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Tricare,Tricare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC All Payer,UHC All Payer,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Exchange,UHC Exchange,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Medicaid,UHC Medicaid,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UMR CPD,UMR CPD,17.76,,,,,,,per diem,17.76,17.76,"Per diem rate, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,UHC Medicare,UHC Medicare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
ENVELOPE ARM SLING - LARGE    ,33132597,CDM,270,RC,,,,,,Inpatient,,,17.76,17.76,Wellcare,Wellcare,17.76,,,,,,,case rate,17.76,17.76,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health PPO CPD,Meritain Health PPO CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/Commercial Product,Aetna/Commercial Product,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health CPD,Meritain Health CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Starmark CPD,Starmark CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna Medicare,Aetna Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Ambetter ,Ambetter ,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access,Anthem Blue Access,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access Choice,Anthem Blue Access Choice,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Preferred,Anthem Blue Preferred,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Pathway,Anthem Pathway,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Alliance,Anthem Alliance,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Medicare,Anthem Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna,Cigna,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna PPO,Cigna PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna Medicare Advantage,Cigna Medicare Advantage,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Essence,Essence,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink HMO,Healthlink HMO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink PPO,Healthlink PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,HomeState Health Plan,HomeState Health Plan,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Humana Gold,Humana Gold,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medicaid MO,Medicaid MO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medica,Medica,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Tricare,Tricare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC All Payer,UHC All Payer,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Exchange,UHC Exchange,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicaid,UHC Medicaid,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UMR CPD,UMR CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicare,UHC Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT SMALL  ,33132599,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Wellcare,Wellcare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Meritain Health PPO CPD,Meritain Health PPO CPD,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Aetna/Commercial Product,Aetna/Commercial Product,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Meritain Health CPD,Meritain Health CPD,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Starmark CPD,Starmark CPD,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Aetna Medicare,Aetna Medicare,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Ambetter ,Ambetter ,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Blue Access,Anthem Blue Access,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Blue Access Choice,Anthem Blue Access Choice,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Blue Preferred,Anthem Blue Preferred,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Pathway,Anthem Pathway,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Alliance,Anthem Alliance,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Anthem Medicare,Anthem Medicare,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Cigna,Cigna,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Cigna PPO,Cigna PPO,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Cigna Medicare Advantage,Cigna Medicare Advantage,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Essence,Essence,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Healthlink HMO,Healthlink HMO,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Healthlink PPO,Healthlink PPO,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,HomeState Health Plan,HomeState Health Plan,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Humana Gold,Humana Gold,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Medicaid MO,Medicaid MO,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Medica,Medica,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Tricare,Tricare,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,UHC All Payer,UHC All Payer,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,UHC Exchange,UHC Exchange,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,UHC Medicaid,UHC Medicaid,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,UMR CPD,UMR CPD,73.44,,,,,,,per diem,73.44,73.44,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,UHC Medicare,UHC Medicare,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT MED    ,33132600,CDM,270,RC,,,,,,Inpatient,,,73.44,73.44,Wellcare,Wellcare,73.44,,,,,,,case rate,73.44,73.44,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health PPO CPD,Meritain Health PPO CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/Commercial Product,Aetna/Commercial Product,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health CPD,Meritain Health CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Starmark CPD,Starmark CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna Medicare,Aetna Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Ambetter ,Ambetter ,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access,Anthem Blue Access,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access Choice,Anthem Blue Access Choice,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Preferred,Anthem Blue Preferred,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Pathway,Anthem Pathway,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Alliance,Anthem Alliance,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Medicare,Anthem Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna,Cigna,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna PPO,Cigna PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna Medicare Advantage,Cigna Medicare Advantage,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Essence,Essence,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink HMO,Healthlink HMO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink PPO,Healthlink PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,HomeState Health Plan,HomeState Health Plan,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Humana Gold,Humana Gold,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medicaid MO,Medicaid MO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medica,Medica,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Tricare,Tricare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC All Payer,UHC All Payer,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Exchange,UHC Exchange,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicaid,UHC Medicaid,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UMR CPD,UMR CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicare,UHC Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - LT LARGE  ,33132601,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Wellcare,Wellcare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health PPO CPD,Meritain Health PPO CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/Commercial Product,Aetna/Commercial Product,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health CPD,Meritain Health CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Starmark CPD,Starmark CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna Medicare,Aetna Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Ambetter ,Ambetter ,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access,Anthem Blue Access,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access Choice,Anthem Blue Access Choice,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Preferred,Anthem Blue Preferred,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Pathway,Anthem Pathway,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Alliance,Anthem Alliance,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Medicare,Anthem Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna,Cigna,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna PPO,Cigna PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna Medicare Advantage,Cigna Medicare Advantage,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Essence,Essence,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink HMO,Healthlink HMO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink PPO,Healthlink PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,HomeState Health Plan,HomeState Health Plan,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Humana Gold,Humana Gold,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medicaid MO,Medicaid MO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medica,Medica,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Tricare,Tricare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC All Payer,UHC All Payer,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Exchange,UHC Exchange,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicaid,UHC Medicaid,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UMR CPD,UMR CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicare,UHC Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT SMALL  ,33132602,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Wellcare,Wellcare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health PPO CPD,Meritain Health PPO CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/Commercial Product,Aetna/Commercial Product,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health CPD,Meritain Health CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Starmark CPD,Starmark CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna Medicare,Aetna Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Ambetter ,Ambetter ,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access,Anthem Blue Access,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access Choice,Anthem Blue Access Choice,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Preferred,Anthem Blue Preferred,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Pathway,Anthem Pathway,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Alliance,Anthem Alliance,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Medicare,Anthem Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna,Cigna,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna PPO,Cigna PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna Medicare Advantage,Cigna Medicare Advantage,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Essence,Essence,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink HMO,Healthlink HMO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink PPO,Healthlink PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,HomeState Health Plan,HomeState Health Plan,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Humana Gold,Humana Gold,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medicaid MO,Medicaid MO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medica,Medica,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Tricare,Tricare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC All Payer,UHC All Payer,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Exchange,UHC Exchange,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicaid,UHC Medicaid,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UMR CPD,UMR CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicare,UHC Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT MEDIUM ,33132603,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Wellcare,Wellcare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health PPO CPD,Meritain Health PPO CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna/Commercial Product,Aetna/Commercial Product,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Meritain Health CPD,Meritain Health CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Starmark CPD,Starmark CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Aetna Medicare,Aetna Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Ambetter ,Ambetter ,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access,Anthem Blue Access,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Access Choice,Anthem Blue Access Choice,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Blue Preferred,Anthem Blue Preferred,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Pathway,Anthem Pathway,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Alliance,Anthem Alliance,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Anthem Medicare,Anthem Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna,Cigna,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna PPO,Cigna PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Cigna Medicare Advantage,Cigna Medicare Advantage,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Essence,Essence,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink HMO,Healthlink HMO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Healthlink PPO,Healthlink PPO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,HomeState Health Plan,HomeState Health Plan,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Humana Gold,Humana Gold,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medicaid MO,Medicaid MO,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Medica,Medica,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Tricare,Tricare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC All Payer,UHC All Payer,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Exchange,UHC Exchange,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicaid,UHC Medicaid,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UMR CPD,UMR CPD,73.47,,,,,,,per diem,73.47,73.47,"Per diem rate, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,UHC Medicare,UHC Medicare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
FUNCT HAND SPLINT - RT LARGE  ,33132604,CDM,270,RC,,,,,,Inpatient,,,73.47,73.47,Wellcare,Wellcare,73.47,,,,,,,case rate,73.47,73.47,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health PPO CPD,Meritain Health PPO CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/Commercial Product,Aetna/Commercial Product,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health CPD,Meritain Health CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Starmark CPD,Starmark CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna Medicare,Aetna Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Ambetter ,Ambetter ,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access,Anthem Blue Access,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access Choice,Anthem Blue Access Choice,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Preferred,Anthem Blue Preferred,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Pathway,Anthem Pathway,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Alliance,Anthem Alliance,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Medicare,Anthem Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna,Cigna,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna PPO,Cigna PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna Medicare Advantage,Cigna Medicare Advantage,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Essence,Essence,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink HMO,Healthlink HMO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink PPO,Healthlink PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,HomeState Health Plan,HomeState Health Plan,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Humana Gold,Humana Gold,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medicaid MO,Medicaid MO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medica,Medica,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Tricare,Tricare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC All Payer,UHC All Payer,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Exchange,UHC Exchange,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicaid,UHC Medicaid,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UMR CPD,UMR CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicare,UHC Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-LARGE     ,33132607,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Wellcare,Wellcare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health PPO CPD,Meritain Health PPO CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/Commercial Product,Aetna/Commercial Product,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health CPD,Meritain Health CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Starmark CPD,Starmark CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna Medicare,Aetna Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Ambetter ,Ambetter ,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access,Anthem Blue Access,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access Choice,Anthem Blue Access Choice,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Preferred,Anthem Blue Preferred,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Pathway,Anthem Pathway,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Alliance,Anthem Alliance,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Medicare,Anthem Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna,Cigna,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna PPO,Cigna PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna Medicare Advantage,Cigna Medicare Advantage,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Essence,Essence,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink HMO,Healthlink HMO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink PPO,Healthlink PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,HomeState Health Plan,HomeState Health Plan,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Humana Gold,Humana Gold,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medicaid MO,Medicaid MO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medica,Medica,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Tricare,Tricare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC All Payer,UHC All Payer,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Exchange,UHC Exchange,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicaid,UHC Medicaid,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UMR CPD,UMR CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicare,UHC Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB LEFT-XLARGE    ,33132608,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Wellcare,Wellcare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Meritain Health PPO CPD,Meritain Health PPO CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna/Commercial Product,Aetna/Commercial Product,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Meritain Health CPD,Meritain Health CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Starmark CPD,Starmark CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna Medicare,Aetna Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Ambetter ,Ambetter ,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Access,Anthem Blue Access,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Access Choice,Anthem Blue Access Choice,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Preferred,Anthem Blue Preferred,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Pathway,Anthem Pathway,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Alliance,Anthem Alliance,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Medicare,Anthem Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna,Cigna,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna PPO,Cigna PPO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna Medicare Advantage,Cigna Medicare Advantage,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Essence,Essence,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthlink HMO,Healthlink HMO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthlink PPO,Healthlink PPO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,HomeState Health Plan,HomeState Health Plan,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Humana Gold,Humana Gold,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Medicaid MO,Medicaid MO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Medica,Medica,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Tricare,Tricare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC All Payer,UHC All Payer,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Exchange,UHC Exchange,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Medicaid,UHC Medicaid,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UMR CPD,UMR CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Medicare,UHC Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-LEFT       ,33132611,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Wellcare,Wellcare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Meritain Health PPO CPD,Meritain Health PPO CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna/Commercial Product,Aetna/Commercial Product,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Meritain Health CPD,Meritain Health CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Starmark CPD,Starmark CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Aetna Medicare,Aetna Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Ambetter ,Ambetter ,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Access,Anthem Blue Access,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Access Choice,Anthem Blue Access Choice,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Blue Preferred,Anthem Blue Preferred,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Pathway,Anthem Pathway,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Alliance,Anthem Alliance,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Anthem Medicare,Anthem Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna,Cigna,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna PPO,Cigna PPO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Cigna Medicare Advantage,Cigna Medicare Advantage,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Essence,Essence,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthlink HMO,Healthlink HMO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Healthlink PPO,Healthlink PPO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,HomeState Health Plan,HomeState Health Plan,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Humana Gold,Humana Gold,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Medicaid MO,Medicaid MO,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Medica,Medica,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Tricare,Tricare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC All Payer,UHC All Payer,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Exchange,UHC Exchange,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Medicaid,UHC Medicaid,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UMR CPD,UMR CPD,26.25,,,,,,,per diem,26.25,26.25,"Per diem rate, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,UHC Medicare,UHC Medicare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
COMPRESSION GLOVES-RIGHT      ,33132612,CDM,270,RC,,,,,,Inpatient,,,26.25,26.25,Wellcare,Wellcare,26.25,,,,,,,case rate,26.25,26.25,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Meritain Health PPO CPD,Meritain Health PPO CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna/Commercial Product,Aetna/Commercial Product,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Meritain Health CPD,Meritain Health CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Starmark CPD,Starmark CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna Medicare,Aetna Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Ambetter ,Ambetter ,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Access,Anthem Blue Access,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Access Choice,Anthem Blue Access Choice,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Preferred,Anthem Blue Preferred,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Pathway,Anthem Pathway,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Alliance,Anthem Alliance,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Medicare,Anthem Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna,Cigna,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna PPO,Cigna PPO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna Medicare Advantage,Cigna Medicare Advantage,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Essence,Essence,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthlink HMO,Healthlink HMO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthlink PPO,Healthlink PPO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,HomeState Health Plan,HomeState Health Plan,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Humana Gold,Humana Gold,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Medicaid MO,Medicaid MO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Medica,Medica,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Tricare,Tricare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC All Payer,UHC All Payer,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Exchange,UHC Exchange,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Medicaid,UHC Medicaid,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UMR CPD,UMR CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Medicare,UHC Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT SM/M     ,33132613,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Wellcare,Wellcare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Meritain Health PPO CPD,Meritain Health PPO CPD,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Aetna/Commercial Product,Aetna/Commercial Product,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Meritain Health CPD,Meritain Health CPD,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Starmark CPD,Starmark CPD,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Aetna Medicare,Aetna Medicare,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Ambetter ,Ambetter ,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Blue Access,Anthem Blue Access,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Blue Access Choice,Anthem Blue Access Choice,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Blue Preferred,Anthem Blue Preferred,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Pathway,Anthem Pathway,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Alliance,Anthem Alliance,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Anthem Medicare,Anthem Medicare,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Cigna,Cigna,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Cigna PPO,Cigna PPO,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Cigna Medicare Advantage,Cigna Medicare Advantage,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Essence,Essence,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Healthlink HMO,Healthlink HMO,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Healthlink PPO,Healthlink PPO,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,HomeState Health Plan,HomeState Health Plan,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Humana Gold,Humana Gold,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Medicaid MO,Medicaid MO,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Medica,Medica,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Tricare,Tricare,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,UHC All Payer,UHC All Payer,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,UHC Exchange,UHC Exchange,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,UHC Medicaid,UHC Medicaid,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,UMR CPD,UMR CPD,143.16,,,,,,,per diem,143.16,143.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,UHC Medicare,UHC Medicare,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS RIGHT LARGE    ,33132614,CDM,279,RC,,,,,,Inpatient,,,143.16,143.16,Wellcare,Wellcare,143.16,,,,,,,case rate,143.16,143.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Meritain Health PPO CPD,Meritain Health PPO CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna/Commercial Product,Aetna/Commercial Product,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Meritain Health CPD,Meritain Health CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Starmark CPD,Starmark CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Aetna Medicare,Aetna Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Ambetter ,Ambetter ,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Access,Anthem Blue Access,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Access Choice,Anthem Blue Access Choice,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Blue Preferred,Anthem Blue Preferred,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Pathway,Anthem Pathway,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Alliance,Anthem Alliance,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Anthem Medicare,Anthem Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna,Cigna,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna PPO,Cigna PPO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Cigna Medicare Advantage,Cigna Medicare Advantage,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Essence,Essence,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthlink HMO,Healthlink HMO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Healthlink PPO,Healthlink PPO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,HomeState Health Plan,HomeState Health Plan,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Humana Gold,Humana Gold,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Medicaid MO,Medicaid MO,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Medica,Medica,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Tricare,Tricare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC All Payer,UHC All Payer,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Exchange,UHC Exchange,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Medicaid,UHC Medicaid,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UMR CPD,UMR CPD,137.07,,,,,,,per diem,137.07,137.07,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,UHC Medicare,UHC Medicare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT SM/M      ,33132615,CDM,279,RC,,,,,,Inpatient,,,137.07,137.07,Wellcare,Wellcare,137.07,,,,,,,case rate,137.07,137.07,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Meritain Health PPO CPD,Meritain Health PPO CPD,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Aetna/Commercial Product,Aetna/Commercial Product,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Meritain Health CPD,Meritain Health CPD,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Starmark CPD,Starmark CPD,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Aetna Medicare,Aetna Medicare,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Ambetter ,Ambetter ,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Blue Access,Anthem Blue Access,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Blue Access Choice,Anthem Blue Access Choice,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Blue Preferred,Anthem Blue Preferred,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Pathway,Anthem Pathway,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Alliance,Anthem Alliance,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Anthem Medicare,Anthem Medicare,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Cigna,Cigna,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Cigna PPO,Cigna PPO,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Cigna Medicare Advantage,Cigna Medicare Advantage,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Essence,Essence,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Healthlink HMO,Healthlink HMO,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Healthlink PPO,Healthlink PPO,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,HomeState Health Plan,HomeState Health Plan,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Humana Gold,Humana Gold,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Medicaid MO,Medicaid MO,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Medica,Medica,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Tricare,Tricare,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,UHC All Payer,UHC All Payer,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,UHC Exchange,UHC Exchange,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,UHC Medicaid,UHC Medicaid,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,UMR CPD,UMR CPD,137.16,,,,,,,per diem,137.16,137.16,"Per diem rate, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,UHC Medicare,UHC Medicare,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
WALKER SPLINTS LEFT LARGE     ,33132616,CDM,279,RC,,,,,,Inpatient,,,137.16,137.16,Wellcare,Wellcare,137.16,,,,,,,case rate,137.16,137.16,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health PPO CPD,Meritain Health PPO CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/Commercial Product,Aetna/Commercial Product,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health CPD,Meritain Health CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Starmark CPD,Starmark CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna Medicare,Aetna Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Ambetter ,Ambetter ,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access,Anthem Blue Access,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access Choice,Anthem Blue Access Choice,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Preferred,Anthem Blue Preferred,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Pathway,Anthem Pathway,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Alliance,Anthem Alliance,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Medicare,Anthem Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna,Cigna,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna PPO,Cigna PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna Medicare Advantage,Cigna Medicare Advantage,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Essence,Essence,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink HMO,Healthlink HMO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink PPO,Healthlink PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,HomeState Health Plan,HomeState Health Plan,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Humana Gold,Humana Gold,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medicaid MO,Medicaid MO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medica,Medica,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Tricare,Tricare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC All Payer,UHC All Payer,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Exchange,UHC Exchange,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicaid,UHC Medicaid,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UMR CPD,UMR CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicare,UHC Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-LARGE    ,33132621,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Wellcare,Wellcare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health PPO CPD,Meritain Health PPO CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna/Commercial Product,Aetna/Commercial Product,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Meritain Health CPD,Meritain Health CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Starmark CPD,Starmark CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Aetna Medicare,Aetna Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Ambetter ,Ambetter ,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access,Anthem Blue Access,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Access Choice,Anthem Blue Access Choice,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Blue Preferred,Anthem Blue Preferred,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Pathway,Anthem Pathway,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Alliance,Anthem Alliance,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Anthem Medicare,Anthem Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna,Cigna,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna PPO,Cigna PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Cigna Medicare Advantage,Cigna Medicare Advantage,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Essence,Essence,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink HMO,Healthlink HMO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Healthlink PPO,Healthlink PPO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,HomeState Health Plan,HomeState Health Plan,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Humana Gold,Humana Gold,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medicaid MO,Medicaid MO,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Medica,Medica,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Tricare,Tricare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC All Payer,UHC All Payer,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Exchange,UHC Exchange,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicaid,UHC Medicaid,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UMR CPD,UMR CPD,54.66,,,,,,,per diem,54.66,54.66,"Per diem rate, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,UHC Medicare,UHC Medicare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ENLARGED THUMB RIGHT-XLARGE   ,33132622,CDM,270,RC,,,,,,Inpatient,,,54.66,54.66,Wellcare,Wellcare,54.66,,,,,,,case rate,54.66,54.66,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-SM       ,33132624,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-MED      ,33132625,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH LEFT-LARGE    ,33132626,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-SM      ,33132627,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-MED     ,33132628,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health PPO CPD,Meritain Health PPO CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna/Commercial Product,Aetna/Commercial Product,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Meritain Health CPD,Meritain Health CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Starmark CPD,Starmark CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Aetna Medicare,Aetna Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Ambetter ,Ambetter ,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access,Anthem Blue Access,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Access Choice,Anthem Blue Access Choice,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Blue Preferred,Anthem Blue Preferred,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Pathway,Anthem Pathway,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Alliance,Anthem Alliance,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Anthem Medicare,Anthem Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna,Cigna,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna PPO,Cigna PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Cigna Medicare Advantage,Cigna Medicare Advantage,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Essence,Essence,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink HMO,Healthlink HMO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Healthlink PPO,Healthlink PPO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,HomeState Health Plan,HomeState Health Plan,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Humana Gold,Humana Gold,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medicaid MO,Medicaid MO,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Medica,Medica,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Tricare,Tricare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC All Payer,UHC All Payer,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Exchange,UHC Exchange,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicaid,UHC Medicaid,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UMR CPD,UMR CPD,99.33,,,,,,,per diem,99.33,99.33,"Per diem rate, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,UHC Medicare,UHC Medicare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
ANKLE/FOOT ORTH RIGHT-LARGE   ,33132629,CDM,270,RC,,,,,,Inpatient,,,99.33,99.33,Wellcare,Wellcare,99.33,,,,,,,case rate,99.33,99.33,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Meritain Health PPO CPD,Meritain Health PPO CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Aetna/Commercial Product,Aetna/Commercial Product,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Meritain Health CPD,Meritain Health CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Starmark CPD,Starmark CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Aetna Medicare,Aetna Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Ambetter ,Ambetter ,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Blue Access,Anthem Blue Access,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Blue Access Choice,Anthem Blue Access Choice,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Blue Preferred,Anthem Blue Preferred,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Pathway,Anthem Pathway,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Alliance,Anthem Alliance,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Anthem Medicare,Anthem Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Cigna,Cigna,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Cigna PPO,Cigna PPO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Cigna Medicare Advantage,Cigna Medicare Advantage,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Essence,Essence,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Healthlink HMO,Healthlink HMO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Healthlink PPO,Healthlink PPO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,HomeState Health Plan,HomeState Health Plan,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Humana Gold,Humana Gold,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Medicaid MO,Medicaid MO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Medica,Medica,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Tricare,Tricare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,UHC All Payer,UHC All Payer,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,UHC Exchange,UHC Exchange,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,UHC Medicaid,UHC Medicaid,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,UMR CPD,UMR CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,UHC Medicare,UHC Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33132630,CDM,270,RC,,,,,,Inpatient,,,85.62,85.62,Wellcare,Wellcare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Meritain Health PPO CPD,Meritain Health PPO CPD,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Aetna/Commercial Product,Aetna/Commercial Product,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Meritain Health CPD,Meritain Health CPD,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Starmark CPD,Starmark CPD,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Aetna Medicare,Aetna Medicare,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Ambetter ,Ambetter ,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Blue Access,Anthem Blue Access,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Blue Access Choice,Anthem Blue Access Choice,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Blue Preferred,Anthem Blue Preferred,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Pathway,Anthem Pathway,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Alliance,Anthem Alliance,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Anthem Medicare,Anthem Medicare,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Cigna,Cigna,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Cigna PPO,Cigna PPO,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Cigna Medicare Advantage,Cigna Medicare Advantage,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Essence,Essence,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Healthlink HMO,Healthlink HMO,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Healthlink PPO,Healthlink PPO,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,HomeState Health Plan,HomeState Health Plan,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Humana Gold,Humana Gold,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Medicaid MO,Medicaid MO,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Medica,Medica,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Tricare,Tricare,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,UHC All Payer,UHC All Payer,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,UHC Exchange,UHC Exchange,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,UHC Medicaid,UHC Medicaid,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,UMR CPD,UMR CPD,92.28,,,,,,,per diem,92.28,92.28,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,UHC Medicare,UHC Medicare,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33132631,CDM,270,RC,,,,,,Inpatient,,,92.28,92.28,Wellcare,Wellcare,92.28,,,,,,,case rate,92.28,92.28,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Meritain Health PPO CPD,Meritain Health PPO CPD,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Aetna/Commercial Product,Aetna/Commercial Product,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Meritain Health CPD,Meritain Health CPD,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Starmark CPD,Starmark CPD,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Aetna Medicare,Aetna Medicare,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Ambetter ,Ambetter ,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Blue Access,Anthem Blue Access,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Blue Access Choice,Anthem Blue Access Choice,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Blue Preferred,Anthem Blue Preferred,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Pathway,Anthem Pathway,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Alliance,Anthem Alliance,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Anthem Medicare,Anthem Medicare,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Cigna,Cigna,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Cigna PPO,Cigna PPO,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Cigna Medicare Advantage,Cigna Medicare Advantage,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Essence,Essence,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Healthlink HMO,Healthlink HMO,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Healthlink PPO,Healthlink PPO,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,HomeState Health Plan,HomeState Health Plan,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Humana Gold,Humana Gold,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Medicaid MO,Medicaid MO,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Medica,Medica,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Tricare,Tricare,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,UHC All Payer,UHC All Payer,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,UHC Exchange,UHC Exchange,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,UHC Medicaid,UHC Medicaid,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,UMR CPD,UMR CPD,95.37,,,,,,,per diem,95.37,95.37,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,UHC Medicare,UHC Medicare,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33132632,CDM,270,RC,,,,,,Inpatient,,,95.37,95.37,Wellcare,Wellcare,95.37,,,,,,,case rate,95.37,95.37,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Meritain Health PPO CPD,Meritain Health PPO CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna/Commercial Product,Aetna/Commercial Product,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Meritain Health CPD,Meritain Health CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Starmark CPD,Starmark CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna Medicare,Aetna Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Ambetter ,Ambetter ,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Access,Anthem Blue Access,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Access Choice,Anthem Blue Access Choice,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Preferred,Anthem Blue Preferred,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Pathway,Anthem Pathway,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Alliance,Anthem Alliance,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Medicare,Anthem Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna,Cigna,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna PPO,Cigna PPO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna Medicare Advantage,Cigna Medicare Advantage,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Essence,Essence,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthlink HMO,Healthlink HMO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthlink PPO,Healthlink PPO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,HomeState Health Plan,HomeState Health Plan,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Humana Gold,Humana Gold,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Medicaid MO,Medicaid MO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Medica,Medica,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Tricare,Tricare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC All Payer,UHC All Payer,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Exchange,UHC Exchange,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Medicaid,UHC Medicaid,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UMR CPD,UMR CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Medicare,UHC Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-RIGHT                 ,33132636,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Wellcare,Wellcare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Meritain Health PPO CPD,Meritain Health PPO CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna/Commercial Product,Aetna/Commercial Product,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Meritain Health CPD,Meritain Health CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Starmark CPD,Starmark CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Aetna Medicare,Aetna Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Ambetter ,Ambetter ,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Access,Anthem Blue Access,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Access Choice,Anthem Blue Access Choice,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Blue Preferred,Anthem Blue Preferred,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Pathway,Anthem Pathway,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Alliance,Anthem Alliance,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Anthem Medicare,Anthem Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna,Cigna,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna PPO,Cigna PPO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Cigna Medicare Advantage,Cigna Medicare Advantage,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Essence,Essence,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthlink HMO,Healthlink HMO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Healthlink PPO,Healthlink PPO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,HomeState Health Plan,HomeState Health Plan,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Humana Gold,Humana Gold,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Medicaid MO,Medicaid MO,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Medica,Medica,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Tricare,Tricare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC All Payer,UHC All Payer,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Exchange,UHC Exchange,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Medicaid,UHC Medicaid,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UMR CPD,UMR CPD,152.52,,,,,,,per diem,152.52,152.52,"Per diem rate, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,UHC Medicare,UHC Medicare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
AIRCAST-LEFT                  ,33132637,CDM,270,RC,,,,,,Inpatient,,,152.52,152.52,Wellcare,Wellcare,152.52,,,,,,,case rate,152.52,152.52,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-SM ,33132640,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-M  ,33132641,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT RIGHT-LG ,33132642,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-SM  ,33132643,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-M   ,33132644,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health PPO CPD,Meritain Health PPO CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna/Commercial Product,Aetna/Commercial Product,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Meritain Health CPD,Meritain Health CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Starmark CPD,Starmark CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Aetna Medicare,Aetna Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Ambetter ,Ambetter ,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access,Anthem Blue Access,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Access Choice,Anthem Blue Access Choice,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Blue Preferred,Anthem Blue Preferred,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Pathway,Anthem Pathway,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Alliance,Anthem Alliance,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Anthem Medicare,Anthem Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna,Cigna,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna PPO,Cigna PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Cigna Medicare Advantage,Cigna Medicare Advantage,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Essence,Essence,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink HMO,Healthlink HMO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Healthlink PPO,Healthlink PPO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,HomeState Health Plan,HomeState Health Plan,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Humana Gold,Humana Gold,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medicaid MO,Medicaid MO,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Medica,Medica,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Tricare,Tricare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC All Payer,UHC All Payer,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Exchange,UHC Exchange,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicaid,UHC Medicaid,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UMR CPD,UMR CPD,63.39,,,,,,,per diem,63.39,63.39,"Per diem rate, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,UHC Medicare,UHC Medicare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
COMFORT THUMB SPLINT LEFT-LG  ,33132645,CDM,270,RC,,,,,,Inpatient,,,63.39,63.39,Wellcare,Wellcare,63.39,,,,,,,case rate,63.39,63.39,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Meritain Health PPO CPD,Meritain Health PPO CPD,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Aetna/Commercial Product,Aetna/Commercial Product,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Meritain Health CPD,Meritain Health CPD,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Starmark CPD,Starmark CPD,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Aetna Medicare,Aetna Medicare,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Ambetter ,Ambetter ,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Blue Access,Anthem Blue Access,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Blue Access Choice,Anthem Blue Access Choice,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Blue Preferred,Anthem Blue Preferred,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Pathway,Anthem Pathway,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Alliance,Anthem Alliance,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Anthem Medicare,Anthem Medicare,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Cigna,Cigna,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Cigna PPO,Cigna PPO,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Cigna Medicare Advantage,Cigna Medicare Advantage,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Essence,Essence,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Healthlink HMO,Healthlink HMO,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Healthlink PPO,Healthlink PPO,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,HomeState Health Plan,HomeState Health Plan,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Humana Gold,Humana Gold,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Medicaid MO,Medicaid MO,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Medica,Medica,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Tricare,Tricare,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,UHC All Payer,UHC All Payer,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,UHC Exchange,UHC Exchange,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,UHC Medicaid,UHC Medicaid,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,UMR CPD,UMR CPD,29.07,,,,,,,per diem,29.07,29.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,UHC Medicare,UHC Medicare,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33132657,CDM,270,RC,,,,,,Inpatient,,,29.07,29.07,Wellcare,Wellcare,29.07,,,,,,,case rate,29.07,29.07,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Meritain Health PPO CPD,Meritain Health PPO CPD,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Aetna/Commercial Product,Aetna/Commercial Product,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Meritain Health CPD,Meritain Health CPD,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Starmark CPD,Starmark CPD,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Aetna Medicare,Aetna Medicare,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Ambetter ,Ambetter ,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Blue Access,Anthem Blue Access,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Blue Access Choice,Anthem Blue Access Choice,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Blue Preferred,Anthem Blue Preferred,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Pathway,Anthem Pathway,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Alliance,Anthem Alliance,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Anthem Medicare,Anthem Medicare,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Cigna,Cigna,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Cigna PPO,Cigna PPO,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Cigna Medicare Advantage,Cigna Medicare Advantage,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Essence,Essence,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Healthlink HMO,Healthlink HMO,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Healthlink PPO,Healthlink PPO,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,HomeState Health Plan,HomeState Health Plan,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Humana Gold,Humana Gold,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Medicaid MO,Medicaid MO,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Medica,Medica,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Tricare,Tricare,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,UHC All Payer,UHC All Payer,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,UHC Exchange,UHC Exchange,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,UHC Medicaid,UHC Medicaid,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,UMR CPD,UMR CPD,180.48,,,,,,,per diem,180.48,180.48,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,UHC Medicare,UHC Medicare,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33132662,CDM,270,RC,,,,,,Inpatient,,,180.48,180.48,Wellcare,Wellcare,180.48,,,,,,,case rate,180.48,180.48,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Meritain Health PPO CPD,Meritain Health PPO CPD,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Aetna/Commercial Product,Aetna/Commercial Product,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Meritain Health CPD,Meritain Health CPD,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Starmark CPD,Starmark CPD,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Aetna Medicare,Aetna Medicare,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Ambetter ,Ambetter ,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Blue Access,Anthem Blue Access,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Blue Access Choice,Anthem Blue Access Choice,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Blue Preferred,Anthem Blue Preferred,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Pathway,Anthem Pathway,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Alliance,Anthem Alliance,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Anthem Medicare,Anthem Medicare,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Cigna,Cigna,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Cigna PPO,Cigna PPO,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Cigna Medicare Advantage,Cigna Medicare Advantage,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Essence,Essence,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Healthlink HMO,Healthlink HMO,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Healthlink PPO,Healthlink PPO,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,HomeState Health Plan,HomeState Health Plan,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Humana Gold,Humana Gold,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Medicaid MO,Medicaid MO,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Medica,Medica,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Tricare,Tricare,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,UHC All Payer,UHC All Payer,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,UHC Exchange,UHC Exchange,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,UHC Medicaid,UHC Medicaid,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,UMR CPD,UMR CPD,837,,,,,,,per diem,837,837,"Per diem rate, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,UHC Medicare,UHC Medicare,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
ROOKE PROTECTOR               ,33132696,CDM,270,RC,,,,,,Inpatient,,,837,837,Wellcare,Wellcare,837,,,,,,,case rate,837,837,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Meritain Health PPO CPD,Meritain Health PPO CPD,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Aetna/Commercial Product,Aetna/Commercial Product,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Meritain Health CPD,Meritain Health CPD,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Starmark CPD,Starmark CPD,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Aetna Medicare,Aetna Medicare,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Ambetter ,Ambetter ,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Blue Access,Anthem Blue Access,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Blue Access Choice,Anthem Blue Access Choice,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Blue Preferred,Anthem Blue Preferred,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Pathway,Anthem Pathway,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Alliance,Anthem Alliance,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Anthem Medicare,Anthem Medicare,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Cigna,Cigna,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Cigna PPO,Cigna PPO,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Cigna Medicare Advantage,Cigna Medicare Advantage,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Essence,Essence,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Healthlink HMO,Healthlink HMO,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Healthlink PPO,Healthlink PPO,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,HomeState Health Plan,HomeState Health Plan,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Humana Gold,Humana Gold,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Medicaid MO,Medicaid MO,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Medica,Medica,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Tricare,Tricare,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,UHC All Payer,UHC All Payer,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,UHC Exchange,UHC Exchange,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,UHC Medicaid,UHC Medicaid,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,UMR CPD,UMR CPD,603.6,,,,,,,per diem,603.6,603.6,"Per diem rate, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,UHC Medicare,UHC Medicare,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
CPCAP HEATED HUMIDIFIER       ,33132699,CDM,279,RC,,,,,,Inpatient,,,603.6,603.6,Wellcare,Wellcare,603.6,,,,,,,case rate,603.6,603.6,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Meritain Health PPO CPD,Meritain Health PPO CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Aetna/Commercial Product,Aetna/Commercial Product,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Meritain Health CPD,Meritain Health CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Starmark CPD,Starmark CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Aetna Medicare,Aetna Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Ambetter ,Ambetter ,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access,Anthem Blue Access,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access Choice,Anthem Blue Access Choice,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Blue Preferred,Anthem Blue Preferred,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Pathway,Anthem Pathway,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Alliance,Anthem Alliance,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Anthem Medicare,Anthem Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Cigna,Cigna,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Cigna PPO,Cigna PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Cigna Medicare Advantage,Cigna Medicare Advantage,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Essence,Essence,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Healthlink HMO,Healthlink HMO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Healthlink PPO,Healthlink PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,HomeState Health Plan,HomeState Health Plan,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Humana Gold,Humana Gold,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Medicaid MO,Medicaid MO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Medica,Medica,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Tricare,Tricare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,UHC All Payer,UHC All Payer,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,UHC Exchange,UHC Exchange,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,UHC Medicaid,UHC Medicaid,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,UMR CPD,UMR CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,UHC Medicare,UHC Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
COLLAR SET CERV EX TL ADLT    ,33133104,CDM,270,RC,,,,,,Inpatient,,,18,18,Wellcare,Wellcare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Meritain Health PPO CPD,Meritain Health PPO CPD,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Aetna/Commercial Product,Aetna/Commercial Product,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Meritain Health CPD,Meritain Health CPD,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Starmark CPD,Starmark CPD,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Aetna Medicare,Aetna Medicare,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Ambetter ,Ambetter ,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Blue Access,Anthem Blue Access,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Blue Access Choice,Anthem Blue Access Choice,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Blue Preferred,Anthem Blue Preferred,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Pathway,Anthem Pathway,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Alliance,Anthem Alliance,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Anthem Medicare,Anthem Medicare,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Cigna,Cigna,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Cigna PPO,Cigna PPO,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Cigna Medicare Advantage,Cigna Medicare Advantage,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Essence,Essence,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Healthlink HMO,Healthlink HMO,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Healthlink PPO,Healthlink PPO,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,HomeState Health Plan,HomeState Health Plan,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Humana Gold,Humana Gold,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Medicaid MO,Medicaid MO,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Medica,Medica,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Tricare,Tricare,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,UHC All Payer,UHC All Payer,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,UHC Exchange,UHC Exchange,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,UHC Medicaid,UHC Medicaid,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,UMR CPD,UMR CPD,165.37,,,,,,,per diem,165.37,165.37,"Per diem rate, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,UHC Medicare,UHC Medicare,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
ACCEL RECIP HAND PIECE        ,33133106,CDM,270,RC,,,,,,Inpatient,,,165.37,165.37,Wellcare,Wellcare,165.37,,,,,,,case rate,165.37,165.37,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health PPO CPD,Meritain Health PPO CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/Commercial Product,Aetna/Commercial Product,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health CPD,Meritain Health CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Starmark CPD,Starmark CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna Medicare,Aetna Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Ambetter ,Ambetter ,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access,Anthem Blue Access,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access Choice,Anthem Blue Access Choice,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Preferred,Anthem Blue Preferred,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Pathway,Anthem Pathway,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Alliance,Anthem Alliance,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Medicare,Anthem Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna,Cigna,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna PPO,Cigna PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna Medicare Advantage,Cigna Medicare Advantage,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Essence,Essence,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink HMO,Healthlink HMO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink PPO,Healthlink PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,HomeState Health Plan,HomeState Health Plan,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Humana Gold,Humana Gold,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medicaid MO,Medicaid MO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medica,Medica,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Tricare,Tricare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC All Payer,UHC All Payer,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Exchange,UHC Exchange,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicaid,UHC Medicaid,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UMR CPD,UMR CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicare,UHC Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BINDER ABD UNIV               ,33133115,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Wellcare,Wellcare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Meritain Health PPO CPD,Meritain Health PPO CPD,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Aetna/Commercial Product,Aetna/Commercial Product,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Meritain Health CPD,Meritain Health CPD,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Starmark CPD,Starmark CPD,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Aetna Medicare,Aetna Medicare,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Ambetter ,Ambetter ,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Blue Access,Anthem Blue Access,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Blue Access Choice,Anthem Blue Access Choice,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Blue Preferred,Anthem Blue Preferred,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Pathway,Anthem Pathway,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Alliance,Anthem Alliance,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Anthem Medicare,Anthem Medicare,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Cigna,Cigna,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Cigna PPO,Cigna PPO,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Cigna Medicare Advantage,Cigna Medicare Advantage,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Essence,Essence,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Healthlink HMO,Healthlink HMO,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Healthlink PPO,Healthlink PPO,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,HomeState Health Plan,HomeState Health Plan,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Humana Gold,Humana Gold,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Medicaid MO,Medicaid MO,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Medica,Medica,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Tricare,Tricare,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,UHC All Payer,UHC All Payer,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,UHC Exchange,UHC Exchange,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,UHC Medicaid,UHC Medicaid,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,UMR CPD,UMR CPD,96.45,,,,,,,per diem,96.45,96.45,"Per diem rate, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,UHC Medicare,UHC Medicare,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
PILLOW ABDUCTION SMALL        ,33133123,CDM,270,RC,,,,,,Inpatient,,,96.45,96.45,Wellcare,Wellcare,96.45,,,,,,,case rate,96.45,96.45,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Meritain Health PPO CPD,Meritain Health PPO CPD,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Aetna/Commercial Product,Aetna/Commercial Product,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Meritain Health CPD,Meritain Health CPD,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Starmark CPD,Starmark CPD,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Aetna Medicare,Aetna Medicare,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Ambetter ,Ambetter ,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Blue Access,Anthem Blue Access,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Blue Access Choice,Anthem Blue Access Choice,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Blue Preferred,Anthem Blue Preferred,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Pathway,Anthem Pathway,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Alliance,Anthem Alliance,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Anthem Medicare,Anthem Medicare,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Cigna,Cigna,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Cigna PPO,Cigna PPO,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Cigna Medicare Advantage,Cigna Medicare Advantage,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Essence,Essence,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Healthlink HMO,Healthlink HMO,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Healthlink PPO,Healthlink PPO,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,HomeState Health Plan,HomeState Health Plan,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Humana Gold,Humana Gold,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Medicaid MO,Medicaid MO,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Medica,Medica,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Tricare,Tricare,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,UHC All Payer,UHC All Payer,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,UHC Exchange,UHC Exchange,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,UHC Medicaid,UHC Medicaid,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,UMR CPD,UMR CPD,67.89,,,,,,,per diem,67.89,67.89,"Per diem rate, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,UHC Medicare,UHC Medicare,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
KNEE SPREADER NC81006         ,33133130,CDM,270,RC,,,,,,Inpatient,,,67.89,67.89,Wellcare,Wellcare,67.89,,,,,,,case rate,67.89,67.89,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 8"" X 7.5""       ",33133190,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABDOMINAL PAD 5"" X 9""         ",33133191,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Meritain Health PPO CPD,Meritain Health PPO CPD,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Aetna/Commercial Product,Aetna/Commercial Product,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Meritain Health CPD,Meritain Health CPD,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Starmark CPD,Starmark CPD,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Aetna Medicare,Aetna Medicare,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Ambetter ,Ambetter ,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Blue Access,Anthem Blue Access,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Blue Access Choice,Anthem Blue Access Choice,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Blue Preferred,Anthem Blue Preferred,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Pathway,Anthem Pathway,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Alliance,Anthem Alliance,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Anthem Medicare,Anthem Medicare,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Cigna,Cigna,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Cigna PPO,Cigna PPO,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Cigna Medicare Advantage,Cigna Medicare Advantage,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Essence,Essence,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Healthlink HMO,Healthlink HMO,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Healthlink PPO,Healthlink PPO,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,HomeState Health Plan,HomeState Health Plan,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Humana Gold,Humana Gold,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Medicaid MO,Medicaid MO,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Medica,Medica,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Tricare,Tricare,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,UHC All Payer,UHC All Payer,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,UHC Exchange,UHC Exchange,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,UHC Medicaid,UHC Medicaid,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,UMR CPD,UMR CPD,162.75,,,,,,,per diem,162.75,162.75,"Per diem rate, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,UHC Medicare,UHC Medicare,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
COMFY BOOT W/AMB PAD ADULT    ,33133264,CDM,270,RC,,,,,,Inpatient,,,162.75,162.75,Wellcare,Wellcare,162.75,,,,,,,case rate,162.75,162.75,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Meritain Health PPO CPD,Meritain Health PPO CPD,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Aetna/Commercial Product,Aetna/Commercial Product,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Meritain Health CPD,Meritain Health CPD,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Starmark CPD,Starmark CPD,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Aetna Medicare,Aetna Medicare,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Ambetter ,Ambetter ,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Blue Access,Anthem Blue Access,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Blue Access Choice,Anthem Blue Access Choice,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Blue Preferred,Anthem Blue Preferred,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Pathway,Anthem Pathway,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Alliance,Anthem Alliance,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Anthem Medicare,Anthem Medicare,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Cigna,Cigna,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Cigna PPO,Cigna PPO,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Cigna Medicare Advantage,Cigna Medicare Advantage,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Essence,Essence,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Healthlink HMO,Healthlink HMO,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Healthlink PPO,Healthlink PPO,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,HomeState Health Plan,HomeState Health Plan,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Humana Gold,Humana Gold,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Medicaid MO,Medicaid MO,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Medica,Medica,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Tricare,Tricare,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,UHC All Payer,UHC All Payer,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,UHC Exchange,UHC Exchange,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,UHC Medicaid,UHC Medicaid,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,UMR CPD,UMR CPD,133.23,,,,,,,per diem,133.23,133.23,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,UHC Medicare,UHC Medicare,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL HEELMEDIX      ,33133265,CDM,270,RC,,,,,,Inpatient,,,133.23,133.23,Wellcare,Wellcare,133.23,,,,,,,case rate,133.23,133.23,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Meritain Health PPO CPD,Meritain Health PPO CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna/Commercial Product,Aetna/Commercial Product,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Meritain Health CPD,Meritain Health CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Starmark CPD,Starmark CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Aetna Medicare,Aetna Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Ambetter ,Ambetter ,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Access,Anthem Blue Access,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Access Choice,Anthem Blue Access Choice,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Blue Preferred,Anthem Blue Preferred,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Pathway,Anthem Pathway,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Alliance,Anthem Alliance,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Anthem Medicare,Anthem Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna,Cigna,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna PPO,Cigna PPO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Cigna Medicare Advantage,Cigna Medicare Advantage,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Essence,Essence,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthlink HMO,Healthlink HMO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Healthlink PPO,Healthlink PPO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,HomeState Health Plan,HomeState Health Plan,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Humana Gold,Humana Gold,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Medicaid MO,Medicaid MO,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Medica,Medica,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Tricare,Tricare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC All Payer,UHC All Payer,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Exchange,UHC Exchange,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Medicaid,UHC Medicaid,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UMR CPD,UMR CPD,65.7,,,,,,,per diem,65.7,65.7,"Per diem rate, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,UHC Medicare,UHC Medicare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
LONG ARM SPLINT               ,33133267,CDM,270,RC,,,,,,Inpatient,,,65.7,65.7,Wellcare,Wellcare,65.7,,,,,,,case rate,65.7,65.7,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health PPO CPD,Meritain Health PPO CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/Commercial Product,Aetna/Commercial Product,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health CPD,Meritain Health CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Starmark CPD,Starmark CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna Medicare,Aetna Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Ambetter ,Ambetter ,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access,Anthem Blue Access,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access Choice,Anthem Blue Access Choice,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Preferred,Anthem Blue Preferred,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Pathway,Anthem Pathway,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Alliance,Anthem Alliance,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Medicare,Anthem Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna,Cigna,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna PPO,Cigna PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna Medicare Advantage,Cigna Medicare Advantage,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Essence,Essence,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink HMO,Healthlink HMO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink PPO,Healthlink PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,HomeState Health Plan,HomeState Health Plan,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Humana Gold,Humana Gold,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medicaid MO,Medicaid MO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medica,Medica,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Tricare,Tricare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC All Payer,UHC All Payer,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Exchange,UHC Exchange,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicaid,UHC Medicaid,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UMR CPD,UMR CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicare,UHC Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM 2/PAD STRAP BLU XLG ,33133310,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Wellcare,Wellcare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Meritain Health PPO CPD,Meritain Health PPO CPD,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Aetna/Commercial Product,Aetna/Commercial Product,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Meritain Health CPD,Meritain Health CPD,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Starmark CPD,Starmark CPD,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Aetna Medicare,Aetna Medicare,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Ambetter ,Ambetter ,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Blue Access,Anthem Blue Access,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Blue Access Choice,Anthem Blue Access Choice,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Blue Preferred,Anthem Blue Preferred,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Pathway,Anthem Pathway,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Alliance,Anthem Alliance,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Anthem Medicare,Anthem Medicare,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Cigna,Cigna,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Cigna PPO,Cigna PPO,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Cigna Medicare Advantage,Cigna Medicare Advantage,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Essence,Essence,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Healthlink HMO,Healthlink HMO,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Healthlink PPO,Healthlink PPO,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,HomeState Health Plan,HomeState Health Plan,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Humana Gold,Humana Gold,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Medicaid MO,Medicaid MO,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Medica,Medica,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Tricare,Tricare,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,UHC All Payer,UHC All Payer,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,UHC Exchange,UHC Exchange,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,UHC Medicaid,UHC Medicaid,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,UMR CPD,UMR CPD,8.07,,,,,,,per diem,8.07,8.07,"Per diem rate, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,UHC Medicare,UHC Medicare,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM DELUXE XXS          ,33133311,CDM,270,RC,,,,,,Inpatient,,,8.07,8.07,Wellcare,Wellcare,8.07,,,,,,,case rate,8.07,8.07,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Meritain Health PPO CPD,Meritain Health PPO CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna/Commercial Product,Aetna/Commercial Product,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Meritain Health CPD,Meritain Health CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Starmark CPD,Starmark CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna Medicare,Aetna Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Ambetter ,Ambetter ,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Access,Anthem Blue Access,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Access Choice,Anthem Blue Access Choice,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Preferred,Anthem Blue Preferred,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Pathway,Anthem Pathway,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Alliance,Anthem Alliance,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Medicare,Anthem Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna,Cigna,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna PPO,Cigna PPO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna Medicare Advantage,Cigna Medicare Advantage,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Essence,Essence,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthlink HMO,Healthlink HMO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthlink PPO,Healthlink PPO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,HomeState Health Plan,HomeState Health Plan,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Humana Gold,Humana Gold,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Medicaid MO,Medicaid MO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Medica,Medica,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Tricare,Tricare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC All Payer,UHC All Payer,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Exchange,UHC Exchange,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Medicaid,UHC Medicaid,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UMR CPD,UMR CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Medicare,UHC Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33133312,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Wellcare,Wellcare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Meritain Health PPO CPD,Meritain Health PPO CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna/Commercial Product,Aetna/Commercial Product,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Meritain Health CPD,Meritain Health CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Starmark CPD,Starmark CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Aetna Medicare,Aetna Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Ambetter ,Ambetter ,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Access,Anthem Blue Access,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Access Choice,Anthem Blue Access Choice,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Blue Preferred,Anthem Blue Preferred,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Pathway,Anthem Pathway,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Alliance,Anthem Alliance,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Anthem Medicare,Anthem Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna,Cigna,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna PPO,Cigna PPO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Cigna Medicare Advantage,Cigna Medicare Advantage,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Essence,Essence,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthlink HMO,Healthlink HMO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Healthlink PPO,Healthlink PPO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,HomeState Health Plan,HomeState Health Plan,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Humana Gold,Humana Gold,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Medicaid MO,Medicaid MO,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Medica,Medica,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Tricare,Tricare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC All Payer,UHC All Payer,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Exchange,UHC Exchange,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Medicaid,UHC Medicaid,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UMR CPD,UMR CPD,5.87,,,,,,,per diem,5.87,5.87,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,UHC Medicare,UHC Medicare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33133313,CDM,270,RC,,,,,,Inpatient,,,5.87,5.87,Wellcare,Wellcare,5.87,,,,,,,case rate,5.87,5.87,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health PPO CPD,Meritain Health PPO CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/Commercial Product,Aetna/Commercial Product,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health CPD,Meritain Health CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Starmark CPD,Starmark CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna Medicare,Aetna Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Ambetter ,Ambetter ,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access,Anthem Blue Access,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access Choice,Anthem Blue Access Choice,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Preferred,Anthem Blue Preferred,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Pathway,Anthem Pathway,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Alliance,Anthem Alliance,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Medicare,Anthem Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna,Cigna,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna PPO,Cigna PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna Medicare Advantage,Cigna Medicare Advantage,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Essence,Essence,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink HMO,Healthlink HMO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink PPO,Healthlink PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,HomeState Health Plan,HomeState Health Plan,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Humana Gold,Humana Gold,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medicaid MO,Medicaid MO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medica,Medica,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Tricare,Tricare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC All Payer,UHC All Payer,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Exchange,UHC Exchange,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicaid,UHC Medicaid,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UMR CPD,UMR CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicare,UHC Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM PADDED STRAP LG     ,33133314,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Wellcare,Wellcare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Meritain Health PPO CPD,Meritain Health PPO CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna/Commercial Product,Aetna/Commercial Product,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Meritain Health CPD,Meritain Health CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Starmark CPD,Starmark CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna Medicare,Aetna Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Ambetter ,Ambetter ,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Access,Anthem Blue Access,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Access Choice,Anthem Blue Access Choice,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Preferred,Anthem Blue Preferred,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Pathway,Anthem Pathway,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Alliance,Anthem Alliance,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Medicare,Anthem Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna,Cigna,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna PPO,Cigna PPO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna Medicare Advantage,Cigna Medicare Advantage,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Essence,Essence,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthlink HMO,Healthlink HMO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthlink PPO,Healthlink PPO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,HomeState Health Plan,HomeState Health Plan,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Humana Gold,Humana Gold,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Medicaid MO,Medicaid MO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Medica,Medica,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Tricare,Tricare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC All Payer,UHC All Payer,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Exchange,UHC Exchange,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Medicaid,UHC Medicaid,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UMR CPD,UMR CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Medicare,UHC Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS LG     ,33133315,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Wellcare,Wellcare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Meritain Health PPO CPD,Meritain Health PPO CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna/Commercial Product,Aetna/Commercial Product,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Meritain Health CPD,Meritain Health CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Starmark CPD,Starmark CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Aetna Medicare,Aetna Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Ambetter ,Ambetter ,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Access,Anthem Blue Access,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Access Choice,Anthem Blue Access Choice,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Blue Preferred,Anthem Blue Preferred,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Pathway,Anthem Pathway,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Alliance,Anthem Alliance,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Anthem Medicare,Anthem Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna,Cigna,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna PPO,Cigna PPO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Cigna Medicare Advantage,Cigna Medicare Advantage,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Essence,Essence,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthlink HMO,Healthlink HMO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Healthlink PPO,Healthlink PPO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,HomeState Health Plan,HomeState Health Plan,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Humana Gold,Humana Gold,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Medicaid MO,Medicaid MO,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Medica,Medica,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Tricare,Tricare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC All Payer,UHC All Payer,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Exchange,UHC Exchange,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Medicaid,UHC Medicaid,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UMR CPD,UMR CPD,11.37,,,,,,,per diem,11.37,11.37,"Per diem rate, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,UHC Medicare,UHC Medicare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM POUCH CANVAS MED    ,33133316,CDM,270,RC,,,,,,Inpatient,,,11.37,11.37,Wellcare,Wellcare,11.37,,,,,,,case rate,11.37,11.37,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health PPO CPD,Meritain Health PPO CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/Commercial Product,Aetna/Commercial Product,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health CPD,Meritain Health CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Starmark CPD,Starmark CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna Medicare,Aetna Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Ambetter ,Ambetter ,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access,Anthem Blue Access,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access Choice,Anthem Blue Access Choice,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Preferred,Anthem Blue Preferred,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Pathway,Anthem Pathway,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Alliance,Anthem Alliance,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Medicare,Anthem Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna,Cigna,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna PPO,Cigna PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna Medicare Advantage,Cigna Medicare Advantage,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Essence,Essence,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink HMO,Healthlink HMO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink PPO,Healthlink PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,HomeState Health Plan,HomeState Health Plan,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Humana Gold,Humana Gold,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medicaid MO,Medicaid MO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medica,Medica,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Tricare,Tricare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC All Payer,UHC All Payer,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Exchange,UHC Exchange,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicaid,UHC Medicaid,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UMR CPD,UMR CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicare,UHC Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33133317,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Wellcare,Wellcare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health PPO CPD,Meritain Health PPO CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/Commercial Product,Aetna/Commercial Product,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health CPD,Meritain Health CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Starmark CPD,Starmark CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna Medicare,Aetna Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Ambetter ,Ambetter ,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access,Anthem Blue Access,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access Choice,Anthem Blue Access Choice,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Preferred,Anthem Blue Preferred,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Pathway,Anthem Pathway,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Alliance,Anthem Alliance,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Medicare,Anthem Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna,Cigna,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna PPO,Cigna PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna Medicare Advantage,Cigna Medicare Advantage,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Essence,Essence,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink HMO,Healthlink HMO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink PPO,Healthlink PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,HomeState Health Plan,HomeState Health Plan,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Humana Gold,Humana Gold,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medicaid MO,Medicaid MO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medica,Medica,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Tricare,Tricare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC All Payer,UHC All Payer,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Exchange,UHC Exchange,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicaid,UHC Medicaid,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UMR CPD,UMR CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicare,UHC Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33133318,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Wellcare,Wellcare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health PPO CPD,Meritain Health PPO CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna/Commercial Product,Aetna/Commercial Product,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Meritain Health CPD,Meritain Health CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Starmark CPD,Starmark CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Aetna Medicare,Aetna Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Ambetter ,Ambetter ,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access,Anthem Blue Access,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Access Choice,Anthem Blue Access Choice,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Blue Preferred,Anthem Blue Preferred,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Pathway,Anthem Pathway,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Alliance,Anthem Alliance,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Anthem Medicare,Anthem Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna,Cigna,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna PPO,Cigna PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Cigna Medicare Advantage,Cigna Medicare Advantage,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Essence,Essence,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink HMO,Healthlink HMO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Healthlink PPO,Healthlink PPO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,HomeState Health Plan,HomeState Health Plan,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Humana Gold,Humana Gold,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medicaid MO,Medicaid MO,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Medica,Medica,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Tricare,Tricare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC All Payer,UHC All Payer,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Exchange,UHC Exchange,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicaid,UHC Medicaid,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UMR CPD,UMR CPD,6.23,,,,,,,per diem,6.23,6.23,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,UHC Medicare,UHC Medicare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU SM  ,33133319,CDM,270,RC,,,,,,Inpatient,,,6.23,6.23,Wellcare,Wellcare,6.23,,,,,,,case rate,6.23,6.23,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Meritain Health PPO CPD,Meritain Health PPO CPD,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Aetna/Commercial Product,Aetna/Commercial Product,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Meritain Health CPD,Meritain Health CPD,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Starmark CPD,Starmark CPD,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Aetna Medicare,Aetna Medicare,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Ambetter ,Ambetter ,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Blue Access,Anthem Blue Access,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Blue Access Choice,Anthem Blue Access Choice,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Blue Preferred,Anthem Blue Preferred,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Pathway,Anthem Pathway,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Alliance,Anthem Alliance,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Anthem Medicare,Anthem Medicare,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Cigna,Cigna,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Cigna PPO,Cigna PPO,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Cigna Medicare Advantage,Cigna Medicare Advantage,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Essence,Essence,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Healthlink HMO,Healthlink HMO,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Healthlink PPO,Healthlink PPO,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,HomeState Health Plan,HomeState Health Plan,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Humana Gold,Humana Gold,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Medicaid MO,Medicaid MO,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Medica,Medica,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Tricare,Tricare,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,UHC All Payer,UHC All Payer,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,UHC Exchange,UHC Exchange,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,UHC Medicaid,UHC Medicaid,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,UMR CPD,UMR CPD,50.62,,,,,,,per diem,50.62,50.62,"Per diem rate, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,UHC Medicare,UHC Medicare,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
SPLINT BALL SOLID 1/8WHT LG EX,33133346,CDM,270,RC,,,,,,Inpatient,,,50.62,50.62,Wellcare,Wellcare,50.62,,,,,,,case rate,50.62,50.62,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Meritain Health PPO CPD,Meritain Health PPO CPD,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Aetna/Commercial Product,Aetna/Commercial Product,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Meritain Health CPD,Meritain Health CPD,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Starmark CPD,Starmark CPD,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Aetna Medicare,Aetna Medicare,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Ambetter ,Ambetter ,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Blue Access,Anthem Blue Access,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Blue Access Choice,Anthem Blue Access Choice,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Blue Preferred,Anthem Blue Preferred,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Pathway,Anthem Pathway,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Alliance,Anthem Alliance,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Anthem Medicare,Anthem Medicare,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Cigna,Cigna,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Cigna PPO,Cigna PPO,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Cigna Medicare Advantage,Cigna Medicare Advantage,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Essence,Essence,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Healthlink HMO,Healthlink HMO,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Healthlink PPO,Healthlink PPO,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,HomeState Health Plan,HomeState Health Plan,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Humana Gold,Humana Gold,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Medicaid MO,Medicaid MO,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Medica,Medica,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Tricare,Tricare,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,UHC All Payer,UHC All Payer,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,UHC Exchange,UHC Exchange,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,UHC Medicaid,UHC Medicaid,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,UMR CPD,UMR CPD,14.4,,,,,,,per diem,14.4,14.4,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,UHC Medicare,UHC Medicare,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33133551,CDM,279,RC,,,,,,Inpatient,,,14.4,14.4,Wellcare,Wellcare,14.4,,,,,,,case rate,14.4,14.4,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health PPO CPD,Meritain Health PPO CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/Commercial Product,Aetna/Commercial Product,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health CPD,Meritain Health CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Starmark CPD,Starmark CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna Medicare,Aetna Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Ambetter ,Ambetter ,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access,Anthem Blue Access,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access Choice,Anthem Blue Access Choice,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Preferred,Anthem Blue Preferred,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Pathway,Anthem Pathway,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Alliance,Anthem Alliance,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Medicare,Anthem Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna,Cigna,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna PPO,Cigna PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna Medicare Advantage,Cigna Medicare Advantage,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Essence,Essence,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink HMO,Healthlink HMO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink PPO,Healthlink PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,HomeState Health Plan,HomeState Health Plan,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Humana Gold,Humana Gold,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Medicaid MO,Medicaid MO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Medica,Medica,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Tricare,Tricare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC All Payer,UHC All Payer,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Exchange,UHC Exchange,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicaid,UHC Medicaid,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,UMR CPD,UMR CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicare,UHC Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33133552,CDM,279,RC,,,,,,Inpatient,,,54,54,Wellcare,Wellcare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Meritain Health PPO CPD,Meritain Health PPO CPD,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Aetna/Commercial Product,Aetna/Commercial Product,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Meritain Health CPD,Meritain Health CPD,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Starmark CPD,Starmark CPD,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Aetna Medicare,Aetna Medicare,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Ambetter ,Ambetter ,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Blue Access,Anthem Blue Access,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Blue Access Choice,Anthem Blue Access Choice,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Blue Preferred,Anthem Blue Preferred,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Pathway,Anthem Pathway,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Alliance,Anthem Alliance,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Anthem Medicare,Anthem Medicare,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Cigna,Cigna,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Cigna PPO,Cigna PPO,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Cigna Medicare Advantage,Cigna Medicare Advantage,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Essence,Essence,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Healthlink HMO,Healthlink HMO,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Healthlink PPO,Healthlink PPO,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,HomeState Health Plan,HomeState Health Plan,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Humana Gold,Humana Gold,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Medicaid MO,Medicaid MO,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Medica,Medica,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Tricare,Tricare,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,UHC All Payer,UHC All Payer,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,UHC Exchange,UHC Exchange,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,UHC Medicaid,UHC Medicaid,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,UMR CPD,UMR CPD,9.6,,,,,,,per diem,9.6,9.6,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,UHC Medicare,UHC Medicare,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb) RENT,33133553,CDM,279,RC,,,,,,Inpatient,,,9.6,9.6,Wellcare,Wellcare,9.6,,,,,,,case rate,9.6,9.6,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health PPO CPD,Meritain Health PPO CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/Commercial Product,Aetna/Commercial Product,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health CPD,Meritain Health CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Starmark CPD,Starmark CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna Medicare,Aetna Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Ambetter ,Ambetter ,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access,Anthem Blue Access,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access Choice,Anthem Blue Access Choice,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Preferred,Anthem Blue Preferred,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Pathway,Anthem Pathway,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Alliance,Anthem Alliance,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Medicare,Anthem Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna,Cigna,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna PPO,Cigna PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna Medicare Advantage,Cigna Medicare Advantage,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Essence,Essence,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink HMO,Healthlink HMO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink PPO,Healthlink PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,HomeState Health Plan,HomeState Health Plan,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Humana Gold,Humana Gold,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Medicaid MO,Medicaid MO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Medica,Medica,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Tricare,Tricare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC All Payer,UHC All Payer,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Exchange,UHC Exchange,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicaid,UHC Medicaid,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,UMR CPD,UMR CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicare,UHC Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33133554,CDM,279,RC,,,,,,Inpatient,,,18,18,Wellcare,Wellcare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Meritain Health PPO CPD,Meritain Health PPO CPD,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Aetna/Commercial Product,Aetna/Commercial Product,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Meritain Health CPD,Meritain Health CPD,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Starmark CPD,Starmark CPD,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Aetna Medicare,Aetna Medicare,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Ambetter ,Ambetter ,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Blue Access,Anthem Blue Access,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Blue Access Choice,Anthem Blue Access Choice,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Blue Preferred,Anthem Blue Preferred,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Pathway,Anthem Pathway,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Alliance,Anthem Alliance,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Anthem Medicare,Anthem Medicare,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Cigna,Cigna,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Cigna PPO,Cigna PPO,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Cigna Medicare Advantage,Cigna Medicare Advantage,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Essence,Essence,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Healthlink HMO,Healthlink HMO,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Healthlink PPO,Healthlink PPO,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,HomeState Health Plan,HomeState Health Plan,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Humana Gold,Humana Gold,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Medicaid MO,Medicaid MO,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Medica,Medica,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Tricare,Tricare,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,UHC All Payer,UHC All Payer,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,UHC Exchange,UHC Exchange,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,UHC Medicaid,UHC Medicaid,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,UMR CPD,UMR CPD,84.6,,,,,,,per diem,84.6,84.6,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,UHC Medicare,UHC Medicare,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33133555,CDM,279,RC,,,,,,Inpatient,,,84.6,84.6,Wellcare,Wellcare,84.6,,,,,,,case rate,84.6,84.6,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Meritain Health PPO CPD,Meritain Health PPO CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Aetna/Commercial Product,Aetna/Commercial Product,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Meritain Health CPD,Meritain Health CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Starmark CPD,Starmark CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Aetna Medicare,Aetna Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Ambetter ,Ambetter ,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Blue Access,Anthem Blue Access,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Blue Access Choice,Anthem Blue Access Choice,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Blue Preferred,Anthem Blue Preferred,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Pathway,Anthem Pathway,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Alliance,Anthem Alliance,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Anthem Medicare,Anthem Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Cigna,Cigna,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Cigna PPO,Cigna PPO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Cigna Medicare Advantage,Cigna Medicare Advantage,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Essence,Essence,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Healthlink HMO,Healthlink HMO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Healthlink PPO,Healthlink PPO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,HomeState Health Plan,HomeState Health Plan,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Humana Gold,Humana Gold,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Medicaid MO,Medicaid MO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Medica,Medica,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Tricare,Tricare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,UHC All Payer,UHC All Payer,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,UHC Exchange,UHC Exchange,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,UHC Medicaid,UHC Medicaid,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,UMR CPD,UMR CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,UHC Medicare,UHC Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33133556,CDM,279,RC,,,,,,Inpatient,,,19.2,19.2,Wellcare,Wellcare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Meritain Health PPO CPD,Meritain Health PPO CPD,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Aetna/Commercial Product,Aetna/Commercial Product,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Meritain Health CPD,Meritain Health CPD,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Starmark CPD,Starmark CPD,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Aetna Medicare,Aetna Medicare,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Ambetter ,Ambetter ,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Blue Access,Anthem Blue Access,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Blue Access Choice,Anthem Blue Access Choice,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Blue Preferred,Anthem Blue Preferred,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Pathway,Anthem Pathway,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Alliance,Anthem Alliance,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Anthem Medicare,Anthem Medicare,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Cigna,Cigna,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Cigna PPO,Cigna PPO,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Cigna Medicare Advantage,Cigna Medicare Advantage,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Essence,Essence,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Healthlink HMO,Healthlink HMO,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Healthlink PPO,Healthlink PPO,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,HomeState Health Plan,HomeState Health Plan,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Humana Gold,Humana Gold,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Medicaid MO,Medicaid MO,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Medica,Medica,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Tricare,Tricare,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,UHC All Payer,UHC All Payer,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,UHC Exchange,UHC Exchange,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,UHC Medicaid,UHC Medicaid,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,UMR CPD,UMR CPD,6.67,,,,,,,per diem,6.67,6.67,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,UHC Medicare,UHC Medicare,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33133557,CDM,279,RC,,,,,,Inpatient,,,6.67,6.67,Wellcare,Wellcare,6.67,,,,,,,case rate,6.67,6.67,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health PPO CPD,Meritain Health PPO CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/Commercial Product,Aetna/Commercial Product,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health CPD,Meritain Health CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Starmark CPD,Starmark CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna Medicare,Aetna Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Ambetter ,Ambetter ,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access,Anthem Blue Access,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access Choice,Anthem Blue Access Choice,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Preferred,Anthem Blue Preferred,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Pathway,Anthem Pathway,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Alliance,Anthem Alliance,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Medicare,Anthem Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna,Cigna,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna PPO,Cigna PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna Medicare Advantage,Cigna Medicare Advantage,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Essence,Essence,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink HMO,Healthlink HMO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink PPO,Healthlink PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,HomeState Health Plan,HomeState Health Plan,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Humana Gold,Humana Gold,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Medicaid MO,Medicaid MO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Medica,Medica,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Tricare,Tricare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC All Payer,UHC All Payer,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Exchange,UHC Exchange,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicaid,UHC Medicaid,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,UMR CPD,UMR CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicare,UHC Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33133558,CDM,279,RC,,,,,,Inpatient,,,54,54,Wellcare,Wellcare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health PPO CPD,Meritain Health PPO CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/Commercial Product,Aetna/Commercial Product,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health CPD,Meritain Health CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Starmark CPD,Starmark CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna Medicare,Aetna Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Ambetter ,Ambetter ,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access,Anthem Blue Access,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access Choice,Anthem Blue Access Choice,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Preferred,Anthem Blue Preferred,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Pathway,Anthem Pathway,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Alliance,Anthem Alliance,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Medicare,Anthem Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna,Cigna,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna PPO,Cigna PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna Medicare Advantage,Cigna Medicare Advantage,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Essence,Essence,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink HMO,Healthlink HMO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink PPO,Healthlink PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,HomeState Health Plan,HomeState Health Plan,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Humana Gold,Humana Gold,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Medicaid MO,Medicaid MO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Medica,Medica,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Tricare,Tricare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC All Payer,UHC All Payer,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Exchange,UHC Exchange,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicaid,UHC Medicaid,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,UMR CPD,UMR CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicare,UHC Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33133559,CDM,279,RC,,,,,,Inpatient,,,18,18,Wellcare,Wellcare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33133560,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33133561,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Meritain Health PPO CPD,Meritain Health PPO CPD,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Aetna/Commercial Product,Aetna/Commercial Product,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Meritain Health CPD,Meritain Health CPD,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Starmark CPD,Starmark CPD,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Aetna Medicare,Aetna Medicare,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Ambetter ,Ambetter ,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Blue Access,Anthem Blue Access,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Blue Access Choice,Anthem Blue Access Choice,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Blue Preferred,Anthem Blue Preferred,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Pathway,Anthem Pathway,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Alliance,Anthem Alliance,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Anthem Medicare,Anthem Medicare,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Cigna,Cigna,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Cigna PPO,Cigna PPO,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Cigna Medicare Advantage,Cigna Medicare Advantage,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Essence,Essence,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Healthlink HMO,Healthlink HMO,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Healthlink PPO,Healthlink PPO,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,HomeState Health Plan,HomeState Health Plan,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Humana Gold,Humana Gold,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Medicaid MO,Medicaid MO,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Medica,Medica,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Tricare,Tricare,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,UHC All Payer,UHC All Payer,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,UHC Exchange,UHC Exchange,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,UHC Medicaid,UHC Medicaid,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,UMR CPD,UMR CPD,96,,,,,,,per diem,96,96,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,UHC Medicare,UHC Medicare,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33133562,CDM,279,RC,,,,,,Inpatient,,,96,96,Wellcare,Wellcare,96,,,,,,,case rate,96,96,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health PPO CPD,Meritain Health PPO CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/Commercial Product,Aetna/Commercial Product,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health CPD,Meritain Health CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Starmark CPD,Starmark CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna Medicare,Aetna Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Ambetter ,Ambetter ,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access,Anthem Blue Access,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access Choice,Anthem Blue Access Choice,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Preferred,Anthem Blue Preferred,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Pathway,Anthem Pathway,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Alliance,Anthem Alliance,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Medicare,Anthem Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna,Cigna,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna PPO,Cigna PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna Medicare Advantage,Cigna Medicare Advantage,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Essence,Essence,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink HMO,Healthlink HMO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink PPO,Healthlink PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,HomeState Health Plan,HomeState Health Plan,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Humana Gold,Humana Gold,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Medicaid MO,Medicaid MO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Medica,Medica,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Tricare,Tricare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC All Payer,UHC All Payer,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Exchange,UHC Exchange,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicaid,UHC Medicaid,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,UMR CPD,UMR CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicare,UHC Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33133563,CDM,279,RC,,,,,,Inpatient,,,144,144,Wellcare,Wellcare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health PPO CPD,Meritain Health PPO CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/Commercial Product,Aetna/Commercial Product,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health CPD,Meritain Health CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Starmark CPD,Starmark CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna Medicare,Aetna Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Ambetter ,Ambetter ,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access,Anthem Blue Access,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access Choice,Anthem Blue Access Choice,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Preferred,Anthem Blue Preferred,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Pathway,Anthem Pathway,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Alliance,Anthem Alliance,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Medicare,Anthem Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna,Cigna,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna PPO,Cigna PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna Medicare Advantage,Cigna Medicare Advantage,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Essence,Essence,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink HMO,Healthlink HMO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink PPO,Healthlink PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,HomeState Health Plan,HomeState Health Plan,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Humana Gold,Humana Gold,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Medicaid MO,Medicaid MO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Medica,Medica,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Tricare,Tricare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC All Payer,UHC All Payer,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Exchange,UHC Exchange,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicaid,UHC Medicaid,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,UMR CPD,UMR CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicare,UHC Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33133564,CDM,279,RC,,,,,,Inpatient,,,12,12,Wellcare,Wellcare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Meritain Health PPO CPD,Meritain Health PPO CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna/Commercial Product,Aetna/Commercial Product,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Meritain Health CPD,Meritain Health CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Starmark CPD,Starmark CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna Medicare,Aetna Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Ambetter ,Ambetter ,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Access,Anthem Blue Access,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Access Choice,Anthem Blue Access Choice,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Preferred,Anthem Blue Preferred,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Pathway,Anthem Pathway,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Alliance,Anthem Alliance,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Medicare,Anthem Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna,Cigna,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna PPO,Cigna PPO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna Medicare Advantage,Cigna Medicare Advantage,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Essence,Essence,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthlink HMO,Healthlink HMO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthlink PPO,Healthlink PPO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,HomeState Health Plan,HomeState Health Plan,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Humana Gold,Humana Gold,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Medicaid MO,Medicaid MO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Medica,Medica,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Tricare,Tricare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC All Payer,UHC All Payer,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Exchange,UHC Exchange,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Medicaid,UHC Medicaid,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UMR CPD,UMR CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Medicare,UHC Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33133565,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Wellcare,Wellcare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Meritain Health PPO CPD,Meritain Health PPO CPD,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Aetna/Commercial Product,Aetna/Commercial Product,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Meritain Health CPD,Meritain Health CPD,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Starmark CPD,Starmark CPD,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Aetna Medicare,Aetna Medicare,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Ambetter ,Ambetter ,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Blue Access,Anthem Blue Access,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Blue Access Choice,Anthem Blue Access Choice,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Blue Preferred,Anthem Blue Preferred,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Pathway,Anthem Pathway,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Alliance,Anthem Alliance,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Anthem Medicare,Anthem Medicare,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Cigna,Cigna,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Cigna PPO,Cigna PPO,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Cigna Medicare Advantage,Cigna Medicare Advantage,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Essence,Essence,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Healthlink HMO,Healthlink HMO,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Healthlink PPO,Healthlink PPO,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,HomeState Health Plan,HomeState Health Plan,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Humana Gold,Humana Gold,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Medicaid MO,Medicaid MO,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Medica,Medica,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Tricare,Tricare,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,UHC All Payer,UHC All Payer,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,UHC Exchange,UHC Exchange,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,UHC Medicaid,UHC Medicaid,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,UMR CPD,UMR CPD,2.4,,,,,,,per diem,2.4,2.4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,UHC Medicare,UHC Medicare,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33133566,CDM,279,RC,,,,,,Inpatient,,,2.4,2.4,Wellcare,Wellcare,2.4,,,,,,,case rate,2.4,2.4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Meritain Health PPO CPD,Meritain Health PPO CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna/Commercial Product,Aetna/Commercial Product,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Meritain Health CPD,Meritain Health CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Starmark CPD,Starmark CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Aetna Medicare,Aetna Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Ambetter ,Ambetter ,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Access,Anthem Blue Access,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Access Choice,Anthem Blue Access Choice,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Blue Preferred,Anthem Blue Preferred,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Pathway,Anthem Pathway,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Alliance,Anthem Alliance,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Anthem Medicare,Anthem Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna,Cigna,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna PPO,Cigna PPO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Cigna Medicare Advantage,Cigna Medicare Advantage,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Essence,Essence,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthlink HMO,Healthlink HMO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Healthlink PPO,Healthlink PPO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,HomeState Health Plan,HomeState Health Plan,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Humana Gold,Humana Gold,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Medicaid MO,Medicaid MO,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Medica,Medica,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Tricare,Tricare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC All Payer,UHC All Payer,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Exchange,UHC Exchange,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Medicaid,UHC Medicaid,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UMR CPD,UMR CPD,28.8,,,,,,,per diem,28.8,28.8,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,UHC Medicare,UHC Medicare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33133567,CDM,279,RC,,,,,,Inpatient,,,28.8,28.8,Wellcare,Wellcare,28.8,,,,,,,case rate,28.8,28.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Meritain Health PPO CPD,Meritain Health PPO CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna/Commercial Product,Aetna/Commercial Product,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Meritain Health CPD,Meritain Health CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Starmark CPD,Starmark CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna Medicare,Aetna Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Ambetter ,Ambetter ,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Access,Anthem Blue Access,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Access Choice,Anthem Blue Access Choice,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Preferred,Anthem Blue Preferred,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Pathway,Anthem Pathway,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Alliance,Anthem Alliance,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Medicare,Anthem Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna,Cigna,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna PPO,Cigna PPO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna Medicare Advantage,Cigna Medicare Advantage,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Essence,Essence,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthlink HMO,Healthlink HMO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthlink PPO,Healthlink PPO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,HomeState Health Plan,HomeState Health Plan,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Humana Gold,Humana Gold,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Medicaid MO,Medicaid MO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Medica,Medica,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Tricare,Tricare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC All Payer,UHC All Payer,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Exchange,UHC Exchange,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Medicaid,UHC Medicaid,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UMR CPD,UMR CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Medicare,UHC Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33133568,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Wellcare,Wellcare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health PPO CPD,Meritain Health PPO CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/Commercial Product,Aetna/Commercial Product,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health CPD,Meritain Health CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Starmark CPD,Starmark CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna Medicare,Aetna Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Ambetter ,Ambetter ,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access,Anthem Blue Access,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access Choice,Anthem Blue Access Choice,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Preferred,Anthem Blue Preferred,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Pathway,Anthem Pathway,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Alliance,Anthem Alliance,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Medicare,Anthem Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna,Cigna,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna PPO,Cigna PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna Medicare Advantage,Cigna Medicare Advantage,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Essence,Essence,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink HMO,Healthlink HMO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink PPO,Healthlink PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,HomeState Health Plan,HomeState Health Plan,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Humana Gold,Humana Gold,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Medicaid MO,Medicaid MO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Medica,Medica,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Tricare,Tricare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC All Payer,UHC All Payer,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Exchange,UHC Exchange,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicaid,UHC Medicaid,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,UMR CPD,UMR CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicare,UHC Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33133570,CDM,279,RC,,,,,,Inpatient,,,4,4,Wellcare,Wellcare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Meritain Health PPO CPD,Meritain Health PPO CPD,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Aetna/Commercial Product,Aetna/Commercial Product,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Meritain Health CPD,Meritain Health CPD,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Starmark CPD,Starmark CPD,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Aetna Medicare,Aetna Medicare,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Ambetter ,Ambetter ,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Blue Access,Anthem Blue Access,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Blue Access Choice,Anthem Blue Access Choice,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Blue Preferred,Anthem Blue Preferred,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Pathway,Anthem Pathway,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Alliance,Anthem Alliance,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Anthem Medicare,Anthem Medicare,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Cigna,Cigna,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Cigna PPO,Cigna PPO,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Cigna Medicare Advantage,Cigna Medicare Advantage,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Essence,Essence,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Healthlink HMO,Healthlink HMO,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Healthlink PPO,Healthlink PPO,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,HomeState Health Plan,HomeState Health Plan,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Humana Gold,Humana Gold,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Medicaid MO,Medicaid MO,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Medica,Medica,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Tricare,Tricare,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,UHC All Payer,UHC All Payer,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,UHC Exchange,UHC Exchange,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,UHC Medicaid,UHC Medicaid,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,UMR CPD,UMR CPD,92.58,,,,,,,per diem,92.58,92.58,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,UHC Medicare,UHC Medicare,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33133571,CDM,279,RC,,,,,,Inpatient,,,92.58,92.58,Wellcare,Wellcare,92.58,,,,,,,case rate,92.58,92.58,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Meritain Health PPO CPD,Meritain Health PPO CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna/Commercial Product,Aetna/Commercial Product,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Meritain Health CPD,Meritain Health CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Starmark CPD,Starmark CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Aetna Medicare,Aetna Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Ambetter ,Ambetter ,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Access,Anthem Blue Access,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Access Choice,Anthem Blue Access Choice,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Blue Preferred,Anthem Blue Preferred,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Pathway,Anthem Pathway,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Alliance,Anthem Alliance,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Anthem Medicare,Anthem Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna,Cigna,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna PPO,Cigna PPO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Cigna Medicare Advantage,Cigna Medicare Advantage,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Essence,Essence,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthlink HMO,Healthlink HMO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Healthlink PPO,Healthlink PPO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,HomeState Health Plan,HomeState Health Plan,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Humana Gold,Humana Gold,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Medicaid MO,Medicaid MO,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Medica,Medica,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Tricare,Tricare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC All Payer,UHC All Payer,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Exchange,UHC Exchange,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Medicaid,UHC Medicaid,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UMR CPD,UMR CPD,21.6,,,,,,,per diem,21.6,21.6,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,UHC Medicare,UHC Medicare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33133572,CDM,279,RC,,,,,,Inpatient,,,21.6,21.6,Wellcare,Wellcare,21.6,,,,,,,case rate,21.6,21.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Meritain Health PPO CPD,Meritain Health PPO CPD,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Aetna/Commercial Product,Aetna/Commercial Product,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Meritain Health CPD,Meritain Health CPD,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Starmark CPD,Starmark CPD,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Aetna Medicare,Aetna Medicare,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Ambetter ,Ambetter ,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Blue Access,Anthem Blue Access,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Blue Access Choice,Anthem Blue Access Choice,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Blue Preferred,Anthem Blue Preferred,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Pathway,Anthem Pathway,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Alliance,Anthem Alliance,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Anthem Medicare,Anthem Medicare,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Cigna,Cigna,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Cigna PPO,Cigna PPO,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Cigna Medicare Advantage,Cigna Medicare Advantage,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Essence,Essence,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Healthlink HMO,Healthlink HMO,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Healthlink PPO,Healthlink PPO,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,HomeState Health Plan,HomeState Health Plan,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Humana Gold,Humana Gold,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Medicaid MO,Medicaid MO,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Medica,Medica,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Tricare,Tricare,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,UHC All Payer,UHC All Payer,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,UHC Exchange,UHC Exchange,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,UHC Medicaid,UHC Medicaid,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,UMR CPD,UMR CPD,30.6,,,,,,,per diem,30.6,30.6,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,UHC Medicare,UHC Medicare,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33133573,CDM,279,RC,,,,,,Inpatient,,,30.6,30.6,Wellcare,Wellcare,30.6,,,,,,,case rate,30.6,30.6,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Meritain Health PPO CPD,Meritain Health PPO CPD,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Aetna/Commercial Product,Aetna/Commercial Product,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Meritain Health CPD,Meritain Health CPD,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Starmark CPD,Starmark CPD,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Aetna Medicare,Aetna Medicare,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Ambetter ,Ambetter ,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Blue Access,Anthem Blue Access,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Blue Access Choice,Anthem Blue Access Choice,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Blue Preferred,Anthem Blue Preferred,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Pathway,Anthem Pathway,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Alliance,Anthem Alliance,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Anthem Medicare,Anthem Medicare,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Cigna,Cigna,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Cigna PPO,Cigna PPO,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Cigna Medicare Advantage,Cigna Medicare Advantage,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Essence,Essence,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Healthlink HMO,Healthlink HMO,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Healthlink PPO,Healthlink PPO,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,HomeState Health Plan,HomeState Health Plan,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Humana Gold,Humana Gold,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Medicaid MO,Medicaid MO,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Medica,Medica,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Tricare,Tricare,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,UHC All Payer,UHC All Payer,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,UHC Exchange,UHC Exchange,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,UHC Medicaid,UHC Medicaid,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,UMR CPD,UMR CPD,14.3,,,,,,,per diem,14.3,14.3,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,UHC Medicare,UHC Medicare,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33133574,CDM,279,RC,,,,,,Inpatient,,,14.3,14.3,Wellcare,Wellcare,14.3,,,,,,,case rate,14.3,14.3,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Meritain Health PPO CPD,Meritain Health PPO CPD,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Aetna/Commercial Product,Aetna/Commercial Product,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Meritain Health CPD,Meritain Health CPD,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Starmark CPD,Starmark CPD,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Aetna Medicare,Aetna Medicare,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Ambetter ,Ambetter ,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Blue Access,Anthem Blue Access,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Blue Access Choice,Anthem Blue Access Choice,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Blue Preferred,Anthem Blue Preferred,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Pathway,Anthem Pathway,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Alliance,Anthem Alliance,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Anthem Medicare,Anthem Medicare,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Cigna,Cigna,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Cigna PPO,Cigna PPO,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Cigna Medicare Advantage,Cigna Medicare Advantage,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Essence,Essence,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Healthlink HMO,Healthlink HMO,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Healthlink PPO,Healthlink PPO,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,HomeState Health Plan,HomeState Health Plan,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Humana Gold,Humana Gold,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Medicaid MO,Medicaid MO,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Medica,Medica,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Tricare,Tricare,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,UHC All Payer,UHC All Payer,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,UHC Exchange,UHC Exchange,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,UHC Medicaid,UHC Medicaid,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,UMR CPD,UMR CPD,31.2,,,,,,,per diem,31.2,31.2,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,UHC Medicare,UHC Medicare,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33133575,CDM,279,RC,,,,,,Inpatient,,,31.2,31.2,Wellcare,Wellcare,31.2,,,,,,,case rate,31.2,31.2,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Meritain Health PPO CPD,Meritain Health PPO CPD,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Aetna/Commercial Product,Aetna/Commercial Product,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Meritain Health CPD,Meritain Health CPD,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Starmark CPD,Starmark CPD,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Aetna Medicare,Aetna Medicare,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Ambetter ,Ambetter ,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Blue Access,Anthem Blue Access,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Blue Access Choice,Anthem Blue Access Choice,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Blue Preferred,Anthem Blue Preferred,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Pathway,Anthem Pathway,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Alliance,Anthem Alliance,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Anthem Medicare,Anthem Medicare,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Cigna,Cigna,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Cigna PPO,Cigna PPO,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Cigna Medicare Advantage,Cigna Medicare Advantage,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Essence,Essence,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Healthlink HMO,Healthlink HMO,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Healthlink PPO,Healthlink PPO,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,HomeState Health Plan,HomeState Health Plan,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Humana Gold,Humana Gold,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Medicaid MO,Medicaid MO,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Medica,Medica,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Tricare,Tricare,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,UHC All Payer,UHC All Payer,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,UHC Exchange,UHC Exchange,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,UHC Medicaid,UHC Medicaid,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,UMR CPD,UMR CPD,115.63,,,,,,,per diem,115.63,115.63,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,UHC Medicare,UHC Medicare,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33133577,CDM,279,RC,,,,,,Inpatient,,,115.63,115.63,Wellcare,Wellcare,115.63,,,,,,,case rate,115.63,115.63,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Meritain Health PPO CPD,Meritain Health PPO CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna/Commercial Product,Aetna/Commercial Product,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Meritain Health CPD,Meritain Health CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Starmark CPD,Starmark CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna Medicare,Aetna Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Ambetter ,Ambetter ,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Access,Anthem Blue Access,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Access Choice,Anthem Blue Access Choice,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Preferred,Anthem Blue Preferred,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Pathway,Anthem Pathway,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Alliance,Anthem Alliance,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Medicare,Anthem Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna,Cigna,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna PPO,Cigna PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna Medicare Advantage,Cigna Medicare Advantage,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Essence,Essence,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthlink HMO,Healthlink HMO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthlink PPO,Healthlink PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,HomeState Health Plan,HomeState Health Plan,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Humana Gold,Humana Gold,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Medicaid MO,Medicaid MO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Medica,Medica,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Tricare,Tricare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC All Payer,UHC All Payer,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Exchange,UHC Exchange,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Medicaid,UHC Medicaid,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UMR CPD,UMR CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Medicare,UHC Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.                    ,33133592,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Wellcare,Wellcare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Meritain Health PPO CPD,Meritain Health PPO CPD,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Aetna/Commercial Product,Aetna/Commercial Product,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Meritain Health CPD,Meritain Health CPD,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Starmark CPD,Starmark CPD,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Aetna Medicare,Aetna Medicare,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Ambetter ,Ambetter ,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Blue Access,Anthem Blue Access,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Blue Access Choice,Anthem Blue Access Choice,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Blue Preferred,Anthem Blue Preferred,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Pathway,Anthem Pathway,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Alliance,Anthem Alliance,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Anthem Medicare,Anthem Medicare,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Cigna,Cigna,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Cigna PPO,Cigna PPO,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Cigna Medicare Advantage,Cigna Medicare Advantage,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Essence,Essence,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Healthlink HMO,Healthlink HMO,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Healthlink PPO,Healthlink PPO,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,HomeState Health Plan,HomeState Health Plan,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Humana Gold,Humana Gold,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Medicaid MO,Medicaid MO,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Medica,Medica,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Tricare,Tricare,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,UHC All Payer,UHC All Payer,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,UHC Exchange,UHC Exchange,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,UHC Medicaid,UHC Medicaid,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,UMR CPD,UMR CPD,35.1,,,,,,,per diem,35.1,35.1,"Per diem rate, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,UHC Medicare,UHC Medicare,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
WOUND VAC.>50 SQ CM-RH        ,33133593,CDM,279,RC,,,,,,Inpatient,,,35.1,35.1,Wellcare,Wellcare,35.1,,,,,,,case rate,35.1,35.1,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Meritain Health PPO CPD,Meritain Health PPO CPD,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Aetna/Commercial Product,Aetna/Commercial Product,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Meritain Health CPD,Meritain Health CPD,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Starmark CPD,Starmark CPD,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Aetna Medicare,Aetna Medicare,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Ambetter ,Ambetter ,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Blue Access,Anthem Blue Access,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Blue Access Choice,Anthem Blue Access Choice,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Blue Preferred,Anthem Blue Preferred,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Pathway,Anthem Pathway,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Alliance,Anthem Alliance,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Anthem Medicare,Anthem Medicare,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Cigna,Cigna,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Cigna PPO,Cigna PPO,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Cigna Medicare Advantage,Cigna Medicare Advantage,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Essence,Essence,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Healthlink HMO,Healthlink HMO,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Healthlink PPO,Healthlink PPO,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,HomeState Health Plan,HomeState Health Plan,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Humana Gold,Humana Gold,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Medicaid MO,Medicaid MO,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Medica,Medica,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Tricare,Tricare,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,UHC All Payer,UHC All Payer,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,UHC Exchange,UHC Exchange,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,UHC Medicaid,UHC Medicaid,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,UMR CPD,UMR CPD,113.7,,,,,,,per diem,113.7,113.7,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,UHC Medicare,UHC Medicare,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,33133606,CDM,279,RC,,,,,,Inpatient,,,113.7,113.7,Wellcare,Wellcare,113.7,,,,,,,case rate,113.7,113.7,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES SM,33133633,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES SM,33133634,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES M ,33133635,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES M ,33133636,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER OPEN FINGER GLOVES LG,33133637,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health PPO CPD,Meritain Health PPO CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna/Commercial Product,Aetna/Commercial Product,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Meritain Health CPD,Meritain Health CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Starmark CPD,Starmark CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Aetna Medicare,Aetna Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Ambetter ,Ambetter ,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access,Anthem Blue Access,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Access Choice,Anthem Blue Access Choice,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Blue Preferred,Anthem Blue Preferred,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Pathway,Anthem Pathway,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Alliance,Anthem Alliance,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Anthem Medicare,Anthem Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna,Cigna,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna PPO,Cigna PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Cigna Medicare Advantage,Cigna Medicare Advantage,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Essence,Essence,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink HMO,Healthlink HMO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Healthlink PPO,Healthlink PPO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,HomeState Health Plan,HomeState Health Plan,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Humana Gold,Humana Gold,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medicaid MO,Medicaid MO,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Medica,Medica,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Tricare,Tricare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC All Payer,UHC All Payer,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Exchange,UHC Exchange,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicaid,UHC Medicaid,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UMR CPD,UMR CPD,38.19,,,,,,,per diem,38.19,38.19,"Per diem rate, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,UHC Medicare,UHC Medicare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
ISOTONER FULL FINGER GLOVES LG,33133638,CDM,270,RC,,,,,,Inpatient,,,38.19,38.19,Wellcare,Wellcare,38.19,,,,,,,case rate,38.19,38.19,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Meritain Health PPO CPD,Meritain Health PPO CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Aetna/Commercial Product,Aetna/Commercial Product,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Meritain Health CPD,Meritain Health CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Starmark CPD,Starmark CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Aetna Medicare,Aetna Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Ambetter ,Ambetter ,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Blue Access,Anthem Blue Access,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Blue Access Choice,Anthem Blue Access Choice,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Blue Preferred,Anthem Blue Preferred,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Pathway,Anthem Pathway,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Alliance,Anthem Alliance,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Anthem Medicare,Anthem Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Cigna,Cigna,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Cigna PPO,Cigna PPO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Cigna Medicare Advantage,Cigna Medicare Advantage,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Essence,Essence,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Healthlink HMO,Healthlink HMO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Healthlink PPO,Healthlink PPO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,HomeState Health Plan,HomeState Health Plan,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Humana Gold,Humana Gold,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Medicaid MO,Medicaid MO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Medica,Medica,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Tricare,Tricare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,UHC All Payer,UHC All Payer,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,UHC Exchange,UHC Exchange,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,UHC Medicaid,UHC Medicaid,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,UMR CPD,UMR CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,UHC Medicare,UHC Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE XL      ,33133639,CDM,270,RC,,,,,,Inpatient,,,61.53,61.53,Wellcare,Wellcare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Meritain Health PPO CPD,Meritain Health PPO CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna/Commercial Product,Aetna/Commercial Product,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Meritain Health CPD,Meritain Health CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Starmark CPD,Starmark CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna Medicare,Aetna Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Ambetter ,Ambetter ,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Access,Anthem Blue Access,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Access Choice,Anthem Blue Access Choice,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Preferred,Anthem Blue Preferred,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Pathway,Anthem Pathway,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Alliance,Anthem Alliance,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Medicare,Anthem Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna,Cigna,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna PPO,Cigna PPO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna Medicare Advantage,Cigna Medicare Advantage,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Essence,Essence,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthlink HMO,Healthlink HMO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthlink PPO,Healthlink PPO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,HomeState Health Plan,HomeState Health Plan,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Humana Gold,Humana Gold,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Medicaid MO,Medicaid MO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Medica,Medica,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Tricare,Tricare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC All Payer,UHC All Payer,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Exchange,UHC Exchange,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Medicaid,UHC Medicaid,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UMR CPD,UMR CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Medicare,UHC Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE LARGE   ,33133640,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Wellcare,Wellcare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Meritain Health PPO CPD,Meritain Health PPO CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna/Commercial Product,Aetna/Commercial Product,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Meritain Health CPD,Meritain Health CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Starmark CPD,Starmark CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Aetna Medicare,Aetna Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Ambetter ,Ambetter ,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Access,Anthem Blue Access,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Access Choice,Anthem Blue Access Choice,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Blue Preferred,Anthem Blue Preferred,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Pathway,Anthem Pathway,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Alliance,Anthem Alliance,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Anthem Medicare,Anthem Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna,Cigna,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna PPO,Cigna PPO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Cigna Medicare Advantage,Cigna Medicare Advantage,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Essence,Essence,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthlink HMO,Healthlink HMO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Healthlink PPO,Healthlink PPO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,HomeState Health Plan,HomeState Health Plan,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Humana Gold,Humana Gold,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Medicaid MO,Medicaid MO,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Medica,Medica,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Tricare,Tricare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC All Payer,UHC All Payer,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Exchange,UHC Exchange,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Medicaid,UHC Medicaid,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UMR CPD,UMR CPD,64.02,,,,,,,per diem,64.02,64.02,"Per diem rate, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,UHC Medicare,UHC Medicare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
HATCH PARA PUSH GLOVE SMALL   ,33133641,CDM,270,RC,,,,,,Inpatient,,,64.02,64.02,Wellcare,Wellcare,64.02,,,,,,,case rate,64.02,64.02,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health PPO CPD,Meritain Health PPO CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/Commercial Product,Aetna/Commercial Product,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health CPD,Meritain Health CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Starmark CPD,Starmark CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna Medicare,Aetna Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Ambetter ,Ambetter ,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access,Anthem Blue Access,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access Choice,Anthem Blue Access Choice,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Preferred,Anthem Blue Preferred,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Pathway,Anthem Pathway,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Alliance,Anthem Alliance,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Medicare,Anthem Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna,Cigna,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna PPO,Cigna PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna Medicare Advantage,Cigna Medicare Advantage,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Essence,Essence,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink HMO,Healthlink HMO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink PPO,Healthlink PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,HomeState Health Plan,HomeState Health Plan,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Humana Gold,Humana Gold,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medicaid MO,Medicaid MO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medica,Medica,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Tricare,Tricare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC All Payer,UHC All Payer,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Exchange,UHC Exchange,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicaid,UHC Medicaid,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UMR CPD,UMR CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicare,UHC Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT S/M          ,33133642,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Wellcare,Wellcare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health PPO CPD,Meritain Health PPO CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/Commercial Product,Aetna/Commercial Product,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health CPD,Meritain Health CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Starmark CPD,Starmark CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna Medicare,Aetna Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Ambetter ,Ambetter ,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access,Anthem Blue Access,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access Choice,Anthem Blue Access Choice,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Preferred,Anthem Blue Preferred,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Pathway,Anthem Pathway,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Alliance,Anthem Alliance,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Medicare,Anthem Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna,Cigna,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna PPO,Cigna PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna Medicare Advantage,Cigna Medicare Advantage,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Essence,Essence,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink HMO,Healthlink HMO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink PPO,Healthlink PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,HomeState Health Plan,HomeState Health Plan,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Humana Gold,Humana Gold,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medicaid MO,Medicaid MO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medica,Medica,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Tricare,Tricare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC All Payer,UHC All Payer,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Exchange,UHC Exchange,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicaid,UHC Medicaid,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UMR CPD,UMR CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicare,UHC Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT S/M         ,33133643,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Wellcare,Wellcare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health PPO CPD,Meritain Health PPO CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/Commercial Product,Aetna/Commercial Product,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health CPD,Meritain Health CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Starmark CPD,Starmark CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna Medicare,Aetna Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Ambetter ,Ambetter ,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access,Anthem Blue Access,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access Choice,Anthem Blue Access Choice,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Preferred,Anthem Blue Preferred,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Pathway,Anthem Pathway,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Alliance,Anthem Alliance,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Medicare,Anthem Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna,Cigna,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna PPO,Cigna PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna Medicare Advantage,Cigna Medicare Advantage,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Essence,Essence,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink HMO,Healthlink HMO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink PPO,Healthlink PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,HomeState Health Plan,HomeState Health Plan,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Humana Gold,Humana Gold,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medicaid MO,Medicaid MO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medica,Medica,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Tricare,Tricare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC All Payer,UHC All Payer,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Exchange,UHC Exchange,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicaid,UHC Medicaid,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UMR CPD,UMR CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicare,UHC Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE LEFT LG/XL        ,33133644,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Wellcare,Wellcare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health PPO CPD,Meritain Health PPO CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna/Commercial Product,Aetna/Commercial Product,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Meritain Health CPD,Meritain Health CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Starmark CPD,Starmark CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Aetna Medicare,Aetna Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Ambetter ,Ambetter ,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access,Anthem Blue Access,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Access Choice,Anthem Blue Access Choice,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Blue Preferred,Anthem Blue Preferred,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Pathway,Anthem Pathway,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Alliance,Anthem Alliance,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Anthem Medicare,Anthem Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna,Cigna,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna PPO,Cigna PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Cigna Medicare Advantage,Cigna Medicare Advantage,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Essence,Essence,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink HMO,Healthlink HMO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Healthlink PPO,Healthlink PPO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,HomeState Health Plan,HomeState Health Plan,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Humana Gold,Humana Gold,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medicaid MO,Medicaid MO,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Medica,Medica,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Tricare,Tricare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC All Payer,UHC All Payer,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Exchange,UHC Exchange,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicaid,UHC Medicaid,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UMR CPD,UMR CPD,46.38,,,,,,,per diem,46.38,46.38,"Per diem rate, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,UHC Medicare,UHC Medicare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
WRIST BRACE RIGHT LG/XL       ,33133645,CDM,270,RC,,,,,,Inpatient,,,46.38,46.38,Wellcare,Wellcare,46.38,,,,,,,case rate,46.38,46.38,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health PPO CPD,Meritain Health PPO CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/Commercial Product,Aetna/Commercial Product,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health CPD,Meritain Health CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Starmark CPD,Starmark CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna Medicare,Aetna Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Ambetter ,Ambetter ,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access,Anthem Blue Access,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access Choice,Anthem Blue Access Choice,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Preferred,Anthem Blue Preferred,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Pathway,Anthem Pathway,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Alliance,Anthem Alliance,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Medicare,Anthem Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna,Cigna,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna PPO,Cigna PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna Medicare Advantage,Cigna Medicare Advantage,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Essence,Essence,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink HMO,Healthlink HMO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink PPO,Healthlink PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,HomeState Health Plan,HomeState Health Plan,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Humana Gold,Humana Gold,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medicaid MO,Medicaid MO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medica,Medica,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Tricare,Tricare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC All Payer,UHC All Payer,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Exchange,UHC Exchange,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicaid,UHC Medicaid,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UMR CPD,UMR CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicare,UHC Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/M,33133650,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Wellcare,Wellcare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health PPO CPD,Meritain Health PPO CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/Commercial Product,Aetna/Commercial Product,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health CPD,Meritain Health CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Starmark CPD,Starmark CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna Medicare,Aetna Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Ambetter ,Ambetter ,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access,Anthem Blue Access,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access Choice,Anthem Blue Access Choice,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Preferred,Anthem Blue Preferred,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Pathway,Anthem Pathway,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Alliance,Anthem Alliance,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Medicare,Anthem Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna,Cigna,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna PPO,Cigna PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna Medicare Advantage,Cigna Medicare Advantage,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Essence,Essence,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink HMO,Healthlink HMO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink PPO,Healthlink PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,HomeState Health Plan,HomeState Health Plan,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Humana Gold,Humana Gold,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medicaid MO,Medicaid MO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medica,Medica,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Tricare,Tricare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC All Payer,UHC All Payer,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Exchange,UHC Exchange,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicaid,UHC Medicaid,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UMR CPD,UMR CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicare,UHC Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED ANTISPASTICITY LFT/L,33133651,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Wellcare,Wellcare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health PPO CPD,Meritain Health PPO CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/Commercial Product,Aetna/Commercial Product,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health CPD,Meritain Health CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Starmark CPD,Starmark CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna Medicare,Aetna Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Ambetter ,Ambetter ,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access,Anthem Blue Access,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access Choice,Anthem Blue Access Choice,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Preferred,Anthem Blue Preferred,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Pathway,Anthem Pathway,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Alliance,Anthem Alliance,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Medicare,Anthem Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna,Cigna,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna PPO,Cigna PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna Medicare Advantage,Cigna Medicare Advantage,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Essence,Essence,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink HMO,Healthlink HMO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink PPO,Healthlink PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,HomeState Health Plan,HomeState Health Plan,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Humana Gold,Humana Gold,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medicaid MO,Medicaid MO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medica,Medica,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Tricare,Tricare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC All Payer,UHC All Payer,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Exchange,UHC Exchange,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicaid,UHC Medicaid,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UMR CPD,UMR CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicare,UHC Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/MD,33133652,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Wellcare,Wellcare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health PPO CPD,Meritain Health PPO CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna/Commercial Product,Aetna/Commercial Product,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Meritain Health CPD,Meritain Health CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Starmark CPD,Starmark CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Aetna Medicare,Aetna Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Ambetter ,Ambetter ,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access,Anthem Blue Access,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Access Choice,Anthem Blue Access Choice,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Blue Preferred,Anthem Blue Preferred,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Pathway,Anthem Pathway,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Alliance,Anthem Alliance,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Anthem Medicare,Anthem Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna,Cigna,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna PPO,Cigna PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Cigna Medicare Advantage,Cigna Medicare Advantage,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Essence,Essence,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink HMO,Healthlink HMO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Healthlink PPO,Healthlink PPO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,HomeState Health Plan,HomeState Health Plan,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Humana Gold,Humana Gold,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medicaid MO,Medicaid MO,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Medica,Medica,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Tricare,Tricare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC All Payer,UHC All Payer,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Exchange,UHC Exchange,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicaid,UHC Medicaid,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UMR CPD,UMR CPD,113.82,,,,,,,per diem,113.82,113.82,"Per diem rate, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,UHC Medicare,UHC Medicare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
PREFORMED BALL SPLINT RIGHT/LG,33133653,CDM,270,RC,,,,,,Inpatient,,,113.82,113.82,Wellcare,Wellcare,113.82,,,,,,,case rate,113.82,113.82,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Meritain Health PPO CPD,Meritain Health PPO CPD,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Aetna/Commercial Product,Aetna/Commercial Product,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Meritain Health CPD,Meritain Health CPD,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Starmark CPD,Starmark CPD,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Aetna Medicare,Aetna Medicare,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Ambetter ,Ambetter ,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Blue Access,Anthem Blue Access,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Blue Access Choice,Anthem Blue Access Choice,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Blue Preferred,Anthem Blue Preferred,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Pathway,Anthem Pathway,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Alliance,Anthem Alliance,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Anthem Medicare,Anthem Medicare,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Cigna,Cigna,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Cigna PPO,Cigna PPO,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Cigna Medicare Advantage,Cigna Medicare Advantage,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Essence,Essence,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Healthlink HMO,Healthlink HMO,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Healthlink PPO,Healthlink PPO,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,HomeState Health Plan,HomeState Health Plan,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Humana Gold,Humana Gold,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Medicaid MO,Medicaid MO,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Medica,Medica,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Tricare,Tricare,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,UHC All Payer,UHC All Payer,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,UHC Exchange,UHC Exchange,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,UHC Medicaid,UHC Medicaid,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,UMR CPD,UMR CPD,16.62,,,,,,,per diem,16.62,16.62,"Per diem rate, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,UHC Medicare,UHC Medicare,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
BINDER 9IN 3 PANEL 30IN T     ,33136209,CDM,270,RC,,,,,,Inpatient,,,16.62,16.62,Wellcare,Wellcare,16.62,,,,,,,case rate,16.62,16.62,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Meritain Health PPO CPD,Meritain Health PPO CPD,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Aetna/Commercial Product,Aetna/Commercial Product,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Meritain Health CPD,Meritain Health CPD,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Starmark CPD,Starmark CPD,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Aetna Medicare,Aetna Medicare,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Ambetter ,Ambetter ,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Blue Access,Anthem Blue Access,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Blue Access Choice,Anthem Blue Access Choice,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Blue Preferred,Anthem Blue Preferred,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Pathway,Anthem Pathway,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Alliance,Anthem Alliance,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Anthem Medicare,Anthem Medicare,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Cigna,Cigna,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Cigna PPO,Cigna PPO,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Cigna Medicare Advantage,Cigna Medicare Advantage,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Essence,Essence,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Healthlink HMO,Healthlink HMO,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Healthlink PPO,Healthlink PPO,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,HomeState Health Plan,HomeState Health Plan,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Humana Gold,Humana Gold,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Medicaid MO,Medicaid MO,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Medica,Medica,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Tricare,Tricare,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,UHC All Payer,UHC All Payer,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,UHC Exchange,UHC Exchange,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,UHC Medicaid,UHC Medicaid,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,UMR CPD,UMR CPD,13.66,,,,,,,per diem,13.66,13.66,"Per diem rate, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,UHC Medicare,UHC Medicare,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
COLLAR CERV SERPENTINE MED    ,33136210,CDM,270,RC,,,,,,Inpatient,,,13.66,13.66,Wellcare,Wellcare,13.66,,,,,,,case rate,13.66,13.66,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Meritain Health PPO CPD,Meritain Health PPO CPD,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Aetna/Commercial Product,Aetna/Commercial Product,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Meritain Health CPD,Meritain Health CPD,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Starmark CPD,Starmark CPD,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Aetna Medicare,Aetna Medicare,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Ambetter ,Ambetter ,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Blue Access,Anthem Blue Access,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Blue Access Choice,Anthem Blue Access Choice,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Blue Preferred,Anthem Blue Preferred,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Pathway,Anthem Pathway,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Alliance,Anthem Alliance,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Anthem Medicare,Anthem Medicare,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Cigna,Cigna,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Cigna PPO,Cigna PPO,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Cigna Medicare Advantage,Cigna Medicare Advantage,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Essence,Essence,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Healthlink HMO,Healthlink HMO,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Healthlink PPO,Healthlink PPO,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,HomeState Health Plan,HomeState Health Plan,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Humana Gold,Humana Gold,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Medicaid MO,Medicaid MO,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Medica,Medica,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Tricare,Tricare,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,UHC All Payer,UHC All Payer,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,UHC Exchange,UHC Exchange,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,UHC Medicaid,UHC Medicaid,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,UMR CPD,UMR CPD,7.94,,,,,,,per diem,7.94,7.94,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,UHC Medicare,UHC Medicare,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL STANDARD ,33136223,CDM,270,RC,,,,,,Inpatient,,,7.94,7.94,Wellcare,Wellcare,7.94,,,,,,,case rate,7.94,7.94,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Meritain Health PPO CPD,Meritain Health PPO CPD,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Aetna/Commercial Product,Aetna/Commercial Product,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Meritain Health CPD,Meritain Health CPD,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Starmark CPD,Starmark CPD,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Aetna Medicare,Aetna Medicare,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Ambetter ,Ambetter ,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Blue Access,Anthem Blue Access,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Blue Access Choice,Anthem Blue Access Choice,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Blue Preferred,Anthem Blue Preferred,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Pathway,Anthem Pathway,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Alliance,Anthem Alliance,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Anthem Medicare,Anthem Medicare,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Cigna,Cigna,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Cigna PPO,Cigna PPO,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Cigna Medicare Advantage,Cigna Medicare Advantage,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Essence,Essence,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Healthlink HMO,Healthlink HMO,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Healthlink PPO,Healthlink PPO,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,HomeState Health Plan,HomeState Health Plan,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Humana Gold,Humana Gold,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Medicaid MO,Medicaid MO,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Medica,Medica,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Tricare,Tricare,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,UHC All Payer,UHC All Payer,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,UHC Exchange,UHC Exchange,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,UHC Medicaid,UHC Medicaid,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,UMR CPD,UMR CPD,5.36,,,,,,,per diem,5.36,5.36,"Per diem rate, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,UHC Medicare,UHC Medicare,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
SET FEED GRAVITY EASY FEED 100,33136262,CDM,279,RC,,,,,,Inpatient,,,5.36,5.36,Wellcare,Wellcare,5.36,,,,,,,case rate,5.36,5.36,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Meritain Health PPO CPD,Meritain Health PPO CPD,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Aetna/Commercial Product,Aetna/Commercial Product,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Meritain Health CPD,Meritain Health CPD,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Starmark CPD,Starmark CPD,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Aetna Medicare,Aetna Medicare,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Ambetter ,Ambetter ,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Blue Access,Anthem Blue Access,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Blue Access Choice,Anthem Blue Access Choice,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Blue Preferred,Anthem Blue Preferred,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Pathway,Anthem Pathway,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Alliance,Anthem Alliance,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Anthem Medicare,Anthem Medicare,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Cigna,Cigna,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Cigna PPO,Cigna PPO,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Cigna Medicare Advantage,Cigna Medicare Advantage,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Essence,Essence,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Healthlink HMO,Healthlink HMO,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Healthlink PPO,Healthlink PPO,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,HomeState Health Plan,HomeState Health Plan,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Humana Gold,Humana Gold,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Medicaid MO,Medicaid MO,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Medica,Medica,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Tricare,Tricare,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,UHC All Payer,UHC All Payer,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,UHC Exchange,UHC Exchange,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,UHC Medicaid,UHC Medicaid,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,UMR CPD,UMR CPD,113.19,,,,,,,per diem,113.19,113.19,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,UHC Medicare,UHC Medicare,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/G     ,33136276,CDM,279,RC,,,,,,Inpatient,,,113.19,113.19,Wellcare,Wellcare,113.19,,,,,,,case rate,113.19,113.19,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Meritain Health PPO CPD,Meritain Health PPO CPD,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Aetna/Commercial Product,Aetna/Commercial Product,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Meritain Health CPD,Meritain Health CPD,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Starmark CPD,Starmark CPD,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Aetna Medicare,Aetna Medicare,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Ambetter ,Ambetter ,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Blue Access,Anthem Blue Access,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Blue Access Choice,Anthem Blue Access Choice,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Blue Preferred,Anthem Blue Preferred,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Pathway,Anthem Pathway,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Alliance,Anthem Alliance,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Anthem Medicare,Anthem Medicare,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Cigna,Cigna,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Cigna PPO,Cigna PPO,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Cigna Medicare Advantage,Cigna Medicare Advantage,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Essence,Essence,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Healthlink HMO,Healthlink HMO,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Healthlink PPO,Healthlink PPO,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,HomeState Health Plan,HomeState Health Plan,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Humana Gold,Humana Gold,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Medicaid MO,Medicaid MO,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Medica,Medica,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Tricare,Tricare,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,UHC All Payer,UHC All Payer,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,UHC Exchange,UHC Exchange,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,UHC Medicaid,UHC Medicaid,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,UMR CPD,UMR CPD,148.1,,,,,,,per diem,148.1,148.1,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,UHC Medicare,UHC Medicare,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33136279,CDM,270,RC,,,,,,Inpatient,,,148.1,148.1,Wellcare,Wellcare,148.1,,,,,,,case rate,148.1,148.1,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Meritain Health PPO CPD,Meritain Health PPO CPD,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Aetna/Commercial Product,Aetna/Commercial Product,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Meritain Health CPD,Meritain Health CPD,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Starmark CPD,Starmark CPD,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Aetna Medicare,Aetna Medicare,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Ambetter ,Ambetter ,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Blue Access,Anthem Blue Access,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Blue Access Choice,Anthem Blue Access Choice,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Blue Preferred,Anthem Blue Preferred,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Pathway,Anthem Pathway,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Alliance,Anthem Alliance,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Anthem Medicare,Anthem Medicare,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Cigna,Cigna,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Cigna PPO,Cigna PPO,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Cigna Medicare Advantage,Cigna Medicare Advantage,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Essence,Essence,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Healthlink HMO,Healthlink HMO,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Healthlink PPO,Healthlink PPO,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,HomeState Health Plan,HomeState Health Plan,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Humana Gold,Humana Gold,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Medicaid MO,Medicaid MO,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Medica,Medica,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Tricare,Tricare,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,UHC All Payer,UHC All Payer,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,UHC Exchange,UHC Exchange,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,UHC Medicaid,UHC Medicaid,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,UMR CPD,UMR CPD,37.52,,,,,,,per diem,37.52,37.52,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,UHC Medicare,UHC Medicare,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33136303,CDM,270,RC,,,,,,Inpatient,,,37.52,37.52,Wellcare,Wellcare,37.52,,,,,,,case rate,37.52,37.52,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Meritain Health PPO CPD,Meritain Health PPO CPD,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Aetna/Commercial Product,Aetna/Commercial Product,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Meritain Health CPD,Meritain Health CPD,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Starmark CPD,Starmark CPD,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Aetna Medicare,Aetna Medicare,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Ambetter ,Ambetter ,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Blue Access,Anthem Blue Access,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Blue Access Choice,Anthem Blue Access Choice,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Blue Preferred,Anthem Blue Preferred,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Pathway,Anthem Pathway,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Alliance,Anthem Alliance,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Anthem Medicare,Anthem Medicare,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Cigna,Cigna,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Cigna PPO,Cigna PPO,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Cigna Medicare Advantage,Cigna Medicare Advantage,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Essence,Essence,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Healthlink HMO,Healthlink HMO,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Healthlink PPO,Healthlink PPO,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,HomeState Health Plan,HomeState Health Plan,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Humana Gold,Humana Gold,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Medicaid MO,Medicaid MO,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Medica,Medica,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Tricare,Tricare,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,UHC All Payer,UHC All Payer,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,UHC Exchange,UHC Exchange,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,UHC Medicaid,UHC Medicaid,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,UMR CPD,UMR CPD,96.92,,,,,,,per diem,96.92,96.92,"Per diem rate, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,UHC Medicare,UHC Medicare,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"COLLAR, ADULT REGULAR (ASPEN) ",33136341,CDM,270,RC,,,,,,Inpatient,,,96.92,96.92,Wellcare,Wellcare,96.92,,,,,,,case rate,96.92,96.92,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Meritain Health PPO CPD,Meritain Health PPO CPD,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Aetna/Commercial Product,Aetna/Commercial Product,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Meritain Health CPD,Meritain Health CPD,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Starmark CPD,Starmark CPD,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Aetna Medicare,Aetna Medicare,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Ambetter ,Ambetter ,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Blue Access,Anthem Blue Access,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Blue Access Choice,Anthem Blue Access Choice,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Blue Preferred,Anthem Blue Preferred,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Pathway,Anthem Pathway,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Alliance,Anthem Alliance,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Anthem Medicare,Anthem Medicare,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Cigna,Cigna,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Cigna PPO,Cigna PPO,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Cigna Medicare Advantage,Cigna Medicare Advantage,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Essence,Essence,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Healthlink HMO,Healthlink HMO,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Healthlink PPO,Healthlink PPO,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,HomeState Health Plan,HomeState Health Plan,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Humana Gold,Humana Gold,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Medicaid MO,Medicaid MO,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Medica,Medica,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Tricare,Tricare,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,UHC All Payer,UHC All Payer,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,UHC Exchange,UHC Exchange,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,UHC Medicaid,UHC Medicaid,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,UMR CPD,UMR CPD,67.72,,,,,,,per diem,67.72,67.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,UHC Medicare,UHC Medicare,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 15"" 55-72""   ",33136343,CDM,270,RC,,,,,,Inpatient,,,67.72,67.72,Wellcare,Wellcare,67.72,,,,,,,case rate,67.72,67.72,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Meritain Health PPO CPD,Meritain Health PPO CPD,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Aetna/Commercial Product,Aetna/Commercial Product,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Meritain Health CPD,Meritain Health CPD,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Starmark CPD,Starmark CPD,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Aetna Medicare,Aetna Medicare,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Ambetter ,Ambetter ,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Blue Access,Anthem Blue Access,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Blue Access Choice,Anthem Blue Access Choice,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Blue Preferred,Anthem Blue Preferred,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Pathway,Anthem Pathway,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Alliance,Anthem Alliance,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Anthem Medicare,Anthem Medicare,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Cigna,Cigna,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Cigna PPO,Cigna PPO,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Cigna Medicare Advantage,Cigna Medicare Advantage,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Essence,Essence,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Healthlink HMO,Healthlink HMO,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Healthlink PPO,Healthlink PPO,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,HomeState Health Plan,HomeState Health Plan,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Humana Gold,Humana Gold,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Medicaid MO,Medicaid MO,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Medica,Medica,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Tricare,Tricare,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,UHC All Payer,UHC All Payer,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,UHC Exchange,UHC Exchange,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,UHC Medicaid,UHC Medicaid,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,UMR CPD,UMR CPD,10.1,,,,,,,per diem,10.1,10.1,"Per diem rate, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,UHC Medicare,UHC Medicare,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
ARM SLING LRG                 ,33136352,CDM,270,RC,,,,,,Inpatient,,,10.1,10.1,Wellcare,Wellcare,10.1,,,,,,,case rate,10.1,10.1,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Meritain Health PPO CPD,Meritain Health PPO CPD,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Aetna/Commercial Product,Aetna/Commercial Product,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Meritain Health CPD,Meritain Health CPD,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Starmark CPD,Starmark CPD,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Aetna Medicare,Aetna Medicare,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Ambetter ,Ambetter ,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Blue Access,Anthem Blue Access,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Blue Access Choice,Anthem Blue Access Choice,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Blue Preferred,Anthem Blue Preferred,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Pathway,Anthem Pathway,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Alliance,Anthem Alliance,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Anthem Medicare,Anthem Medicare,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Cigna,Cigna,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Cigna PPO,Cigna PPO,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Cigna Medicare Advantage,Cigna Medicare Advantage,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Essence,Essence,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Healthlink HMO,Healthlink HMO,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Healthlink PPO,Healthlink PPO,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,HomeState Health Plan,HomeState Health Plan,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Humana Gold,Humana Gold,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Medicaid MO,Medicaid MO,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Medica,Medica,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Tricare,Tricare,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,UHC All Payer,UHC All Payer,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,UHC Exchange,UHC Exchange,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,UHC Medicaid,UHC Medicaid,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,UMR CPD,UMR CPD,58.49,,,,,,,per diem,58.49,58.49,"Per diem rate, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,UHC Medicare,UHC Medicare,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
KNEE BRACE ELEASTIC MUELL     ,33136360,CDM,270,RC,,,,,,Inpatient,,,58.49,58.49,Wellcare,Wellcare,58.49,,,,,,,case rate,58.49,58.49,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Meritain Health PPO CPD,Meritain Health PPO CPD,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Aetna/Commercial Product,Aetna/Commercial Product,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Meritain Health CPD,Meritain Health CPD,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Starmark CPD,Starmark CPD,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Aetna Medicare,Aetna Medicare,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Ambetter ,Ambetter ,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Blue Access,Anthem Blue Access,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Blue Access Choice,Anthem Blue Access Choice,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Blue Preferred,Anthem Blue Preferred,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Pathway,Anthem Pathway,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Alliance,Anthem Alliance,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Anthem Medicare,Anthem Medicare,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Cigna,Cigna,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Cigna PPO,Cigna PPO,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Cigna Medicare Advantage,Cigna Medicare Advantage,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Essence,Essence,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Healthlink HMO,Healthlink HMO,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Healthlink PPO,Healthlink PPO,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,HomeState Health Plan,HomeState Health Plan,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Humana Gold,Humana Gold,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Medicaid MO,Medicaid MO,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Medica,Medica,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Tricare,Tricare,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,UHC All Payer,UHC All Payer,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,UHC Exchange,UHC Exchange,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,UHC Medicaid,UHC Medicaid,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,UMR CPD,UMR CPD,286.72,,,,,,,per diem,286.72,286.72,"Per diem rate, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,UHC Medicare,UHC Medicare,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
SOFT SHELL HELMET 8OZ         ,33136442,CDM,270,RC,,,,,,Inpatient,,,286.72,286.72,Wellcare,Wellcare,286.72,,,,,,,case rate,286.72,286.72,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health PPO CPD,Meritain Health PPO CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/Commercial Product,Aetna/Commercial Product,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health CPD,Meritain Health CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Starmark CPD,Starmark CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna Medicare,Aetna Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Ambetter ,Ambetter ,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access,Anthem Blue Access,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access Choice,Anthem Blue Access Choice,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Preferred,Anthem Blue Preferred,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Pathway,Anthem Pathway,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Alliance,Anthem Alliance,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Medicare,Anthem Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna,Cigna,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna PPO,Cigna PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna Medicare Advantage,Cigna Medicare Advantage,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Essence,Essence,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink HMO,Healthlink HMO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink PPO,Healthlink PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,HomeState Health Plan,HomeState Health Plan,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Humana Gold,Humana Gold,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medicaid MO,Medicaid MO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medica,Medica,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Tricare,Tricare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC All Payer,UHC All Payer,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Exchange,UHC Exchange,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicaid,UHC Medicaid,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UMR CPD,UMR CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicare,UHC Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33136451,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Wellcare,Wellcare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Meritain Health PPO CPD,Meritain Health PPO CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna/Commercial Product,Aetna/Commercial Product,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Meritain Health CPD,Meritain Health CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Starmark CPD,Starmark CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna Medicare,Aetna Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Ambetter ,Ambetter ,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Access,Anthem Blue Access,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Access Choice,Anthem Blue Access Choice,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Preferred,Anthem Blue Preferred,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Pathway,Anthem Pathway,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Alliance,Anthem Alliance,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Medicare,Anthem Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna,Cigna,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna PPO,Cigna PPO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna Medicare Advantage,Cigna Medicare Advantage,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Essence,Essence,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthlink HMO,Healthlink HMO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthlink PPO,Healthlink PPO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,HomeState Health Plan,HomeState Health Plan,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Humana Gold,Humana Gold,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Medicaid MO,Medicaid MO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Medica,Medica,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Tricare,Tricare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC All Payer,UHC All Payer,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Exchange,UHC Exchange,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Medicaid,UHC Medicaid,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UMR CPD,UMR CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Medicare,UHC Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33136452,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Wellcare,Wellcare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Meritain Health PPO CPD,Meritain Health PPO CPD,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Aetna/Commercial Product,Aetna/Commercial Product,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Meritain Health CPD,Meritain Health CPD,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Starmark CPD,Starmark CPD,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Aetna Medicare,Aetna Medicare,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Ambetter ,Ambetter ,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Blue Access,Anthem Blue Access,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Blue Access Choice,Anthem Blue Access Choice,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Blue Preferred,Anthem Blue Preferred,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Pathway,Anthem Pathway,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Alliance,Anthem Alliance,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Anthem Medicare,Anthem Medicare,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Cigna,Cigna,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Cigna PPO,Cigna PPO,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Cigna Medicare Advantage,Cigna Medicare Advantage,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Essence,Essence,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Healthlink HMO,Healthlink HMO,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Healthlink PPO,Healthlink PPO,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,HomeState Health Plan,HomeState Health Plan,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Humana Gold,Humana Gold,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Medicaid MO,Medicaid MO,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Medica,Medica,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Tricare,Tricare,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,UHC All Payer,UHC All Payer,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,UHC Exchange,UHC Exchange,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,UHC Medicaid,UHC Medicaid,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,UMR CPD,UMR CPD,26.19,,,,,,,per diem,26.19,26.19,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,UHC Medicare,UHC Medicare,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE (700lb)     ,33136453,CDM,279,RC,,,,,,Inpatient,,,26.19,26.19,Wellcare,Wellcare,26.19,,,,,,,case rate,26.19,26.19,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Meritain Health PPO CPD,Meritain Health PPO CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Aetna/Commercial Product,Aetna/Commercial Product,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Meritain Health CPD,Meritain Health CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Starmark CPD,Starmark CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Aetna Medicare,Aetna Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Ambetter ,Ambetter ,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Blue Access,Anthem Blue Access,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Blue Access Choice,Anthem Blue Access Choice,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Blue Preferred,Anthem Blue Preferred,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Pathway,Anthem Pathway,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Alliance,Anthem Alliance,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Anthem Medicare,Anthem Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Cigna,Cigna,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Cigna PPO,Cigna PPO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Cigna Medicare Advantage,Cigna Medicare Advantage,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Essence,Essence,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Healthlink HMO,Healthlink HMO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Healthlink PPO,Healthlink PPO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,HomeState Health Plan,HomeState Health Plan,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Humana Gold,Humana Gold,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Medicaid MO,Medicaid MO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Medica,Medica,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Tricare,Tricare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,UHC All Payer,UHC All Payer,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,UHC Exchange,UHC Exchange,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,UHC Medicaid,UHC Medicaid,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,UMR CPD,UMR CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,UHC Medicare,UHC Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33136454,CDM,279,RC,,,,,,Inpatient,,,133.39,133.39,Wellcare,Wellcare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Meritain Health PPO CPD,Meritain Health PPO CPD,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Aetna/Commercial Product,Aetna/Commercial Product,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Meritain Health CPD,Meritain Health CPD,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Starmark CPD,Starmark CPD,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Aetna Medicare,Aetna Medicare,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Ambetter ,Ambetter ,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Blue Access,Anthem Blue Access,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Blue Access Choice,Anthem Blue Access Choice,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Blue Preferred,Anthem Blue Preferred,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Pathway,Anthem Pathway,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Alliance,Anthem Alliance,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Anthem Medicare,Anthem Medicare,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Cigna,Cigna,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Cigna PPO,Cigna PPO,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Cigna Medicare Advantage,Cigna Medicare Advantage,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Essence,Essence,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Healthlink HMO,Healthlink HMO,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Healthlink PPO,Healthlink PPO,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,HomeState Health Plan,HomeState Health Plan,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Humana Gold,Humana Gold,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Medicaid MO,Medicaid MO,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Medica,Medica,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Tricare,Tricare,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,UHC All Payer,UHC All Payer,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,UHC Exchange,UHC Exchange,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,UHC Medicaid,UHC Medicaid,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,UMR CPD,UMR CPD,77.77,,,,,,,per diem,77.77,77.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,UHC Medicare,UHC Medicare,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33136455,CDM,279,RC,,,,,,Inpatient,,,77.77,77.77,Wellcare,Wellcare,77.77,,,,,,,case rate,77.77,77.77,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health PPO CPD,Meritain Health PPO CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/Commercial Product,Aetna/Commercial Product,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health CPD,Meritain Health CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Starmark CPD,Starmark CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna Medicare,Aetna Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Ambetter ,Ambetter ,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access,Anthem Blue Access,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access Choice,Anthem Blue Access Choice,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Preferred,Anthem Blue Preferred,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Pathway,Anthem Pathway,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Alliance,Anthem Alliance,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Medicare,Anthem Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna,Cigna,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna PPO,Cigna PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna Medicare Advantage,Cigna Medicare Advantage,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Essence,Essence,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink HMO,Healthlink HMO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink PPO,Healthlink PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,HomeState Health Plan,HomeState Health Plan,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Humana Gold,Humana Gold,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medicaid MO,Medicaid MO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medica,Medica,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Tricare,Tricare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC All Payer,UHC All Payer,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Exchange,UHC Exchange,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicaid,UHC Medicaid,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UMR CPD,UMR CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicare,UHC Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33136456,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Wellcare,Wellcare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Meritain Health PPO CPD,Meritain Health PPO CPD,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Aetna/Commercial Product,Aetna/Commercial Product,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Meritain Health CPD,Meritain Health CPD,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Starmark CPD,Starmark CPD,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Aetna Medicare,Aetna Medicare,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Ambetter ,Ambetter ,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Blue Access,Anthem Blue Access,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Blue Access Choice,Anthem Blue Access Choice,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Blue Preferred,Anthem Blue Preferred,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Pathway,Anthem Pathway,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Alliance,Anthem Alliance,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Anthem Medicare,Anthem Medicare,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Cigna,Cigna,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Cigna PPO,Cigna PPO,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Cigna Medicare Advantage,Cigna Medicare Advantage,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Essence,Essence,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Healthlink HMO,Healthlink HMO,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Healthlink PPO,Healthlink PPO,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,HomeState Health Plan,HomeState Health Plan,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Humana Gold,Humana Gold,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Medicaid MO,Medicaid MO,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Medica,Medica,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Tricare,Tricare,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,UHC All Payer,UHC All Payer,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,UHC Exchange,UHC Exchange,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,UHC Medicaid,UHC Medicaid,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,UMR CPD,UMR CPD,157.08,,,,,,,per diem,157.08,157.08,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,UHC Medicare,UHC Medicare,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33136457,CDM,279,RC,,,,,,Inpatient,,,157.08,157.08,Wellcare,Wellcare,157.08,,,,,,,case rate,157.08,157.08,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Meritain Health PPO CPD,Meritain Health PPO CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna/Commercial Product,Aetna/Commercial Product,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Meritain Health CPD,Meritain Health CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Starmark CPD,Starmark CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna Medicare,Aetna Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Ambetter ,Ambetter ,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Access,Anthem Blue Access,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Access Choice,Anthem Blue Access Choice,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Preferred,Anthem Blue Preferred,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Pathway,Anthem Pathway,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Alliance,Anthem Alliance,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Medicare,Anthem Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna,Cigna,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna PPO,Cigna PPO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna Medicare Advantage,Cigna Medicare Advantage,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Essence,Essence,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthlink HMO,Healthlink HMO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthlink PPO,Healthlink PPO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,HomeState Health Plan,HomeState Health Plan,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Humana Gold,Humana Gold,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Medicaid MO,Medicaid MO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Medica,Medica,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Tricare,Tricare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC All Payer,UHC All Payer,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Exchange,UHC Exchange,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Medicaid,UHC Medicaid,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UMR CPD,UMR CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Medicare,UHC Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33136458,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Wellcare,Wellcare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Meritain Health PPO CPD,Meritain Health PPO CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna/Commercial Product,Aetna/Commercial Product,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Meritain Health CPD,Meritain Health CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Starmark CPD,Starmark CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Aetna Medicare,Aetna Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Ambetter ,Ambetter ,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Access,Anthem Blue Access,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Access Choice,Anthem Blue Access Choice,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Blue Preferred,Anthem Blue Preferred,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Pathway,Anthem Pathway,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Alliance,Anthem Alliance,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Anthem Medicare,Anthem Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna,Cigna,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna PPO,Cigna PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Cigna Medicare Advantage,Cigna Medicare Advantage,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Essence,Essence,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthlink HMO,Healthlink HMO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Healthlink PPO,Healthlink PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,HomeState Health Plan,HomeState Health Plan,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Humana Gold,Humana Gold,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Medicaid MO,Medicaid MO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Medica,Medica,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Tricare,Tricare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC All Payer,UHC All Payer,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Exchange,UHC Exchange,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Medicaid,UHC Medicaid,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UMR CPD,UMR CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,UHC Medicare,UHC Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4      ,33136459,CDM,279,RC,,,,,,Inpatient,,,12.36,12.36,Wellcare,Wellcare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Meritain Health PPO CPD,Meritain Health PPO CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna/Commercial Product,Aetna/Commercial Product,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Meritain Health CPD,Meritain Health CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Starmark CPD,Starmark CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Aetna Medicare,Aetna Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Ambetter ,Ambetter ,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Access,Anthem Blue Access,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Access Choice,Anthem Blue Access Choice,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Blue Preferred,Anthem Blue Preferred,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Pathway,Anthem Pathway,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Alliance,Anthem Alliance,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Anthem Medicare,Anthem Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna,Cigna,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna PPO,Cigna PPO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Cigna Medicare Advantage,Cigna Medicare Advantage,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Essence,Essence,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthlink HMO,Healthlink HMO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Healthlink PPO,Healthlink PPO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,HomeState Health Plan,HomeState Health Plan,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Humana Gold,Humana Gold,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Medicaid MO,Medicaid MO,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Medica,Medica,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Tricare,Tricare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC All Payer,UHC All Payer,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Exchange,UHC Exchange,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Medicaid,UHC Medicaid,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UMR CPD,UMR CPD,99.91,,,,,,,per diem,99.91,99.91,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,UHC Medicare,UHC Medicare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33136460,CDM,279,RC,,,,,,Inpatient,,,99.91,99.91,Wellcare,Wellcare,99.91,,,,,,,case rate,99.91,99.91,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health PPO CPD,Meritain Health PPO CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/Commercial Product,Aetna/Commercial Product,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health CPD,Meritain Health CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Starmark CPD,Starmark CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna Medicare,Aetna Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Ambetter ,Ambetter ,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access,Anthem Blue Access,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access Choice,Anthem Blue Access Choice,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Preferred,Anthem Blue Preferred,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Pathway,Anthem Pathway,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Alliance,Anthem Alliance,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Medicare,Anthem Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna,Cigna,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna PPO,Cigna PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna Medicare Advantage,Cigna Medicare Advantage,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Essence,Essence,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink HMO,Healthlink HMO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink PPO,Healthlink PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,HomeState Health Plan,HomeState Health Plan,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Humana Gold,Humana Gold,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medicaid MO,Medicaid MO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medica,Medica,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Tricare,Tricare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC All Payer,UHC All Payer,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Exchange,UHC Exchange,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicaid,UHC Medicaid,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UMR CPD,UMR CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicare,UHC Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33136461,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Wellcare,Wellcare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health PPO CPD,Meritain Health PPO CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/Commercial Product,Aetna/Commercial Product,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health CPD,Meritain Health CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Starmark CPD,Starmark CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Aetna Medicare,Aetna Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Ambetter ,Ambetter ,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access,Anthem Blue Access,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access Choice,Anthem Blue Access Choice,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Preferred,Anthem Blue Preferred,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Pathway,Anthem Pathway,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Alliance,Anthem Alliance,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Medicare,Anthem Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna,Cigna,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna PPO,Cigna PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Cigna Medicare Advantage,Cigna Medicare Advantage,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Essence,Essence,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink HMO,Healthlink HMO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink PPO,Healthlink PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,HomeState Health Plan,HomeState Health Plan,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Humana Gold,Humana Gold,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Medicaid MO,Medicaid MO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Medica,Medica,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Tricare,Tricare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC All Payer,UHC All Payer,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Exchange,UHC Exchange,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicaid,UHC Medicaid,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UMR CPD,UMR CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicare,UHC Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33136462,CDM,279,RC,,,,,,Inpatient,,,94.25,94.25,Wellcare,Wellcare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Meritain Health PPO CPD,Meritain Health PPO CPD,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Aetna/Commercial Product,Aetna/Commercial Product,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Meritain Health CPD,Meritain Health CPD,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Starmark CPD,Starmark CPD,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Aetna Medicare,Aetna Medicare,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Ambetter ,Ambetter ,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Blue Access,Anthem Blue Access,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Blue Access Choice,Anthem Blue Access Choice,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Blue Preferred,Anthem Blue Preferred,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Pathway,Anthem Pathway,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Alliance,Anthem Alliance,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Anthem Medicare,Anthem Medicare,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Cigna,Cigna,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Cigna PPO,Cigna PPO,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Cigna Medicare Advantage,Cigna Medicare Advantage,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Essence,Essence,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Healthlink HMO,Healthlink HMO,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Healthlink PPO,Healthlink PPO,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,HomeState Health Plan,HomeState Health Plan,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Humana Gold,Humana Gold,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Medicaid MO,Medicaid MO,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Medica,Medica,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Tricare,Tricare,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,UHC All Payer,UHC All Payer,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,UHC Exchange,UHC Exchange,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,UHC Medicaid,UHC Medicaid,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,UMR CPD,UMR CPD,89.1,,,,,,,per diem,89.1,89.1,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,UHC Medicare,UHC Medicare,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33136463,CDM,279,RC,,,,,,Inpatient,,,89.1,89.1,Wellcare,Wellcare,89.1,,,,,,,case rate,89.1,89.1,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Meritain Health PPO CPD,Meritain Health PPO CPD,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Aetna/Commercial Product,Aetna/Commercial Product,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Meritain Health CPD,Meritain Health CPD,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Starmark CPD,Starmark CPD,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Aetna Medicare,Aetna Medicare,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Ambetter ,Ambetter ,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Blue Access,Anthem Blue Access,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Blue Access Choice,Anthem Blue Access Choice,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Blue Preferred,Anthem Blue Preferred,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Pathway,Anthem Pathway,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Alliance,Anthem Alliance,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Anthem Medicare,Anthem Medicare,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Cigna,Cigna,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Cigna PPO,Cigna PPO,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Cigna Medicare Advantage,Cigna Medicare Advantage,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Essence,Essence,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Healthlink HMO,Healthlink HMO,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Healthlink PPO,Healthlink PPO,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,HomeState Health Plan,HomeState Health Plan,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Humana Gold,Humana Gold,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Medicaid MO,Medicaid MO,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Medica,Medica,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Tricare,Tricare,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,UHC All Payer,UHC All Payer,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,UHC Exchange,UHC Exchange,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,UHC Medicaid,UHC Medicaid,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,UMR CPD,UMR CPD,188.49,,,,,,,per diem,188.49,188.49,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,UHC Medicare,UHC Medicare,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33136464,CDM,279,RC,,,,,,Inpatient,,,188.49,188.49,Wellcare,Wellcare,188.49,,,,,,,case rate,188.49,188.49,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health PPO CPD,Meritain Health PPO CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/Commercial Product,Aetna/Commercial Product,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health CPD,Meritain Health CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Starmark CPD,Starmark CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna Medicare,Aetna Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Ambetter ,Ambetter ,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access,Anthem Blue Access,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access Choice,Anthem Blue Access Choice,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Preferred,Anthem Blue Preferred,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Pathway,Anthem Pathway,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Alliance,Anthem Alliance,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Medicare,Anthem Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna,Cigna,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna PPO,Cigna PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna Medicare Advantage,Cigna Medicare Advantage,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Essence,Essence,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink HMO,Healthlink HMO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink PPO,Healthlink PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,HomeState Health Plan,HomeState Health Plan,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Humana Gold,Humana Gold,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Medicaid MO,Medicaid MO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Medica,Medica,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Tricare,Tricare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC All Payer,UHC All Payer,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Exchange,UHC Exchange,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicaid,UHC Medicaid,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UMR CPD,UMR CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicare,UHC Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFR     ,33136465,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Wellcare,Wellcare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Meritain Health PPO CPD,Meritain Health PPO CPD,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Aetna/Commercial Product,Aetna/Commercial Product,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Meritain Health CPD,Meritain Health CPD,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Starmark CPD,Starmark CPD,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Aetna Medicare,Aetna Medicare,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Ambetter ,Ambetter ,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Blue Access,Anthem Blue Access,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Blue Access Choice,Anthem Blue Access Choice,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Blue Preferred,Anthem Blue Preferred,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Pathway,Anthem Pathway,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Alliance,Anthem Alliance,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Anthem Medicare,Anthem Medicare,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Cigna,Cigna,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Cigna PPO,Cigna PPO,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Cigna Medicare Advantage,Cigna Medicare Advantage,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Essence,Essence,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Healthlink HMO,Healthlink HMO,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Healthlink PPO,Healthlink PPO,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,HomeState Health Plan,HomeState Health Plan,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Humana Gold,Humana Gold,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Medicaid MO,Medicaid MO,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Medica,Medica,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Tricare,Tricare,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,UHC All Payer,UHC All Payer,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,UHC Exchange,UHC Exchange,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,UHC Medicaid,UHC Medicaid,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,UMR CPD,UMR CPD,22.15,,,,,,,per diem,22.15,22.15,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,UHC Medicare,UHC Medicare,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33136466,CDM,279,RC,,,,,,Inpatient,,,22.15,22.15,Wellcare,Wellcare,22.15,,,,,,,case rate,22.15,22.15,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health PPO CPD,Meritain Health PPO CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/Commercial Product,Aetna/Commercial Product,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health CPD,Meritain Health CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Starmark CPD,Starmark CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna Medicare,Aetna Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Ambetter ,Ambetter ,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access,Anthem Blue Access,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access Choice,Anthem Blue Access Choice,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Preferred,Anthem Blue Preferred,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Pathway,Anthem Pathway,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Alliance,Anthem Alliance,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Medicare,Anthem Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna,Cigna,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna PPO,Cigna PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna Medicare Advantage,Cigna Medicare Advantage,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Essence,Essence,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink HMO,Healthlink HMO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink PPO,Healthlink PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,HomeState Health Plan,HomeState Health Plan,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Humana Gold,Humana Gold,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Medicaid MO,Medicaid MO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Medica,Medica,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Tricare,Tricare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC All Payer,UHC All Payer,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Exchange,UHC Exchange,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicaid,UHC Medicaid,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UMR CPD,UMR CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicare,UHC Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER      ,33136467,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Wellcare,Wellcare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health PPO CPD,Meritain Health PPO CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/Commercial Product,Aetna/Commercial Product,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health CPD,Meritain Health CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Starmark CPD,Starmark CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna Medicare,Aetna Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Ambetter ,Ambetter ,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access,Anthem Blue Access,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access Choice,Anthem Blue Access Choice,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Preferred,Anthem Blue Preferred,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Pathway,Anthem Pathway,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Alliance,Anthem Alliance,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Medicare,Anthem Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna,Cigna,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna PPO,Cigna PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna Medicare Advantage,Cigna Medicare Advantage,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Essence,Essence,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink HMO,Healthlink HMO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink PPO,Healthlink PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,HomeState Health Plan,HomeState Health Plan,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Humana Gold,Humana Gold,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medicaid MO,Medicaid MO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medica,Medica,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Tricare,Tricare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC All Payer,UHC All Payer,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Exchange,UHC Exchange,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicaid,UHC Medicaid,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UMR CPD,UMR CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicare,UHC Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33136468,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Wellcare,Wellcare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health PPO CPD,Meritain Health PPO CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/Commercial Product,Aetna/Commercial Product,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health CPD,Meritain Health CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Starmark CPD,Starmark CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Aetna Medicare,Aetna Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Ambetter ,Ambetter ,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access,Anthem Blue Access,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access Choice,Anthem Blue Access Choice,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Preferred,Anthem Blue Preferred,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Pathway,Anthem Pathway,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Alliance,Anthem Alliance,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Medicare,Anthem Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna,Cigna,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna PPO,Cigna PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Cigna Medicare Advantage,Cigna Medicare Advantage,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Essence,Essence,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink HMO,Healthlink HMO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink PPO,Healthlink PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,HomeState Health Plan,HomeState Health Plan,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Humana Gold,Humana Gold,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Medicaid MO,Medicaid MO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Medica,Medica,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Tricare,Tricare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC All Payer,UHC All Payer,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Exchange,UHC Exchange,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicaid,UHC Medicaid,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UMR CPD,UMR CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicare,UHC Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33136469,CDM,279,RC,,,,,,Inpatient,,,53.56,53.56,Wellcare,Wellcare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Meritain Health PPO CPD,Meritain Health PPO CPD,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Aetna/Commercial Product,Aetna/Commercial Product,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Meritain Health CPD,Meritain Health CPD,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Starmark CPD,Starmark CPD,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Aetna Medicare,Aetna Medicare,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Ambetter ,Ambetter ,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Blue Access,Anthem Blue Access,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Blue Access Choice,Anthem Blue Access Choice,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Blue Preferred,Anthem Blue Preferred,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Pathway,Anthem Pathway,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Alliance,Anthem Alliance,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Anthem Medicare,Anthem Medicare,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Cigna,Cigna,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Cigna PPO,Cigna PPO,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Cigna Medicare Advantage,Cigna Medicare Advantage,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Essence,Essence,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Healthlink HMO,Healthlink HMO,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Healthlink PPO,Healthlink PPO,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,HomeState Health Plan,HomeState Health Plan,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Humana Gold,Humana Gold,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Medicaid MO,Medicaid MO,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Medica,Medica,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Tricare,Tricare,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,UHC All Payer,UHC All Payer,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,UHC Exchange,UHC Exchange,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,UHC Medicaid,UHC Medicaid,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,UMR CPD,UMR CPD,166.86,,,,,,,per diem,166.86,166.86,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,UHC Medicare,UHC Medicare,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33136472,CDM,279,RC,,,,,,Inpatient,,,166.86,166.86,Wellcare,Wellcare,166.86,,,,,,,case rate,166.86,166.86,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health PPO CPD,Meritain Health PPO CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/Commercial Product,Aetna/Commercial Product,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health CPD,Meritain Health CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Starmark CPD,Starmark CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna Medicare,Aetna Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Ambetter ,Ambetter ,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access,Anthem Blue Access,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access Choice,Anthem Blue Access Choice,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Preferred,Anthem Blue Preferred,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Pathway,Anthem Pathway,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Alliance,Anthem Alliance,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Medicare,Anthem Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna,Cigna,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna PPO,Cigna PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna Medicare Advantage,Cigna Medicare Advantage,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Essence,Essence,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink HMO,Healthlink HMO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink PPO,Healthlink PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,HomeState Health Plan,HomeState Health Plan,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Humana Gold,Humana Gold,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medicaid MO,Medicaid MO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medica,Medica,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Tricare,Tricare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC All Payer,UHC All Payer,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Exchange,UHC Exchange,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicaid,UHC Medicaid,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UMR CPD,UMR CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicare,UHC Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33136473,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Wellcare,Wellcare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Meritain Health PPO CPD,Meritain Health PPO CPD,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Aetna/Commercial Product,Aetna/Commercial Product,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Meritain Health CPD,Meritain Health CPD,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Starmark CPD,Starmark CPD,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Aetna Medicare,Aetna Medicare,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Ambetter ,Ambetter ,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Blue Access,Anthem Blue Access,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Blue Access Choice,Anthem Blue Access Choice,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Blue Preferred,Anthem Blue Preferred,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Pathway,Anthem Pathway,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Alliance,Anthem Alliance,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Anthem Medicare,Anthem Medicare,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Cigna,Cigna,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Cigna PPO,Cigna PPO,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Cigna Medicare Advantage,Cigna Medicare Advantage,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Essence,Essence,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Healthlink HMO,Healthlink HMO,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Healthlink PPO,Healthlink PPO,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,HomeState Health Plan,HomeState Health Plan,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Humana Gold,Humana Gold,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Medicaid MO,Medicaid MO,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Medica,Medica,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Tricare,Tricare,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,UHC All Payer,UHC All Payer,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,UHC Exchange,UHC Exchange,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,UHC Medicaid,UHC Medicaid,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,UMR CPD,UMR CPD,18.03,,,,,,,per diem,18.03,18.03,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,UHC Medicare,UHC Medicare,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33136474,CDM,279,RC,,,,,,Inpatient,,,18.03,18.03,Wellcare,Wellcare,18.03,,,,,,,case rate,18.03,18.03,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health PPO CPD,Meritain Health PPO CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/Commercial Product,Aetna/Commercial Product,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health CPD,Meritain Health CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Starmark CPD,Starmark CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna Medicare,Aetna Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Ambetter ,Ambetter ,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access,Anthem Blue Access,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access Choice,Anthem Blue Access Choice,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Preferred,Anthem Blue Preferred,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Pathway,Anthem Pathway,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Alliance,Anthem Alliance,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Medicare,Anthem Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna,Cigna,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna PPO,Cigna PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna Medicare Advantage,Cigna Medicare Advantage,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Essence,Essence,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink HMO,Healthlink HMO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink PPO,Healthlink PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,HomeState Health Plan,HomeState Health Plan,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Humana Gold,Humana Gold,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Medicaid MO,Medicaid MO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Medica,Medica,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Tricare,Tricare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC All Payer,UHC All Payer,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Exchange,UHC Exchange,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicaid,UHC Medicaid,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UMR CPD,UMR CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicare,UHC Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33136475,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Wellcare,Wellcare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Meritain Health PPO CPD,Meritain Health PPO CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Aetna/Commercial Product,Aetna/Commercial Product,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Meritain Health CPD,Meritain Health CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Starmark CPD,Starmark CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Aetna Medicare,Aetna Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Ambetter ,Ambetter ,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Access,Anthem Blue Access,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Access Choice,Anthem Blue Access Choice,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Preferred,Anthem Blue Preferred,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Pathway,Anthem Pathway,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Alliance,Anthem Alliance,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Medicare,Anthem Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Cigna,Cigna,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Cigna PPO,Cigna PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Cigna Medicare Advantage,Cigna Medicare Advantage,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Essence,Essence,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Healthlink HMO,Healthlink HMO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Healthlink PPO,Healthlink PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,HomeState Health Plan,HomeState Health Plan,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Humana Gold,Humana Gold,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Medicaid MO,Medicaid MO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Medica,Medica,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Tricare,Tricare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,UHC All Payer,UHC All Payer,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,UHC Exchange,UHC Exchange,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,UHC Medicaid,UHC Medicaid,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,UMR CPD,UMR CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,UHC Medicare,UHC Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33136477,CDM,279,RC,,,,,,Inpatient,,,7.21,7.21,Wellcare,Wellcare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Meritain Health PPO CPD,Meritain Health PPO CPD,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Aetna/Commercial Product,Aetna/Commercial Product,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Meritain Health CPD,Meritain Health CPD,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Starmark CPD,Starmark CPD,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Aetna Medicare,Aetna Medicare,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Ambetter ,Ambetter ,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Blue Access,Anthem Blue Access,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Blue Access Choice,Anthem Blue Access Choice,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Blue Preferred,Anthem Blue Preferred,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Pathway,Anthem Pathway,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Alliance,Anthem Alliance,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Anthem Medicare,Anthem Medicare,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Cigna,Cigna,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Cigna PPO,Cigna PPO,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Cigna Medicare Advantage,Cigna Medicare Advantage,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Essence,Essence,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Healthlink HMO,Healthlink HMO,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Healthlink PPO,Healthlink PPO,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,HomeState Health Plan,HomeState Health Plan,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Humana Gold,Humana Gold,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Medicaid MO,Medicaid MO,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Medica,Medica,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Tricare,Tricare,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,UHC All Payer,UHC All Payer,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,UHC Exchange,UHC Exchange,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,UHC Medicaid,UHC Medicaid,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,UMR CPD,UMR CPD,171.5,,,,,,,per diem,171.5,171.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,UHC Medicare,UHC Medicare,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE      ,33136478,CDM,279,RC,,,,,,Inpatient,,,171.5,171.5,Wellcare,Wellcare,171.5,,,,,,,case rate,171.5,171.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Meritain Health PPO CPD,Meritain Health PPO CPD,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Aetna/Commercial Product,Aetna/Commercial Product,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Meritain Health CPD,Meritain Health CPD,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Starmark CPD,Starmark CPD,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Aetna Medicare,Aetna Medicare,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Ambetter ,Ambetter ,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Blue Access,Anthem Blue Access,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Blue Access Choice,Anthem Blue Access Choice,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Blue Preferred,Anthem Blue Preferred,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Pathway,Anthem Pathway,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Alliance,Anthem Alliance,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Anthem Medicare,Anthem Medicare,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Cigna,Cigna,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Cigna PPO,Cigna PPO,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Cigna Medicare Advantage,Cigna Medicare Advantage,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Essence,Essence,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Healthlink HMO,Healthlink HMO,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Healthlink PPO,Healthlink PPO,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,HomeState Health Plan,HomeState Health Plan,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Humana Gold,Humana Gold,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Medicaid MO,Medicaid MO,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Medica,Medica,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Tricare,Tricare,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,UHC All Payer,UHC All Payer,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,UHC Exchange,UHC Exchange,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,UHC Medicaid,UHC Medicaid,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,UMR CPD,UMR CPD,74.42,,,,,,,per diem,74.42,74.42,"Per diem rate, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,UHC Medicare,UHC Medicare,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
SIZE WISE PULSE AIR MATTRESS  ,33136479,CDM,279,RC,,,,,,Inpatient,,,74.42,74.42,Wellcare,Wellcare,74.42,,,,,,,case rate,74.42,74.42,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health PPO CPD,Meritain Health PPO CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/Commercial Product,Aetna/Commercial Product,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health CPD,Meritain Health CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Starmark CPD,Starmark CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna Medicare,Aetna Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Ambetter ,Ambetter ,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access,Anthem Blue Access,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access Choice,Anthem Blue Access Choice,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Preferred,Anthem Blue Preferred,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Pathway,Anthem Pathway,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Alliance,Anthem Alliance,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Medicare,Anthem Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna,Cigna,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna PPO,Cigna PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna Medicare Advantage,Cigna Medicare Advantage,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Essence,Essence,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink HMO,Healthlink HMO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink PPO,Healthlink PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,HomeState Health Plan,HomeState Health Plan,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Humana Gold,Humana Gold,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medicaid MO,Medicaid MO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medica,Medica,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Tricare,Tricare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC All Payer,UHC All Payer,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Exchange,UHC Exchange,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicaid,UHC Medicaid,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UMR CPD,UMR CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicare,UHC Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33136480,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Wellcare,Wellcare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Meritain Health PPO CPD,Meritain Health PPO CPD,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Aetna/Commercial Product,Aetna/Commercial Product,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Meritain Health CPD,Meritain Health CPD,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Starmark CPD,Starmark CPD,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Aetna Medicare,Aetna Medicare,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Ambetter ,Ambetter ,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Blue Access,Anthem Blue Access,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Blue Access Choice,Anthem Blue Access Choice,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Blue Preferred,Anthem Blue Preferred,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Pathway,Anthem Pathway,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Alliance,Anthem Alliance,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Anthem Medicare,Anthem Medicare,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Cigna,Cigna,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Cigna PPO,Cigna PPO,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Cigna Medicare Advantage,Cigna Medicare Advantage,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Essence,Essence,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Healthlink HMO,Healthlink HMO,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Healthlink PPO,Healthlink PPO,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,HomeState Health Plan,HomeState Health Plan,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Humana Gold,Humana Gold,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Medicaid MO,Medicaid MO,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Medica,Medica,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Tricare,Tricare,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,UHC All Payer,UHC All Payer,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,UHC Exchange,UHC Exchange,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,UHC Medicaid,UHC Medicaid,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,UMR CPD,UMR CPD,7.73,,,,,,,per diem,7.73,7.73,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,UHC Medicare,UHC Medicare,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33136482,CDM,279,RC,,,,,,Inpatient,,,7.73,7.73,Wellcare,Wellcare,7.73,,,,,,,case rate,7.73,7.73,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health PPO CPD,Meritain Health PPO CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/Commercial Product,Aetna/Commercial Product,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health CPD,Meritain Health CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Starmark CPD,Starmark CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna Medicare,Aetna Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Ambetter ,Ambetter ,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access,Anthem Blue Access,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access Choice,Anthem Blue Access Choice,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Preferred,Anthem Blue Preferred,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Pathway,Anthem Pathway,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Alliance,Anthem Alliance,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Medicare,Anthem Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna,Cigna,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna PPO,Cigna PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna Medicare Advantage,Cigna Medicare Advantage,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Essence,Essence,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink HMO,Healthlink HMO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink PPO,Healthlink PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,HomeState Health Plan,HomeState Health Plan,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Humana Gold,Humana Gold,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medicaid MO,Medicaid MO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medica,Medica,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Tricare,Tricare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC All Payer,UHC All Payer,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Exchange,UHC Exchange,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicaid,UHC Medicaid,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UMR CPD,UMR CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicare,UHC Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33136483,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Wellcare,Wellcare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health PPO CPD,Meritain Health PPO CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna/Commercial Product,Aetna/Commercial Product,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Meritain Health CPD,Meritain Health CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Starmark CPD,Starmark CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Aetna Medicare,Aetna Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Ambetter ,Ambetter ,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access,Anthem Blue Access,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Access Choice,Anthem Blue Access Choice,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Blue Preferred,Anthem Blue Preferred,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Pathway,Anthem Pathway,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Alliance,Anthem Alliance,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Anthem Medicare,Anthem Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna,Cigna,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna PPO,Cigna PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Cigna Medicare Advantage,Cigna Medicare Advantage,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Essence,Essence,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink HMO,Healthlink HMO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Healthlink PPO,Healthlink PPO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,HomeState Health Plan,HomeState Health Plan,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Humana Gold,Humana Gold,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medicaid MO,Medicaid MO,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Medica,Medica,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Tricare,Tricare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC All Payer,UHC All Payer,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Exchange,UHC Exchange,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicaid,UHC Medicaid,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UMR CPD,UMR CPD,33.48,,,,,,,per diem,33.48,33.48,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,UHC Medicare,UHC Medicare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33136484,CDM,279,RC,,,,,,Inpatient,,,33.48,33.48,Wellcare,Wellcare,33.48,,,,,,,case rate,33.48,33.48,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Meritain Health PPO CPD,Meritain Health PPO CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna/Commercial Product,Aetna/Commercial Product,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Meritain Health CPD,Meritain Health CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Starmark CPD,Starmark CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Aetna Medicare,Aetna Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Ambetter ,Ambetter ,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Access,Anthem Blue Access,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Access Choice,Anthem Blue Access Choice,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Blue Preferred,Anthem Blue Preferred,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Pathway,Anthem Pathway,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Alliance,Anthem Alliance,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Anthem Medicare,Anthem Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna,Cigna,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna PPO,Cigna PPO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Cigna Medicare Advantage,Cigna Medicare Advantage,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Essence,Essence,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthlink HMO,Healthlink HMO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Healthlink PPO,Healthlink PPO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,HomeState Health Plan,HomeState Health Plan,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Humana Gold,Humana Gold,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Medicaid MO,Medicaid MO,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Medica,Medica,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Tricare,Tricare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC All Payer,UHC All Payer,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Exchange,UHC Exchange,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Medicaid,UHC Medicaid,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UMR CPD,UMR CPD,35.54,,,,,,,per diem,35.54,35.54,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,UHC Medicare,UHC Medicare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS          ,33136485,CDM,279,RC,,,,,,Inpatient,,,35.54,35.54,Wellcare,Wellcare,35.54,,,,,,,case rate,35.54,35.54,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health PPO CPD,Meritain Health PPO CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/Commercial Product,Aetna/Commercial Product,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health CPD,Meritain Health CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Starmark CPD,Starmark CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna Medicare,Aetna Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Ambetter ,Ambetter ,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access,Anthem Blue Access,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access Choice,Anthem Blue Access Choice,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Preferred,Anthem Blue Preferred,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Pathway,Anthem Pathway,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Alliance,Anthem Alliance,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Medicare,Anthem Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna,Cigna,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna PPO,Cigna PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna Medicare Advantage,Cigna Medicare Advantage,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Essence,Essence,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink HMO,Healthlink HMO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink PPO,Healthlink PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,HomeState Health Plan,HomeState Health Plan,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Humana Gold,Humana Gold,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medicaid MO,Medicaid MO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medica,Medica,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Tricare,Tricare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC All Payer,UHC All Payer,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Exchange,UHC Exchange,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicaid,UHC Medicaid,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UMR CPD,UMR CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicare,UHC Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33136486,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Wellcare,Wellcare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health PPO CPD,Meritain Health PPO CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/Commercial Product,Aetna/Commercial Product,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health CPD,Meritain Health CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Starmark CPD,Starmark CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Aetna Medicare,Aetna Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Ambetter ,Ambetter ,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access,Anthem Blue Access,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access Choice,Anthem Blue Access Choice,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Preferred,Anthem Blue Preferred,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Pathway,Anthem Pathway,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Alliance,Anthem Alliance,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Medicare,Anthem Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna,Cigna,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna PPO,Cigna PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Cigna Medicare Advantage,Cigna Medicare Advantage,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Essence,Essence,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink HMO,Healthlink HMO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink PPO,Healthlink PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,HomeState Health Plan,HomeState Health Plan,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Humana Gold,Humana Gold,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Medicaid MO,Medicaid MO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Medica,Medica,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Tricare,Tricare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC All Payer,UHC All Payer,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Exchange,UHC Exchange,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicaid,UHC Medicaid,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UMR CPD,UMR CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicare,UHC Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33136487,CDM,279,RC,,,,,,Inpatient,,,266.77,266.77,Wellcare,Wellcare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Meritain Health PPO CPD,Meritain Health PPO CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna/Commercial Product,Aetna/Commercial Product,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Meritain Health CPD,Meritain Health CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Starmark CPD,Starmark CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Aetna Medicare,Aetna Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Ambetter ,Ambetter ,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Access,Anthem Blue Access,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Access Choice,Anthem Blue Access Choice,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Blue Preferred,Anthem Blue Preferred,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Pathway,Anthem Pathway,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Alliance,Anthem Alliance,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Anthem Medicare,Anthem Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna,Cigna,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna PPO,Cigna PPO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Cigna Medicare Advantage,Cigna Medicare Advantage,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Essence,Essence,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthlink HMO,Healthlink HMO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Healthlink PPO,Healthlink PPO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,HomeState Health Plan,HomeState Health Plan,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Humana Gold,Humana Gold,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Medicaid MO,Medicaid MO,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Medica,Medica,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Tricare,Tricare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC All Payer,UHC All Payer,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Exchange,UHC Exchange,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Medicaid,UHC Medicaid,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UMR CPD,UMR CPD,56.65,,,,,,,per diem,56.65,56.65,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,UHC Medicare,UHC Medicare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33136488,CDM,279,RC,,,,,,Inpatient,,,56.65,56.65,Wellcare,Wellcare,56.65,,,,,,,case rate,56.65,56.65,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Meritain Health PPO CPD,Meritain Health PPO CPD,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Aetna/Commercial Product,Aetna/Commercial Product,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Meritain Health CPD,Meritain Health CPD,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Starmark CPD,Starmark CPD,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Aetna Medicare,Aetna Medicare,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Ambetter ,Ambetter ,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Blue Access,Anthem Blue Access,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Blue Access Choice,Anthem Blue Access Choice,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Blue Preferred,Anthem Blue Preferred,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Pathway,Anthem Pathway,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Alliance,Anthem Alliance,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Anthem Medicare,Anthem Medicare,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Cigna,Cigna,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Cigna PPO,Cigna PPO,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Cigna Medicare Advantage,Cigna Medicare Advantage,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Essence,Essence,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Healthlink HMO,Healthlink HMO,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Healthlink PPO,Healthlink PPO,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,HomeState Health Plan,HomeState Health Plan,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Humana Gold,Humana Gold,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Medicaid MO,Medicaid MO,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Medica,Medica,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Tricare,Tricare,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,UHC All Payer,UHC All Payer,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,UHC Exchange,UHC Exchange,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,UHC Medicaid,UHC Medicaid,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,UMR CPD,UMR CPD,534.06,,,,,,,per diem,534.06,534.06,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,UHC Medicare,UHC Medicare,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33136489,CDM,279,RC,,,,,,Inpatient,,,534.06,534.06,Wellcare,Wellcare,534.06,,,,,,,case rate,534.06,534.06,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health PPO CPD,Meritain Health PPO CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/Commercial Product,Aetna/Commercial Product,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health CPD,Meritain Health CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Starmark CPD,Starmark CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna Medicare,Aetna Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Ambetter ,Ambetter ,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access,Anthem Blue Access,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access Choice,Anthem Blue Access Choice,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Preferred,Anthem Blue Preferred,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Pathway,Anthem Pathway,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Alliance,Anthem Alliance,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Medicare,Anthem Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna,Cigna,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna PPO,Cigna PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna Medicare Advantage,Cigna Medicare Advantage,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Essence,Essence,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink HMO,Healthlink HMO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink PPO,Healthlink PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,HomeState Health Plan,HomeState Health Plan,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Humana Gold,Humana Gold,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medicaid MO,Medicaid MO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medica,Medica,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Tricare,Tricare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC All Payer,UHC All Payer,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Exchange,UHC Exchange,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicaid,UHC Medicaid,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UMR CPD,UMR CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicare,UHC Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33136490,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Wellcare,Wellcare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Meritain Health PPO CPD,Meritain Health PPO CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna/Commercial Product,Aetna/Commercial Product,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Meritain Health CPD,Meritain Health CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Starmark CPD,Starmark CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna Medicare,Aetna Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Ambetter ,Ambetter ,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Access,Anthem Blue Access,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Access Choice,Anthem Blue Access Choice,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Preferred,Anthem Blue Preferred,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Pathway,Anthem Pathway,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Alliance,Anthem Alliance,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Medicare,Anthem Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna,Cigna,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna PPO,Cigna PPO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna Medicare Advantage,Cigna Medicare Advantage,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Essence,Essence,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthlink HMO,Healthlink HMO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthlink PPO,Healthlink PPO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,HomeState Health Plan,HomeState Health Plan,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Humana Gold,Humana Gold,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Medicaid MO,Medicaid MO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Medica,Medica,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Tricare,Tricare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC All Payer,UHC All Payer,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Exchange,UHC Exchange,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Medicaid,UHC Medicaid,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UMR CPD,UMR CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Medicare,UHC Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33136491,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Wellcare,Wellcare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33136492,CDM,279,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Meritain Health PPO CPD,Meritain Health PPO CPD,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Aetna/Commercial Product,Aetna/Commercial Product,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Meritain Health CPD,Meritain Health CPD,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Starmark CPD,Starmark CPD,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Aetna Medicare,Aetna Medicare,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Ambetter ,Ambetter ,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Blue Access,Anthem Blue Access,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Blue Access Choice,Anthem Blue Access Choice,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Blue Preferred,Anthem Blue Preferred,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Pathway,Anthem Pathway,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Alliance,Anthem Alliance,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Anthem Medicare,Anthem Medicare,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Cigna,Cigna,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Cigna PPO,Cigna PPO,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Cigna Medicare Advantage,Cigna Medicare Advantage,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Essence,Essence,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Healthlink HMO,Healthlink HMO,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Healthlink PPO,Healthlink PPO,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,HomeState Health Plan,HomeState Health Plan,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Humana Gold,Humana Gold,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Medicaid MO,Medicaid MO,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Medica,Medica,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Tricare,Tricare,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,UHC All Payer,UHC All Payer,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,UHC Exchange,UHC Exchange,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,UHC Medicaid,UHC Medicaid,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,UMR CPD,UMR CPD,60.26,,,,,,,per diem,60.26,60.26,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,UHC Medicare,UHC Medicare,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33136493,CDM,279,RC,,,,,,Inpatient,,,60.26,60.26,Wellcare,Wellcare,60.26,,,,,,,case rate,60.26,60.26,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Meritain Health PPO CPD,Meritain Health PPO CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna/Commercial Product,Aetna/Commercial Product,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Meritain Health CPD,Meritain Health CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Starmark CPD,Starmark CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna Medicare,Aetna Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Ambetter ,Ambetter ,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Access,Anthem Blue Access,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Access Choice,Anthem Blue Access Choice,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Preferred,Anthem Blue Preferred,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Pathway,Anthem Pathway,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Alliance,Anthem Alliance,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Medicare,Anthem Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna,Cigna,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna PPO,Cigna PPO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna Medicare Advantage,Cigna Medicare Advantage,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Essence,Essence,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthlink HMO,Healthlink HMO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthlink PPO,Healthlink PPO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,HomeState Health Plan,HomeState Health Plan,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Humana Gold,Humana Gold,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Medicaid MO,Medicaid MO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Medica,Medica,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Tricare,Tricare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC All Payer,UHC All Payer,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Exchange,UHC Exchange,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Medicaid,UHC Medicaid,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UMR CPD,UMR CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Medicare,UHC Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136494,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Wellcare,Wellcare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Meritain Health PPO CPD,Meritain Health PPO CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna/Commercial Product,Aetna/Commercial Product,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Meritain Health CPD,Meritain Health CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Starmark CPD,Starmark CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna Medicare,Aetna Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Ambetter ,Ambetter ,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Access,Anthem Blue Access,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Access Choice,Anthem Blue Access Choice,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Preferred,Anthem Blue Preferred,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Pathway,Anthem Pathway,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Alliance,Anthem Alliance,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Medicare,Anthem Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna,Cigna,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna PPO,Cigna PPO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna Medicare Advantage,Cigna Medicare Advantage,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Essence,Essence,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthlink HMO,Healthlink HMO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthlink PPO,Healthlink PPO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,HomeState Health Plan,HomeState Health Plan,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Humana Gold,Humana Gold,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Medicaid MO,Medicaid MO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Medica,Medica,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Tricare,Tricare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC All Payer,UHC All Payer,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Exchange,UHC Exchange,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Medicaid,UHC Medicaid,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UMR CPD,UMR CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Medicare,UHC Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136495,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Wellcare,Wellcare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health PPO CPD,Meritain Health PPO CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/Commercial Product,Aetna/Commercial Product,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health CPD,Meritain Health CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Starmark CPD,Starmark CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Aetna Medicare,Aetna Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Ambetter ,Ambetter ,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access,Anthem Blue Access,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access Choice,Anthem Blue Access Choice,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Preferred,Anthem Blue Preferred,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Pathway,Anthem Pathway,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Alliance,Anthem Alliance,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Medicare,Anthem Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna,Cigna,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna PPO,Cigna PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Cigna Medicare Advantage,Cigna Medicare Advantage,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Essence,Essence,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink HMO,Healthlink HMO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink PPO,Healthlink PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,HomeState Health Plan,HomeState Health Plan,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Humana Gold,Humana Gold,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Medicaid MO,Medicaid MO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Medica,Medica,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Tricare,Tricare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC All Payer,UHC All Payer,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Exchange,UHC Exchange,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicaid,UHC Medicaid,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UMR CPD,UMR CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicare,UHC Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33136496,CDM,279,RC,,,,,,Inpatient,,,40.17,40.17,Wellcare,Wellcare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health PPO CPD,Meritain Health PPO CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna/Commercial Product,Aetna/Commercial Product,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Meritain Health CPD,Meritain Health CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Starmark CPD,Starmark CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Aetna Medicare,Aetna Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Ambetter ,Ambetter ,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access,Anthem Blue Access,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Access Choice,Anthem Blue Access Choice,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Blue Preferred,Anthem Blue Preferred,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Pathway,Anthem Pathway,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Alliance,Anthem Alliance,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Anthem Medicare,Anthem Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna,Cigna,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna PPO,Cigna PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Cigna Medicare Advantage,Cigna Medicare Advantage,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Essence,Essence,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink HMO,Healthlink HMO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Healthlink PPO,Healthlink PPO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,HomeState Health Plan,HomeState Health Plan,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Humana Gold,Humana Gold,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medicaid MO,Medicaid MO,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Medica,Medica,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Tricare,Tricare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC All Payer,UHC All Payer,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Exchange,UHC Exchange,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicaid,UHC Medicaid,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UMR CPD,UMR CPD,26.78,,,,,,,per diem,26.78,26.78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,UHC Medicare,UHC Medicare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33136497,CDM,279,RC,,,,,,Inpatient,,,26.78,26.78,Wellcare,Wellcare,26.78,,,,,,,case rate,26.78,26.78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Meritain Health PPO CPD,Meritain Health PPO CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Aetna/Commercial Product,Aetna/Commercial Product,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Meritain Health CPD,Meritain Health CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Starmark CPD,Starmark CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Aetna Medicare,Aetna Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Ambetter ,Ambetter ,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Access,Anthem Blue Access,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Access Choice,Anthem Blue Access Choice,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Preferred,Anthem Blue Preferred,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Pathway,Anthem Pathway,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Alliance,Anthem Alliance,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Medicare,Anthem Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Cigna,Cigna,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Cigna PPO,Cigna PPO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Cigna Medicare Advantage,Cigna Medicare Advantage,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Essence,Essence,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Healthlink HMO,Healthlink HMO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Healthlink PPO,Healthlink PPO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,HomeState Health Plan,HomeState Health Plan,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Humana Gold,Humana Gold,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Medicaid MO,Medicaid MO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Medica,Medica,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Tricare,Tricare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,UHC All Payer,UHC All Payer,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,UHC Exchange,UHC Exchange,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,UHC Medicaid,UHC Medicaid,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,UMR CPD,UMR CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,UHC Medicare,UHC Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33136498,CDM,279,RC,,,,,,Inpatient,,,83.43,83.43,Wellcare,Wellcare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Meritain Health PPO CPD,Meritain Health PPO CPD,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Aetna/Commercial Product,Aetna/Commercial Product,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Meritain Health CPD,Meritain Health CPD,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Starmark CPD,Starmark CPD,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Aetna Medicare,Aetna Medicare,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Ambetter ,Ambetter ,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Blue Access,Anthem Blue Access,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Blue Access Choice,Anthem Blue Access Choice,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Blue Preferred,Anthem Blue Preferred,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Pathway,Anthem Pathway,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Alliance,Anthem Alliance,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Anthem Medicare,Anthem Medicare,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Cigna,Cigna,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Cigna PPO,Cigna PPO,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Cigna Medicare Advantage,Cigna Medicare Advantage,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Essence,Essence,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Healthlink HMO,Healthlink HMO,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Healthlink PPO,Healthlink PPO,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,HomeState Health Plan,HomeState Health Plan,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Humana Gold,Humana Gold,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Medicaid MO,Medicaid MO,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Medica,Medica,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Tricare,Tricare,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,UHC All Payer,UHC All Payer,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,UHC Exchange,UHC Exchange,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,UHC Medicaid,UHC Medicaid,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,UMR CPD,UMR CPD,57.68,,,,,,,per diem,57.68,57.68,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,UHC Medicare,UHC Medicare,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33136499,CDM,279,RC,,,,,,Inpatient,,,57.68,57.68,Wellcare,Wellcare,57.68,,,,,,,case rate,57.68,57.68,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Meritain Health PPO CPD,Meritain Health PPO CPD,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Aetna/Commercial Product,Aetna/Commercial Product,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Meritain Health CPD,Meritain Health CPD,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Starmark CPD,Starmark CPD,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Aetna Medicare,Aetna Medicare,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Ambetter ,Ambetter ,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Blue Access,Anthem Blue Access,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Blue Access Choice,Anthem Blue Access Choice,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Blue Preferred,Anthem Blue Preferred,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Pathway,Anthem Pathway,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Alliance,Anthem Alliance,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Anthem Medicare,Anthem Medicare,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Cigna,Cigna,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Cigna PPO,Cigna PPO,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Cigna Medicare Advantage,Cigna Medicare Advantage,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Essence,Essence,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Healthlink HMO,Healthlink HMO,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Healthlink PPO,Healthlink PPO,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,HomeState Health Plan,HomeState Health Plan,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Humana Gold,Humana Gold,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Medicaid MO,Medicaid MO,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Medica,Medica,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Tricare,Tricare,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,UHC All Payer,UHC All Payer,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,UHC Exchange,UHC Exchange,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,UHC Medicaid,UHC Medicaid,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,UMR CPD,UMR CPD,82.4,,,,,,,per diem,82.4,82.4,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,UHC Medicare,UHC Medicare,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33136500,CDM,279,RC,,,,,,Inpatient,,,82.4,82.4,Wellcare,Wellcare,82.4,,,,,,,case rate,82.4,82.4,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Meritain Health PPO CPD,Meritain Health PPO CPD,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Aetna/Commercial Product,Aetna/Commercial Product,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Meritain Health CPD,Meritain Health CPD,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Starmark CPD,Starmark CPD,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Aetna Medicare,Aetna Medicare,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Ambetter ,Ambetter ,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Blue Access,Anthem Blue Access,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Blue Access Choice,Anthem Blue Access Choice,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Blue Preferred,Anthem Blue Preferred,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Pathway,Anthem Pathway,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Alliance,Anthem Alliance,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Anthem Medicare,Anthem Medicare,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Cigna,Cigna,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Cigna PPO,Cigna PPO,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Cigna Medicare Advantage,Cigna Medicare Advantage,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Essence,Essence,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Healthlink HMO,Healthlink HMO,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Healthlink PPO,Healthlink PPO,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,HomeState Health Plan,HomeState Health Plan,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Humana Gold,Humana Gold,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Medicaid MO,Medicaid MO,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Medica,Medica,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Tricare,Tricare,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,UHC All Payer,UHC All Payer,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,UHC Exchange,UHC Exchange,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,UHC Medicaid,UHC Medicaid,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,UMR CPD,UMR CPD,46.87,,,,,,,per diem,46.87,46.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,UHC Medicare,UHC Medicare,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33136501,CDM,279,RC,,,,,,Inpatient,,,46.87,46.87,Wellcare,Wellcare,46.87,,,,,,,case rate,46.87,46.87,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Meritain Health PPO CPD,Meritain Health PPO CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Aetna/Commercial Product,Aetna/Commercial Product,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Meritain Health CPD,Meritain Health CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Starmark CPD,Starmark CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Aetna Medicare,Aetna Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Ambetter ,Ambetter ,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Blue Access,Anthem Blue Access,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Blue Access Choice,Anthem Blue Access Choice,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Blue Preferred,Anthem Blue Preferred,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Pathway,Anthem Pathway,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Alliance,Anthem Alliance,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Anthem Medicare,Anthem Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Cigna,Cigna,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Cigna PPO,Cigna PPO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Cigna Medicare Advantage,Cigna Medicare Advantage,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Essence,Essence,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Healthlink HMO,Healthlink HMO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Healthlink PPO,Healthlink PPO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,HomeState Health Plan,HomeState Health Plan,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Humana Gold,Humana Gold,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Medicaid MO,Medicaid MO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Medica,Medica,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Tricare,Tricare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,UHC All Payer,UHC All Payer,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,UHC Exchange,UHC Exchange,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,UHC Medicaid,UHC Medicaid,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,UMR CPD,UMR CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,UHC Medicare,UHC Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
AV IMPULSE SYSTEM FOOT PUMP   ,33136503,CDM,279,RC,,,,,,Inpatient,,,39.14,39.14,Wellcare,Wellcare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Meritain Health PPO CPD,Meritain Health PPO CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna/Commercial Product,Aetna/Commercial Product,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Meritain Health CPD,Meritain Health CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Starmark CPD,Starmark CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Aetna Medicare,Aetna Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Ambetter ,Ambetter ,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Access,Anthem Blue Access,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Access Choice,Anthem Blue Access Choice,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Blue Preferred,Anthem Blue Preferred,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Pathway,Anthem Pathway,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Alliance,Anthem Alliance,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Anthem Medicare,Anthem Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna,Cigna,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna PPO,Cigna PPO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Cigna Medicare Advantage,Cigna Medicare Advantage,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Essence,Essence,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthlink HMO,Healthlink HMO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Healthlink PPO,Healthlink PPO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,HomeState Health Plan,HomeState Health Plan,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Humana Gold,Humana Gold,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Medicaid MO,Medicaid MO,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Medica,Medica,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Tricare,Tricare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC All Payer,UHC All Payer,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Exchange,UHC Exchange,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Medicaid,UHC Medicaid,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UMR CPD,UMR CPD,50.99,,,,,,,per diem,50.99,50.99,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,UHC Medicare,UHC Medicare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33136504,CDM,279,RC,,,,,,Inpatient,,,50.99,50.99,Wellcare,Wellcare,50.99,,,,,,,case rate,50.99,50.99,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Meritain Health PPO CPD,Meritain Health PPO CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna/Commercial Product,Aetna/Commercial Product,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Meritain Health CPD,Meritain Health CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Starmark CPD,Starmark CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Aetna Medicare,Aetna Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Ambetter ,Ambetter ,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Access,Anthem Blue Access,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Access Choice,Anthem Blue Access Choice,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Blue Preferred,Anthem Blue Preferred,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Pathway,Anthem Pathway,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Alliance,Anthem Alliance,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Anthem Medicare,Anthem Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna,Cigna,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna PPO,Cigna PPO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Cigna Medicare Advantage,Cigna Medicare Advantage,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Essence,Essence,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthlink HMO,Healthlink HMO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Healthlink PPO,Healthlink PPO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,HomeState Health Plan,HomeState Health Plan,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Humana Gold,Humana Gold,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Medicaid MO,Medicaid MO,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Medica,Medica,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Tricare,Tricare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC All Payer,UHC All Payer,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Exchange,UHC Exchange,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Medicaid,UHC Medicaid,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UMR CPD,UMR CPD,134.42,,,,,,,per diem,134.42,134.42,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,UHC Medicare,UHC Medicare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33136505,CDM,279,RC,,,,,,Inpatient,,,134.42,134.42,Wellcare,Wellcare,134.42,,,,,,,case rate,134.42,134.42,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Meritain Health PPO CPD,Meritain Health PPO CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna/Commercial Product,Aetna/Commercial Product,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Meritain Health CPD,Meritain Health CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Starmark CPD,Starmark CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Aetna Medicare,Aetna Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Ambetter ,Ambetter ,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Access,Anthem Blue Access,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Access Choice,Anthem Blue Access Choice,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Blue Preferred,Anthem Blue Preferred,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Pathway,Anthem Pathway,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Alliance,Anthem Alliance,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Anthem Medicare,Anthem Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna,Cigna,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna PPO,Cigna PPO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Cigna Medicare Advantage,Cigna Medicare Advantage,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Essence,Essence,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthlink HMO,Healthlink HMO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Healthlink PPO,Healthlink PPO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,HomeState Health Plan,HomeState Health Plan,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Humana Gold,Humana Gold,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Medicaid MO,Medicaid MO,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Medica,Medica,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Tricare,Tricare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC All Payer,UHC All Payer,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Exchange,UHC Exchange,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Medicaid,UHC Medicaid,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UMR CPD,UMR CPD,76.74,,,,,,,per diem,76.74,76.74,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,UHC Medicare,UHC Medicare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33136507,CDM,279,RC,,,,,,Inpatient,,,76.74,76.74,Wellcare,Wellcare,76.74,,,,,,,case rate,76.74,76.74,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Meritain Health PPO CPD,Meritain Health PPO CPD,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Aetna/Commercial Product,Aetna/Commercial Product,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Meritain Health CPD,Meritain Health CPD,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Starmark CPD,Starmark CPD,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Aetna Medicare,Aetna Medicare,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Ambetter ,Ambetter ,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Blue Access,Anthem Blue Access,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Blue Access Choice,Anthem Blue Access Choice,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Blue Preferred,Anthem Blue Preferred,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Pathway,Anthem Pathway,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Alliance,Anthem Alliance,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Anthem Medicare,Anthem Medicare,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Cigna,Cigna,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Cigna PPO,Cigna PPO,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Cigna Medicare Advantage,Cigna Medicare Advantage,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Essence,Essence,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Healthlink HMO,Healthlink HMO,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Healthlink PPO,Healthlink PPO,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,HomeState Health Plan,HomeState Health Plan,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Humana Gold,Humana Gold,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Medicaid MO,Medicaid MO,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Medica,Medica,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Tricare,Tricare,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,UHC All Payer,UHC All Payer,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,UHC Exchange,UHC Exchange,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,UHC Medicaid,UHC Medicaid,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,UMR CPD,UMR CPD,29.87,,,,,,,per diem,29.87,29.87,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,UHC Medicare,UHC Medicare,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33136508,CDM,279,RC,,,,,,Inpatient,,,29.87,29.87,Wellcare,Wellcare,29.87,,,,,,,case rate,29.87,29.87,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Meritain Health PPO CPD,Meritain Health PPO CPD,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Aetna/Commercial Product,Aetna/Commercial Product,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Meritain Health CPD,Meritain Health CPD,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Starmark CPD,Starmark CPD,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Aetna Medicare,Aetna Medicare,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Ambetter ,Ambetter ,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Blue Access,Anthem Blue Access,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Blue Access Choice,Anthem Blue Access Choice,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Blue Preferred,Anthem Blue Preferred,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Pathway,Anthem Pathway,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Alliance,Anthem Alliance,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Anthem Medicare,Anthem Medicare,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Cigna,Cigna,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Cigna PPO,Cigna PPO,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Cigna Medicare Advantage,Cigna Medicare Advantage,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Essence,Essence,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Healthlink HMO,Healthlink HMO,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Healthlink PPO,Healthlink PPO,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,HomeState Health Plan,HomeState Health Plan,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Humana Gold,Humana Gold,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Medicaid MO,Medicaid MO,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Medica,Medica,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Tricare,Tricare,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,UHC All Payer,UHC All Payer,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,UHC Exchange,UHC Exchange,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,UHC Medicaid,UHC Medicaid,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,UMR CPD,UMR CPD,214.24,,,,,,,per diem,214.24,214.24,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,UHC Medicare,UHC Medicare,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33136511,CDM,279,RC,,,,,,Inpatient,,,214.24,214.24,Wellcare,Wellcare,214.24,,,,,,,case rate,214.24,214.24,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health PPO CPD,Meritain Health PPO CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna/Commercial Product,Aetna/Commercial Product,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Meritain Health CPD,Meritain Health CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Starmark CPD,Starmark CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Aetna Medicare,Aetna Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Ambetter ,Ambetter ,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access,Anthem Blue Access,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Access Choice,Anthem Blue Access Choice,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Blue Preferred,Anthem Blue Preferred,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Pathway,Anthem Pathway,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Alliance,Anthem Alliance,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Anthem Medicare,Anthem Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna,Cigna,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna PPO,Cigna PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Cigna Medicare Advantage,Cigna Medicare Advantage,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Essence,Essence,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink HMO,Healthlink HMO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Healthlink PPO,Healthlink PPO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,HomeState Health Plan,HomeState Health Plan,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Humana Gold,Humana Gold,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medicaid MO,Medicaid MO,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Medica,Medica,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Tricare,Tricare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC All Payer,UHC All Payer,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Exchange,UHC Exchange,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicaid,UHC Medicaid,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UMR CPD,UMR CPD,44.29,,,,,,,per diem,44.29,44.29,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,UHC Medicare,UHC Medicare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33136512,CDM,279,RC,,,,,,Inpatient,,,44.29,44.29,Wellcare,Wellcare,44.29,,,,,,,case rate,44.29,44.29,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Meritain Health PPO CPD,Meritain Health PPO CPD,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Aetna/Commercial Product,Aetna/Commercial Product,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Meritain Health CPD,Meritain Health CPD,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Starmark CPD,Starmark CPD,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Aetna Medicare,Aetna Medicare,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Ambetter ,Ambetter ,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Blue Access,Anthem Blue Access,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Blue Access Choice,Anthem Blue Access Choice,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Blue Preferred,Anthem Blue Preferred,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Pathway,Anthem Pathway,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Alliance,Anthem Alliance,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Anthem Medicare,Anthem Medicare,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Cigna,Cigna,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Cigna PPO,Cigna PPO,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Cigna Medicare Advantage,Cigna Medicare Advantage,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Essence,Essence,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Healthlink HMO,Healthlink HMO,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Healthlink PPO,Healthlink PPO,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,HomeState Health Plan,HomeState Health Plan,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Humana Gold,Humana Gold,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Medicaid MO,Medicaid MO,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Medica,Medica,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Tricare,Tricare,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,UHC All Payer,UHC All Payer,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,UHC Exchange,UHC Exchange,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,UHC Medicaid,UHC Medicaid,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,UMR CPD,UMR CPD,136.99,,,,,,,per diem,136.99,136.99,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,UHC Medicare,UHC Medicare,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33136514,CDM,279,RC,,,,,,Inpatient,,,136.99,136.99,Wellcare,Wellcare,136.99,,,,,,,case rate,136.99,136.99,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Meritain Health PPO CPD,Meritain Health PPO CPD,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Aetna/Commercial Product,Aetna/Commercial Product,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Meritain Health CPD,Meritain Health CPD,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Starmark CPD,Starmark CPD,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Aetna Medicare,Aetna Medicare,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Ambetter ,Ambetter ,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Blue Access,Anthem Blue Access,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Blue Access Choice,Anthem Blue Access Choice,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Blue Preferred,Anthem Blue Preferred,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Pathway,Anthem Pathway,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Alliance,Anthem Alliance,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Anthem Medicare,Anthem Medicare,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Cigna,Cigna,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Cigna PPO,Cigna PPO,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Cigna Medicare Advantage,Cigna Medicare Advantage,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Essence,Essence,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Healthlink HMO,Healthlink HMO,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Healthlink PPO,Healthlink PPO,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,HomeState Health Plan,HomeState Health Plan,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Humana Gold,Humana Gold,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Medicaid MO,Medicaid MO,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Medica,Medica,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Tricare,Tricare,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,UHC All Payer,UHC All Payer,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,UHC Exchange,UHC Exchange,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,UHC Medicaid,UHC Medicaid,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,UMR CPD,UMR CPD,75.19,,,,,,,per diem,75.19,75.19,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,UHC Medicare,UHC Medicare,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33136515,CDM,279,RC,,,,,,Inpatient,,,75.19,75.19,Wellcare,Wellcare,75.19,,,,,,,case rate,75.19,75.19,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Meritain Health PPO CPD,Meritain Health PPO CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna/Commercial Product,Aetna/Commercial Product,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Meritain Health CPD,Meritain Health CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Starmark CPD,Starmark CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna Medicare,Aetna Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Ambetter ,Ambetter ,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Access,Anthem Blue Access,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Access Choice,Anthem Blue Access Choice,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Preferred,Anthem Blue Preferred,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Pathway,Anthem Pathway,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Alliance,Anthem Alliance,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Medicare,Anthem Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna,Cigna,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna PPO,Cigna PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna Medicare Advantage,Cigna Medicare Advantage,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Essence,Essence,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthlink HMO,Healthlink HMO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthlink PPO,Healthlink PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,HomeState Health Plan,HomeState Health Plan,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Humana Gold,Humana Gold,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Medicaid MO,Medicaid MO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Medica,Medica,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Tricare,Tricare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC All Payer,UHC All Payer,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Exchange,UHC Exchange,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Medicaid,UHC Medicaid,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UMR CPD,UMR CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Medicare,UHC Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33136516,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Wellcare,Wellcare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Meritain Health PPO CPD,Meritain Health PPO CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna/Commercial Product,Aetna/Commercial Product,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Meritain Health CPD,Meritain Health CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Starmark CPD,Starmark CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Aetna Medicare,Aetna Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Ambetter ,Ambetter ,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Access,Anthem Blue Access,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Access Choice,Anthem Blue Access Choice,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Blue Preferred,Anthem Blue Preferred,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Pathway,Anthem Pathway,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Alliance,Anthem Alliance,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Anthem Medicare,Anthem Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna,Cigna,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna PPO,Cigna PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Cigna Medicare Advantage,Cigna Medicare Advantage,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Essence,Essence,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthlink HMO,Healthlink HMO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Healthlink PPO,Healthlink PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,HomeState Health Plan,HomeState Health Plan,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Humana Gold,Humana Gold,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Medicaid MO,Medicaid MO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Medica,Medica,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Tricare,Tricare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC All Payer,UHC All Payer,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Exchange,UHC Exchange,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Medicaid,UHC Medicaid,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UMR CPD,UMR CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,UHC Medicare,UHC Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33136517,CDM,279,RC,,,,,,Inpatient,,,161.2,161.2,Wellcare,Wellcare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Meritain Health PPO CPD,Meritain Health PPO CPD,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Aetna/Commercial Product,Aetna/Commercial Product,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Meritain Health CPD,Meritain Health CPD,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Starmark CPD,Starmark CPD,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Aetna Medicare,Aetna Medicare,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Ambetter ,Ambetter ,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Blue Access,Anthem Blue Access,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Blue Access Choice,Anthem Blue Access Choice,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Blue Preferred,Anthem Blue Preferred,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Pathway,Anthem Pathway,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Alliance,Anthem Alliance,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Anthem Medicare,Anthem Medicare,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Cigna,Cigna,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Cigna PPO,Cigna PPO,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Cigna Medicare Advantage,Cigna Medicare Advantage,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Essence,Essence,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Healthlink HMO,Healthlink HMO,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Healthlink PPO,Healthlink PPO,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,HomeState Health Plan,HomeState Health Plan,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Humana Gold,Humana Gold,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Medicaid MO,Medicaid MO,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Medica,Medica,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Tricare,Tricare,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,UHC All Payer,UHC All Payer,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,UHC Exchange,UHC Exchange,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,UHC Medicaid,UHC Medicaid,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,UMR CPD,UMR CPD,144.72,,,,,,,per diem,144.72,144.72,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,UHC Medicare,UHC Medicare,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33136518,CDM,279,RC,,,,,,Inpatient,,,144.72,144.72,Wellcare,Wellcare,144.72,,,,,,,case rate,144.72,144.72,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Meritain Health PPO CPD,Meritain Health PPO CPD,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Aetna/Commercial Product,Aetna/Commercial Product,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Meritain Health CPD,Meritain Health CPD,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Starmark CPD,Starmark CPD,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Aetna Medicare,Aetna Medicare,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Ambetter ,Ambetter ,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Blue Access,Anthem Blue Access,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Blue Access Choice,Anthem Blue Access Choice,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Blue Preferred,Anthem Blue Preferred,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Pathway,Anthem Pathway,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Alliance,Anthem Alliance,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Anthem Medicare,Anthem Medicare,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Cigna,Cigna,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Cigna PPO,Cigna PPO,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Cigna Medicare Advantage,Cigna Medicare Advantage,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Essence,Essence,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Healthlink HMO,Healthlink HMO,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Healthlink PPO,Healthlink PPO,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,HomeState Health Plan,HomeState Health Plan,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Humana Gold,Humana Gold,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Medicaid MO,Medicaid MO,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Medica,Medica,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Tricare,Tricare,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,UHC All Payer,UHC All Payer,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,UHC Exchange,UHC Exchange,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,UHC Medicaid,UHC Medicaid,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,UMR CPD,UMR CPD,16.48,,,,,,,per diem,16.48,16.48,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,UHC Medicare,UHC Medicare,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33136519,CDM,279,RC,,,,,,Inpatient,,,16.48,16.48,Wellcare,Wellcare,16.48,,,,,,,case rate,16.48,16.48,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Meritain Health PPO CPD,Meritain Health PPO CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna/Commercial Product,Aetna/Commercial Product,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Meritain Health CPD,Meritain Health CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Starmark CPD,Starmark CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Aetna Medicare,Aetna Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Ambetter ,Ambetter ,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Access,Anthem Blue Access,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Access Choice,Anthem Blue Access Choice,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Blue Preferred,Anthem Blue Preferred,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Pathway,Anthem Pathway,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Alliance,Anthem Alliance,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Anthem Medicare,Anthem Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna,Cigna,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna PPO,Cigna PPO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Cigna Medicare Advantage,Cigna Medicare Advantage,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Essence,Essence,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthlink HMO,Healthlink HMO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Healthlink PPO,Healthlink PPO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,HomeState Health Plan,HomeState Health Plan,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Humana Gold,Humana Gold,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Medicaid MO,Medicaid MO,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Medica,Medica,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Tricare,Tricare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC All Payer,UHC All Payer,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Exchange,UHC Exchange,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Medicaid,UHC Medicaid,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UMR CPD,UMR CPD,71.07,,,,,,,per diem,71.07,71.07,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,UHC Medicare,UHC Medicare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33136521,CDM,279,RC,,,,,,Inpatient,,,71.07,71.07,Wellcare,Wellcare,71.07,,,,,,,case rate,71.07,71.07,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Meritain Health PPO CPD,Meritain Health PPO CPD,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Aetna/Commercial Product,Aetna/Commercial Product,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Meritain Health CPD,Meritain Health CPD,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Starmark CPD,Starmark CPD,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Aetna Medicare,Aetna Medicare,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Ambetter ,Ambetter ,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Blue Access,Anthem Blue Access,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Blue Access Choice,Anthem Blue Access Choice,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Blue Preferred,Anthem Blue Preferred,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Pathway,Anthem Pathway,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Alliance,Anthem Alliance,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Anthem Medicare,Anthem Medicare,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Cigna,Cigna,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Cigna PPO,Cigna PPO,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Cigna Medicare Advantage,Cigna Medicare Advantage,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Essence,Essence,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Healthlink HMO,Healthlink HMO,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Healthlink PPO,Healthlink PPO,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,HomeState Health Plan,HomeState Health Plan,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Humana Gold,Humana Gold,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Medicaid MO,Medicaid MO,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Medica,Medica,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Tricare,Tricare,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,UHC All Payer,UHC All Payer,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,UHC Exchange,UHC Exchange,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,UHC Medicaid,UHC Medicaid,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,UMR CPD,UMR CPD,27.81,,,,,,,per diem,27.81,27.81,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,UHC Medicare,UHC Medicare,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33136522,CDM,279,RC,,,,,,Inpatient,,,27.81,27.81,Wellcare,Wellcare,27.81,,,,,,,case rate,27.81,27.81,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Meritain Health PPO CPD,Meritain Health PPO CPD,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Aetna/Commercial Product,Aetna/Commercial Product,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Meritain Health CPD,Meritain Health CPD,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Starmark CPD,Starmark CPD,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Aetna Medicare,Aetna Medicare,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Ambetter ,Ambetter ,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Blue Access,Anthem Blue Access,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Blue Access Choice,Anthem Blue Access Choice,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Blue Preferred,Anthem Blue Preferred,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Pathway,Anthem Pathway,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Alliance,Anthem Alliance,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Anthem Medicare,Anthem Medicare,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Cigna,Cigna,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Cigna PPO,Cigna PPO,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Cigna Medicare Advantage,Cigna Medicare Advantage,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Essence,Essence,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Healthlink HMO,Healthlink HMO,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Healthlink PPO,Healthlink PPO,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,HomeState Health Plan,HomeState Health Plan,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Humana Gold,Humana Gold,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Medicaid MO,Medicaid MO,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Medica,Medica,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Tricare,Tricare,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,UHC All Payer,UHC All Payer,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,UHC Exchange,UHC Exchange,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,UHC Medicaid,UHC Medicaid,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,UMR CPD,UMR CPD,695.25,,,,,,,per diem,695.25,695.25,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,UHC Medicare,UHC Medicare,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33136523,CDM,279,RC,,,,,,Inpatient,,,695.25,695.25,Wellcare,Wellcare,695.25,,,,,,,case rate,695.25,695.25,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Meritain Health PPO CPD,Meritain Health PPO CPD,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Aetna/Commercial Product,Aetna/Commercial Product,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Meritain Health CPD,Meritain Health CPD,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Starmark CPD,Starmark CPD,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Aetna Medicare,Aetna Medicare,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Ambetter ,Ambetter ,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Blue Access,Anthem Blue Access,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Blue Access Choice,Anthem Blue Access Choice,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Blue Preferred,Anthem Blue Preferred,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Pathway,Anthem Pathway,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Alliance,Anthem Alliance,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Anthem Medicare,Anthem Medicare,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Cigna,Cigna,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Cigna PPO,Cigna PPO,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Cigna Medicare Advantage,Cigna Medicare Advantage,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Essence,Essence,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Healthlink HMO,Healthlink HMO,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Healthlink PPO,Healthlink PPO,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,HomeState Health Plan,HomeState Health Plan,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Humana Gold,Humana Gold,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Medicaid MO,Medicaid MO,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Medica,Medica,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Tricare,Tricare,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,UHC All Payer,UHC All Payer,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,UHC Exchange,UHC Exchange,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,UHC Medicaid,UHC Medicaid,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,UMR CPD,UMR CPD,11.33,,,,,,,per diem,11.33,11.33,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,UHC Medicare,UHC Medicare,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONTINU,33136524,CDM,279,RC,,,,,,Inpatient,,,11.33,11.33,Wellcare,Wellcare,11.33,,,,,,,case rate,11.33,11.33,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Meritain Health PPO CPD,Meritain Health PPO CPD,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Aetna/Commercial Product,Aetna/Commercial Product,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Meritain Health CPD,Meritain Health CPD,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Starmark CPD,Starmark CPD,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Aetna Medicare,Aetna Medicare,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Ambetter ,Ambetter ,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Blue Access,Anthem Blue Access,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Blue Access Choice,Anthem Blue Access Choice,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Blue Preferred,Anthem Blue Preferred,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Pathway,Anthem Pathway,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Alliance,Anthem Alliance,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Anthem Medicare,Anthem Medicare,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Cigna,Cigna,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Cigna PPO,Cigna PPO,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Cigna Medicare Advantage,Cigna Medicare Advantage,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Essence,Essence,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Healthlink HMO,Healthlink HMO,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Healthlink PPO,Healthlink PPO,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,HomeState Health Plan,HomeState Health Plan,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Humana Gold,Humana Gold,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Medicaid MO,Medicaid MO,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Medica,Medica,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Tricare,Tricare,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,UHC All Payer,UHC All Payer,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,UHC Exchange,UHC Exchange,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,UHC Medicaid,UHC Medicaid,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,UMR CPD,UMR CPD,35.02,,,,,,,per diem,35.02,35.02,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,UHC Medicare,UHC Medicare,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER      ,33136525,CDM,279,RC,,,,,,Inpatient,,,35.02,35.02,Wellcare,Wellcare,35.02,,,,,,,case rate,35.02,35.02,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Meritain Health PPO CPD,Meritain Health PPO CPD,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Aetna/Commercial Product,Aetna/Commercial Product,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Meritain Health CPD,Meritain Health CPD,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Starmark CPD,Starmark CPD,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Aetna Medicare,Aetna Medicare,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Ambetter ,Ambetter ,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Blue Access,Anthem Blue Access,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Blue Access Choice,Anthem Blue Access Choice,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Blue Preferred,Anthem Blue Preferred,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Pathway,Anthem Pathway,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Alliance,Anthem Alliance,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Anthem Medicare,Anthem Medicare,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Cigna,Cigna,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Cigna PPO,Cigna PPO,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Cigna Medicare Advantage,Cigna Medicare Advantage,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Essence,Essence,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Healthlink HMO,Healthlink HMO,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Healthlink PPO,Healthlink PPO,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,HomeState Health Plan,HomeState Health Plan,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Humana Gold,Humana Gold,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Medicaid MO,Medicaid MO,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Medica,Medica,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Tricare,Tricare,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,UHC All Payer,UHC All Payer,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,UHC Exchange,UHC Exchange,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,UHC Medicaid,UHC Medicaid,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,UMR CPD,UMR CPD,155.53,,,,,,,per diem,155.53,155.53,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,UHC Medicare,UHC Medicare,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33136526,CDM,279,RC,,,,,,Inpatient,,,155.53,155.53,Wellcare,Wellcare,155.53,,,,,,,case rate,155.53,155.53,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Meritain Health PPO CPD,Meritain Health PPO CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna/Commercial Product,Aetna/Commercial Product,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Meritain Health CPD,Meritain Health CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Starmark CPD,Starmark CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna Medicare,Aetna Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Ambetter ,Ambetter ,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Access,Anthem Blue Access,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Access Choice,Anthem Blue Access Choice,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Preferred,Anthem Blue Preferred,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Pathway,Anthem Pathway,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Alliance,Anthem Alliance,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Medicare,Anthem Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna,Cigna,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna PPO,Cigna PPO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna Medicare Advantage,Cigna Medicare Advantage,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Essence,Essence,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthlink HMO,Healthlink HMO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthlink PPO,Healthlink PPO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,HomeState Health Plan,HomeState Health Plan,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Humana Gold,Humana Gold,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Medicaid MO,Medicaid MO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Medica,Medica,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Tricare,Tricare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC All Payer,UHC All Payer,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Exchange,UHC Exchange,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Medicaid,UHC Medicaid,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UMR CPD,UMR CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Medicare,UHC Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
IPPB AP5 RESPIRATORY MACHINE  ,33136528,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Wellcare,Wellcare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Meritain Health PPO CPD,Meritain Health PPO CPD,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Aetna/Commercial Product,Aetna/Commercial Product,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Meritain Health CPD,Meritain Health CPD,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Starmark CPD,Starmark CPD,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Aetna Medicare,Aetna Medicare,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Ambetter ,Ambetter ,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Blue Access,Anthem Blue Access,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Blue Access Choice,Anthem Blue Access Choice,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Blue Preferred,Anthem Blue Preferred,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Pathway,Anthem Pathway,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Alliance,Anthem Alliance,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Anthem Medicare,Anthem Medicare,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Cigna,Cigna,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Cigna PPO,Cigna PPO,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Cigna Medicare Advantage,Cigna Medicare Advantage,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Essence,Essence,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Healthlink HMO,Healthlink HMO,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Healthlink PPO,Healthlink PPO,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,HomeState Health Plan,HomeState Health Plan,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Humana Gold,Humana Gold,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Medicaid MO,Medicaid MO,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Medica,Medica,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Tricare,Tricare,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,UHC All Payer,UHC All Payer,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,UHC Exchange,UHC Exchange,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,UHC Medicaid,UHC Medicaid,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,UMR CPD,UMR CPD,56.14,,,,,,,per diem,56.14,56.14,"Per diem rate, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,UHC Medicare,UHC Medicare,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
VISION BI-PAP MACHINE RENTAL  ,33136529,CDM,279,RC,,,,,,Inpatient,,,56.14,56.14,Wellcare,Wellcare,56.14,,,,,,,case rate,56.14,56.14,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
PULSATE AIR MATTRESS          ,33136534,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health PPO CPD,Meritain Health PPO CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna/Commercial Product,Aetna/Commercial Product,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Meritain Health CPD,Meritain Health CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Starmark CPD,Starmark CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Aetna Medicare,Aetna Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Ambetter ,Ambetter ,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access,Anthem Blue Access,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Access Choice,Anthem Blue Access Choice,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Blue Preferred,Anthem Blue Preferred,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Pathway,Anthem Pathway,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Alliance,Anthem Alliance,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Anthem Medicare,Anthem Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna,Cigna,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna PPO,Cigna PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Cigna Medicare Advantage,Cigna Medicare Advantage,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Essence,Essence,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink HMO,Healthlink HMO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Healthlink PPO,Healthlink PPO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,HomeState Health Plan,HomeState Health Plan,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Humana Gold,Humana Gold,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Medicaid MO,Medicaid MO,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Medica,Medica,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Tricare,Tricare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC All Payer,UHC All Payer,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Exchange,UHC Exchange,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicaid,UHC Medicaid,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,UMR CPD,UMR CPD,144,,,,,,,per diem,144,144,"Per diem rate, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,UHC Medicare,UHC Medicare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
VAIL/ENCLOSURE BED            ,33136535,CDM,279,RC,,,,,,Inpatient,,,144,144,Wellcare,Wellcare,144,,,,,,,case rate,144,144,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Meritain Health PPO CPD,Meritain Health PPO CPD,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Aetna/Commercial Product,Aetna/Commercial Product,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Meritain Health CPD,Meritain Health CPD,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Starmark CPD,Starmark CPD,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Aetna Medicare,Aetna Medicare,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Ambetter ,Ambetter ,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Blue Access,Anthem Blue Access,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Blue Access Choice,Anthem Blue Access Choice,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Blue Preferred,Anthem Blue Preferred,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Pathway,Anthem Pathway,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Alliance,Anthem Alliance,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Anthem Medicare,Anthem Medicare,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Cigna,Cigna,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Cigna PPO,Cigna PPO,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Cigna Medicare Advantage,Cigna Medicare Advantage,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Essence,Essence,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Healthlink HMO,Healthlink HMO,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Healthlink PPO,Healthlink PPO,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,HomeState Health Plan,HomeState Health Plan,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Humana Gold,Humana Gold,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Medicaid MO,Medicaid MO,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Medica,Medica,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Tricare,Tricare,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,UHC All Payer,UHC All Payer,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,UHC Exchange,UHC Exchange,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,UHC Medicaid,UHC Medicaid,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,UMR CPD,UMR CPD,10.2,,,,,,,per diem,10.2,10.2,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,UHC Medicare,UHC Medicare,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY                ,33136538,CDM,279,RC,,,,,,Inpatient,,,10.2,10.2,Wellcare,Wellcare,10.2,,,,,,,case rate,10.2,10.2,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Meritain Health PPO CPD,Meritain Health PPO CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Aetna/Commercial Product,Aetna/Commercial Product,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Meritain Health CPD,Meritain Health CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Starmark CPD,Starmark CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Aetna Medicare,Aetna Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Ambetter ,Ambetter ,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Blue Access,Anthem Blue Access,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Blue Access Choice,Anthem Blue Access Choice,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Blue Preferred,Anthem Blue Preferred,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Pathway,Anthem Pathway,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Alliance,Anthem Alliance,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Anthem Medicare,Anthem Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Cigna,Cigna,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Cigna PPO,Cigna PPO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Cigna Medicare Advantage,Cigna Medicare Advantage,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Essence,Essence,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Healthlink HMO,Healthlink HMO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Healthlink PPO,Healthlink PPO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,HomeState Health Plan,HomeState Health Plan,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Humana Gold,Humana Gold,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Medicaid MO,Medicaid MO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Medica,Medica,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Tricare,Tricare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,UHC All Payer,UHC All Payer,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,UHC Exchange,UHC Exchange,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,UHC Medicaid,UHC Medicaid,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,UMR CPD,UMR CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,UHC Medicare,UHC Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136544,CDM,270,RC,,,,,,Inpatient,,,78.28,78.28,Wellcare,Wellcare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Meritain Health PPO CPD,Meritain Health PPO CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Aetna/Commercial Product,Aetna/Commercial Product,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Meritain Health CPD,Meritain Health CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Starmark CPD,Starmark CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Aetna Medicare,Aetna Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Ambetter ,Ambetter ,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Blue Access,Anthem Blue Access,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Blue Access Choice,Anthem Blue Access Choice,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Blue Preferred,Anthem Blue Preferred,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Pathway,Anthem Pathway,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Alliance,Anthem Alliance,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Anthem Medicare,Anthem Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Cigna,Cigna,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Cigna PPO,Cigna PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Cigna Medicare Advantage,Cigna Medicare Advantage,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Essence,Essence,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Healthlink HMO,Healthlink HMO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Healthlink PPO,Healthlink PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,HomeState Health Plan,HomeState Health Plan,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Humana Gold,Humana Gold,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Medicaid MO,Medicaid MO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Medica,Medica,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Tricare,Tricare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,UHC All Payer,UHC All Payer,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,UHC Exchange,UHC Exchange,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,UHC Medicaid,UHC Medicaid,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,UMR CPD,UMR CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,UHC Medicare,UHC Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136582,CDM,270,RC,,,,,,Inpatient,,,167.89,167.89,Wellcare,Wellcare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health PPO CPD,Meritain Health PPO CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Aetna/Commercial Product,Aetna/Commercial Product,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Meritain Health CPD,Meritain Health CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Starmark CPD,Starmark CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Aetna Medicare,Aetna Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Ambetter ,Ambetter ,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access,Anthem Blue Access,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Access Choice,Anthem Blue Access Choice,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Blue Preferred,Anthem Blue Preferred,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Pathway,Anthem Pathway,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Alliance,Anthem Alliance,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Anthem Medicare,Anthem Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Cigna,Cigna,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Cigna PPO,Cigna PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Cigna Medicare Advantage,Cigna Medicare Advantage,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Essence,Essence,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink HMO,Healthlink HMO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Healthlink PPO,Healthlink PPO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,HomeState Health Plan,HomeState Health Plan,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Humana Gold,Humana Gold,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Medicaid MO,Medicaid MO,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Medica,Medica,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Tricare,Tricare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,UHC All Payer,UHC All Payer,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,UHC Exchange,UHC Exchange,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicaid,UHC Medicaid,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,UMR CPD,UMR CPD,94.25,,,,,,,per diem,94.25,94.25,"Per diem rate, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,UHC Medicare,UHC Medicare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
KNEE ABDUCTION WEDGE W/STRAP  ,33136585,CDM,270,RC,,,,,,Inpatient,,,94.25,94.25,Wellcare,Wellcare,94.25,,,,,,,case rate,94.25,94.25,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Meritain Health PPO CPD,Meritain Health PPO CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna/Commercial Product,Aetna/Commercial Product,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Meritain Health CPD,Meritain Health CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Starmark CPD,Starmark CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna Medicare,Aetna Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Ambetter ,Ambetter ,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Access,Anthem Blue Access,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Access Choice,Anthem Blue Access Choice,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Preferred,Anthem Blue Preferred,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Pathway,Anthem Pathway,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Alliance,Anthem Alliance,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Medicare,Anthem Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna,Cigna,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna PPO,Cigna PPO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna Medicare Advantage,Cigna Medicare Advantage,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Essence,Essence,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthlink HMO,Healthlink HMO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthlink PPO,Healthlink PPO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,HomeState Health Plan,HomeState Health Plan,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Humana Gold,Humana Gold,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Medicaid MO,Medicaid MO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Medica,Medica,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Tricare,Tricare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC All Payer,UHC All Payer,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Exchange,UHC Exchange,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Medicaid,UHC Medicaid,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UMR CPD,UMR CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Medicare,UHC Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES (AP,33136589,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Wellcare,Wellcare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health PPO CPD,Meritain Health PPO CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/Commercial Product,Aetna/Commercial Product,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health CPD,Meritain Health CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Starmark CPD,Starmark CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna Medicare,Aetna Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Ambetter ,Ambetter ,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access,Anthem Blue Access,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access Choice,Anthem Blue Access Choice,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Preferred,Anthem Blue Preferred,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Pathway,Anthem Pathway,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Alliance,Anthem Alliance,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Medicare,Anthem Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna,Cigna,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna PPO,Cigna PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna Medicare Advantage,Cigna Medicare Advantage,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Essence,Essence,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink HMO,Healthlink HMO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink PPO,Healthlink PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,HomeState Health Plan,HomeState Health Plan,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Humana Gold,Humana Gold,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Medicaid MO,Medicaid MO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Medica,Medica,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Tricare,Tricare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC All Payer,UHC All Payer,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Exchange,UHC Exchange,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicaid,UHC Medicaid,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UMR CPD,UMR CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicare,UHC Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 14IN         ,33136596,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Wellcare,Wellcare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Meritain Health PPO CPD,Meritain Health PPO CPD,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Aetna/Commercial Product,Aetna/Commercial Product,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Meritain Health CPD,Meritain Health CPD,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Starmark CPD,Starmark CPD,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Aetna Medicare,Aetna Medicare,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Ambetter ,Ambetter ,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Blue Access,Anthem Blue Access,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Blue Access Choice,Anthem Blue Access Choice,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Blue Preferred,Anthem Blue Preferred,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Pathway,Anthem Pathway,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Alliance,Anthem Alliance,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Anthem Medicare,Anthem Medicare,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Cigna,Cigna,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Cigna PPO,Cigna PPO,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Cigna Medicare Advantage,Cigna Medicare Advantage,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Essence,Essence,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Healthlink HMO,Healthlink HMO,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Healthlink PPO,Healthlink PPO,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,HomeState Health Plan,HomeState Health Plan,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Humana Gold,Humana Gold,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Medicaid MO,Medicaid MO,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Medica,Medica,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Tricare,Tricare,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,UHC All Payer,UHC All Payer,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,UHC Exchange,UHC Exchange,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,UHC Medicaid,UHC Medicaid,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,UMR CPD,UMR CPD,38.11,,,,,,,per diem,38.11,38.11,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,UHC Medicare,UHC Medicare,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 16IN         ,33136597,CDM,270,RC,,,,,,Inpatient,,,38.11,38.11,Wellcare,Wellcare,38.11,,,,,,,case rate,38.11,38.11,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Meritain Health PPO CPD,Meritain Health PPO CPD,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Aetna/Commercial Product,Aetna/Commercial Product,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Meritain Health CPD,Meritain Health CPD,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Starmark CPD,Starmark CPD,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Aetna Medicare,Aetna Medicare,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Ambetter ,Ambetter ,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Blue Access,Anthem Blue Access,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Blue Access Choice,Anthem Blue Access Choice,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Blue Preferred,Anthem Blue Preferred,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Pathway,Anthem Pathway,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Alliance,Anthem Alliance,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Anthem Medicare,Anthem Medicare,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Cigna,Cigna,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Cigna PPO,Cigna PPO,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Cigna Medicare Advantage,Cigna Medicare Advantage,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Essence,Essence,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Healthlink HMO,Healthlink HMO,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Healthlink PPO,Healthlink PPO,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,HomeState Health Plan,HomeState Health Plan,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Humana Gold,Humana Gold,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Medicaid MO,Medicaid MO,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Medica,Medica,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Tricare,Tricare,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,UHC All Payer,UHC All Payer,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,UHC Exchange,UHC Exchange,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,UHC Medicaid,UHC Medicaid,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,UMR CPD,UMR CPD,43.26,,,,,,,per diem,43.26,43.26,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,UHC Medicare,UHC Medicare,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 20IN         ,33136598,CDM,270,RC,,,,,,Inpatient,,,43.26,43.26,Wellcare,Wellcare,43.26,,,,,,,case rate,43.26,43.26,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Meritain Health PPO CPD,Meritain Health PPO CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna/Commercial Product,Aetna/Commercial Product,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Meritain Health CPD,Meritain Health CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Starmark CPD,Starmark CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna Medicare,Aetna Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Ambetter ,Ambetter ,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Access,Anthem Blue Access,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Access Choice,Anthem Blue Access Choice,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Preferred,Anthem Blue Preferred,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Pathway,Anthem Pathway,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Alliance,Anthem Alliance,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Medicare,Anthem Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna,Cigna,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna PPO,Cigna PPO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna Medicare Advantage,Cigna Medicare Advantage,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Essence,Essence,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthlink HMO,Healthlink HMO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthlink PPO,Healthlink PPO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,HomeState Health Plan,HomeState Health Plan,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Humana Gold,Humana Gold,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Medicaid MO,Medicaid MO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Medica,Medica,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Tricare,Tricare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC All Payer,UHC All Payer,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Exchange,UHC Exchange,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Medicaid,UHC Medicaid,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UMR CPD,UMR CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Medicare,UHC Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
KNEE IMMOBILIZER 24IN         ,33136599,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Wellcare,Wellcare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Meritain Health PPO CPD,Meritain Health PPO CPD,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Aetna/Commercial Product,Aetna/Commercial Product,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Meritain Health CPD,Meritain Health CPD,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Starmark CPD,Starmark CPD,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Aetna Medicare,Aetna Medicare,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Ambetter ,Ambetter ,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Blue Access,Anthem Blue Access,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Blue Access Choice,Anthem Blue Access Choice,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Blue Preferred,Anthem Blue Preferred,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Pathway,Anthem Pathway,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Alliance,Anthem Alliance,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Anthem Medicare,Anthem Medicare,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Cigna,Cigna,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Cigna PPO,Cigna PPO,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Cigna Medicare Advantage,Cigna Medicare Advantage,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Essence,Essence,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Healthlink HMO,Healthlink HMO,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Healthlink PPO,Healthlink PPO,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,HomeState Health Plan,HomeState Health Plan,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Humana Gold,Humana Gold,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Medicaid MO,Medicaid MO,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Medica,Medica,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Tricare,Tricare,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,UHC All Payer,UHC All Payer,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,UHC Exchange,UHC Exchange,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,UHC Medicaid,UHC Medicaid,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,UMR CPD,UMR CPD,45.84,,,,,,,per diem,45.84,45.84,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,UHC Medicare,UHC Medicare,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33136637,CDM,270,RC,,,,,,Inpatient,,,45.84,45.84,Wellcare,Wellcare,45.84,,,,,,,case rate,45.84,45.84,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Meritain Health PPO CPD,Meritain Health PPO CPD,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Aetna/Commercial Product,Aetna/Commercial Product,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Meritain Health CPD,Meritain Health CPD,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Starmark CPD,Starmark CPD,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Aetna Medicare,Aetna Medicare,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Ambetter ,Ambetter ,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Blue Access,Anthem Blue Access,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Blue Access Choice,Anthem Blue Access Choice,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Blue Preferred,Anthem Blue Preferred,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Pathway,Anthem Pathway,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Alliance,Anthem Alliance,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Anthem Medicare,Anthem Medicare,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Cigna,Cigna,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Cigna PPO,Cigna PPO,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Cigna Medicare Advantage,Cigna Medicare Advantage,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Essence,Essence,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Healthlink HMO,Healthlink HMO,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Healthlink PPO,Healthlink PPO,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,HomeState Health Plan,HomeState Health Plan,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Humana Gold,Humana Gold,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Medicaid MO,Medicaid MO,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Medica,Medica,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Tricare,Tricare,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,UHC All Payer,UHC All Payer,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,UHC Exchange,UHC Exchange,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,UHC Medicaid,UHC Medicaid,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,UMR CPD,UMR CPD,178.5,,,,,,,per diem,178.5,178.5,"Per diem rate, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,UHC Medicare,UHC Medicare,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO BUNNY BOOT-EACH         ,33136638,CDM,270,RC,,,,,,Inpatient,,,178.5,178.5,Wellcare,Wellcare,178.5,,,,,,,case rate,178.5,178.5,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO CERVICAL COLLAR-A/S     ,33136639,CDM,270,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Meritain Health PPO CPD,Meritain Health PPO CPD,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Aetna/Commercial Product,Aetna/Commercial Product,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Meritain Health CPD,Meritain Health CPD,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Starmark CPD,Starmark CPD,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Aetna Medicare,Aetna Medicare,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Ambetter ,Ambetter ,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Blue Access,Anthem Blue Access,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Blue Access Choice,Anthem Blue Access Choice,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Blue Preferred,Anthem Blue Preferred,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Pathway,Anthem Pathway,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Alliance,Anthem Alliance,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Anthem Medicare,Anthem Medicare,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Cigna,Cigna,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Cigna PPO,Cigna PPO,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Cigna Medicare Advantage,Cigna Medicare Advantage,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Essence,Essence,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Healthlink HMO,Healthlink HMO,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Healthlink PPO,Healthlink PPO,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,HomeState Health Plan,HomeState Health Plan,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Humana Gold,Humana Gold,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Medicaid MO,Medicaid MO,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Medica,Medica,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Tricare,Tricare,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,UHC All Payer,UHC All Payer,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,UHC Exchange,UHC Exchange,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,UHC Medicaid,UHC Medicaid,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,UMR CPD,UMR CPD,73.65,,,,,,,per diem,73.65,73.65,"Per diem rate, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,UHC Medicare,UHC Medicare,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO POSTOP SHOE-A/S         ,33136640,CDM,270,RC,,,,,,Inpatient,,,73.65,73.65,Wellcare,Wellcare,73.65,,,,,,,case rate,73.65,73.65,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Meritain Health PPO CPD,Meritain Health PPO CPD,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Aetna/Commercial Product,Aetna/Commercial Product,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Meritain Health CPD,Meritain Health CPD,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Starmark CPD,Starmark CPD,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Aetna Medicare,Aetna Medicare,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Ambetter ,Ambetter ,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Blue Access,Anthem Blue Access,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Blue Access Choice,Anthem Blue Access Choice,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Blue Preferred,Anthem Blue Preferred,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Pathway,Anthem Pathway,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Alliance,Anthem Alliance,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Anthem Medicare,Anthem Medicare,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Cigna,Cigna,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Cigna PPO,Cigna PPO,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Cigna Medicare Advantage,Cigna Medicare Advantage,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Essence,Essence,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Healthlink HMO,Healthlink HMO,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Healthlink PPO,Healthlink PPO,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,HomeState Health Plan,HomeState Health Plan,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Humana Gold,Humana Gold,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Medicaid MO,Medicaid MO,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Medica,Medica,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Tricare,Tricare,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,UHC All Payer,UHC All Payer,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,UHC Exchange,UHC Exchange,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,UHC Medicaid,UHC Medicaid,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,UMR CPD,UMR CPD,135.96,,,,,,,per diem,135.96,135.96,"Per diem rate, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,UHC Medicare,UHC Medicare,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO SHOULDER IMMOBIL- A/S   ,33136641,CDM,270,RC,,,,,,Inpatient,,,135.96,135.96,Wellcare,Wellcare,135.96,,,,,,,case rate,135.96,135.96,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Meritain Health PPO CPD,Meritain Health PPO CPD,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Aetna/Commercial Product,Aetna/Commercial Product,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Meritain Health CPD,Meritain Health CPD,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Starmark CPD,Starmark CPD,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Aetna Medicare,Aetna Medicare,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Ambetter ,Ambetter ,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Blue Access,Anthem Blue Access,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Blue Access Choice,Anthem Blue Access Choice,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Blue Preferred,Anthem Blue Preferred,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Pathway,Anthem Pathway,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Alliance,Anthem Alliance,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Anthem Medicare,Anthem Medicare,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Cigna,Cigna,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Cigna PPO,Cigna PPO,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Cigna Medicare Advantage,Cigna Medicare Advantage,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Essence,Essence,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Healthlink HMO,Healthlink HMO,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Healthlink PPO,Healthlink PPO,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,HomeState Health Plan,HomeState Health Plan,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Humana Gold,Humana Gold,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Medicaid MO,Medicaid MO,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Medica,Medica,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Tricare,Tricare,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,UHC All Payer,UHC All Payer,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,UHC Exchange,UHC Exchange,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,UHC Medicaid,UHC Medicaid,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,UMR CPD,UMR CPD,97.85,,,,,,,per diem,97.85,97.85,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,UHC Medicare,UHC Medicare,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33136642,CDM,270,RC,,,,,,Inpatient,,,97.85,97.85,Wellcare,Wellcare,97.85,,,,,,,case rate,97.85,97.85,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Meritain Health PPO CPD,Meritain Health PPO CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna/Commercial Product,Aetna/Commercial Product,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Meritain Health CPD,Meritain Health CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Starmark CPD,Starmark CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Aetna Medicare,Aetna Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Ambetter ,Ambetter ,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Access,Anthem Blue Access,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Access Choice,Anthem Blue Access Choice,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Blue Preferred,Anthem Blue Preferred,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Pathway,Anthem Pathway,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Alliance,Anthem Alliance,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Anthem Medicare,Anthem Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna,Cigna,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna PPO,Cigna PPO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Cigna Medicare Advantage,Cigna Medicare Advantage,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Essence,Essence,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthlink HMO,Healthlink HMO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Healthlink PPO,Healthlink PPO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,HomeState Health Plan,HomeState Health Plan,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Humana Gold,Humana Gold,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Medicaid MO,Medicaid MO,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Medica,Medica,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Tricare,Tricare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC All Payer,UHC All Payer,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Exchange,UHC Exchange,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Medicaid,UHC Medicaid,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UMR CPD,UMR CPD,34.51,,,,,,,per diem,34.51,34.51,"Per diem rate, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,UHC Medicare,UHC Medicare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
ALL PURPOSE BOOT ALL SIZES    ,33136648,CDM,270,RC,,,,,,Inpatient,,,34.51,34.51,Wellcare,Wellcare,34.51,,,,,,,case rate,34.51,34.51,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health PPO CPD,Meritain Health PPO CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna/Commercial Product,Aetna/Commercial Product,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Meritain Health CPD,Meritain Health CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Starmark CPD,Starmark CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Aetna Medicare,Aetna Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Ambetter ,Ambetter ,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access,Anthem Blue Access,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Access Choice,Anthem Blue Access Choice,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Blue Preferred,Anthem Blue Preferred,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Pathway,Anthem Pathway,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Alliance,Anthem Alliance,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Anthem Medicare,Anthem Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna,Cigna,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna PPO,Cigna PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Cigna Medicare Advantage,Cigna Medicare Advantage,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Essence,Essence,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink HMO,Healthlink HMO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Healthlink PPO,Healthlink PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,HomeState Health Plan,HomeState Health Plan,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Humana Gold,Humana Gold,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Medicaid MO,Medicaid MO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Medica,Medica,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Tricare,Tricare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC All Payer,UHC All Payer,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Exchange,UHC Exchange,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicaid,UHC Medicaid,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UMR CPD,UMR CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,UHC Medicare,UHC Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 14""          ",33136655,CDM,270,RC,,,,,,Inpatient,,,53.56,53.56,Wellcare,Wellcare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Meritain Health PPO CPD,Meritain Health PPO CPD,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Aetna/Commercial Product,Aetna/Commercial Product,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Meritain Health CPD,Meritain Health CPD,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Starmark CPD,Starmark CPD,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Aetna Medicare,Aetna Medicare,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Ambetter ,Ambetter ,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Blue Access,Anthem Blue Access,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Blue Access Choice,Anthem Blue Access Choice,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Blue Preferred,Anthem Blue Preferred,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Pathway,Anthem Pathway,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Alliance,Anthem Alliance,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Anthem Medicare,Anthem Medicare,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Cigna,Cigna,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Cigna PPO,Cigna PPO,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Cigna Medicare Advantage,Cigna Medicare Advantage,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Essence,Essence,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Healthlink HMO,Healthlink HMO,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Healthlink PPO,Healthlink PPO,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,HomeState Health Plan,HomeState Health Plan,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Humana Gold,Humana Gold,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Medicaid MO,Medicaid MO,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Medica,Medica,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Tricare,Tricare,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,UHC All Payer,UHC All Payer,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,UHC Exchange,UHC Exchange,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,UHC Medicaid,UHC Medicaid,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,UMR CPD,UMR CPD,82.92,,,,,,,per diem,82.92,82.92,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,UHC Medicare,UHC Medicare,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16""          ",33136656,CDM,270,RC,,,,,,Inpatient,,,82.92,82.92,Wellcare,Wellcare,82.92,,,,,,,case rate,82.92,82.92,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Meritain Health PPO CPD,Meritain Health PPO CPD,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Aetna/Commercial Product,Aetna/Commercial Product,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Meritain Health CPD,Meritain Health CPD,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Starmark CPD,Starmark CPD,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Aetna Medicare,Aetna Medicare,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Ambetter ,Ambetter ,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Blue Access,Anthem Blue Access,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Blue Access Choice,Anthem Blue Access Choice,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Blue Preferred,Anthem Blue Preferred,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Pathway,Anthem Pathway,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Alliance,Anthem Alliance,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Anthem Medicare,Anthem Medicare,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Cigna,Cigna,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Cigna PPO,Cigna PPO,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Cigna Medicare Advantage,Cigna Medicare Advantage,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Essence,Essence,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Healthlink HMO,Healthlink HMO,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Healthlink PPO,Healthlink PPO,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,HomeState Health Plan,HomeState Health Plan,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Humana Gold,Humana Gold,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Medicaid MO,Medicaid MO,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Medica,Medica,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Tricare,Tricare,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,UHC All Payer,UHC All Payer,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,UHC Exchange,UHC Exchange,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,UHC Medicaid,UHC Medicaid,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,UMR CPD,UMR CPD,85.49,,,,,,,per diem,85.49,85.49,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,UHC Medicare,UHC Medicare,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 20""          ",33136657,CDM,270,RC,,,,,,Inpatient,,,85.49,85.49,Wellcare,Wellcare,85.49,,,,,,,case rate,85.49,85.49,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Meritain Health PPO CPD,Meritain Health PPO CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna/Commercial Product,Aetna/Commercial Product,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Meritain Health CPD,Meritain Health CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Starmark CPD,Starmark CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Aetna Medicare,Aetna Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Ambetter ,Ambetter ,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Access,Anthem Blue Access,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Access Choice,Anthem Blue Access Choice,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Blue Preferred,Anthem Blue Preferred,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Pathway,Anthem Pathway,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Alliance,Anthem Alliance,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Anthem Medicare,Anthem Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna,Cigna,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna PPO,Cigna PPO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Cigna Medicare Advantage,Cigna Medicare Advantage,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Essence,Essence,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthlink HMO,Healthlink HMO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Healthlink PPO,Healthlink PPO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,HomeState Health Plan,HomeState Health Plan,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Humana Gold,Humana Gold,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Medicaid MO,Medicaid MO,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Medica,Medica,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Tricare,Tricare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC All Payer,UHC All Payer,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Exchange,UHC Exchange,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Medicaid,UHC Medicaid,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UMR CPD,UMR CPD,48.93,,,,,,,per diem,48.93,48.93,"Per diem rate, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,UHC Medicare,UHC Medicare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEWW IMMOBILIZER 24""         ",33136658,CDM,270,RC,,,,,,Inpatient,,,48.93,48.93,Wellcare,Wellcare,48.93,,,,,,,case rate,48.93,48.93,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health PPO CPD,Meritain Health PPO CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Aetna/Commercial Product,Aetna/Commercial Product,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Meritain Health CPD,Meritain Health CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Starmark CPD,Starmark CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Aetna Medicare,Aetna Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Ambetter ,Ambetter ,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access,Anthem Blue Access,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Access Choice,Anthem Blue Access Choice,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Blue Preferred,Anthem Blue Preferred,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Pathway,Anthem Pathway,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Alliance,Anthem Alliance,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Anthem Medicare,Anthem Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Cigna,Cigna,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Cigna PPO,Cigna PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Cigna Medicare Advantage,Cigna Medicare Advantage,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Essence,Essence,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink HMO,Healthlink HMO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Healthlink PPO,Healthlink PPO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,HomeState Health Plan,HomeState Health Plan,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Humana Gold,Humana Gold,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Medicaid MO,Medicaid MO,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Medica,Medica,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Tricare,Tricare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,UHC All Payer,UHC All Payer,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,UHC Exchange,UHC Exchange,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicaid,UHC Medicaid,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,UMR CPD,UMR CPD,266.77,,,,,,,per diem,266.77,266.77,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,UHC Medicare,UHC Medicare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 21"" BARIATRIC",33136665,CDM,270,RC,,,,,,Inpatient,,,266.77,266.77,Wellcare,Wellcare,266.77,,,,,,,case rate,266.77,266.77,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Meritain Health PPO CPD,Meritain Health PPO CPD,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Aetna/Commercial Product,Aetna/Commercial Product,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Meritain Health CPD,Meritain Health CPD,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Starmark CPD,Starmark CPD,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Aetna Medicare,Aetna Medicare,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Ambetter ,Ambetter ,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Blue Access,Anthem Blue Access,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Blue Access Choice,Anthem Blue Access Choice,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Blue Preferred,Anthem Blue Preferred,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Pathway,Anthem Pathway,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Alliance,Anthem Alliance,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Anthem Medicare,Anthem Medicare,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Cigna,Cigna,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Cigna PPO,Cigna PPO,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Cigna Medicare Advantage,Cigna Medicare Advantage,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Essence,Essence,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Healthlink HMO,Healthlink HMO,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Healthlink PPO,Healthlink PPO,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,HomeState Health Plan,HomeState Health Plan,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Humana Gold,Humana Gold,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Medicaid MO,Medicaid MO,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Medica,Medica,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Tricare,Tricare,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,UHC All Payer,UHC All Payer,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,UHC Exchange,UHC Exchange,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,UHC Medicaid,UHC Medicaid,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,UMR CPD,UMR CPD,82.47,,,,,,,per diem,82.47,82.47,"Per diem rate, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,UHC Medicare,UHC Medicare,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FIG-8 ANKLE BRACE XXL         ,33136666,CDM,270,RC,,,,,,Inpatient,,,82.47,82.47,Wellcare,Wellcare,82.47,,,,,,,case rate,82.47,82.47,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33139018,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Meritain Health PPO CPD,Meritain Health PPO CPD,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Aetna/Commercial Product,Aetna/Commercial Product,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Meritain Health CPD,Meritain Health CPD,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Starmark CPD,Starmark CPD,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Aetna Medicare,Aetna Medicare,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Ambetter ,Ambetter ,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Blue Access,Anthem Blue Access,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Blue Access Choice,Anthem Blue Access Choice,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Blue Preferred,Anthem Blue Preferred,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Pathway,Anthem Pathway,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Alliance,Anthem Alliance,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Anthem Medicare,Anthem Medicare,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Cigna,Cigna,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Cigna PPO,Cigna PPO,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Cigna Medicare Advantage,Cigna Medicare Advantage,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Essence,Essence,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Healthlink HMO,Healthlink HMO,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Healthlink PPO,Healthlink PPO,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,HomeState Health Plan,HomeState Health Plan,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Humana Gold,Humana Gold,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Medicaid MO,Medicaid MO,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Medica,Medica,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Tricare,Tricare,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,UHC All Payer,UHC All Payer,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,UHC Exchange,UHC Exchange,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,UHC Medicaid,UHC Medicaid,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,UMR CPD,UMR CPD,561.5,,,,,,,per diem,561.5,561.5,"Per diem rate, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,UHC Medicare,UHC Medicare,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
JAC-EXCEL MIDSIZE UNIT W/HN   ,33139053,CDM,279,RC,,,,,,Inpatient,,,561.5,561.5,Wellcare,Wellcare,561.5,,,,,,,case rate,561.5,561.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Meritain Health PPO CPD,Meritain Health PPO CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna/Commercial Product,Aetna/Commercial Product,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Meritain Health CPD,Meritain Health CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Starmark CPD,Starmark CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna Medicare,Aetna Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Ambetter ,Ambetter ,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Access,Anthem Blue Access,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Access Choice,Anthem Blue Access Choice,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Preferred,Anthem Blue Preferred,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Pathway,Anthem Pathway,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Alliance,Anthem Alliance,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Medicare,Anthem Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna,Cigna,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna PPO,Cigna PPO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna Medicare Advantage,Cigna Medicare Advantage,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Essence,Essence,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthlink HMO,Healthlink HMO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthlink PPO,Healthlink PPO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,HomeState Health Plan,HomeState Health Plan,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Humana Gold,Humana Gold,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Medicaid MO,Medicaid MO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Medica,Medica,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Tricare,Tricare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC All Payer,UHC All Payer,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Exchange,UHC Exchange,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Medicaid,UHC Medicaid,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UMR CPD,UMR CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Medicare,UHC Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33139221,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Wellcare,Wellcare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Meritain Health PPO CPD,Meritain Health PPO CPD,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Aetna/Commercial Product,Aetna/Commercial Product,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Meritain Health CPD,Meritain Health CPD,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Starmark CPD,Starmark CPD,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Aetna Medicare,Aetna Medicare,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Ambetter ,Ambetter ,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Blue Access,Anthem Blue Access,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Blue Access Choice,Anthem Blue Access Choice,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Blue Preferred,Anthem Blue Preferred,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Pathway,Anthem Pathway,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Alliance,Anthem Alliance,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Anthem Medicare,Anthem Medicare,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Cigna,Cigna,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Cigna PPO,Cigna PPO,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Cigna Medicare Advantage,Cigna Medicare Advantage,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Essence,Essence,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Healthlink HMO,Healthlink HMO,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Healthlink PPO,Healthlink PPO,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,HomeState Health Plan,HomeState Health Plan,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Humana Gold,Humana Gold,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Medicaid MO,Medicaid MO,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Medica,Medica,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Tricare,Tricare,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,UHC All Payer,UHC All Payer,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,UHC Exchange,UHC Exchange,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,UHC Medicaid,UHC Medicaid,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,UMR CPD,UMR CPD,25.5,,,,,,,per diem,25.5,25.5,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,UHC Medicare,UHC Medicare,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33139229,CDM,270,RC,,,,,,Inpatient,,,25.5,25.5,Wellcare,Wellcare,25.5,,,,,,,case rate,25.5,25.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Meritain Health PPO CPD,Meritain Health PPO CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Aetna/Commercial Product,Aetna/Commercial Product,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Meritain Health CPD,Meritain Health CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Starmark CPD,Starmark CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Aetna Medicare,Aetna Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Ambetter ,Ambetter ,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Access,Anthem Blue Access,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Access Choice,Anthem Blue Access Choice,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Blue Preferred,Anthem Blue Preferred,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Pathway,Anthem Pathway,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Alliance,Anthem Alliance,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Anthem Medicare,Anthem Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Cigna,Cigna,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Cigna PPO,Cigna PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Cigna Medicare Advantage,Cigna Medicare Advantage,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Essence,Essence,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Healthlink HMO,Healthlink HMO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Healthlink PPO,Healthlink PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,HomeState Health Plan,HomeState Health Plan,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Humana Gold,Humana Gold,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Medicaid MO,Medicaid MO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Medica,Medica,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Tricare,Tricare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,UHC All Payer,UHC All Payer,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,UHC Exchange,UHC Exchange,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,UHC Medicaid,UHC Medicaid,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,UMR CPD,UMR CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,UHC Medicare,UHC Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33139238,CDM,270,RC,,,,,,Inpatient,,,7.21,7.21,Wellcare,Wellcare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Meritain Health PPO CPD,Meritain Health PPO CPD,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Aetna/Commercial Product,Aetna/Commercial Product,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Meritain Health CPD,Meritain Health CPD,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Starmark CPD,Starmark CPD,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Aetna Medicare,Aetna Medicare,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Ambetter ,Ambetter ,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Blue Access,Anthem Blue Access,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Blue Access Choice,Anthem Blue Access Choice,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Blue Preferred,Anthem Blue Preferred,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Pathway,Anthem Pathway,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Alliance,Anthem Alliance,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Anthem Medicare,Anthem Medicare,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Cigna,Cigna,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Cigna PPO,Cigna PPO,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Cigna Medicare Advantage,Cigna Medicare Advantage,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Essence,Essence,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Healthlink HMO,Healthlink HMO,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Healthlink PPO,Healthlink PPO,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,HomeState Health Plan,HomeState Health Plan,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Humana Gold,Humana Gold,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Medicaid MO,Medicaid MO,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Medica,Medica,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Tricare,Tricare,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,UHC All Payer,UHC All Payer,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,UHC Exchange,UHC Exchange,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,UHC Medicaid,UHC Medicaid,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,UMR CPD,UMR CPD,566,,,,,,,per diem,566,566,"Per diem rate, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,UHC Medicare,UHC Medicare,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
VAC FREEDOM CANNISTER W/GEL 5/,33139300,CDM,279,RC,,,,,,Inpatient,,,566,566,Wellcare,Wellcare,566,,,,,,,case rate,566,566,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Meritain Health PPO CPD,Meritain Health PPO CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna/Commercial Product,Aetna/Commercial Product,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Meritain Health CPD,Meritain Health CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Starmark CPD,Starmark CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna Medicare,Aetna Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Ambetter ,Ambetter ,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Access,Anthem Blue Access,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Access Choice,Anthem Blue Access Choice,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Preferred,Anthem Blue Preferred,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Pathway,Anthem Pathway,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Alliance,Anthem Alliance,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Medicare,Anthem Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna,Cigna,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna PPO,Cigna PPO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna Medicare Advantage,Cigna Medicare Advantage,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Essence,Essence,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthlink HMO,Healthlink HMO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthlink PPO,Healthlink PPO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,HomeState Health Plan,HomeState Health Plan,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Humana Gold,Humana Gold,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Medicaid MO,Medicaid MO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Medica,Medica,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Tricare,Tricare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC All Payer,UHC All Payer,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Exchange,UHC Exchange,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Medicaid,UHC Medicaid,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UMR CPD,UMR CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Medicare,UHC Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33139303,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Wellcare,Wellcare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Meritain Health PPO CPD,Meritain Health PPO CPD,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Aetna/Commercial Product,Aetna/Commercial Product,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Meritain Health CPD,Meritain Health CPD,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Starmark CPD,Starmark CPD,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Aetna Medicare,Aetna Medicare,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Ambetter ,Ambetter ,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Blue Access,Anthem Blue Access,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Blue Access Choice,Anthem Blue Access Choice,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Blue Preferred,Anthem Blue Preferred,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Pathway,Anthem Pathway,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Alliance,Anthem Alliance,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Anthem Medicare,Anthem Medicare,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Cigna,Cigna,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Cigna PPO,Cigna PPO,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Cigna Medicare Advantage,Cigna Medicare Advantage,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Essence,Essence,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Healthlink HMO,Healthlink HMO,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Healthlink PPO,Healthlink PPO,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,HomeState Health Plan,HomeState Health Plan,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Humana Gold,Humana Gold,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Medicaid MO,Medicaid MO,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Medica,Medica,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Tricare,Tricare,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,UHC All Payer,UHC All Payer,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,UHC Exchange,UHC Exchange,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,UHC Medicaid,UHC Medicaid,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,UMR CPD,UMR CPD,41.72,,,,,,,per diem,41.72,41.72,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,UHC Medicare,UHC Medicare,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER 10""          ",33139327,CDM,270,RC,,,,,,Inpatient,,,41.72,41.72,Wellcare,Wellcare,41.72,,,,,,,case rate,41.72,41.72,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Meritain Health PPO CPD,Meritain Health PPO CPD,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Aetna/Commercial Product,Aetna/Commercial Product,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Meritain Health CPD,Meritain Health CPD,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Starmark CPD,Starmark CPD,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Aetna Medicare,Aetna Medicare,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Ambetter ,Ambetter ,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Blue Access,Anthem Blue Access,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Blue Access Choice,Anthem Blue Access Choice,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Blue Preferred,Anthem Blue Preferred,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Pathway,Anthem Pathway,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Alliance,Anthem Alliance,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Anthem Medicare,Anthem Medicare,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Cigna,Cigna,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Cigna PPO,Cigna PPO,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Cigna Medicare Advantage,Cigna Medicare Advantage,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Essence,Essence,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Healthlink HMO,Healthlink HMO,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Healthlink PPO,Healthlink PPO,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,HomeState Health Plan,HomeState Health Plan,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Humana Gold,Humana Gold,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Medicaid MO,Medicaid MO,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Medica,Medica,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Tricare,Tricare,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,UHC All Payer,UHC All Payer,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,UHC Exchange,UHC Exchange,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,UHC Medicaid,UHC Medicaid,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,UMR CPD,UMR CPD,306,,,,,,,per diem,306,306,"Per diem rate, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,UHC Medicare,UHC Medicare,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
"CERVICAL COLLAR,SEMI-RIGID, TH",33139358,CDM,270,RC,,,,,,Inpatient,,,306,306,Wellcare,Wellcare,306,,,,,,,case rate,306,306,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Meritain Health PPO CPD,Meritain Health PPO CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna/Commercial Product,Aetna/Commercial Product,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Meritain Health CPD,Meritain Health CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Starmark CPD,Starmark CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna Medicare,Aetna Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Ambetter ,Ambetter ,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Access,Anthem Blue Access,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Access Choice,Anthem Blue Access Choice,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Preferred,Anthem Blue Preferred,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Pathway,Anthem Pathway,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Alliance,Anthem Alliance,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Medicare,Anthem Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna,Cigna,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna PPO,Cigna PPO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna Medicare Advantage,Cigna Medicare Advantage,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Essence,Essence,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthlink HMO,Healthlink HMO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthlink PPO,Healthlink PPO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,HomeState Health Plan,HomeState Health Plan,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Humana Gold,Humana Gold,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Medicaid MO,Medicaid MO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Medica,Medica,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Tricare,Tricare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC All Payer,UHC All Payer,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Exchange,UHC Exchange,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Medicaid,UHC Medicaid,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UMR CPD,UMR CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Medicare,UHC Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33139361,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Wellcare,Wellcare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Meritain Health PPO CPD,Meritain Health PPO CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Aetna/Commercial Product,Aetna/Commercial Product,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Meritain Health CPD,Meritain Health CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Starmark CPD,Starmark CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Aetna Medicare,Aetna Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Ambetter ,Ambetter ,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access,Anthem Blue Access,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access Choice,Anthem Blue Access Choice,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Blue Preferred,Anthem Blue Preferred,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Pathway,Anthem Pathway,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Alliance,Anthem Alliance,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Anthem Medicare,Anthem Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Cigna,Cigna,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Cigna PPO,Cigna PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Cigna Medicare Advantage,Cigna Medicare Advantage,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Essence,Essence,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Healthlink HMO,Healthlink HMO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Healthlink PPO,Healthlink PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,HomeState Health Plan,HomeState Health Plan,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Humana Gold,Humana Gold,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Medicaid MO,Medicaid MO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Medica,Medica,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Tricare,Tricare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,UHC All Payer,UHC All Payer,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,UHC Exchange,UHC Exchange,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,UHC Medicaid,UHC Medicaid,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,UMR CPD,UMR CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,UHC Medicare,UHC Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
"PODOUS BOOT, REG              ",33139362,CDM,270,RC,,,,,,Inpatient,,,131,131,Wellcare,Wellcare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33139375,CDM,279,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED CONTOURA 880 R  ,33139376,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Meritain Health PPO CPD,Meritain Health PPO CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna/Commercial Product,Aetna/Commercial Product,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Meritain Health CPD,Meritain Health CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Starmark CPD,Starmark CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna Medicare,Aetna Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Ambetter ,Ambetter ,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Access,Anthem Blue Access,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Access Choice,Anthem Blue Access Choice,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Preferred,Anthem Blue Preferred,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Pathway,Anthem Pathway,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Alliance,Anthem Alliance,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Medicare,Anthem Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna,Cigna,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna PPO,Cigna PPO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna Medicare Advantage,Cigna Medicare Advantage,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Essence,Essence,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthlink HMO,Healthlink HMO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthlink PPO,Healthlink PPO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,HomeState Health Plan,HomeState Health Plan,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Humana Gold,Humana Gold,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Medicaid MO,Medicaid MO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Medica,Medica,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Tricare,Tricare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC All Payer,UHC All Payer,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Exchange,UHC Exchange,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Medicaid,UHC Medicaid,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UMR CPD,UMR CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Medicare,UHC Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL 700l ,33139377,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Wellcare,Wellcare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Meritain Health PPO CPD,Meritain Health PPO CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna/Commercial Product,Aetna/Commercial Product,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Meritain Health CPD,Meritain Health CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Starmark CPD,Starmark CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna Medicare,Aetna Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Ambetter ,Ambetter ,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Access,Anthem Blue Access,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Access Choice,Anthem Blue Access Choice,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Preferred,Anthem Blue Preferred,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Pathway,Anthem Pathway,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Alliance,Anthem Alliance,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Medicare,Anthem Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna,Cigna,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna PPO,Cigna PPO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna Medicare Advantage,Cigna Medicare Advantage,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Essence,Essence,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthlink HMO,Healthlink HMO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthlink PPO,Healthlink PPO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,HomeState Health Plan,HomeState Health Plan,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Humana Gold,Humana Gold,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Medicaid MO,Medicaid MO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Medica,Medica,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Tricare,Tricare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC All Payer,UHC All Payer,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Exchange,UHC Exchange,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Medicaid,UHC Medicaid,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,UMR CPD,UMR CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Medicare,UHC Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33139378,CDM,279,RC,,,,,,Inpatient,,,125,125,Wellcare,Wellcare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Meritain Health PPO CPD,Meritain Health PPO CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna/Commercial Product,Aetna/Commercial Product,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Meritain Health CPD,Meritain Health CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Starmark CPD,Starmark CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna Medicare,Aetna Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Ambetter ,Ambetter ,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Access,Anthem Blue Access,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Access Choice,Anthem Blue Access Choice,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Preferred,Anthem Blue Preferred,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Pathway,Anthem Pathway,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Alliance,Anthem Alliance,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Medicare,Anthem Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna,Cigna,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna PPO,Cigna PPO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna Medicare Advantage,Cigna Medicare Advantage,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Essence,Essence,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthlink HMO,Healthlink HMO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthlink PPO,Healthlink PPO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,HomeState Health Plan,HomeState Health Plan,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Humana Gold,Humana Gold,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Medicaid MO,Medicaid MO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Medica,Medica,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Tricare,Tricare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC All Payer,UHC All Payer,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Exchange,UHC Exchange,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Medicaid,UHC Medicaid,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,UMR CPD,UMR CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Medicare,UHC Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33139379,CDM,279,RC,,,,,,Inpatient,,,73,73,Wellcare,Wellcare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33139380,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Meritain Health PPO CPD,Meritain Health PPO CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Aetna/Commercial Product,Aetna/Commercial Product,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Meritain Health CPD,Meritain Health CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Starmark CPD,Starmark CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Aetna Medicare,Aetna Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Ambetter ,Ambetter ,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Blue Access,Anthem Blue Access,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Blue Access Choice,Anthem Blue Access Choice,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Blue Preferred,Anthem Blue Preferred,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Pathway,Anthem Pathway,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Alliance,Anthem Alliance,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Anthem Medicare,Anthem Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Cigna,Cigna,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Cigna PPO,Cigna PPO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Cigna Medicare Advantage,Cigna Medicare Advantage,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Essence,Essence,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Healthlink HMO,Healthlink HMO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Healthlink PPO,Healthlink PPO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,HomeState Health Plan,HomeState Health Plan,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Humana Gold,Humana Gold,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Medicaid MO,Medicaid MO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Medica,Medica,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Tricare,Tricare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,UHC All Payer,UHC All Payer,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,UHC Exchange,UHC Exchange,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,UHC Medicaid,UHC Medicaid,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,UMR CPD,UMR CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,UHC Medicare,UHC Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33139381,CDM,279,RC,,,,,,Inpatient,,,195,195,Wellcare,Wellcare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health PPO CPD,Meritain Health PPO CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/Commercial Product,Aetna/Commercial Product,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health CPD,Meritain Health CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Starmark CPD,Starmark CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna Medicare,Aetna Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Ambetter ,Ambetter ,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access,Anthem Blue Access,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access Choice,Anthem Blue Access Choice,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Preferred,Anthem Blue Preferred,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Pathway,Anthem Pathway,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Alliance,Anthem Alliance,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Medicare,Anthem Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna,Cigna,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna PPO,Cigna PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna Medicare Advantage,Cigna Medicare Advantage,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Essence,Essence,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink HMO,Healthlink HMO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink PPO,Healthlink PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,HomeState Health Plan,HomeState Health Plan,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Humana Gold,Humana Gold,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medicaid MO,Medicaid MO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medica,Medica,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Tricare,Tricare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC All Payer,UHC All Payer,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Exchange,UHC Exchange,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicaid,UHC Medicaid,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UMR CPD,UMR CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicare,UHC Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33139382,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Wellcare,Wellcare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Meritain Health PPO CPD,Meritain Health PPO CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna/Commercial Product,Aetna/Commercial Product,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Meritain Health CPD,Meritain Health CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Starmark CPD,Starmark CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna Medicare,Aetna Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Ambetter ,Ambetter ,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Access,Anthem Blue Access,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Access Choice,Anthem Blue Access Choice,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Preferred,Anthem Blue Preferred,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Pathway,Anthem Pathway,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Alliance,Anthem Alliance,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Medicare,Anthem Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna,Cigna,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna PPO,Cigna PPO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna Medicare Advantage,Cigna Medicare Advantage,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Essence,Essence,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthlink HMO,Healthlink HMO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthlink PPO,Healthlink PPO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,HomeState Health Plan,HomeState Health Plan,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Humana Gold,Humana Gold,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Medicaid MO,Medicaid MO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Medica,Medica,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Tricare,Tricare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC All Payer,UHC All Payer,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Exchange,UHC Exchange,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Medicaid,UHC Medicaid,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UMR CPD,UMR CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Medicare,UHC Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33139383,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Wellcare,Wellcare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33139384,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33139385,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT RECLIN,33139386,CDM,279,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33139387,CDM,279,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Meritain Health PPO CPD,Meritain Health PPO CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna/Commercial Product,Aetna/Commercial Product,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Meritain Health CPD,Meritain Health CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Starmark CPD,Starmark CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna Medicare,Aetna Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Ambetter ,Ambetter ,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Access,Anthem Blue Access,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Access Choice,Anthem Blue Access Choice,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Preferred,Anthem Blue Preferred,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Pathway,Anthem Pathway,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Alliance,Anthem Alliance,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Medicare,Anthem Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna,Cigna,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna PPO,Cigna PPO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna Medicare Advantage,Cigna Medicare Advantage,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Essence,Essence,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthlink HMO,Healthlink HMO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthlink PPO,Healthlink PPO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,HomeState Health Plan,HomeState Health Plan,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Humana Gold,Humana Gold,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Medicaid MO,Medicaid MO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Medica,Medica,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Tricare,Tricare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC All Payer,UHC All Payer,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Exchange,UHC Exchange,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Medicaid,UHC Medicaid,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UMR CPD,UMR CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Medicare,UHC Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33139388,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Wellcare,Wellcare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health PPO CPD,Meritain Health PPO CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/Commercial Product,Aetna/Commercial Product,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health CPD,Meritain Health CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Starmark CPD,Starmark CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna Medicare,Aetna Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Ambetter ,Ambetter ,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access,Anthem Blue Access,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access Choice,Anthem Blue Access Choice,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Preferred,Anthem Blue Preferred,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Pathway,Anthem Pathway,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Alliance,Anthem Alliance,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Medicare,Anthem Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna,Cigna,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna PPO,Cigna PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna Medicare Advantage,Cigna Medicare Advantage,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Essence,Essence,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink HMO,Healthlink HMO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink PPO,Healthlink PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,HomeState Health Plan,HomeState Health Plan,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Humana Gold,Humana Gold,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medicaid MO,Medicaid MO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medica,Medica,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Tricare,Tricare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC All Payer,UHC All Payer,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Exchange,UHC Exchange,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicaid,UHC Medicaid,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UMR CPD,UMR CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicare,UHC Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33139389,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Wellcare,Wellcare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Meritain Health PPO CPD,Meritain Health PPO CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna/Commercial Product,Aetna/Commercial Product,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Meritain Health CPD,Meritain Health CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Starmark CPD,Starmark CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna Medicare,Aetna Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Ambetter ,Ambetter ,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access,Anthem Blue Access,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access Choice,Anthem Blue Access Choice,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Preferred,Anthem Blue Preferred,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Pathway,Anthem Pathway,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Alliance,Anthem Alliance,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Medicare,Anthem Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna,Cigna,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna PPO,Cigna PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna Medicare Advantage,Cigna Medicare Advantage,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Essence,Essence,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthlink HMO,Healthlink HMO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthlink PPO,Healthlink PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,HomeState Health Plan,HomeState Health Plan,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Humana Gold,Humana Gold,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Medicaid MO,Medicaid MO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Medica,Medica,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Tricare,Tricare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC All Payer,UHC All Payer,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Exchange,UHC Exchange,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Medicaid,UHC Medicaid,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,UMR CPD,UMR CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Medicare,UHC Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY DA,33139390,CDM,279,RC,,,,,,Inpatient,,,21,21,Wellcare,Wellcare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health PPO CPD,Meritain Health PPO CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/Commercial Product,Aetna/Commercial Product,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health CPD,Meritain Health CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Starmark CPD,Starmark CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna Medicare,Aetna Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Ambetter ,Ambetter ,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access,Anthem Blue Access,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access Choice,Anthem Blue Access Choice,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Preferred,Anthem Blue Preferred,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Pathway,Anthem Pathway,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Alliance,Anthem Alliance,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Medicare,Anthem Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna,Cigna,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna PPO,Cigna PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna Medicare Advantage,Cigna Medicare Advantage,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Essence,Essence,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink HMO,Healthlink HMO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink PPO,Healthlink PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,HomeState Health Plan,HomeState Health Plan,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Humana Gold,Humana Gold,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Medicaid MO,Medicaid MO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Medica,Medica,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Tricare,Tricare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC All Payer,UHC All Payer,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Exchange,UHC Exchange,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicaid,UHC Medicaid,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,UMR CPD,UMR CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicare,UHC Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33139391,CDM,279,RC,,,,,,Inpatient,,,50,50,Wellcare,Wellcare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health PPO CPD,Meritain Health PPO CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/Commercial Product,Aetna/Commercial Product,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health CPD,Meritain Health CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Starmark CPD,Starmark CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna Medicare,Aetna Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Ambetter ,Ambetter ,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access,Anthem Blue Access,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access Choice,Anthem Blue Access Choice,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Preferred,Anthem Blue Preferred,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Pathway,Anthem Pathway,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Alliance,Anthem Alliance,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Medicare,Anthem Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna,Cigna,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna PPO,Cigna PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna Medicare Advantage,Cigna Medicare Advantage,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Essence,Essence,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink HMO,Healthlink HMO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink PPO,Healthlink PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,HomeState Health Plan,HomeState Health Plan,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Humana Gold,Humana Gold,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Medicaid MO,Medicaid MO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Medica,Medica,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Tricare,Tricare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC All Payer,UHC All Payer,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Exchange,UHC Exchange,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicaid,UHC Medicaid,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,UMR CPD,UMR CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicare,UHC Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33139392,CDM,279,RC,,,,,,Inpatient,,,4,4,Wellcare,Wellcare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health PPO CPD,Meritain Health PPO CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/Commercial Product,Aetna/Commercial Product,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health CPD,Meritain Health CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Starmark CPD,Starmark CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna Medicare,Aetna Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Ambetter ,Ambetter ,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access,Anthem Blue Access,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access Choice,Anthem Blue Access Choice,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Preferred,Anthem Blue Preferred,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Pathway,Anthem Pathway,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Alliance,Anthem Alliance,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Medicare,Anthem Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna,Cigna,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna PPO,Cigna PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna Medicare Advantage,Cigna Medicare Advantage,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Essence,Essence,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink HMO,Healthlink HMO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink PPO,Healthlink PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,HomeState Health Plan,HomeState Health Plan,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Humana Gold,Humana Gold,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Medicaid MO,Medicaid MO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Medica,Medica,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Tricare,Tricare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC All Payer,UHC All Payer,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Exchange,UHC Exchange,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicaid,UHC Medicaid,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,UMR CPD,UMR CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicare,UHC Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33139393,CDM,279,RC,,,,,,Inpatient,,,50,50,Wellcare,Wellcare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health PPO CPD,Meritain Health PPO CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/Commercial Product,Aetna/Commercial Product,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health CPD,Meritain Health CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Starmark CPD,Starmark CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna Medicare,Aetna Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Ambetter ,Ambetter ,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access,Anthem Blue Access,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access Choice,Anthem Blue Access Choice,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Preferred,Anthem Blue Preferred,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Pathway,Anthem Pathway,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Alliance,Anthem Alliance,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Medicare,Anthem Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna,Cigna,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna PPO,Cigna PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna Medicare Advantage,Cigna Medicare Advantage,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Essence,Essence,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink HMO,Healthlink HMO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink PPO,Healthlink PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,HomeState Health Plan,HomeState Health Plan,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Humana Gold,Humana Gold,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Medicaid MO,Medicaid MO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Medica,Medica,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Tricare,Tricare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC All Payer,UHC All Payer,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Exchange,UHC Exchange,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicaid,UHC Medicaid,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,UMR CPD,UMR CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicare,UHC Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33139395,CDM,279,RC,,,,,,Inpatient,,,135,135,Wellcare,Wellcare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health PPO CPD,Meritain Health PPO CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/Commercial Product,Aetna/Commercial Product,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health CPD,Meritain Health CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Starmark CPD,Starmark CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna Medicare,Aetna Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Ambetter ,Ambetter ,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access,Anthem Blue Access,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access Choice,Anthem Blue Access Choice,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Preferred,Anthem Blue Preferred,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Pathway,Anthem Pathway,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Alliance,Anthem Alliance,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Medicare,Anthem Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna,Cigna,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna PPO,Cigna PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna Medicare Advantage,Cigna Medicare Advantage,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Essence,Essence,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink HMO,Healthlink HMO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink PPO,Healthlink PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,HomeState Health Plan,HomeState Health Plan,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Humana Gold,Humana Gold,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Medicaid MO,Medicaid MO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Medica,Medica,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Tricare,Tricare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC All Payer,UHC All Payer,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Exchange,UHC Exchange,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicaid,UHC Medicaid,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,UMR CPD,UMR CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicare,UHC Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33139396,CDM,279,RC,,,,,,Inpatient,,,156,156,Wellcare,Wellcare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33139397,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Meritain Health PPO CPD,Meritain Health PPO CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna/Commercial Product,Aetna/Commercial Product,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Meritain Health CPD,Meritain Health CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Starmark CPD,Starmark CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna Medicare,Aetna Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Ambetter ,Ambetter ,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Access,Anthem Blue Access,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Access Choice,Anthem Blue Access Choice,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Preferred,Anthem Blue Preferred,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Pathway,Anthem Pathway,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Alliance,Anthem Alliance,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Medicare,Anthem Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna,Cigna,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna PPO,Cigna PPO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna Medicare Advantage,Cigna Medicare Advantage,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Essence,Essence,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthlink HMO,Healthlink HMO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthlink PPO,Healthlink PPO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,HomeState Health Plan,HomeState Health Plan,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Humana Gold,Humana Gold,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Medicaid MO,Medicaid MO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Medica,Medica,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Tricare,Tricare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC All Payer,UHC All Payer,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Exchange,UHC Exchange,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Medicaid,UHC Medicaid,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UMR CPD,UMR CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Medicare,UHC Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33139398,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Wellcare,Wellcare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33139399,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health PPO CPD,Meritain Health PPO CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/Commercial Product,Aetna/Commercial Product,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health CPD,Meritain Health CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Starmark CPD,Starmark CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna Medicare,Aetna Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Ambetter ,Ambetter ,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access,Anthem Blue Access,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access Choice,Anthem Blue Access Choice,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Preferred,Anthem Blue Preferred,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Pathway,Anthem Pathway,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Alliance,Anthem Alliance,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Medicare,Anthem Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna,Cigna,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna PPO,Cigna PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna Medicare Advantage,Cigna Medicare Advantage,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Essence,Essence,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink HMO,Healthlink HMO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink PPO,Healthlink PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,HomeState Health Plan,HomeState Health Plan,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Humana Gold,Humana Gold,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Medicaid MO,Medicaid MO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Medica,Medica,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Tricare,Tricare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC All Payer,UHC All Payer,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Exchange,UHC Exchange,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicaid,UHC Medicaid,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,UMR CPD,UMR CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicare,UHC Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33139401,CDM,279,RC,,,,,,Inpatient,,,7,7,Wellcare,Wellcare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health PPO CPD,Meritain Health PPO CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/Commercial Product,Aetna/Commercial Product,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health CPD,Meritain Health CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Starmark CPD,Starmark CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna Medicare,Aetna Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Ambetter ,Ambetter ,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access,Anthem Blue Access,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access Choice,Anthem Blue Access Choice,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Preferred,Anthem Blue Preferred,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Pathway,Anthem Pathway,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Alliance,Anthem Alliance,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Medicare,Anthem Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna,Cigna,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna PPO,Cigna PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna Medicare Advantage,Cigna Medicare Advantage,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Essence,Essence,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink HMO,Healthlink HMO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink PPO,Healthlink PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,HomeState Health Plan,HomeState Health Plan,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Humana Gold,Humana Gold,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Medicaid MO,Medicaid MO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Medica,Medica,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Tricare,Tricare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC All Payer,UHC All Payer,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Exchange,UHC Exchange,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicaid,UHC Medicaid,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UMR CPD,UMR CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicare,UHC Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33139402,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Wellcare,Wellcare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33139403,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33139404,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health PPO CPD,Meritain Health PPO CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/Commercial Product,Aetna/Commercial Product,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health CPD,Meritain Health CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Starmark CPD,Starmark CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna Medicare,Aetna Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Ambetter ,Ambetter ,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access,Anthem Blue Access,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access Choice,Anthem Blue Access Choice,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Preferred,Anthem Blue Preferred,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Pathway,Anthem Pathway,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Alliance,Anthem Alliance,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Medicare,Anthem Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna,Cigna,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna PPO,Cigna PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna Medicare Advantage,Cigna Medicare Advantage,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Essence,Essence,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink HMO,Healthlink HMO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink PPO,Healthlink PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,HomeState Health Plan,HomeState Health Plan,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Humana Gold,Humana Gold,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Medicaid MO,Medicaid MO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Medica,Medica,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Tricare,Tricare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC All Payer,UHC All Payer,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Exchange,UHC Exchange,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicaid,UHC Medicaid,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,UMR CPD,UMR CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicare,UHC Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33139406,CDM,279,RC,,,,,,Inpatient,,,7,7,Wellcare,Wellcare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33139407,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33139408,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health PPO CPD,Meritain Health PPO CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/Commercial Product,Aetna/Commercial Product,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health CPD,Meritain Health CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Starmark CPD,Starmark CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna Medicare,Aetna Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Ambetter ,Ambetter ,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access,Anthem Blue Access,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access Choice,Anthem Blue Access Choice,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Preferred,Anthem Blue Preferred,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Pathway,Anthem Pathway,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Alliance,Anthem Alliance,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Medicare,Anthem Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna,Cigna,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna PPO,Cigna PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna Medicare Advantage,Cigna Medicare Advantage,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Essence,Essence,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink HMO,Healthlink HMO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink PPO,Healthlink PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,HomeState Health Plan,HomeState Health Plan,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Humana Gold,Humana Gold,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medicaid MO,Medicaid MO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medica,Medica,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Tricare,Tricare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC All Payer,UHC All Payer,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Exchange,UHC Exchange,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicaid,UHC Medicaid,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UMR CPD,UMR CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicare,UHC Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33139409,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Wellcare,Wellcare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health PPO CPD,Meritain Health PPO CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/Commercial Product,Aetna/Commercial Product,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health CPD,Meritain Health CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Starmark CPD,Starmark CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna Medicare,Aetna Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Ambetter ,Ambetter ,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access,Anthem Blue Access,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access Choice,Anthem Blue Access Choice,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Preferred,Anthem Blue Preferred,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Pathway,Anthem Pathway,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Alliance,Anthem Alliance,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Medicare,Anthem Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna,Cigna,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna PPO,Cigna PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna Medicare Advantage,Cigna Medicare Advantage,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Essence,Essence,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink HMO,Healthlink HMO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink PPO,Healthlink PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,HomeState Health Plan,HomeState Health Plan,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Humana Gold,Humana Gold,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medicaid MO,Medicaid MO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medica,Medica,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Tricare,Tricare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC All Payer,UHC All Payer,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Exchange,UHC Exchange,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicaid,UHC Medicaid,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UMR CPD,UMR CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicare,UHC Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33139410,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Wellcare,Wellcare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health PPO CPD,Meritain Health PPO CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/Commercial Product,Aetna/Commercial Product,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health CPD,Meritain Health CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Starmark CPD,Starmark CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna Medicare,Aetna Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Ambetter ,Ambetter ,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access,Anthem Blue Access,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access Choice,Anthem Blue Access Choice,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Preferred,Anthem Blue Preferred,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Pathway,Anthem Pathway,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Alliance,Anthem Alliance,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Medicare,Anthem Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna,Cigna,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna PPO,Cigna PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna Medicare Advantage,Cigna Medicare Advantage,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Essence,Essence,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink HMO,Healthlink HMO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink PPO,Healthlink PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,HomeState Health Plan,HomeState Health Plan,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Humana Gold,Humana Gold,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medicaid MO,Medicaid MO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medica,Medica,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Tricare,Tricare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC All Payer,UHC All Payer,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Exchange,UHC Exchange,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicaid,UHC Medicaid,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UMR CPD,UMR CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicare,UHC Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33139411,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Wellcare,Wellcare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Meritain Health PPO CPD,Meritain Health PPO CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna/Commercial Product,Aetna/Commercial Product,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Meritain Health CPD,Meritain Health CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Starmark CPD,Starmark CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna Medicare,Aetna Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Ambetter ,Ambetter ,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Access,Anthem Blue Access,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Access Choice,Anthem Blue Access Choice,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Preferred,Anthem Blue Preferred,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Pathway,Anthem Pathway,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Alliance,Anthem Alliance,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Medicare,Anthem Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna,Cigna,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna PPO,Cigna PPO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna Medicare Advantage,Cigna Medicare Advantage,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Essence,Essence,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthlink HMO,Healthlink HMO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthlink PPO,Healthlink PPO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,HomeState Health Plan,HomeState Health Plan,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Humana Gold,Humana Gold,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Medicaid MO,Medicaid MO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Medica,Medica,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Tricare,Tricare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC All Payer,UHC All Payer,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Exchange,UHC Exchange,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Medicaid,UHC Medicaid,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,UMR CPD,UMR CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Medicare,UHC Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33139412,CDM,279,RC,,,,,,Inpatient,,,53,53,Wellcare,Wellcare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Meritain Health PPO CPD,Meritain Health PPO CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna/Commercial Product,Aetna/Commercial Product,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Meritain Health CPD,Meritain Health CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Starmark CPD,Starmark CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna Medicare,Aetna Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Ambetter ,Ambetter ,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Access,Anthem Blue Access,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Access Choice,Anthem Blue Access Choice,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Preferred,Anthem Blue Preferred,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Pathway,Anthem Pathway,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Alliance,Anthem Alliance,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Medicare,Anthem Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna,Cigna,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna PPO,Cigna PPO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna Medicare Advantage,Cigna Medicare Advantage,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Essence,Essence,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthlink HMO,Healthlink HMO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthlink PPO,Healthlink PPO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,HomeState Health Plan,HomeState Health Plan,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Humana Gold,Humana Gold,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Medicaid MO,Medicaid MO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Medica,Medica,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Tricare,Tricare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC All Payer,UHC All Payer,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Exchange,UHC Exchange,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Medicaid,UHC Medicaid,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,UMR CPD,UMR CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Medicare,UHC Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33139413,CDM,279,RC,,,,,,Inpatient,,,499,499,Wellcare,Wellcare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL FREEDOM   ,33139414,CDM,279,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33139415,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health PPO CPD,Meritain Health PPO CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/Commercial Product,Aetna/Commercial Product,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health CPD,Meritain Health CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Starmark CPD,Starmark CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna Medicare,Aetna Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Ambetter ,Ambetter ,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access,Anthem Blue Access,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access Choice,Anthem Blue Access Choice,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Preferred,Anthem Blue Preferred,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Pathway,Anthem Pathway,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Alliance,Anthem Alliance,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Medicare,Anthem Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna,Cigna,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna PPO,Cigna PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna Medicare Advantage,Cigna Medicare Advantage,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Essence,Essence,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink HMO,Healthlink HMO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink PPO,Healthlink PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,HomeState Health Plan,HomeState Health Plan,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Humana Gold,Humana Gold,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medicaid MO,Medicaid MO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medica,Medica,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Tricare,Tricare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC All Payer,UHC All Payer,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Exchange,UHC Exchange,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicaid,UHC Medicaid,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UMR CPD,UMR CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicare,UHC Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139416,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Wellcare,Wellcare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health PPO CPD,Meritain Health PPO CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/Commercial Product,Aetna/Commercial Product,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health CPD,Meritain Health CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Starmark CPD,Starmark CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna Medicare,Aetna Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Ambetter ,Ambetter ,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access,Anthem Blue Access,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access Choice,Anthem Blue Access Choice,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Preferred,Anthem Blue Preferred,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Pathway,Anthem Pathway,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Alliance,Anthem Alliance,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Medicare,Anthem Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna,Cigna,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna PPO,Cigna PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna Medicare Advantage,Cigna Medicare Advantage,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Essence,Essence,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink HMO,Healthlink HMO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink PPO,Healthlink PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,HomeState Health Plan,HomeState Health Plan,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Humana Gold,Humana Gold,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Medicaid MO,Medicaid MO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Medica,Medica,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Tricare,Tricare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC All Payer,UHC All Payer,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Exchange,UHC Exchange,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicaid,UHC Medicaid,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,UMR CPD,UMR CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicare,UHC Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139417,CDM,279,RC,,,,,,Inpatient,,,56,56,Wellcare,Wellcare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139418,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health PPO CPD,Meritain Health PPO CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/Commercial Product,Aetna/Commercial Product,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health CPD,Meritain Health CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Starmark CPD,Starmark CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna Medicare,Aetna Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Ambetter ,Ambetter ,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access,Anthem Blue Access,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access Choice,Anthem Blue Access Choice,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Preferred,Anthem Blue Preferred,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Pathway,Anthem Pathway,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Alliance,Anthem Alliance,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Medicare,Anthem Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna,Cigna,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna PPO,Cigna PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna Medicare Advantage,Cigna Medicare Advantage,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Essence,Essence,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink HMO,Healthlink HMO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink PPO,Healthlink PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,HomeState Health Plan,HomeState Health Plan,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Humana Gold,Humana Gold,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Medicaid MO,Medicaid MO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Medica,Medica,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Tricare,Tricare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC All Payer,UHC All Payer,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Exchange,UHC Exchange,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicaid,UHC Medicaid,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,UMR CPD,UMR CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicare,UHC Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139419,CDM,279,RC,,,,,,Inpatient,,,126,126,Wellcare,Wellcare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33139420,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33139421,CDM,279,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Meritain Health PPO CPD,Meritain Health PPO CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna/Commercial Product,Aetna/Commercial Product,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Meritain Health CPD,Meritain Health CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Starmark CPD,Starmark CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna Medicare,Aetna Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Ambetter ,Ambetter ,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Access,Anthem Blue Access,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Access Choice,Anthem Blue Access Choice,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Preferred,Anthem Blue Preferred,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Pathway,Anthem Pathway,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Alliance,Anthem Alliance,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Medicare,Anthem Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna,Cigna,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna PPO,Cigna PPO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna Medicare Advantage,Cigna Medicare Advantage,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Essence,Essence,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthlink HMO,Healthlink HMO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthlink PPO,Healthlink PPO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,HomeState Health Plan,HomeState Health Plan,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Humana Gold,Humana Gold,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Medicaid MO,Medicaid MO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Medica,Medica,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Tricare,Tricare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC All Payer,UHC All Payer,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Exchange,UHC Exchange,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Medicaid,UHC Medicaid,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,UMR CPD,UMR CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Medicare,UHC Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33139422,CDM,279,RC,,,,,,Inpatient,,,78,78,Wellcare,Wellcare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health PPO CPD,Meritain Health PPO CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/Commercial Product,Aetna/Commercial Product,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health CPD,Meritain Health CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Starmark CPD,Starmark CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna Medicare,Aetna Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Ambetter ,Ambetter ,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access,Anthem Blue Access,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access Choice,Anthem Blue Access Choice,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Preferred,Anthem Blue Preferred,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Pathway,Anthem Pathway,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Alliance,Anthem Alliance,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Medicare,Anthem Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna,Cigna,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna PPO,Cigna PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna Medicare Advantage,Cigna Medicare Advantage,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Essence,Essence,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink HMO,Healthlink HMO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink PPO,Healthlink PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,HomeState Health Plan,HomeState Health Plan,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Humana Gold,Humana Gold,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Medicaid MO,Medicaid MO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Medica,Medica,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Tricare,Tricare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC All Payer,UHC All Payer,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Exchange,UHC Exchange,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicaid,UHC Medicaid,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,UMR CPD,UMR CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicare,UHC Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33139423,CDM,279,RC,,,,,,Inpatient,,,54,54,Wellcare,Wellcare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33139424,CDM,279,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Meritain Health PPO CPD,Meritain Health PPO CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna/Commercial Product,Aetna/Commercial Product,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Meritain Health CPD,Meritain Health CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Starmark CPD,Starmark CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna Medicare,Aetna Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Ambetter ,Ambetter ,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Access,Anthem Blue Access,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Access Choice,Anthem Blue Access Choice,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Preferred,Anthem Blue Preferred,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Pathway,Anthem Pathway,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Alliance,Anthem Alliance,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Medicare,Anthem Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna,Cigna,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna PPO,Cigna PPO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna Medicare Advantage,Cigna Medicare Advantage,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Essence,Essence,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthlink HMO,Healthlink HMO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthlink PPO,Healthlink PPO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,HomeState Health Plan,HomeState Health Plan,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Humana Gold,Humana Gold,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Medicaid MO,Medicaid MO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Medica,Medica,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Tricare,Tricare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC All Payer,UHC All Payer,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Exchange,UHC Exchange,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Medicaid,UHC Medicaid,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UMR CPD,UMR CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Medicare,UHC Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33139425,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Wellcare,Wellcare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health PPO CPD,Meritain Health PPO CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/Commercial Product,Aetna/Commercial Product,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health CPD,Meritain Health CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Starmark CPD,Starmark CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna Medicare,Aetna Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Ambetter ,Ambetter ,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access,Anthem Blue Access,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access Choice,Anthem Blue Access Choice,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Preferred,Anthem Blue Preferred,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Pathway,Anthem Pathway,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Alliance,Anthem Alliance,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Medicare,Anthem Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna,Cigna,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna PPO,Cigna PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna Medicare Advantage,Cigna Medicare Advantage,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Essence,Essence,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink HMO,Healthlink HMO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink PPO,Healthlink PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,HomeState Health Plan,HomeState Health Plan,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Humana Gold,Humana Gold,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medicaid MO,Medicaid MO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medica,Medica,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Tricare,Tricare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC All Payer,UHC All Payer,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Exchange,UHC Exchange,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicaid,UHC Medicaid,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UMR CPD,UMR CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicare,UHC Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33139426,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Wellcare,Wellcare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health PPO CPD,Meritain Health PPO CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/Commercial Product,Aetna/Commercial Product,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health CPD,Meritain Health CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Starmark CPD,Starmark CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna Medicare,Aetna Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Ambetter ,Ambetter ,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access,Anthem Blue Access,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access Choice,Anthem Blue Access Choice,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Preferred,Anthem Blue Preferred,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Pathway,Anthem Pathway,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Alliance,Anthem Alliance,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Medicare,Anthem Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna,Cigna,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna PPO,Cigna PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna Medicare Advantage,Cigna Medicare Advantage,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Essence,Essence,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink HMO,Healthlink HMO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink PPO,Healthlink PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,HomeState Health Plan,HomeState Health Plan,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Humana Gold,Humana Gold,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Medicaid MO,Medicaid MO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Medica,Medica,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Tricare,Tricare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC All Payer,UHC All Payer,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Exchange,UHC Exchange,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicaid,UHC Medicaid,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,UMR CPD,UMR CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicare,UHC Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33139427,CDM,279,RC,,,,,,Inpatient,,,56,56,Wellcare,Wellcare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33139428,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health PPO CPD,Meritain Health PPO CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/Commercial Product,Aetna/Commercial Product,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health CPD,Meritain Health CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Starmark CPD,Starmark CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna Medicare,Aetna Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Ambetter ,Ambetter ,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access,Anthem Blue Access,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access Choice,Anthem Blue Access Choice,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Preferred,Anthem Blue Preferred,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Pathway,Anthem Pathway,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Alliance,Anthem Alliance,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Medicare,Anthem Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna,Cigna,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna PPO,Cigna PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna Medicare Advantage,Cigna Medicare Advantage,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Essence,Essence,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink HMO,Healthlink HMO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink PPO,Healthlink PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,HomeState Health Plan,HomeState Health Plan,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Humana Gold,Humana Gold,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Medicaid MO,Medicaid MO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Medica,Medica,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Tricare,Tricare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC All Payer,UHC All Payer,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Exchange,UHC Exchange,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicaid,UHC Medicaid,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,UMR CPD,UMR CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicare,UHC Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33139429,CDM,279,RC,,,,,,Inpatient,,,126,126,Wellcare,Wellcare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33139430,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33139431,CDM,279,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Meritain Health PPO CPD,Meritain Health PPO CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna/Commercial Product,Aetna/Commercial Product,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Meritain Health CPD,Meritain Health CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Starmark CPD,Starmark CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna Medicare,Aetna Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Ambetter ,Ambetter ,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Access,Anthem Blue Access,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Access Choice,Anthem Blue Access Choice,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Preferred,Anthem Blue Preferred,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Pathway,Anthem Pathway,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Alliance,Anthem Alliance,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Medicare,Anthem Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna,Cigna,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna PPO,Cigna PPO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna Medicare Advantage,Cigna Medicare Advantage,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Essence,Essence,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthlink HMO,Healthlink HMO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthlink PPO,Healthlink PPO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,HomeState Health Plan,HomeState Health Plan,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Humana Gold,Humana Gold,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Medicaid MO,Medicaid MO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Medica,Medica,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Tricare,Tricare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC All Payer,UHC All Payer,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Exchange,UHC Exchange,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Medicaid,UHC Medicaid,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UMR CPD,UMR CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Medicare,UHC Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33139433,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Wellcare,Wellcare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33139434,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Meritain Health PPO CPD,Meritain Health PPO CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna/Commercial Product,Aetna/Commercial Product,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Meritain Health CPD,Meritain Health CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Starmark CPD,Starmark CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna Medicare,Aetna Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Ambetter ,Ambetter ,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Access,Anthem Blue Access,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Access Choice,Anthem Blue Access Choice,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Preferred,Anthem Blue Preferred,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Pathway,Anthem Pathway,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Alliance,Anthem Alliance,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Medicare,Anthem Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna,Cigna,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna PPO,Cigna PPO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna Medicare Advantage,Cigna Medicare Advantage,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Essence,Essence,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthlink HMO,Healthlink HMO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthlink PPO,Healthlink PPO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,HomeState Health Plan,HomeState Health Plan,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Humana Gold,Humana Gold,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Medicaid MO,Medicaid MO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Medica,Medica,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Tricare,Tricare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC All Payer,UHC All Payer,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Exchange,UHC Exchange,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Medicaid,UHC Medicaid,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,UMR CPD,UMR CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Medicare,UHC Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33139436,CDM,279,RC,,,,,,Inpatient,,,128,128,Wellcare,Wellcare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Meritain Health PPO CPD,Meritain Health PPO CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna/Commercial Product,Aetna/Commercial Product,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Meritain Health CPD,Meritain Health CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Starmark CPD,Starmark CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna Medicare,Aetna Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Ambetter ,Ambetter ,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Access,Anthem Blue Access,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Access Choice,Anthem Blue Access Choice,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Preferred,Anthem Blue Preferred,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Pathway,Anthem Pathway,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Alliance,Anthem Alliance,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Medicare,Anthem Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna,Cigna,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna PPO,Cigna PPO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna Medicare Advantage,Cigna Medicare Advantage,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Essence,Essence,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthlink HMO,Healthlink HMO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthlink PPO,Healthlink PPO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,HomeState Health Plan,HomeState Health Plan,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Humana Gold,Humana Gold,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Medicaid MO,Medicaid MO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Medica,Medica,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Tricare,Tricare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC All Payer,UHC All Payer,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Exchange,UHC Exchange,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Medicaid,UHC Medicaid,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,UMR CPD,UMR CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Medicare,UHC Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33139437,CDM,279,RC,,,,,,Inpatient,,,70,70,Wellcare,Wellcare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33139438,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Meritain Health PPO CPD,Meritain Health PPO CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna/Commercial Product,Aetna/Commercial Product,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Meritain Health CPD,Meritain Health CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Starmark CPD,Starmark CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna Medicare,Aetna Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Ambetter ,Ambetter ,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Access,Anthem Blue Access,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Access Choice,Anthem Blue Access Choice,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Preferred,Anthem Blue Preferred,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Pathway,Anthem Pathway,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Alliance,Anthem Alliance,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Medicare,Anthem Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna,Cigna,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna PPO,Cigna PPO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna Medicare Advantage,Cigna Medicare Advantage,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Essence,Essence,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthlink HMO,Healthlink HMO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthlink PPO,Healthlink PPO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,HomeState Health Plan,HomeState Health Plan,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Humana Gold,Humana Gold,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Medicaid MO,Medicaid MO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Medica,Medica,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Tricare,Tricare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC All Payer,UHC All Payer,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Exchange,UHC Exchange,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Medicaid,UHC Medicaid,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UMR CPD,UMR CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Medicare,UHC Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33139439,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Wellcare,Wellcare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health PPO CPD,Meritain Health PPO CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/Commercial Product,Aetna/Commercial Product,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health CPD,Meritain Health CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Starmark CPD,Starmark CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna Medicare,Aetna Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Ambetter ,Ambetter ,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access,Anthem Blue Access,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access Choice,Anthem Blue Access Choice,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Preferred,Anthem Blue Preferred,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Pathway,Anthem Pathway,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Alliance,Anthem Alliance,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Medicare,Anthem Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna,Cigna,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna PPO,Cigna PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna Medicare Advantage,Cigna Medicare Advantage,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Essence,Essence,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink HMO,Healthlink HMO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink PPO,Healthlink PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,HomeState Health Plan,HomeState Health Plan,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Humana Gold,Humana Gold,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Medicaid MO,Medicaid MO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Medica,Medica,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Tricare,Tricare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC All Payer,UHC All Payer,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Exchange,UHC Exchange,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicaid,UHC Medicaid,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,UMR CPD,UMR CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicare,UHC Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33139440,CDM,279,RC,,,,,,Inpatient,,,135,135,Wellcare,Wellcare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health PPO CPD,Meritain Health PPO CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/Commercial Product,Aetna/Commercial Product,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health CPD,Meritain Health CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Starmark CPD,Starmark CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna Medicare,Aetna Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Ambetter ,Ambetter ,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access,Anthem Blue Access,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access Choice,Anthem Blue Access Choice,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Preferred,Anthem Blue Preferred,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Pathway,Anthem Pathway,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Alliance,Anthem Alliance,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Medicare,Anthem Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna,Cigna,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna PPO,Cigna PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna Medicare Advantage,Cigna Medicare Advantage,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Essence,Essence,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink HMO,Healthlink HMO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink PPO,Healthlink PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,HomeState Health Plan,HomeState Health Plan,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Humana Gold,Humana Gold,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Medicaid MO,Medicaid MO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Medica,Medica,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Tricare,Tricare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC All Payer,UHC All Payer,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Exchange,UHC Exchange,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicaid,UHC Medicaid,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,UMR CPD,UMR CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicare,UHC Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33139441,CDM,279,RC,,,,,,Inpatient,,,9,9,Wellcare,Wellcare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Meritain Health PPO CPD,Meritain Health PPO CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna/Commercial Product,Aetna/Commercial Product,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Meritain Health CPD,Meritain Health CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Starmark CPD,Starmark CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna Medicare,Aetna Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Ambetter ,Ambetter ,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Access,Anthem Blue Access,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Access Choice,Anthem Blue Access Choice,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Preferred,Anthem Blue Preferred,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Pathway,Anthem Pathway,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Alliance,Anthem Alliance,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Medicare,Anthem Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna,Cigna,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna PPO,Cigna PPO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna Medicare Advantage,Cigna Medicare Advantage,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Essence,Essence,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthlink HMO,Healthlink HMO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthlink PPO,Healthlink PPO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,HomeState Health Plan,HomeState Health Plan,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Humana Gold,Humana Gold,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Medicaid MO,Medicaid MO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Medica,Medica,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Tricare,Tricare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC All Payer,UHC All Payer,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Exchange,UHC Exchange,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Medicaid,UHC Medicaid,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UMR CPD,UMR CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Medicare,UHC Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33139443,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Wellcare,Wellcare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Meritain Health PPO CPD,Meritain Health PPO CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna/Commercial Product,Aetna/Commercial Product,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Meritain Health CPD,Meritain Health CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Starmark CPD,Starmark CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna Medicare,Aetna Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Ambetter ,Ambetter ,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Access,Anthem Blue Access,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Access Choice,Anthem Blue Access Choice,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Preferred,Anthem Blue Preferred,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Pathway,Anthem Pathway,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Alliance,Anthem Alliance,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Medicare,Anthem Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna,Cigna,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna PPO,Cigna PPO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna Medicare Advantage,Cigna Medicare Advantage,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Essence,Essence,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthlink HMO,Healthlink HMO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthlink PPO,Healthlink PPO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,HomeState Health Plan,HomeState Health Plan,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Humana Gold,Humana Gold,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Medicaid MO,Medicaid MO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Medica,Medica,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Tricare,Tricare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC All Payer,UHC All Payer,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Exchange,UHC Exchange,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Medicaid,UHC Medicaid,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,UMR CPD,UMR CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Medicare,UHC Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33139444,CDM,279,RC,,,,,,Inpatient,,,3,3,Wellcare,Wellcare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Meritain Health PPO CPD,Meritain Health PPO CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna/Commercial Product,Aetna/Commercial Product,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Meritain Health CPD,Meritain Health CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Starmark CPD,Starmark CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna Medicare,Aetna Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Ambetter ,Ambetter ,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Access,Anthem Blue Access,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Access Choice,Anthem Blue Access Choice,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Preferred,Anthem Blue Preferred,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Pathway,Anthem Pathway,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Alliance,Anthem Alliance,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Medicare,Anthem Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna,Cigna,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna PPO,Cigna PPO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna Medicare Advantage,Cigna Medicare Advantage,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Essence,Essence,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthlink HMO,Healthlink HMO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthlink PPO,Healthlink PPO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,HomeState Health Plan,HomeState Health Plan,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Humana Gold,Humana Gold,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Medicaid MO,Medicaid MO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Medica,Medica,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Tricare,Tricare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC All Payer,UHC All Payer,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Exchange,UHC Exchange,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Medicaid,UHC Medicaid,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UMR CPD,UMR CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Medicare,UHC Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33139445,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Wellcare,Wellcare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33139446,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Meritain Health PPO CPD,Meritain Health PPO CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna/Commercial Product,Aetna/Commercial Product,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Meritain Health CPD,Meritain Health CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Starmark CPD,Starmark CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna Medicare,Aetna Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Ambetter ,Ambetter ,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Access,Anthem Blue Access,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Access Choice,Anthem Blue Access Choice,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Preferred,Anthem Blue Preferred,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Pathway,Anthem Pathway,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Alliance,Anthem Alliance,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Medicare,Anthem Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna,Cigna,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna PPO,Cigna PPO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna Medicare Advantage,Cigna Medicare Advantage,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Essence,Essence,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthlink HMO,Healthlink HMO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthlink PPO,Healthlink PPO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,HomeState Health Plan,HomeState Health Plan,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Humana Gold,Humana Gold,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Medicaid MO,Medicaid MO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Medica,Medica,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Tricare,Tricare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC All Payer,UHC All Payer,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Exchange,UHC Exchange,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Medicaid,UHC Medicaid,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UMR CPD,UMR CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Medicare,UHC Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33139447,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Wellcare,Wellcare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33139448,CDM,279,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Meritain Health PPO CPD,Meritain Health PPO CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna/Commercial Product,Aetna/Commercial Product,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Meritain Health CPD,Meritain Health CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Starmark CPD,Starmark CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna Medicare,Aetna Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Ambetter ,Ambetter ,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Access,Anthem Blue Access,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Access Choice,Anthem Blue Access Choice,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Preferred,Anthem Blue Preferred,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Pathway,Anthem Pathway,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Alliance,Anthem Alliance,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Medicare,Anthem Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna,Cigna,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna PPO,Cigna PPO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna Medicare Advantage,Cigna Medicare Advantage,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Essence,Essence,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthlink HMO,Healthlink HMO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthlink PPO,Healthlink PPO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,HomeState Health Plan,HomeState Health Plan,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Humana Gold,Humana Gold,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Medicaid MO,Medicaid MO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Medica,Medica,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Tricare,Tricare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC All Payer,UHC All Payer,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Exchange,UHC Exchange,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Medicaid,UHC Medicaid,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,UMR CPD,UMR CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Medicare,UHC Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33139449,CDM,279,RC,,,,,,Inpatient,,,109,109,Wellcare,Wellcare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health PPO CPD,Meritain Health PPO CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/Commercial Product,Aetna/Commercial Product,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health CPD,Meritain Health CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Starmark CPD,Starmark CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna Medicare,Aetna Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Ambetter ,Ambetter ,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access,Anthem Blue Access,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access Choice,Anthem Blue Access Choice,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Preferred,Anthem Blue Preferred,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Pathway,Anthem Pathway,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Alliance,Anthem Alliance,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Medicare,Anthem Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna,Cigna,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna PPO,Cigna PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna Medicare Advantage,Cigna Medicare Advantage,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Essence,Essence,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink HMO,Healthlink HMO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink PPO,Healthlink PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,HomeState Health Plan,HomeState Health Plan,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Humana Gold,Humana Gold,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medicaid MO,Medicaid MO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medica,Medica,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Tricare,Tricare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC All Payer,UHC All Payer,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Exchange,UHC Exchange,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicaid,UHC Medicaid,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UMR CPD,UMR CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicare,UHC Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33139450,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Wellcare,Wellcare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33139451,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33139452,CDM,279,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Meritain Health PPO CPD,Meritain Health PPO CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna/Commercial Product,Aetna/Commercial Product,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Meritain Health CPD,Meritain Health CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Starmark CPD,Starmark CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna Medicare,Aetna Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Ambetter ,Ambetter ,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access,Anthem Blue Access,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access Choice,Anthem Blue Access Choice,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Preferred,Anthem Blue Preferred,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Pathway,Anthem Pathway,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Alliance,Anthem Alliance,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Medicare,Anthem Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna,Cigna,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna PPO,Cigna PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna Medicare Advantage,Cigna Medicare Advantage,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Essence,Essence,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthlink HMO,Healthlink HMO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthlink PPO,Healthlink PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,HomeState Health Plan,HomeState Health Plan,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Humana Gold,Humana Gold,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Medicaid MO,Medicaid MO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Medica,Medica,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Tricare,Tricare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC All Payer,UHC All Payer,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Exchange,UHC Exchange,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Medicaid,UHC Medicaid,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,UMR CPD,UMR CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Medicare,UHC Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33139453,CDM,279,RC,,,,,,Inpatient,,,131,131,Wellcare,Wellcare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health PPO CPD,Meritain Health PPO CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/Commercial Product,Aetna/Commercial Product,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health CPD,Meritain Health CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Starmark CPD,Starmark CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna Medicare,Aetna Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Ambetter ,Ambetter ,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access,Anthem Blue Access,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access Choice,Anthem Blue Access Choice,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Preferred,Anthem Blue Preferred,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Pathway,Anthem Pathway,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Alliance,Anthem Alliance,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Medicare,Anthem Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna,Cigna,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna PPO,Cigna PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna Medicare Advantage,Cigna Medicare Advantage,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Essence,Essence,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink HMO,Healthlink HMO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink PPO,Healthlink PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,HomeState Health Plan,HomeState Health Plan,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Humana Gold,Humana Gold,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Medicaid MO,Medicaid MO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Medica,Medica,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Tricare,Tricare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC All Payer,UHC All Payer,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Exchange,UHC Exchange,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicaid,UHC Medicaid,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,UMR CPD,UMR CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicare,UHC Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33139454,CDM,279,RC,,,,,,Inpatient,,,156,156,Wellcare,Wellcare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33139455,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health PPO CPD,Meritain Health PPO CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/Commercial Product,Aetna/Commercial Product,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health CPD,Meritain Health CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Starmark CPD,Starmark CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna Medicare,Aetna Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Ambetter ,Ambetter ,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access,Anthem Blue Access,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access Choice,Anthem Blue Access Choice,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Preferred,Anthem Blue Preferred,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Pathway,Anthem Pathway,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Alliance,Anthem Alliance,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Medicare,Anthem Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna,Cigna,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna PPO,Cigna PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna Medicare Advantage,Cigna Medicare Advantage,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Essence,Essence,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink HMO,Healthlink HMO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink PPO,Healthlink PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,HomeState Health Plan,HomeState Health Plan,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Humana Gold,Humana Gold,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medicaid MO,Medicaid MO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medica,Medica,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Tricare,Tricare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC All Payer,UHC All Payer,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Exchange,UHC Exchange,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicaid,UHC Medicaid,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UMR CPD,UMR CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicare,UHC Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33139456,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Wellcare,Wellcare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Meritain Health PPO CPD,Meritain Health PPO CPD,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Aetna/Commercial Product,Aetna/Commercial Product,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Meritain Health CPD,Meritain Health CPD,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Starmark CPD,Starmark CPD,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Aetna Medicare,Aetna Medicare,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Ambetter ,Ambetter ,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Blue Access,Anthem Blue Access,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Blue Access Choice,Anthem Blue Access Choice,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Blue Preferred,Anthem Blue Preferred,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Pathway,Anthem Pathway,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Alliance,Anthem Alliance,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Anthem Medicare,Anthem Medicare,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Cigna,Cigna,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Cigna PPO,Cigna PPO,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Cigna Medicare Advantage,Cigna Medicare Advantage,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Essence,Essence,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Healthlink HMO,Healthlink HMO,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Healthlink PPO,Healthlink PPO,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,HomeState Health Plan,HomeState Health Plan,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Humana Gold,Humana Gold,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Medicaid MO,Medicaid MO,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Medica,Medica,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Tricare,Tricare,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,UHC All Payer,UHC All Payer,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,UHC Exchange,UHC Exchange,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,UHC Medicaid,UHC Medicaid,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,UMR CPD,UMR CPD,34.59,,,,,,,per diem,34.59,34.59,"Per diem rate, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,UHC Medicare,UHC Medicare,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
GERI SLEEVES                  ,33139469,CDM,270,RC,,,,,,Inpatient,,,34.59,34.59,Wellcare,Wellcare,34.59,,,,,,,case rate,34.59,34.59,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Meritain Health PPO CPD,Meritain Health PPO CPD,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Aetna/Commercial Product,Aetna/Commercial Product,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Meritain Health CPD,Meritain Health CPD,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Starmark CPD,Starmark CPD,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Aetna Medicare,Aetna Medicare,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Ambetter ,Ambetter ,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Blue Access,Anthem Blue Access,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Blue Access Choice,Anthem Blue Access Choice,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Blue Preferred,Anthem Blue Preferred,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Pathway,Anthem Pathway,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Alliance,Anthem Alliance,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Anthem Medicare,Anthem Medicare,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Cigna,Cigna,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Cigna PPO,Cigna PPO,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Cigna Medicare Advantage,Cigna Medicare Advantage,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Essence,Essence,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Healthlink HMO,Healthlink HMO,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Healthlink PPO,Healthlink PPO,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,HomeState Health Plan,HomeState Health Plan,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Humana Gold,Humana Gold,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Medicaid MO,Medicaid MO,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Medica,Medica,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Tricare,Tricare,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,UHC All Payer,UHC All Payer,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,UHC Exchange,UHC Exchange,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,UHC Medicaid,UHC Medicaid,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,UMR CPD,UMR CPD,9.75,,,,,,,per diem,9.75,9.75,"Per diem rate, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,UHC Medicare,UHC Medicare,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
ARM SLING                     ,33139525,CDM,270,RC,,,,,,Inpatient,,,9.75,9.75,Wellcare,Wellcare,9.75,,,,,,,case rate,9.75,9.75,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health PPO CPD,Meritain Health PPO CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/Commercial Product,Aetna/Commercial Product,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health CPD,Meritain Health CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Starmark CPD,Starmark CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Aetna Medicare,Aetna Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Ambetter ,Ambetter ,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access,Anthem Blue Access,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access Choice,Anthem Blue Access Choice,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Preferred,Anthem Blue Preferred,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Pathway,Anthem Pathway,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Alliance,Anthem Alliance,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Medicare,Anthem Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Cigna,Cigna,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Cigna PPO,Cigna PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Cigna Medicare Advantage,Cigna Medicare Advantage,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Essence,Essence,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink HMO,Healthlink HMO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink PPO,Healthlink PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,HomeState Health Plan,HomeState Health Plan,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Humana Gold,Humana Gold,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Medicaid MO,Medicaid MO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Medica,Medica,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Tricare,Tricare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,UHC All Payer,UHC All Payer,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,UHC Exchange,UHC Exchange,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicaid,UHC Medicaid,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,UMR CPD,UMR CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicare,UHC Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
PRAFO BOOT                    ,33139526,CDM,270,RC,,,,,,Inpatient,,,160.5,160.5,Wellcare,Wellcare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Meritain Health PPO CPD,Meritain Health PPO CPD,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Aetna/Commercial Product,Aetna/Commercial Product,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Meritain Health CPD,Meritain Health CPD,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Starmark CPD,Starmark CPD,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Aetna Medicare,Aetna Medicare,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Ambetter ,Ambetter ,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Blue Access,Anthem Blue Access,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Blue Access Choice,Anthem Blue Access Choice,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Blue Preferred,Anthem Blue Preferred,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Pathway,Anthem Pathway,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Alliance,Anthem Alliance,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Anthem Medicare,Anthem Medicare,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Cigna,Cigna,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Cigna PPO,Cigna PPO,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Cigna Medicare Advantage,Cigna Medicare Advantage,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Essence,Essence,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Healthlink HMO,Healthlink HMO,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Healthlink PPO,Healthlink PPO,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,HomeState Health Plan,HomeState Health Plan,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Humana Gold,Humana Gold,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Medicaid MO,Medicaid MO,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Medica,Medica,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Tricare,Tricare,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,UHC All Payer,UHC All Payer,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,UHC Exchange,UHC Exchange,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,UHC Medicaid,UHC Medicaid,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,UMR CPD,UMR CPD,8.46,,,,,,,per diem,8.46,8.46,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,UHC Medicare,UHC Medicare,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR               ,33139527,CDM,270,RC,,,,,,Inpatient,,,8.46,8.46,Wellcare,Wellcare,8.46,,,,,,,case rate,8.46,8.46,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Meritain Health PPO CPD,Meritain Health PPO CPD,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Aetna/Commercial Product,Aetna/Commercial Product,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Meritain Health CPD,Meritain Health CPD,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Starmark CPD,Starmark CPD,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Aetna Medicare,Aetna Medicare,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Ambetter ,Ambetter ,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Blue Access,Anthem Blue Access,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Blue Access Choice,Anthem Blue Access Choice,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Blue Preferred,Anthem Blue Preferred,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Pathway,Anthem Pathway,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Alliance,Anthem Alliance,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Anthem Medicare,Anthem Medicare,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Cigna,Cigna,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Cigna PPO,Cigna PPO,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Cigna Medicare Advantage,Cigna Medicare Advantage,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Essence,Essence,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Healthlink HMO,Healthlink HMO,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Healthlink PPO,Healthlink PPO,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,HomeState Health Plan,HomeState Health Plan,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Humana Gold,Humana Gold,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Medicaid MO,Medicaid MO,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Medica,Medica,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Tricare,Tricare,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,UHC All Payer,UHC All Payer,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,UHC Exchange,UHC Exchange,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,UHC Medicaid,UHC Medicaid,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,UMR CPD,UMR CPD,39.18,,,,,,,per diem,39.18,39.18,"Per diem rate, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,UHC Medicare,UHC Medicare,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
ABD BINDER                    ,33139528,CDM,270,RC,,,,,,Inpatient,,,39.18,39.18,Wellcare,Wellcare,39.18,,,,,,,case rate,39.18,39.18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health PPO CPD,Meritain Health PPO CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna/Commercial Product,Aetna/Commercial Product,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Meritain Health CPD,Meritain Health CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Starmark CPD,Starmark CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Aetna Medicare,Aetna Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Ambetter ,Ambetter ,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access,Anthem Blue Access,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Access Choice,Anthem Blue Access Choice,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Blue Preferred,Anthem Blue Preferred,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Pathway,Anthem Pathway,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Alliance,Anthem Alliance,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Anthem Medicare,Anthem Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna,Cigna,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna PPO,Cigna PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Cigna Medicare Advantage,Cigna Medicare Advantage,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Essence,Essence,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink HMO,Healthlink HMO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Healthlink PPO,Healthlink PPO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,HomeState Health Plan,HomeState Health Plan,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Humana Gold,Humana Gold,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Medicaid MO,Medicaid MO,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Medica,Medica,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Tricare,Tricare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC All Payer,UHC All Payer,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Exchange,UHC Exchange,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicaid,UHC Medicaid,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,UMR CPD,UMR CPD,18,,,,,,,per diem,18,18,"Per diem rate, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,UHC Medicare,UHC Medicare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - CUST CARE UHS ,33139542,CDM,279,RC,,,,,,Inpatient,,,18,18,Wellcare,Wellcare,18,,,,,,,case rate,18,18,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health PPO CPD,Meritain Health PPO CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/Commercial Product,Aetna/Commercial Product,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health CPD,Meritain Health CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Starmark CPD,Starmark CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna Medicare,Aetna Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Ambetter ,Ambetter ,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access,Anthem Blue Access,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access Choice,Anthem Blue Access Choice,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Preferred,Anthem Blue Preferred,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Pathway,Anthem Pathway,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Alliance,Anthem Alliance,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Medicare,Anthem Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna,Cigna,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna PPO,Cigna PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna Medicare Advantage,Cigna Medicare Advantage,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Essence,Essence,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink HMO,Healthlink HMO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink PPO,Healthlink PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,HomeState Health Plan,HomeState Health Plan,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Humana Gold,Humana Gold,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Medicaid MO,Medicaid MO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Medica,Medica,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Tricare,Tricare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC All Payer,UHC All Payer,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Exchange,UHC Exchange,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicaid,UHC Medicaid,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,UMR CPD,UMR CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicare,UHC Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - ST1400 BOL UHS,33139543,CDM,279,RC,,,,,,Inpatient,,,24,24,Wellcare,Wellcare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health PPO CPD,Meritain Health PPO CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/Commercial Product,Aetna/Commercial Product,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health CPD,Meritain Health CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Starmark CPD,Starmark CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna Medicare,Aetna Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Ambetter ,Ambetter ,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access,Anthem Blue Access,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access Choice,Anthem Blue Access Choice,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Preferred,Anthem Blue Preferred,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Pathway,Anthem Pathway,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Alliance,Anthem Alliance,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Medicare,Anthem Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna,Cigna,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna PPO,Cigna PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna Medicare Advantage,Cigna Medicare Advantage,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Essence,Essence,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink HMO,Healthlink HMO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink PPO,Healthlink PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,HomeState Health Plan,HomeState Health Plan,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Humana Gold,Humana Gold,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Medicaid MO,Medicaid MO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Medica,Medica,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Tricare,Tricare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC All Payer,UHC All Payer,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Exchange,UHC Exchange,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicaid,UHC Medicaid,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,UMR CPD,UMR CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicare,UHC Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - DOLPHIN UHS   ,33139544,CDM,279,RC,,,,,,Inpatient,,,105,105,Wellcare,Wellcare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
MATTRESS RENT - BARIAT UHS    ,33139545,CDM,279,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health PPO CPD,Meritain Health PPO CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/Commercial Product,Aetna/Commercial Product,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health CPD,Meritain Health CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Starmark CPD,Starmark CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna Medicare,Aetna Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Ambetter ,Ambetter ,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access,Anthem Blue Access,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access Choice,Anthem Blue Access Choice,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Preferred,Anthem Blue Preferred,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Pathway,Anthem Pathway,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Alliance,Anthem Alliance,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Medicare,Anthem Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna,Cigna,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna PPO,Cigna PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna Medicare Advantage,Cigna Medicare Advantage,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Essence,Essence,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink HMO,Healthlink HMO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink PPO,Healthlink PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,HomeState Health Plan,HomeState Health Plan,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Humana Gold,Humana Gold,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Medicaid MO,Medicaid MO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Medica,Medica,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Tricare,Tricare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC All Payer,UHC All Payer,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Exchange,UHC Exchange,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicaid,UHC Medicaid,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,UMR CPD,UMR CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicare,UHC Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
BARIATRIC BED RENT UHS        ,33139546,CDM,279,RC,,,,,,Inpatient,,,135,135,Wellcare,Wellcare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health PPO CPD,Meritain Health PPO CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/Commercial Product,Aetna/Commercial Product,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health CPD,Meritain Health CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Starmark CPD,Starmark CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna Medicare,Aetna Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Ambetter ,Ambetter ,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access,Anthem Blue Access,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access Choice,Anthem Blue Access Choice,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Preferred,Anthem Blue Preferred,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Pathway,Anthem Pathway,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Alliance,Anthem Alliance,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Medicare,Anthem Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna,Cigna,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna PPO,Cigna PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna Medicare Advantage,Cigna Medicare Advantage,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Essence,Essence,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink HMO,Healthlink HMO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink PPO,Healthlink PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,HomeState Health Plan,HomeState Health Plan,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Humana Gold,Humana Gold,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Medicaid MO,Medicaid MO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Medica,Medica,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Tricare,Tricare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC All Payer,UHC All Payer,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Exchange,UHC Exchange,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicaid,UHC Medicaid,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,UMR CPD,UMR CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicare,UHC Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
HI/LOW BED RENT UHS           ,33139548,CDM,279,RC,,,,,,Inpatient,,,75,75,Wellcare,Wellcare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Meritain Health PPO CPD,Meritain Health PPO CPD,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Aetna/Commercial Product,Aetna/Commercial Product,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Meritain Health CPD,Meritain Health CPD,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Starmark CPD,Starmark CPD,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Aetna Medicare,Aetna Medicare,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Ambetter ,Ambetter ,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Blue Access,Anthem Blue Access,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Blue Access Choice,Anthem Blue Access Choice,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Blue Preferred,Anthem Blue Preferred,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Pathway,Anthem Pathway,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Alliance,Anthem Alliance,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Anthem Medicare,Anthem Medicare,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Cigna,Cigna,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Cigna PPO,Cigna PPO,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Cigna Medicare Advantage,Cigna Medicare Advantage,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Essence,Essence,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Healthlink HMO,Healthlink HMO,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Healthlink PPO,Healthlink PPO,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,HomeState Health Plan,HomeState Health Plan,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Humana Gold,Humana Gold,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Medicaid MO,Medicaid MO,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Medica,Medica,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Tricare,Tricare,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,UHC All Payer,UHC All Payer,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,UHC Exchange,UHC Exchange,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,UHC Medicaid,UHC Medicaid,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,UMR CPD,UMR CPD,267.18,,,,,,,per diem,267.18,267.18,"Per diem rate, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,UHC Medicare,UHC Medicare,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, DYNAPRO FINGER FLEX   ",33139551,CDM,270,RC,,,,,,Inpatient,,,267.18,267.18,Wellcare,Wellcare,267.18,,,,,,,case rate,267.18,267.18,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Meritain Health PPO CPD,Meritain Health PPO CPD,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Aetna/Commercial Product,Aetna/Commercial Product,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Meritain Health CPD,Meritain Health CPD,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Starmark CPD,Starmark CPD,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Aetna Medicare,Aetna Medicare,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Ambetter ,Ambetter ,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Blue Access,Anthem Blue Access,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Blue Access Choice,Anthem Blue Access Choice,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Blue Preferred,Anthem Blue Preferred,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Pathway,Anthem Pathway,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Alliance,Anthem Alliance,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Anthem Medicare,Anthem Medicare,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Cigna,Cigna,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Cigna PPO,Cigna PPO,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Cigna Medicare Advantage,Cigna Medicare Advantage,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Essence,Essence,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Healthlink HMO,Healthlink HMO,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Healthlink PPO,Healthlink PPO,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,HomeState Health Plan,HomeState Health Plan,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Humana Gold,Humana Gold,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Medicaid MO,Medicaid MO,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Medica,Medica,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Tricare,Tricare,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,UHC All Payer,UHC All Payer,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,UHC Exchange,UHC Exchange,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,UHC Medicaid,UHC Medicaid,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,UMR CPD,UMR CPD,279.51,,,,,,,per diem,279.51,279.51,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,UHC Medicare,UHC Medicare,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EZ FORM        ",33139552,CDM,270,RC,,,,,,Inpatient,,,279.51,279.51,Wellcare,Wellcare,279.51,,,,,,,case rate,279.51,279.51,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Meritain Health PPO CPD,Meritain Health PPO CPD,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Aetna/Commercial Product,Aetna/Commercial Product,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Meritain Health CPD,Meritain Health CPD,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Starmark CPD,Starmark CPD,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Aetna Medicare,Aetna Medicare,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Ambetter ,Ambetter ,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Blue Access,Anthem Blue Access,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Blue Access Choice,Anthem Blue Access Choice,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Blue Preferred,Anthem Blue Preferred,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Pathway,Anthem Pathway,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Alliance,Anthem Alliance,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Anthem Medicare,Anthem Medicare,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Cigna,Cigna,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Cigna PPO,Cigna PPO,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Cigna Medicare Advantage,Cigna Medicare Advantage,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Essence,Essence,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Healthlink HMO,Healthlink HMO,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Healthlink PPO,Healthlink PPO,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,HomeState Health Plan,HomeState Health Plan,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Humana Gold,Humana Gold,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Medicaid MO,Medicaid MO,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Medica,Medica,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Tricare,Tricare,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,UHC All Payer,UHC All Payer,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,UHC Exchange,UHC Exchange,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,UHC Medicaid,UHC Medicaid,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,UMR CPD,UMR CPD,84.93,,,,,,,per diem,84.93,84.93,"Per diem rate, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,UHC Medicare,UHC Medicare,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, POSTERIOR-PREFAB      ",33139553,CDM,270,RC,,,,,,Inpatient,,,84.93,84.93,Wellcare,Wellcare,84.93,,,,,,,case rate,84.93,84.93,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Meritain Health PPO CPD,Meritain Health PPO CPD,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Aetna/Commercial Product,Aetna/Commercial Product,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Meritain Health CPD,Meritain Health CPD,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Starmark CPD,Starmark CPD,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Aetna Medicare,Aetna Medicare,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Ambetter ,Ambetter ,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Blue Access,Anthem Blue Access,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Blue Access Choice,Anthem Blue Access Choice,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Blue Preferred,Anthem Blue Preferred,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Pathway,Anthem Pathway,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Alliance,Anthem Alliance,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Anthem Medicare,Anthem Medicare,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Cigna,Cigna,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Cigna PPO,Cigna PPO,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Cigna Medicare Advantage,Cigna Medicare Advantage,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Essence,Essence,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Healthlink HMO,Healthlink HMO,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Healthlink PPO,Healthlink PPO,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,HomeState Health Plan,HomeState Health Plan,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Humana Gold,Humana Gold,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Medicaid MO,Medicaid MO,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Medica,Medica,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Tricare,Tricare,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,UHC All Payer,UHC All Payer,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,UHC Exchange,UHC Exchange,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,UHC Medicaid,UHC Medicaid,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,UMR CPD,UMR CPD,84.09,,,,,,,per diem,84.09,84.09,"Per diem rate, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,UHC Medicare,UHC Medicare,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, WRIST/THUMB- D RING   ",33139554,CDM,270,RC,,,,,,Inpatient,,,84.09,84.09,Wellcare,Wellcare,84.09,,,,,,,case rate,84.09,84.09,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Meritain Health PPO CPD,Meritain Health PPO CPD,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Aetna/Commercial Product,Aetna/Commercial Product,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Meritain Health CPD,Meritain Health CPD,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Starmark CPD,Starmark CPD,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Aetna Medicare,Aetna Medicare,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Ambetter ,Ambetter ,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Blue Access,Anthem Blue Access,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Blue Access Choice,Anthem Blue Access Choice,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Blue Preferred,Anthem Blue Preferred,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Pathway,Anthem Pathway,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Alliance,Anthem Alliance,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Anthem Medicare,Anthem Medicare,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Cigna,Cigna,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Cigna PPO,Cigna PPO,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Cigna Medicare Advantage,Cigna Medicare Advantage,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Essence,Essence,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Healthlink HMO,Healthlink HMO,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Healthlink PPO,Healthlink PPO,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,HomeState Health Plan,HomeState Health Plan,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Humana Gold,Humana Gold,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Medicaid MO,Medicaid MO,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Medica,Medica,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Tricare,Tricare,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,UHC All Payer,UHC All Payer,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,UHC Exchange,UHC Exchange,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,UHC Medicaid,UHC Medicaid,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,UMR CPD,UMR CPD,183.48,,,,,,,per diem,183.48,183.48,"Per diem rate, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,UHC Medicare,UHC Medicare,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, HAND, RESTING AIRSOFT ",33139555,CDM,270,RC,,,,,,Inpatient,,,183.48,183.48,Wellcare,Wellcare,183.48,,,,,,,case rate,183.48,183.48,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Meritain Health PPO CPD,Meritain Health PPO CPD,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Aetna/Commercial Product,Aetna/Commercial Product,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Meritain Health CPD,Meritain Health CPD,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Starmark CPD,Starmark CPD,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Aetna Medicare,Aetna Medicare,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Ambetter ,Ambetter ,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Blue Access,Anthem Blue Access,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Blue Access Choice,Anthem Blue Access Choice,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Blue Preferred,Anthem Blue Preferred,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Pathway,Anthem Pathway,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Alliance,Anthem Alliance,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Anthem Medicare,Anthem Medicare,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Cigna,Cigna,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Cigna PPO,Cigna PPO,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Cigna Medicare Advantage,Cigna Medicare Advantage,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Essence,Essence,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Healthlink HMO,Healthlink HMO,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Healthlink PPO,Healthlink PPO,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,HomeState Health Plan,HomeState Health Plan,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Humana Gold,Humana Gold,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Medicaid MO,Medicaid MO,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Medica,Medica,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Tricare,Tricare,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,UHC All Payer,UHC All Payer,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,UHC Exchange,UHC Exchange,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,UHC Medicaid,UHC Medicaid,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,UMR CPD,UMR CPD,81.06,,,,,,,per diem,81.06,81.06,"Per diem rate, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,UHC Medicare,UHC Medicare,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SPLINT, ROLYAN EXTRA FLEX PS  ",33139556,CDM,270,RC,,,,,,Inpatient,,,81.06,81.06,Wellcare,Wellcare,81.06,,,,,,,case rate,81.06,81.06,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Meritain Health PPO CPD,Meritain Health PPO CPD,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Aetna/Commercial Product,Aetna/Commercial Product,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Meritain Health CPD,Meritain Health CPD,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Starmark CPD,Starmark CPD,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Aetna Medicare,Aetna Medicare,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Ambetter ,Ambetter ,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Blue Access,Anthem Blue Access,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Blue Access Choice,Anthem Blue Access Choice,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Blue Preferred,Anthem Blue Preferred,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Pathway,Anthem Pathway,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Alliance,Anthem Alliance,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Anthem Medicare,Anthem Medicare,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Cigna,Cigna,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Cigna PPO,Cigna PPO,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Cigna Medicare Advantage,Cigna Medicare Advantage,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Essence,Essence,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Healthlink HMO,Healthlink HMO,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Healthlink PPO,Healthlink PPO,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,HomeState Health Plan,HomeState Health Plan,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Humana Gold,Humana Gold,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Medicaid MO,Medicaid MO,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Medica,Medica,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Tricare,Tricare,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,UHC All Payer,UHC All Payer,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,UHC Exchange,UHC Exchange,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,UHC Medicaid,UHC Medicaid,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,UMR CPD,UMR CPD,315.78,,,,,,,per diem,315.78,315.78,"Per diem rate, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,UHC Medicare,UHC Medicare,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SLING, KNEE                   ",33139558,CDM,270,RC,,,,,,Inpatient,,,315.78,315.78,Wellcare,Wellcare,315.78,,,,,,,case rate,315.78,315.78,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Meritain Health PPO CPD,Meritain Health PPO CPD,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Aetna/Commercial Product,Aetna/Commercial Product,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Meritain Health CPD,Meritain Health CPD,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Starmark CPD,Starmark CPD,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Aetna Medicare,Aetna Medicare,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Ambetter ,Ambetter ,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Blue Access,Anthem Blue Access,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Blue Access Choice,Anthem Blue Access Choice,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Blue Preferred,Anthem Blue Preferred,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Pathway,Anthem Pathway,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Alliance,Anthem Alliance,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Anthem Medicare,Anthem Medicare,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Cigna,Cigna,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Cigna PPO,Cigna PPO,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Cigna Medicare Advantage,Cigna Medicare Advantage,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Essence,Essence,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Healthlink HMO,Healthlink HMO,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Healthlink PPO,Healthlink PPO,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,HomeState Health Plan,HomeState Health Plan,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Humana Gold,Humana Gold,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Medicaid MO,Medicaid MO,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Medica,Medica,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Tricare,Tricare,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,UHC All Payer,UHC All Payer,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,UHC Exchange,UHC Exchange,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,UHC Medicaid,UHC Medicaid,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,UMR CPD,UMR CPD,194.67,,,,,,,per diem,194.67,194.67,"Per diem rate, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,UHC Medicare,UHC Medicare,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, WHFO                  ",33139559,CDM,270,RC,,,,,,Inpatient,,,194.67,194.67,Wellcare,Wellcare,194.67,,,,,,,case rate,194.67,194.67,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Meritain Health PPO CPD,Meritain Health PPO CPD,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Aetna/Commercial Product,Aetna/Commercial Product,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Meritain Health CPD,Meritain Health CPD,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Starmark CPD,Starmark CPD,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Aetna Medicare,Aetna Medicare,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Ambetter ,Ambetter ,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Blue Access,Anthem Blue Access,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Blue Access Choice,Anthem Blue Access Choice,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Blue Preferred,Anthem Blue Preferred,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Pathway,Anthem Pathway,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Alliance,Anthem Alliance,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Anthem Medicare,Anthem Medicare,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Cigna,Cigna,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Cigna PPO,Cigna PPO,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Cigna Medicare Advantage,Cigna Medicare Advantage,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Essence,Essence,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Healthlink HMO,Healthlink HMO,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Healthlink PPO,Healthlink PPO,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,HomeState Health Plan,HomeState Health Plan,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Humana Gold,Humana Gold,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Medicaid MO,Medicaid MO,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Medica,Medica,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Tricare,Tricare,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,UHC All Payer,UHC All Payer,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,UHC Exchange,UHC Exchange,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,UHC Medicaid,UHC Medicaid,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,UMR CPD,UMR CPD,85.98,,,,,,,per diem,85.98,85.98,"Per diem rate, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,UHC Medicare,UHC Medicare,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"SPLINT, PAN MITT, RESTING     ",33139562,CDM,270,RC,,,,,,Inpatient,,,85.98,85.98,Wellcare,Wellcare,85.98,,,,,,,case rate,85.98,85.98,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Meritain Health PPO CPD,Meritain Health PPO CPD,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Aetna/Commercial Product,Aetna/Commercial Product,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Meritain Health CPD,Meritain Health CPD,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Starmark CPD,Starmark CPD,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Aetna Medicare,Aetna Medicare,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Ambetter ,Ambetter ,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Blue Access,Anthem Blue Access,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Blue Access Choice,Anthem Blue Access Choice,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Blue Preferred,Anthem Blue Preferred,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Pathway,Anthem Pathway,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Alliance,Anthem Alliance,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Anthem Medicare,Anthem Medicare,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Cigna,Cigna,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Cigna PPO,Cigna PPO,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Cigna Medicare Advantage,Cigna Medicare Advantage,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Essence,Essence,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Healthlink HMO,Healthlink HMO,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Healthlink PPO,Healthlink PPO,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,HomeState Health Plan,HomeState Health Plan,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Humana Gold,Humana Gold,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Medicaid MO,Medicaid MO,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Medica,Medica,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Tricare,Tricare,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,UHC All Payer,UHC All Payer,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,UHC Exchange,UHC Exchange,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,UHC Medicaid,UHC Medicaid,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,UMR CPD,UMR CPD,20.67,,,,,,,per diem,20.67,20.67,"Per diem rate, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,UHC Medicare,UHC Medicare,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
"GLOVE, EDEMA                  ",33139569,CDM,270,RC,,,,,,Inpatient,,,20.67,20.67,Wellcare,Wellcare,20.67,,,,,,,case rate,20.67,20.67,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Meritain Health PPO CPD,Meritain Health PPO CPD,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Aetna/Commercial Product,Aetna/Commercial Product,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Meritain Health CPD,Meritain Health CPD,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Starmark CPD,Starmark CPD,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Aetna Medicare,Aetna Medicare,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Ambetter ,Ambetter ,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Blue Access,Anthem Blue Access,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Blue Access Choice,Anthem Blue Access Choice,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Blue Preferred,Anthem Blue Preferred,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Pathway,Anthem Pathway,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Alliance,Anthem Alliance,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Anthem Medicare,Anthem Medicare,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Cigna,Cigna,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Cigna PPO,Cigna PPO,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Cigna Medicare Advantage,Cigna Medicare Advantage,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Essence,Essence,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Healthlink HMO,Healthlink HMO,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Healthlink PPO,Healthlink PPO,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,HomeState Health Plan,HomeState Health Plan,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Humana Gold,Humana Gold,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Medicaid MO,Medicaid MO,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Medica,Medica,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Tricare,Tricare,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,UHC All Payer,UHC All Payer,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,UHC Exchange,UHC Exchange,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,UHC Medicaid,UHC Medicaid,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,UMR CPD,UMR CPD,1961.01,,,,,,,per diem,1961.01,1961.01,"Per diem rate, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,UHC Medicare,UHC Medicare,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
CUSTOM AFO                    ,33139578,CDM,270,RC,,,,,,Inpatient,,,1961.01,1961.01,Wellcare,Wellcare,1961.01,,,,,,,case rate,1961.01,1961.01,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Meritain Health PPO CPD,Meritain Health PPO CPD,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Aetna/Commercial Product,Aetna/Commercial Product,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Meritain Health CPD,Meritain Health CPD,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Starmark CPD,Starmark CPD,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Aetna Medicare,Aetna Medicare,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Ambetter ,Ambetter ,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Blue Access,Anthem Blue Access,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Blue Access Choice,Anthem Blue Access Choice,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Blue Preferred,Anthem Blue Preferred,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Pathway,Anthem Pathway,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Alliance,Anthem Alliance,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Anthem Medicare,Anthem Medicare,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Cigna,Cigna,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Cigna PPO,Cigna PPO,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Cigna Medicare Advantage,Cigna Medicare Advantage,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Essence,Essence,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Healthlink HMO,Healthlink HMO,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Healthlink PPO,Healthlink PPO,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,HomeState Health Plan,HomeState Health Plan,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Humana Gold,Humana Gold,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Medicaid MO,Medicaid MO,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Medica,Medica,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Tricare,Tricare,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,UHC All Payer,UHC All Payer,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,UHC Exchange,UHC Exchange,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,UHC Medicaid,UHC Medicaid,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,UMR CPD,UMR CPD,182.97,,,,,,,per diem,182.97,182.97,"Per diem rate, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,UHC Medicare,UHC Medicare,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
HAND SPLING-RESTING           ,33139581,CDM,270,RC,,,,,,Inpatient,,,182.97,182.97,Wellcare,Wellcare,182.97,,,,,,,case rate,182.97,182.97,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Meritain Health PPO CPD,Meritain Health PPO CPD,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Aetna/Commercial Product,Aetna/Commercial Product,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Meritain Health CPD,Meritain Health CPD,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Starmark CPD,Starmark CPD,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Aetna Medicare,Aetna Medicare,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Ambetter ,Ambetter ,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Blue Access,Anthem Blue Access,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Blue Access Choice,Anthem Blue Access Choice,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Blue Preferred,Anthem Blue Preferred,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Pathway,Anthem Pathway,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Alliance,Anthem Alliance,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Anthem Medicare,Anthem Medicare,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Cigna,Cigna,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Cigna PPO,Cigna PPO,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Cigna Medicare Advantage,Cigna Medicare Advantage,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Essence,Essence,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Healthlink HMO,Healthlink HMO,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Healthlink PPO,Healthlink PPO,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,HomeState Health Plan,HomeState Health Plan,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Humana Gold,Humana Gold,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Medicaid MO,Medicaid MO,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Medica,Medica,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Tricare,Tricare,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,UHC All Payer,UHC All Payer,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,UHC Exchange,UHC Exchange,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,UHC Medicaid,UHC Medicaid,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,UMR CPD,UMR CPD,12.5,,,,,,,per diem,12.5,12.5,"Per diem rate, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,UHC Medicare,UHC Medicare,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
CPM DAILY RENTAL              ,33139607,CDM,279,RC,,,,,,Inpatient,,,12.5,12.5,Wellcare,Wellcare,12.5,,,,,,,case rate,12.5,12.5,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health PPO CPD,Meritain Health PPO CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/Commercial Product,Aetna/Commercial Product,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health CPD,Meritain Health CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Starmark CPD,Starmark CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna Medicare,Aetna Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Ambetter ,Ambetter ,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access,Anthem Blue Access,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access Choice,Anthem Blue Access Choice,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Preferred,Anthem Blue Preferred,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Pathway,Anthem Pathway,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Alliance,Anthem Alliance,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Medicare,Anthem Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna,Cigna,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna PPO,Cigna PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna Medicare Advantage,Cigna Medicare Advantage,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Essence,Essence,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink HMO,Healthlink HMO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink PPO,Healthlink PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,HomeState Health Plan,HomeState Health Plan,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Humana Gold,Humana Gold,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Medicaid MO,Medicaid MO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Medica,Medica,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Tricare,Tricare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC All Payer,UHC All Payer,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Exchange,UHC Exchange,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicaid,UHC Medicaid,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,UMR CPD,UMR CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicare,UHC Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
RENTAL BED W/SCALE DAILY      ,33139608,CDM,279,RC,,,,,,Inpatient,,,105,105,Wellcare,Wellcare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Meritain Health PPO CPD,Meritain Health PPO CPD,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Aetna/Commercial Product,Aetna/Commercial Product,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Meritain Health CPD,Meritain Health CPD,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Starmark CPD,Starmark CPD,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Aetna Medicare,Aetna Medicare,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Ambetter ,Ambetter ,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Blue Access,Anthem Blue Access,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Blue Access Choice,Anthem Blue Access Choice,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Blue Preferred,Anthem Blue Preferred,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Pathway,Anthem Pathway,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Alliance,Anthem Alliance,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Anthem Medicare,Anthem Medicare,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Cigna,Cigna,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Cigna PPO,Cigna PPO,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Cigna Medicare Advantage,Cigna Medicare Advantage,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Essence,Essence,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Healthlink HMO,Healthlink HMO,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Healthlink PPO,Healthlink PPO,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,HomeState Health Plan,HomeState Health Plan,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Humana Gold,Humana Gold,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Medicaid MO,Medicaid MO,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Medica,Medica,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Tricare,Tricare,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,UHC All Payer,UHC All Payer,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,UHC Exchange,UHC Exchange,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,UHC Medicaid,UHC Medicaid,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,UMR CPD,UMR CPD,1.51,,,,,,,per diem,1.51,1.51,"Per diem rate, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,UHC Medicare,UHC Medicare,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD ADULT 18 DISP 100/CS ,33140016,CDM,270,RC,,,,,,Inpatient,,,1.51,1.51,Wellcare,Wellcare,1.51,,,,,,,case rate,1.51,1.51,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Meritain Health PPO CPD,Meritain Health PPO CPD,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Aetna/Commercial Product,Aetna/Commercial Product,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Meritain Health CPD,Meritain Health CPD,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Starmark CPD,Starmark CPD,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Aetna Medicare,Aetna Medicare,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Ambetter ,Ambetter ,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Blue Access,Anthem Blue Access,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Blue Access Choice,Anthem Blue Access Choice,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Blue Preferred,Anthem Blue Preferred,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Pathway,Anthem Pathway,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Alliance,Anthem Alliance,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Anthem Medicare,Anthem Medicare,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Cigna,Cigna,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Cigna PPO,Cigna PPO,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Cigna Medicare Advantage,Cigna Medicare Advantage,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Essence,Essence,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Healthlink HMO,Healthlink HMO,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Healthlink PPO,Healthlink PPO,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,HomeState Health Plan,HomeState Health Plan,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Humana Gold,Humana Gold,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Medicaid MO,Medicaid MO,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Medica,Medica,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Tricare,Tricare,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,UHC All Payer,UHC All Payer,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,UHC Exchange,UHC Exchange,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,UHC Medicaid,UHC Medicaid,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,UMR CPD,UMR CPD,1.26,,,,,,,per diem,1.26,1.26,"Per diem rate, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,UHC Medicare,UHC Medicare,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
ARMBOARD WRIST 3X9 DISP 100/CS,33140017,CDM,270,RC,,,,,,Inpatient,,,1.26,1.26,Wellcare,Wellcare,1.26,,,,,,,case rate,1.26,1.26,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Meritain Health PPO CPD,Meritain Health PPO CPD,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Aetna/Commercial Product,Aetna/Commercial Product,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Meritain Health CPD,Meritain Health CPD,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Starmark CPD,Starmark CPD,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Aetna Medicare,Aetna Medicare,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Ambetter ,Ambetter ,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Blue Access,Anthem Blue Access,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Blue Access Choice,Anthem Blue Access Choice,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Blue Preferred,Anthem Blue Preferred,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Pathway,Anthem Pathway,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Alliance,Anthem Alliance,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Anthem Medicare,Anthem Medicare,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Cigna,Cigna,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Cigna PPO,Cigna PPO,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Cigna Medicare Advantage,Cigna Medicare Advantage,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Essence,Essence,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Healthlink HMO,Healthlink HMO,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Healthlink PPO,Healthlink PPO,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,HomeState Health Plan,HomeState Health Plan,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Humana Gold,Humana Gold,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Medicaid MO,Medicaid MO,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Medica,Medica,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Tricare,Tricare,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,UHC All Payer,UHC All Payer,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,UHC Exchange,UHC Exchange,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,UHC Medicaid,UHC Medicaid,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,UMR CPD,UMR CPD,19.64,,,,,,,per diem,19.64,19.64,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,UHC Medicare,UHC Medicare,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 3 PANEL      ,33140037,CDM,270,RC,,,,,,Inpatient,,,19.64,19.64,Wellcare,Wellcare,19.64,,,,,,,case rate,19.64,19.64,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Meritain Health PPO CPD,Meritain Health PPO CPD,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Aetna/Commercial Product,Aetna/Commercial Product,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Meritain Health CPD,Meritain Health CPD,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Starmark CPD,Starmark CPD,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Aetna Medicare,Aetna Medicare,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Ambetter ,Ambetter ,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Blue Access,Anthem Blue Access,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Blue Access Choice,Anthem Blue Access Choice,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Blue Preferred,Anthem Blue Preferred,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Pathway,Anthem Pathway,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Alliance,Anthem Alliance,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Anthem Medicare,Anthem Medicare,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Cigna,Cigna,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Cigna PPO,Cigna PPO,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Cigna Medicare Advantage,Cigna Medicare Advantage,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Essence,Essence,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Healthlink HMO,Healthlink HMO,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Healthlink PPO,Healthlink PPO,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,HomeState Health Plan,HomeState Health Plan,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Humana Gold,Humana Gold,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Medicaid MO,Medicaid MO,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Medica,Medica,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Tricare,Tricare,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,UHC All Payer,UHC All Payer,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,UHC Exchange,UHC Exchange,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,UHC Medicaid,UHC Medicaid,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,UMR CPD,UMR CPD,16.22,,,,,,,per diem,16.22,16.22,"Per diem rate, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,UHC Medicare,UHC Medicare,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
PROTECT HEEL &ELBOW LG 12PR/BX,33140101,CDM,270,RC,,,,,,Inpatient,,,16.22,16.22,Wellcare,Wellcare,16.22,,,,,,,case rate,16.22,16.22,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Meritain Health PPO CPD,Meritain Health PPO CPD,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Aetna/Commercial Product,Aetna/Commercial Product,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Meritain Health CPD,Meritain Health CPD,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Starmark CPD,Starmark CPD,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Aetna Medicare,Aetna Medicare,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Ambetter ,Ambetter ,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Blue Access,Anthem Blue Access,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Blue Access Choice,Anthem Blue Access Choice,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Blue Preferred,Anthem Blue Preferred,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Pathway,Anthem Pathway,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Alliance,Anthem Alliance,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Anthem Medicare,Anthem Medicare,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Cigna,Cigna,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Cigna PPO,Cigna PPO,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Cigna Medicare Advantage,Cigna Medicare Advantage,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Essence,Essence,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Healthlink HMO,Healthlink HMO,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Healthlink PPO,Healthlink PPO,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,HomeState Health Plan,HomeState Health Plan,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Humana Gold,Humana Gold,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Medicaid MO,Medicaid MO,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Medica,Medica,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Tricare,Tricare,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,UHC All Payer,UHC All Payer,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,UHC Exchange,UHC Exchange,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,UHC Medicaid,UHC Medicaid,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,UMR CPD,UMR CPD,331.13,,,,,,,per diem,331.13,331.13,"Per diem rate, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,UHC Medicare,UHC Medicare,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
ROLLATOR TALL ADULT MIDNIGHT B,33140109,CDM,279,RC,,,,,,Inpatient,,,331.13,331.13,Wellcare,Wellcare,331.13,,,,,,,case rate,331.13,331.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Meritain Health PPO CPD,Meritain Health PPO CPD,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Aetna/Commercial Product,Aetna/Commercial Product,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Meritain Health CPD,Meritain Health CPD,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Starmark CPD,Starmark CPD,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Aetna Medicare,Aetna Medicare,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Ambetter ,Ambetter ,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Blue Access,Anthem Blue Access,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Blue Access Choice,Anthem Blue Access Choice,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Blue Preferred,Anthem Blue Preferred,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Pathway,Anthem Pathway,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Alliance,Anthem Alliance,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Anthem Medicare,Anthem Medicare,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Cigna,Cigna,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Cigna PPO,Cigna PPO,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Cigna Medicare Advantage,Cigna Medicare Advantage,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Essence,Essence,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Healthlink HMO,Healthlink HMO,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Healthlink PPO,Healthlink PPO,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,HomeState Health Plan,HomeState Health Plan,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Humana Gold,Humana Gold,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Medicaid MO,Medicaid MO,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Medica,Medica,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Tricare,Tricare,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,UHC All Payer,UHC All Payer,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,UHC Exchange,UHC Exchange,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,UHC Medicaid,UHC Medicaid,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,UMR CPD,UMR CPD,229.13,,,,,,,per diem,229.13,229.13,"Per diem rate, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,UHC Medicare,UHC Medicare,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE 3N1 DROP ARM SILVER   ,33140172,CDM,279,RC,,,,,,Inpatient,,,229.13,229.13,Wellcare,Wellcare,229.13,,,,,,,case rate,229.13,229.13,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Meritain Health PPO CPD,Meritain Health PPO CPD,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Aetna/Commercial Product,Aetna/Commercial Product,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Meritain Health CPD,Meritain Health CPD,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Starmark CPD,Starmark CPD,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Aetna Medicare,Aetna Medicare,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Ambetter ,Ambetter ,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Blue Access,Anthem Blue Access,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Blue Access Choice,Anthem Blue Access Choice,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Blue Preferred,Anthem Blue Preferred,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Pathway,Anthem Pathway,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Alliance,Anthem Alliance,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Anthem Medicare,Anthem Medicare,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Cigna,Cigna,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Cigna PPO,Cigna PPO,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Cigna Medicare Advantage,Cigna Medicare Advantage,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Essence,Essence,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Healthlink HMO,Healthlink HMO,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Healthlink PPO,Healthlink PPO,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,HomeState Health Plan,HomeState Health Plan,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Humana Gold,Humana Gold,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Medicaid MO,Medicaid MO,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Medica,Medica,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Tricare,Tricare,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,UHC All Payer,UHC All Payer,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,UHC Exchange,UHC Exchange,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,UHC Medicaid,UHC Medicaid,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,UMR CPD,UMR CPD,75.63,,,,,,,per diem,75.63,75.63,"Per diem rate, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,UHC Medicare,UHC Medicare,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE ALL IN ONE COATED 4/CA,33140173,CDM,279,RC,,,,,,Inpatient,,,75.63,75.63,Wellcare,Wellcare,75.63,,,,,,,case rate,75.63,75.63,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Meritain Health PPO CPD,Meritain Health PPO CPD,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Aetna/Commercial Product,Aetna/Commercial Product,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Meritain Health CPD,Meritain Health CPD,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Starmark CPD,Starmark CPD,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Aetna Medicare,Aetna Medicare,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Ambetter ,Ambetter ,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Blue Access,Anthem Blue Access,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Blue Access Choice,Anthem Blue Access Choice,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Blue Preferred,Anthem Blue Preferred,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Pathway,Anthem Pathway,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Alliance,Anthem Alliance,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Anthem Medicare,Anthem Medicare,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Cigna,Cigna,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Cigna PPO,Cigna PPO,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Cigna Medicare Advantage,Cigna Medicare Advantage,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Essence,Essence,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Healthlink HMO,Healthlink HMO,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Healthlink PPO,Healthlink PPO,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,HomeState Health Plan,HomeState Health Plan,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Humana Gold,Humana Gold,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Medicaid MO,Medicaid MO,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Medica,Medica,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Tricare,Tricare,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,UHC All Payer,UHC All Payer,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,UHC Exchange,UHC Exchange,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,UHC Medicaid,UHC Medicaid,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,UMR CPD,UMR CPD,318.06,,,,,,,per diem,318.06,318.06,"Per diem rate, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,UHC Medicare,UHC Medicare,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE DROP ARM W/PAD SEAT EA,33140175,CDM,279,RC,,,,,,Inpatient,,,318.06,318.06,Wellcare,Wellcare,318.06,,,,,,,case rate,318.06,318.06,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Meritain Health PPO CPD,Meritain Health PPO CPD,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Aetna/Commercial Product,Aetna/Commercial Product,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Meritain Health CPD,Meritain Health CPD,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Starmark CPD,Starmark CPD,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Aetna Medicare,Aetna Medicare,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Ambetter ,Ambetter ,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Blue Access,Anthem Blue Access,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Blue Access Choice,Anthem Blue Access Choice,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Blue Preferred,Anthem Blue Preferred,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Pathway,Anthem Pathway,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Alliance,Anthem Alliance,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Anthem Medicare,Anthem Medicare,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Cigna,Cigna,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Cigna PPO,Cigna PPO,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Cigna Medicare Advantage,Cigna Medicare Advantage,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Essence,Essence,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Healthlink HMO,Healthlink HMO,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Healthlink PPO,Healthlink PPO,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,HomeState Health Plan,HomeState Health Plan,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Humana Gold,Humana Gold,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Medicaid MO,Medicaid MO,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Medica,Medica,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Tricare,Tricare,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,UHC All Payer,UHC All Payer,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,UHC Exchange,UHC Exchange,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,UHC Medicaid,UHC Medicaid,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,UMR CPD,UMR CPD,395.96,,,,,,,per diem,395.96,395.96,"Per diem rate, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,UHC Medicare,UHC Medicare,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE EXTRA WIDE W/ARMS     ,33140176,CDM,279,RC,,,,,,Inpatient,,,395.96,395.96,Wellcare,Wellcare,395.96,,,,,,,case rate,395.96,395.96,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Meritain Health PPO CPD,Meritain Health PPO CPD,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Aetna/Commercial Product,Aetna/Commercial Product,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Meritain Health CPD,Meritain Health CPD,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Starmark CPD,Starmark CPD,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Aetna Medicare,Aetna Medicare,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Ambetter ,Ambetter ,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Blue Access,Anthem Blue Access,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Blue Access Choice,Anthem Blue Access Choice,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Blue Preferred,Anthem Blue Preferred,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Pathway,Anthem Pathway,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Alliance,Anthem Alliance,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Anthem Medicare,Anthem Medicare,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Cigna,Cigna,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Cigna PPO,Cigna PPO,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Cigna Medicare Advantage,Cigna Medicare Advantage,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Essence,Essence,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Healthlink HMO,Healthlink HMO,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Healthlink PPO,Healthlink PPO,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,HomeState Health Plan,HomeState Health Plan,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Humana Gold,Humana Gold,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Medicaid MO,Medicaid MO,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Medica,Medica,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Tricare,Tricare,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,UHC All Payer,UHC All Payer,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,UHC Exchange,UHC Exchange,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,UHC Medicaid,UHC Medicaid,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,UMR CPD,UMR CPD,625.68,,,,,,,per diem,625.68,625.68,"Per diem rate, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,UHC Medicare,UHC Medicare,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
COMMODE OVERSIZED DROPARM 650L,33140177,CDM,279,RC,,,,,,Inpatient,,,625.68,625.68,Wellcare,Wellcare,625.68,,,,,,,case rate,625.68,625.68,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health PPO CPD,Meritain Health PPO CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/Commercial Product,Aetna/Commercial Product,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health CPD,Meritain Health CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Starmark CPD,Starmark CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna Medicare,Aetna Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Ambetter ,Ambetter ,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access,Anthem Blue Access,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access Choice,Anthem Blue Access Choice,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Preferred,Anthem Blue Preferred,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Pathway,Anthem Pathway,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Alliance,Anthem Alliance,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Medicare,Anthem Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna,Cigna,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna PPO,Cigna PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna Medicare Advantage,Cigna Medicare Advantage,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Essence,Essence,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink HMO,Healthlink HMO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink PPO,Healthlink PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,HomeState Health Plan,HomeState Health Plan,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Humana Gold,Humana Gold,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medicaid MO,Medicaid MO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medica,Medica,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Tricare,Tricare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC All Payer,UHC All Payer,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Exchange,UHC Exchange,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicaid,UHC Medicaid,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UMR CPD,UMR CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicare,UHC Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPPORT     ,33140272,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Wellcare,Wellcare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health PPO CPD,Meritain Health PPO CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/Commercial Product,Aetna/Commercial Product,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health CPD,Meritain Health CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Starmark CPD,Starmark CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna Medicare,Aetna Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Ambetter ,Ambetter ,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access,Anthem Blue Access,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access Choice,Anthem Blue Access Choice,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Preferred,Anthem Blue Preferred,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Pathway,Anthem Pathway,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Alliance,Anthem Alliance,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Medicare,Anthem Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna,Cigna,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna PPO,Cigna PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna Medicare Advantage,Cigna Medicare Advantage,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Essence,Essence,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink HMO,Healthlink HMO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink PPO,Healthlink PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,HomeState Health Plan,HomeState Health Plan,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Humana Gold,Humana Gold,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medicaid MO,Medicaid MO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medica,Medica,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Tricare,Tricare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC All Payer,UHC All Payer,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Exchange,UHC Exchange,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicaid,UHC Medicaid,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UMR CPD,UMR CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicare,UHC Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
TRI-PANEL KNEE IMMOBILIZER    ,33140279,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Wellcare,Wellcare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Meritain Health PPO CPD,Meritain Health PPO CPD,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Aetna/Commercial Product,Aetna/Commercial Product,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Meritain Health CPD,Meritain Health CPD,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Starmark CPD,Starmark CPD,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Aetna Medicare,Aetna Medicare,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Ambetter ,Ambetter ,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Blue Access,Anthem Blue Access,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Blue Access Choice,Anthem Blue Access Choice,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Blue Preferred,Anthem Blue Preferred,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Pathway,Anthem Pathway,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Alliance,Anthem Alliance,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Anthem Medicare,Anthem Medicare,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Cigna,Cigna,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Cigna PPO,Cigna PPO,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Cigna Medicare Advantage,Cigna Medicare Advantage,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Essence,Essence,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Healthlink HMO,Healthlink HMO,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Healthlink PPO,Healthlink PPO,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,HomeState Health Plan,HomeState Health Plan,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Humana Gold,Humana Gold,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Medicaid MO,Medicaid MO,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Medica,Medica,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Tricare,Tricare,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,UHC All Payer,UHC All Payer,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,UHC Exchange,UHC Exchange,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,UHC Medicaid,UHC Medicaid,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,UMR CPD,UMR CPD,31.19,,,,,,,per diem,31.19,31.19,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,UHC Medicare,UHC Medicare,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER STANDARD     ,33140284,CDM,270,RC,,,,,,Inpatient,,,31.19,31.19,Wellcare,Wellcare,31.19,,,,,,,case rate,31.19,31.19,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Meritain Health PPO CPD,Meritain Health PPO CPD,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Aetna/Commercial Product,Aetna/Commercial Product,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Meritain Health CPD,Meritain Health CPD,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Starmark CPD,Starmark CPD,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Aetna Medicare,Aetna Medicare,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Ambetter ,Ambetter ,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Blue Access,Anthem Blue Access,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Blue Access Choice,Anthem Blue Access Choice,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Blue Preferred,Anthem Blue Preferred,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Pathway,Anthem Pathway,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Alliance,Anthem Alliance,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Anthem Medicare,Anthem Medicare,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Cigna,Cigna,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Cigna PPO,Cigna PPO,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Cigna Medicare Advantage,Cigna Medicare Advantage,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Essence,Essence,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Healthlink HMO,Healthlink HMO,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Healthlink PPO,Healthlink PPO,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,HomeState Health Plan,HomeState Health Plan,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Humana Gold,Humana Gold,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Medicaid MO,Medicaid MO,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Medica,Medica,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Tricare,Tricare,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,UHC All Payer,UHC All Payer,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,UHC Exchange,UHC Exchange,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,UHC Medicaid,UHC Medicaid,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,UMR CPD,UMR CPD,32.07,,,,,,,per diem,32.07,32.07,"Per diem rate, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,UHC Medicare,UHC Medicare,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
"KNEE IMMOBILIZER 16"" UNIV     ",33140290,CDM,270,RC,,,,,,Inpatient,,,32.07,32.07,Wellcare,Wellcare,32.07,,,,,,,case rate,32.07,32.07,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-S),33140296,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-S),33140297,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-M),33140298,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-M),33140299,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (L-L),33140300,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health PPO CPD,Meritain Health PPO CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna/Commercial Product,Aetna/Commercial Product,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Meritain Health CPD,Meritain Health CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Starmark CPD,Starmark CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Aetna Medicare,Aetna Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Ambetter ,Ambetter ,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access,Anthem Blue Access,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Access Choice,Anthem Blue Access Choice,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Blue Preferred,Anthem Blue Preferred,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Pathway,Anthem Pathway,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Alliance,Anthem Alliance,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Anthem Medicare,Anthem Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna,Cigna,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna PPO,Cigna PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Cigna Medicare Advantage,Cigna Medicare Advantage,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Essence,Essence,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink HMO,Healthlink HMO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Healthlink PPO,Healthlink PPO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,HomeState Health Plan,HomeState Health Plan,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Humana Gold,Humana Gold,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medicaid MO,Medicaid MO,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Medica,Medica,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Tricare,Tricare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC All Payer,UHC All Payer,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Exchange,UHC Exchange,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicaid,UHC Medicaid,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UMR CPD,UMR CPD,37.77,,,,,,,per diem,37.77,37.77,"Per diem rate, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,UHC Medicare,UHC Medicare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
FOREARM COMP FULL FINGER (R-L),33140301,CDM,270,RC,,,,,,Inpatient,,,37.77,37.77,Wellcare,Wellcare,37.77,,,,,,,case rate,37.77,37.77,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Meritain Health PPO CPD,Meritain Health PPO CPD,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Aetna/Commercial Product,Aetna/Commercial Product,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Meritain Health CPD,Meritain Health CPD,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Starmark CPD,Starmark CPD,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Aetna Medicare,Aetna Medicare,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Ambetter ,Ambetter ,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Blue Access,Anthem Blue Access,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Blue Access Choice,Anthem Blue Access Choice,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Blue Preferred,Anthem Blue Preferred,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Pathway,Anthem Pathway,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Alliance,Anthem Alliance,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Anthem Medicare,Anthem Medicare,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Cigna,Cigna,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Cigna PPO,Cigna PPO,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Cigna Medicare Advantage,Cigna Medicare Advantage,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Essence,Essence,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Healthlink HMO,Healthlink HMO,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Healthlink PPO,Healthlink PPO,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,HomeState Health Plan,HomeState Health Plan,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Humana Gold,Humana Gold,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Medicaid MO,Medicaid MO,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Medica,Medica,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Tricare,Tricare,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,UHC All Payer,UHC All Payer,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,UHC Exchange,UHC Exchange,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,UHC Medicaid,UHC Medicaid,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,UMR CPD,UMR CPD,34.68,,,,,,,per diem,34.68,34.68,"Per diem rate, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,UHC Medicare,UHC Medicare,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
"IMMOBILIZER KNEE CUT AWAY 19"" ",33140303,CDM,270,RC,,,,,,Inpatient,,,34.68,34.68,Wellcare,Wellcare,34.68,,,,,,,case rate,34.68,34.68,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Meritain Health PPO CPD,Meritain Health PPO CPD,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Aetna/Commercial Product,Aetna/Commercial Product,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Meritain Health CPD,Meritain Health CPD,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Starmark CPD,Starmark CPD,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Aetna Medicare,Aetna Medicare,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Ambetter ,Ambetter ,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Blue Access,Anthem Blue Access,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Blue Access Choice,Anthem Blue Access Choice,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Blue Preferred,Anthem Blue Preferred,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Pathway,Anthem Pathway,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Alliance,Anthem Alliance,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Anthem Medicare,Anthem Medicare,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Cigna,Cigna,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Cigna PPO,Cigna PPO,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Cigna Medicare Advantage,Cigna Medicare Advantage,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Essence,Essence,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Healthlink HMO,Healthlink HMO,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Healthlink PPO,Healthlink PPO,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,HomeState Health Plan,HomeState Health Plan,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Humana Gold,Humana Gold,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Medicaid MO,Medicaid MO,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Medica,Medica,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Tricare,Tricare,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,UHC All Payer,UHC All Payer,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,UHC Exchange,UHC Exchange,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,UHC Medicaid,UHC Medicaid,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,UMR CPD,UMR CPD,58.53,,,,,,,per diem,58.53,58.53,"Per diem rate, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,UHC Medicare,UHC Medicare,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
COLLAR PAD REPLCMNT MIAMI J   ,33140308,CDM,270,RC,,,,,,Inpatient,,,58.53,58.53,Wellcare,Wellcare,58.53,,,,,,,case rate,58.53,58.53,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Meritain Health PPO CPD,Meritain Health PPO CPD,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Aetna/Commercial Product,Aetna/Commercial Product,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Meritain Health CPD,Meritain Health CPD,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Starmark CPD,Starmark CPD,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Aetna Medicare,Aetna Medicare,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Ambetter ,Ambetter ,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Blue Access,Anthem Blue Access,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Blue Access Choice,Anthem Blue Access Choice,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Blue Preferred,Anthem Blue Preferred,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Pathway,Anthem Pathway,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Alliance,Anthem Alliance,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Anthem Medicare,Anthem Medicare,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Cigna,Cigna,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Cigna PPO,Cigna PPO,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Cigna Medicare Advantage,Cigna Medicare Advantage,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Essence,Essence,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Healthlink HMO,Healthlink HMO,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Healthlink PPO,Healthlink PPO,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,HomeState Health Plan,HomeState Health Plan,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Humana Gold,Humana Gold,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Medicaid MO,Medicaid MO,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Medica,Medica,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Tricare,Tricare,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,UHC All Payer,UHC All Payer,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,UHC Exchange,UHC Exchange,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,UHC Medicaid,UHC Medicaid,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,UMR CPD,UMR CPD,75.6,,,,,,,per diem,75.6,75.6,"Per diem rate, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,UHC Medicare,UHC Medicare,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SUPPORT L/XL 593-UWS    ,33140335,CDM,270,RC,,,,,,Inpatient,,,75.6,75.6,Wellcare,Wellcare,75.6,,,,,,,case rate,75.6,75.6,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
WRIST SPLINT W THUMB STABILIZR,33140336,CDM,270,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Meritain Health PPO CPD,Meritain Health PPO CPD,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Aetna/Commercial Product,Aetna/Commercial Product,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Meritain Health CPD,Meritain Health CPD,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Starmark CPD,Starmark CPD,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Aetna Medicare,Aetna Medicare,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Ambetter ,Ambetter ,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Blue Access,Anthem Blue Access,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Blue Access Choice,Anthem Blue Access Choice,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Blue Preferred,Anthem Blue Preferred,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Pathway,Anthem Pathway,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Alliance,Anthem Alliance,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Anthem Medicare,Anthem Medicare,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Cigna,Cigna,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Cigna PPO,Cigna PPO,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Cigna Medicare Advantage,Cigna Medicare Advantage,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Essence,Essence,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Healthlink HMO,Healthlink HMO,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Healthlink PPO,Healthlink PPO,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,HomeState Health Plan,HomeState Health Plan,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Humana Gold,Humana Gold,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Medicaid MO,Medicaid MO,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Medica,Medica,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Tricare,Tricare,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,UHC All Payer,UHC All Payer,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,UHC Exchange,UHC Exchange,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,UHC Medicaid,UHC Medicaid,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,UMR CPD,UMR CPD,166.01,,,,,,,per diem,166.01,166.01,"Per diem rate, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,UHC Medicare,UHC Medicare,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER CAREGUARD TOOLESS,33140433,CDM,279,RC,,,,,,Inpatient,,,166.01,166.01,Wellcare,Wellcare,166.01,,,,,,,case rate,166.01,166.01,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Meritain Health PPO CPD,Meritain Health PPO CPD,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Aetna/Commercial Product,Aetna/Commercial Product,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Meritain Health CPD,Meritain Health CPD,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Starmark CPD,Starmark CPD,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Aetna Medicare,Aetna Medicare,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Ambetter ,Ambetter ,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Blue Access,Anthem Blue Access,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Blue Access Choice,Anthem Blue Access Choice,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Blue Preferred,Anthem Blue Preferred,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Pathway,Anthem Pathway,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Alliance,Anthem Alliance,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Anthem Medicare,Anthem Medicare,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Cigna,Cigna,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Cigna PPO,Cigna PPO,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Cigna Medicare Advantage,Cigna Medicare Advantage,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Essence,Essence,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Healthlink HMO,Healthlink HMO,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Healthlink PPO,Healthlink PPO,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,HomeState Health Plan,HomeState Health Plan,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Humana Gold,Humana Gold,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Medicaid MO,Medicaid MO,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Medica,Medica,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Tricare,Tricare,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,UHC All Payer,UHC All Payer,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,UHC Exchange,UHC Exchange,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,UHC Medicaid,UHC Medicaid,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,UMR CPD,UMR CPD,2853.49,,,,,,,per diem,2853.49,2853.49,"Per diem rate, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,UHC Medicare,UHC Medicare,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER COMMODE HEVY DUTY,33140434,CDM,279,RC,,,,,,Inpatient,,,2853.49,2853.49,Wellcare,Wellcare,2853.49,,,,,,,case rate,2853.49,2853.49,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Meritain Health PPO CPD,Meritain Health PPO CPD,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Aetna/Commercial Product,Aetna/Commercial Product,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Meritain Health CPD,Meritain Health CPD,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Starmark CPD,Starmark CPD,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Aetna Medicare,Aetna Medicare,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Ambetter ,Ambetter ,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Blue Access,Anthem Blue Access,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Blue Access Choice,Anthem Blue Access Choice,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Blue Preferred,Anthem Blue Preferred,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Pathway,Anthem Pathway,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Alliance,Anthem Alliance,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Anthem Medicare,Anthem Medicare,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Cigna,Cigna,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Cigna PPO,Cigna PPO,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Cigna Medicare Advantage,Cigna Medicare Advantage,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Essence,Essence,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Healthlink HMO,Healthlink HMO,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Healthlink PPO,Healthlink PPO,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,HomeState Health Plan,HomeState Health Plan,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Humana Gold,Humana Gold,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Medicaid MO,Medicaid MO,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Medica,Medica,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Tricare,Tricare,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,UHC All Payer,UHC All Payer,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,UHC Exchange,UHC Exchange,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,UHC Medicaid,UHC Medicaid,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,UMR CPD,UMR CPD,255.42,,,,,,,per diem,255.42,255.42,"Per diem rate, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,UHC Medicare,UHC Medicare,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CHAIR SHOWER IVC I W/BACK 2/CT,33140435,CDM,279,RC,,,,,,Inpatient,,,255.42,255.42,Wellcare,Wellcare,255.42,,,,,,,case rate,255.42,255.42,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Meritain Health PPO CPD,Meritain Health PPO CPD,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Aetna/Commercial Product,Aetna/Commercial Product,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Meritain Health CPD,Meritain Health CPD,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Starmark CPD,Starmark CPD,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Aetna Medicare,Aetna Medicare,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Ambetter ,Ambetter ,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Blue Access,Anthem Blue Access,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Blue Access Choice,Anthem Blue Access Choice,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Blue Preferred,Anthem Blue Preferred,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Pathway,Anthem Pathway,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Alliance,Anthem Alliance,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Anthem Medicare,Anthem Medicare,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Cigna,Cigna,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Cigna PPO,Cigna PPO,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Cigna Medicare Advantage,Cigna Medicare Advantage,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Essence,Essence,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Healthlink HMO,Healthlink HMO,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Healthlink PPO,Healthlink PPO,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,HomeState Health Plan,HomeState Health Plan,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Humana Gold,Humana Gold,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Medicaid MO,Medicaid MO,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Medica,Medica,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Tricare,Tricare,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,UHC All Payer,UHC All Payer,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,UHC Exchange,UHC Exchange,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,UHC Medicaid,UHC Medicaid,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,UMR CPD,UMR CPD,84.33,,,,,,,per diem,84.33,84.33,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,UHC Medicare,UHC Medicare,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM DELX MED 1PR/CA,33140437,CDM,270,RC,,,,,,Inpatient,,,84.33,84.33,Wellcare,Wellcare,84.33,,,,,,,case rate,84.33,84.33,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
CRUTCH FOREARM TALL ADULT STEE,33140438,CDM,270,RC,,,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Meritain Health PPO CPD,Meritain Health PPO CPD,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Aetna/Commercial Product,Aetna/Commercial Product,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Meritain Health CPD,Meritain Health CPD,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Starmark CPD,Starmark CPD,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Aetna Medicare,Aetna Medicare,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Ambetter ,Ambetter ,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Blue Access,Anthem Blue Access,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Blue Access Choice,Anthem Blue Access Choice,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Blue Preferred,Anthem Blue Preferred,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Pathway,Anthem Pathway,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Alliance,Anthem Alliance,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Anthem Medicare,Anthem Medicare,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Cigna,Cigna,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Cigna PPO,Cigna PPO,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Cigna Medicare Advantage,Cigna Medicare Advantage,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Essence,Essence,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Healthlink HMO,Healthlink HMO,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Healthlink PPO,Healthlink PPO,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,HomeState Health Plan,HomeState Health Plan,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Humana Gold,Humana Gold,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Medicaid MO,Medicaid MO,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Medica,Medica,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Tricare,Tricare,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,UHC All Payer,UHC All Payer,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,UHC Exchange,UHC Exchange,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,UHC Medicaid,UHC Medicaid,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,UMR CPD,UMR CPD,130.82,,,,,,,per diem,130.82,130.82,"Per diem rate, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,UHC Medicare,UHC Medicare,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WALKER ADULT DUAL RELEASE 4/CS,33140459,CDM,279,RC,,,,,,Inpatient,,,130.82,130.82,Wellcare,Wellcare,130.82,,,,,,,case rate,130.82,130.82,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Meritain Health PPO CPD,Meritain Health PPO CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna/Commercial Product,Aetna/Commercial Product,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Meritain Health CPD,Meritain Health CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Starmark CPD,Starmark CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna Medicare,Aetna Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Ambetter ,Ambetter ,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Access,Anthem Blue Access,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Access Choice,Anthem Blue Access Choice,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Preferred,Anthem Blue Preferred,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Pathway,Anthem Pathway,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Alliance,Anthem Alliance,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Medicare,Anthem Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna,Cigna,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna PPO,Cigna PPO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna Medicare Advantage,Cigna Medicare Advantage,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Essence,Essence,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthlink HMO,Healthlink HMO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthlink PPO,Healthlink PPO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,HomeState Health Plan,HomeState Health Plan,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Humana Gold,Humana Gold,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Medicaid MO,Medicaid MO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Medica,Medica,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Tricare,Tricare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC All Payer,UHC All Payer,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Exchange,UHC Exchange,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Medicaid,UHC Medicaid,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UMR CPD,UMR CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Medicare,UHC Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR ADLT W/5 WHEELS DUAL 4/CS,33140460,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Wellcare,Wellcare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Meritain Health PPO CPD,Meritain Health PPO CPD,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Aetna/Commercial Product,Aetna/Commercial Product,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Meritain Health CPD,Meritain Health CPD,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Starmark CPD,Starmark CPD,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Aetna Medicare,Aetna Medicare,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Ambetter ,Ambetter ,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Blue Access,Anthem Blue Access,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Blue Access Choice,Anthem Blue Access Choice,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Blue Preferred,Anthem Blue Preferred,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Pathway,Anthem Pathway,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Alliance,Anthem Alliance,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Anthem Medicare,Anthem Medicare,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Cigna,Cigna,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Cigna PPO,Cigna PPO,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Cigna Medicare Advantage,Cigna Medicare Advantage,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Essence,Essence,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Healthlink HMO,Healthlink HMO,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Healthlink PPO,Healthlink PPO,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,HomeState Health Plan,HomeState Health Plan,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Humana Gold,Humana Gold,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Medicaid MO,Medicaid MO,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Medica,Medica,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Tricare,Tricare,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,UHC All Payer,UHC All Payer,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,UHC Exchange,UHC Exchange,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,UHC Medicaid,UHC Medicaid,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,UMR CPD,UMR CPD,87.07,,,,,,,per diem,87.07,87.07,"Per diem rate, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,UHC Medicare,UHC Medicare,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOLD DUAL RELEASE 4/CA ,33140461,CDM,279,RC,,,,,,Inpatient,,,87.07,87.07,Wellcare,Wellcare,87.07,,,,,,,case rate,87.07,87.07,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Meritain Health PPO CPD,Meritain Health PPO CPD,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Aetna/Commercial Product,Aetna/Commercial Product,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Meritain Health CPD,Meritain Health CPD,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Starmark CPD,Starmark CPD,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Aetna Medicare,Aetna Medicare,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Ambetter ,Ambetter ,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Blue Access,Anthem Blue Access,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Blue Access Choice,Anthem Blue Access Choice,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Blue Preferred,Anthem Blue Preferred,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Pathway,Anthem Pathway,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Alliance,Anthem Alliance,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Anthem Medicare,Anthem Medicare,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Cigna,Cigna,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Cigna PPO,Cigna PPO,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Cigna Medicare Advantage,Cigna Medicare Advantage,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Essence,Essence,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Healthlink HMO,Healthlink HMO,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Healthlink PPO,Healthlink PPO,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,HomeState Health Plan,HomeState Health Plan,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Humana Gold,Humana Gold,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Medicaid MO,Medicaid MO,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Medica,Medica,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Tricare,Tricare,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,UHC All Payer,UHC All Payer,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,UHC Exchange,UHC Exchange,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,UHC Medicaid,UHC Medicaid,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,UMR CPD,UMR CPD,201.63,,,,,,,per diem,201.63,201.63,"Per diem rate, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,UHC Medicare,UHC Medicare,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WALKER FOREARM ATTACHMENT PR  ,33140462,CDM,279,RC,,,,,,Inpatient,,,201.63,201.63,Wellcare,Wellcare,201.63,,,,,,,case rate,201.63,201.63,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Meritain Health PPO CPD,Meritain Health PPO CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna/Commercial Product,Aetna/Commercial Product,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Meritain Health CPD,Meritain Health CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Starmark CPD,Starmark CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Aetna Medicare,Aetna Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Ambetter ,Ambetter ,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Access,Anthem Blue Access,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Access Choice,Anthem Blue Access Choice,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Blue Preferred,Anthem Blue Preferred,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Pathway,Anthem Pathway,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Alliance,Anthem Alliance,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Anthem Medicare,Anthem Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna,Cigna,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna PPO,Cigna PPO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Cigna Medicare Advantage,Cigna Medicare Advantage,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Essence,Essence,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthlink HMO,Healthlink HMO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Healthlink PPO,Healthlink PPO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,HomeState Health Plan,HomeState Health Plan,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Humana Gold,Humana Gold,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Medicaid MO,Medicaid MO,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Medica,Medica,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Tricare,Tricare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC All Payer,UHC All Payer,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Exchange,UHC Exchange,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Medicaid,UHC Medicaid,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UMR CPD,UMR CPD,392.3,,,,,,,per diem,392.3,392.3,"Per diem rate, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,UHC Medicare,UHC Medicare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR JR DUAL REL W/WHEELS 4/CA,33140463,CDM,279,RC,,,,,,Inpatient,,,392.3,392.3,Wellcare,Wellcare,392.3,,,,,,,case rate,392.3,392.3,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Meritain Health PPO CPD,Meritain Health PPO CPD,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Aetna/Commercial Product,Aetna/Commercial Product,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Meritain Health CPD,Meritain Health CPD,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Starmark CPD,Starmark CPD,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Aetna Medicare,Aetna Medicare,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Ambetter ,Ambetter ,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Blue Access,Anthem Blue Access,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Blue Access Choice,Anthem Blue Access Choice,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Blue Preferred,Anthem Blue Preferred,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Pathway,Anthem Pathway,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Alliance,Anthem Alliance,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Anthem Medicare,Anthem Medicare,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Cigna,Cigna,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Cigna PPO,Cigna PPO,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Cigna Medicare Advantage,Cigna Medicare Advantage,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Essence,Essence,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Healthlink HMO,Healthlink HMO,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Healthlink PPO,Healthlink PPO,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,HomeState Health Plan,HomeState Health Plan,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Humana Gold,Humana Gold,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Medicaid MO,Medicaid MO,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Medica,Medica,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Tricare,Tricare,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,UHC All Payer,UHC All Payer,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,UHC Exchange,UHC Exchange,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,UHC Medicaid,UHC Medicaid,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,UMR CPD,UMR CPD,274.84,,,,,,,per diem,274.84,274.84,"Per diem rate, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,UHC Medicare,UHC Medicare,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WLKR SINGLE XWIDE DUAL REL 2/B,33140464,CDM,279,RC,,,,,,Inpatient,,,274.84,274.84,Wellcare,Wellcare,274.84,,,,,,,case rate,274.84,274.84,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Meritain Health PPO CPD,Meritain Health PPO CPD,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Aetna/Commercial Product,Aetna/Commercial Product,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Meritain Health CPD,Meritain Health CPD,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Starmark CPD,Starmark CPD,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Aetna Medicare,Aetna Medicare,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Ambetter ,Ambetter ,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Blue Access,Anthem Blue Access,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Blue Access Choice,Anthem Blue Access Choice,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Blue Preferred,Anthem Blue Preferred,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Pathway,Anthem Pathway,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Alliance,Anthem Alliance,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Anthem Medicare,Anthem Medicare,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Cigna,Cigna,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Cigna PPO,Cigna PPO,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Cigna Medicare Advantage,Cigna Medicare Advantage,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Essence,Essence,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Healthlink HMO,Healthlink HMO,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Healthlink PPO,Healthlink PPO,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,HomeState Health Plan,HomeState Health Plan,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Humana Gold,Humana Gold,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Medicaid MO,Medicaid MO,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Medica,Medica,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Tricare,Tricare,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,UHC All Payer,UHC All Payer,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,UHC Exchange,UHC Exchange,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,UHC Medicaid,UHC Medicaid,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,UMR CPD,UMR CPD,40.32,,,,,,,per diem,40.32,40.32,"Per diem rate, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,UHC Medicare,UHC Medicare,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEEL 5 FIXED BARIATRIC WALKER,33140465,CDM,279,RC,,,,,,Inpatient,,,40.32,40.32,Wellcare,Wellcare,40.32,,,,,,,case rate,40.32,40.32,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Meritain Health PPO CPD,Meritain Health PPO CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna/Commercial Product,Aetna/Commercial Product,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Meritain Health CPD,Meritain Health CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Starmark CPD,Starmark CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna Medicare,Aetna Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Ambetter ,Ambetter ,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Access,Anthem Blue Access,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Access Choice,Anthem Blue Access Choice,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Preferred,Anthem Blue Preferred,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Pathway,Anthem Pathway,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Alliance,Anthem Alliance,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Medicare,Anthem Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna,Cigna,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna PPO,Cigna PPO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna Medicare Advantage,Cigna Medicare Advantage,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Essence,Essence,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthlink HMO,Healthlink HMO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthlink PPO,Healthlink PPO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,HomeState Health Plan,HomeState Health Plan,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Humana Gold,Humana Gold,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Medicaid MO,Medicaid MO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Medica,Medica,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Tricare,Tricare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC All Payer,UHC All Payer,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Exchange,UHC Exchange,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Medicaid,UHC Medicaid,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UMR CPD,UMR CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Medicare,UHC Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 20X20 W/FOOTREST,33140466,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Wellcare,Wellcare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Meritain Health PPO CPD,Meritain Health PPO CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna/Commercial Product,Aetna/Commercial Product,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Meritain Health CPD,Meritain Health CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Starmark CPD,Starmark CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Aetna Medicare,Aetna Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Ambetter ,Ambetter ,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Access,Anthem Blue Access,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Access Choice,Anthem Blue Access Choice,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Blue Preferred,Anthem Blue Preferred,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Pathway,Anthem Pathway,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Alliance,Anthem Alliance,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Anthem Medicare,Anthem Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna,Cigna,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna PPO,Cigna PPO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Cigna Medicare Advantage,Cigna Medicare Advantage,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Essence,Essence,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthlink HMO,Healthlink HMO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Healthlink PPO,Healthlink PPO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,HomeState Health Plan,HomeState Health Plan,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Humana Gold,Humana Gold,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Medicaid MO,Medicaid MO,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Medica,Medica,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Tricare,Tricare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC All Payer,UHC All Payer,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Exchange,UHC Exchange,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Medicaid,UHC Medicaid,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UMR CPD,UMR CPD,941.85,,,,,,,per diem,941.85,941.85,"Per diem rate, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,UHC Medicare,UHC Medicare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHEELCHAIR HD 24X20 W/FTREST I,33140467,CDM,279,RC,,,,,,Inpatient,,,941.85,941.85,Wellcare,Wellcare,941.85,,,,,,,case rate,941.85,941.85,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Meritain Health PPO CPD,Meritain Health PPO CPD,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Aetna/Commercial Product,Aetna/Commercial Product,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Meritain Health CPD,Meritain Health CPD,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Starmark CPD,Starmark CPD,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Aetna Medicare,Aetna Medicare,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Ambetter ,Ambetter ,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Blue Access,Anthem Blue Access,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Blue Access Choice,Anthem Blue Access Choice,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Blue Preferred,Anthem Blue Preferred,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Pathway,Anthem Pathway,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Alliance,Anthem Alliance,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Anthem Medicare,Anthem Medicare,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Cigna,Cigna,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Cigna PPO,Cigna PPO,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Cigna Medicare Advantage,Cigna Medicare Advantage,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Essence,Essence,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Healthlink HMO,Healthlink HMO,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Healthlink PPO,Healthlink PPO,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,HomeState Health Plan,HomeState Health Plan,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Humana Gold,Humana Gold,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Medicaid MO,Medicaid MO,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Medica,Medica,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Tricare,Tricare,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,UHC All Payer,UHC All Payer,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,UHC Exchange,UHC Exchange,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,UHC Medicaid,UHC Medicaid,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,UMR CPD,UMR CPD,1873.34,,,,,,,per diem,1873.34,1873.34,"Per diem rate, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,UHC Medicare,UHC Medicare,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCHAIR RECLIN 20X20 SEAT SLN,33140468,CDM,279,RC,,,,,,Inpatient,,,1873.34,1873.34,Wellcare,Wellcare,1873.34,,,,,,,case rate,1873.34,1873.34,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Meritain Health PPO CPD,Meritain Health PPO CPD,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Aetna/Commercial Product,Aetna/Commercial Product,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Meritain Health CPD,Meritain Health CPD,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Starmark CPD,Starmark CPD,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Aetna Medicare,Aetna Medicare,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Ambetter ,Ambetter ,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Blue Access,Anthem Blue Access,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Blue Access Choice,Anthem Blue Access Choice,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Blue Preferred,Anthem Blue Preferred,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Pathway,Anthem Pathway,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Alliance,Anthem Alliance,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Anthem Medicare,Anthem Medicare,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Cigna,Cigna,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Cigna PPO,Cigna PPO,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Cigna Medicare Advantage,Cigna Medicare Advantage,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Essence,Essence,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Healthlink HMO,Healthlink HMO,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Healthlink PPO,Healthlink PPO,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,HomeState Health Plan,HomeState Health Plan,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Humana Gold,Humana Gold,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Medicaid MO,Medicaid MO,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Medica,Medica,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Tricare,Tricare,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,UHC All Payer,UHC All Payer,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,UHC Exchange,UHC Exchange,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,UHC Medicaid,UHC Medicaid,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,UMR CPD,UMR CPD,1199.27,,,,,,,per diem,1199.27,1199.27,"Per diem rate, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,UHC Medicare,UHC Medicare,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHLCH RECLIN BACK 18X18 FTREST,33140469,CDM,279,RC,,,,,,Inpatient,,,1199.27,1199.27,Wellcare,Wellcare,1199.27,,,,,,,case rate,1199.27,1199.27,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Meritain Health PPO CPD,Meritain Health PPO CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna/Commercial Product,Aetna/Commercial Product,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Meritain Health CPD,Meritain Health CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Starmark CPD,Starmark CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna Medicare,Aetna Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Ambetter ,Ambetter ,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Access,Anthem Blue Access,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Access Choice,Anthem Blue Access Choice,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Preferred,Anthem Blue Preferred,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Pathway,Anthem Pathway,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Alliance,Anthem Alliance,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Medicare,Anthem Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna,Cigna,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna PPO,Cigna PPO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna Medicare Advantage,Cigna Medicare Advantage,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Essence,Essence,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthlink HMO,Healthlink HMO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthlink PPO,Healthlink PPO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,HomeState Health Plan,HomeState Health Plan,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Humana Gold,Humana Gold,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Medicaid MO,Medicaid MO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Medica,Medica,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Tricare,Tricare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC All Payer,UHC All Payer,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Exchange,UHC Exchange,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Medicaid,UHC Medicaid,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UMR CPD,UMR CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Medicare,UHC Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 16X16 W/FTREST ,33140470,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Wellcare,Wellcare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Meritain Health PPO CPD,Meritain Health PPO CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna/Commercial Product,Aetna/Commercial Product,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Meritain Health CPD,Meritain Health CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Starmark CPD,Starmark CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Aetna Medicare,Aetna Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Ambetter ,Ambetter ,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Access,Anthem Blue Access,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Access Choice,Anthem Blue Access Choice,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Blue Preferred,Anthem Blue Preferred,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Pathway,Anthem Pathway,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Alliance,Anthem Alliance,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Anthem Medicare,Anthem Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna,Cigna,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna PPO,Cigna PPO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Cigna Medicare Advantage,Cigna Medicare Advantage,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Essence,Essence,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthlink HMO,Healthlink HMO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Healthlink PPO,Healthlink PPO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,HomeState Health Plan,HomeState Health Plan,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Humana Gold,Humana Gold,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Medicaid MO,Medicaid MO,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Medica,Medica,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Tricare,Tricare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC All Payer,UHC All Payer,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Exchange,UHC Exchange,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Medicaid,UHC Medicaid,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UMR CPD,UMR CPD,340.07,,,,,,,per diem,340.07,340.07,"Per diem rate, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,UHC Medicare,UHC Medicare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELCHAIR STD 18X18 W/FTREST ,33140471,CDM,279,RC,,,,,,Inpatient,,,340.07,340.07,Wellcare,Wellcare,340.07,,,,,,,case rate,340.07,340.07,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Meritain Health PPO CPD,Meritain Health PPO CPD,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Aetna/Commercial Product,Aetna/Commercial Product,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Meritain Health CPD,Meritain Health CPD,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Starmark CPD,Starmark CPD,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Aetna Medicare,Aetna Medicare,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Ambetter ,Ambetter ,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Blue Access,Anthem Blue Access,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Blue Access Choice,Anthem Blue Access Choice,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Blue Preferred,Anthem Blue Preferred,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Pathway,Anthem Pathway,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Alliance,Anthem Alliance,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Anthem Medicare,Anthem Medicare,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Cigna,Cigna,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Cigna PPO,Cigna PPO,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Cigna Medicare Advantage,Cigna Medicare Advantage,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Essence,Essence,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Healthlink HMO,Healthlink HMO,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Healthlink PPO,Healthlink PPO,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,HomeState Health Plan,HomeState Health Plan,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Humana Gold,Humana Gold,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Medicaid MO,Medicaid MO,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Medica,Medica,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Tricare,Tricare,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,UHC All Payer,UHC All Payer,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,UHC Exchange,UHC Exchange,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,UHC Medicaid,UHC Medicaid,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,UMR CPD,UMR CPD,20.16,,,,,,,per diem,20.16,20.16,"Per diem rate, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,UHC Medicare,UHC Medicare,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WHEELS WALKER 3 FIXED 1 GF6036,33140472,CDM,279,RC,,,,,,Inpatient,,,20.16,20.16,Wellcare,Wellcare,20.16,,,,,,,case rate,20.16,20.16,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health PPO CPD,Meritain Health PPO CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna/Commercial Product,Aetna/Commercial Product,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Meritain Health CPD,Meritain Health CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Starmark CPD,Starmark CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Aetna Medicare,Aetna Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Ambetter ,Ambetter ,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access,Anthem Blue Access,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Access Choice,Anthem Blue Access Choice,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Blue Preferred,Anthem Blue Preferred,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Pathway,Anthem Pathway,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Alliance,Anthem Alliance,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Anthem Medicare,Anthem Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna,Cigna,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna PPO,Cigna PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Cigna Medicare Advantage,Cigna Medicare Advantage,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Essence,Essence,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink HMO,Healthlink HMO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Healthlink PPO,Healthlink PPO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,HomeState Health Plan,HomeState Health Plan,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Humana Gold,Humana Gold,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medicaid MO,Medicaid MO,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Medica,Medica,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Tricare,Tricare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC All Payer,UHC All Payer,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Exchange,UHC Exchange,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicaid,UHC Medicaid,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UMR CPD,UMR CPD,94.5,,,,,,,per diem,94.5,94.5,"Per diem rate, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,UHC Medicare,UHC Medicare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
WRAP AROUND KNEE SUPPORT LG/XL,33140473,CDM,270,RC,,,,,,Inpatient,,,94.5,94.5,Wellcare,Wellcare,94.5,,,,,,,case rate,94.5,94.5,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Meritain Health PPO CPD,Meritain Health PPO CPD,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Aetna/Commercial Product,Aetna/Commercial Product,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Meritain Health CPD,Meritain Health CPD,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Starmark CPD,Starmark CPD,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Aetna Medicare,Aetna Medicare,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Ambetter ,Ambetter ,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Blue Access,Anthem Blue Access,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Blue Access Choice,Anthem Blue Access Choice,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Blue Preferred,Anthem Blue Preferred,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Pathway,Anthem Pathway,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Alliance,Anthem Alliance,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Anthem Medicare,Anthem Medicare,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Cigna,Cigna,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Cigna PPO,Cigna PPO,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Cigna Medicare Advantage,Cigna Medicare Advantage,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Essence,Essence,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Healthlink HMO,Healthlink HMO,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Healthlink PPO,Healthlink PPO,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,HomeState Health Plan,HomeState Health Plan,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Humana Gold,Humana Gold,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Medicaid MO,Medicaid MO,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Medica,Medica,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Tricare,Tricare,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,UHC All Payer,UHC All Payer,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,UHC Exchange,UHC Exchange,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,UHC Medicaid,UHC Medicaid,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,UMR CPD,UMR CPD,40.38,,,,,,,per diem,40.38,40.38,"Per diem rate, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,UHC Medicare,UHC Medicare,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
KNEE SUPPORT ADJUST MICROBAN  ,33140475,CDM,270,RC,,,,,,Inpatient,,,40.38,40.38,Wellcare,Wellcare,40.38,,,,,,,case rate,40.38,40.38,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Meritain Health PPO CPD,Meritain Health PPO CPD,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Aetna/Commercial Product,Aetna/Commercial Product,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Meritain Health CPD,Meritain Health CPD,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Starmark CPD,Starmark CPD,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Aetna Medicare,Aetna Medicare,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Ambetter ,Ambetter ,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Blue Access,Anthem Blue Access,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Blue Access Choice,Anthem Blue Access Choice,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Blue Preferred,Anthem Blue Preferred,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Pathway,Anthem Pathway,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Alliance,Anthem Alliance,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Anthem Medicare,Anthem Medicare,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Cigna,Cigna,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Cigna PPO,Cigna PPO,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Cigna Medicare Advantage,Cigna Medicare Advantage,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Essence,Essence,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Healthlink HMO,Healthlink HMO,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Healthlink PPO,Healthlink PPO,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,HomeState Health Plan,HomeState Health Plan,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Humana Gold,Humana Gold,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Medicaid MO,Medicaid MO,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Medica,Medica,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Tricare,Tricare,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,UHC All Payer,UHC All Payer,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,UHC Exchange,UHC Exchange,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,UHC Medicaid,UHC Medicaid,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,UMR CPD,UMR CPD,8.03,,,,,,,per diem,8.03,8.03,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,UHC Medicare,UHC Medicare,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET SMALL   ,33140481,CDM,270,RC,,,,,,Inpatient,,,8.03,8.03,Wellcare,Wellcare,8.03,,,,,,,case rate,8.03,8.03,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Meritain Health PPO CPD,Meritain Health PPO CPD,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Aetna/Commercial Product,Aetna/Commercial Product,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Meritain Health CPD,Meritain Health CPD,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Starmark CPD,Starmark CPD,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Aetna Medicare,Aetna Medicare,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Ambetter ,Ambetter ,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Blue Access,Anthem Blue Access,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Blue Access Choice,Anthem Blue Access Choice,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Blue Preferred,Anthem Blue Preferred,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Pathway,Anthem Pathway,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Alliance,Anthem Alliance,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Anthem Medicare,Anthem Medicare,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Cigna,Cigna,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Cigna PPO,Cigna PPO,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Cigna Medicare Advantage,Cigna Medicare Advantage,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Essence,Essence,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Healthlink HMO,Healthlink HMO,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Healthlink PPO,Healthlink PPO,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,HomeState Health Plan,HomeState Health Plan,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Humana Gold,Humana Gold,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Medicaid MO,Medicaid MO,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Medica,Medica,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Tricare,Tricare,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,UHC All Payer,UHC All Payer,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,UHC Exchange,UHC Exchange,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,UHC Medicaid,UHC Medicaid,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,UMR CPD,UMR CPD,8.88,,,,,,,per diem,8.88,8.88,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,UHC Medicare,UHC Medicare,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET MEDIUM  ,33140482,CDM,270,RC,,,,,,Inpatient,,,8.88,8.88,Wellcare,Wellcare,8.88,,,,,,,case rate,8.88,8.88,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Meritain Health PPO CPD,Meritain Health PPO CPD,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Aetna/Commercial Product,Aetna/Commercial Product,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Meritain Health CPD,Meritain Health CPD,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Starmark CPD,Starmark CPD,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Aetna Medicare,Aetna Medicare,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Ambetter ,Ambetter ,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Blue Access,Anthem Blue Access,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Blue Access Choice,Anthem Blue Access Choice,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Blue Preferred,Anthem Blue Preferred,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Pathway,Anthem Pathway,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Alliance,Anthem Alliance,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Anthem Medicare,Anthem Medicare,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Cigna,Cigna,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Cigna PPO,Cigna PPO,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Cigna Medicare Advantage,Cigna Medicare Advantage,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Essence,Essence,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Healthlink HMO,Healthlink HMO,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Healthlink PPO,Healthlink PPO,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,HomeState Health Plan,HomeState Health Plan,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Humana Gold,Humana Gold,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Medicaid MO,Medicaid MO,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Medica,Medica,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Tricare,Tricare,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,UHC All Payer,UHC All Payer,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,UHC Exchange,UHC Exchange,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,UHC Medicaid,UHC Medicaid,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,UMR CPD,UMR CPD,10.24,,,,,,,per diem,10.24,10.24,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,UHC Medicare,UHC Medicare,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET LARGE   ,33140483,CDM,270,RC,,,,,,Inpatient,,,10.24,10.24,Wellcare,Wellcare,10.24,,,,,,,case rate,10.24,10.24,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Meritain Health PPO CPD,Meritain Health PPO CPD,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Aetna/Commercial Product,Aetna/Commercial Product,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Meritain Health CPD,Meritain Health CPD,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Starmark CPD,Starmark CPD,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Aetna Medicare,Aetna Medicare,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Ambetter ,Ambetter ,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Blue Access,Anthem Blue Access,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Blue Access Choice,Anthem Blue Access Choice,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Blue Preferred,Anthem Blue Preferred,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Pathway,Anthem Pathway,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Alliance,Anthem Alliance,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Anthem Medicare,Anthem Medicare,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Cigna,Cigna,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Cigna PPO,Cigna PPO,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Cigna Medicare Advantage,Cigna Medicare Advantage,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Essence,Essence,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Healthlink HMO,Healthlink HMO,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Healthlink PPO,Healthlink PPO,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,HomeState Health Plan,HomeState Health Plan,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Humana Gold,Humana Gold,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Medicaid MO,Medicaid MO,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Medica,Medica,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Tricare,Tricare,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,UHC All Payer,UHC All Payer,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,UHC Exchange,UHC Exchange,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,UHC Medicaid,UHC Medicaid,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,UMR CPD,UMR CPD,9.77,,,,,,,per diem,9.77,9.77,"Per diem rate, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,UHC Medicare,UHC Medicare,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SLING ARM DEEP POCKET XLARGE  ,33140484,CDM,270,RC,,,,,,Inpatient,,,9.77,9.77,Wellcare,Wellcare,9.77,,,,,,,case rate,9.77,9.77,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Meritain Health PPO CPD,Meritain Health PPO CPD,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Aetna/Commercial Product,Aetna/Commercial Product,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Meritain Health CPD,Meritain Health CPD,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Starmark CPD,Starmark CPD,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Aetna Medicare,Aetna Medicare,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Ambetter ,Ambetter ,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Blue Access,Anthem Blue Access,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Blue Access Choice,Anthem Blue Access Choice,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Blue Preferred,Anthem Blue Preferred,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Pathway,Anthem Pathway,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Alliance,Anthem Alliance,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Anthem Medicare,Anthem Medicare,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Cigna,Cigna,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Cigna PPO,Cigna PPO,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Cigna Medicare Advantage,Cigna Medicare Advantage,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Essence,Essence,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Healthlink HMO,Healthlink HMO,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Healthlink PPO,Healthlink PPO,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,HomeState Health Plan,HomeState Health Plan,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Humana Gold,Humana Gold,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Medicaid MO,Medicaid MO,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Medica,Medica,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Tricare,Tricare,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,UHC All Payer,UHC All Payer,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,UHC Exchange,UHC Exchange,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,UHC Medicaid,UHC Medicaid,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,UMR CPD,UMR CPD,15.66,,,,,,,per diem,15.66,15.66,"Per diem rate, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,UHC Medicare,UHC Medicare,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
SET FEEDING PUMP W/PIERCING PI,33140559,CDM,279,RC,,,,,,Inpatient,,,15.66,15.66,Wellcare,Wellcare,15.66,,,,,,,case rate,15.66,15.66,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Meritain Health PPO CPD,Meritain Health PPO CPD,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Aetna/Commercial Product,Aetna/Commercial Product,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Meritain Health CPD,Meritain Health CPD,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Starmark CPD,Starmark CPD,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Aetna Medicare,Aetna Medicare,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Ambetter ,Ambetter ,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Blue Access,Anthem Blue Access,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Blue Access Choice,Anthem Blue Access Choice,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Blue Preferred,Anthem Blue Preferred,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Pathway,Anthem Pathway,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Alliance,Anthem Alliance,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Anthem Medicare,Anthem Medicare,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Cigna,Cigna,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Cigna PPO,Cigna PPO,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Cigna Medicare Advantage,Cigna Medicare Advantage,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Essence,Essence,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Healthlink HMO,Healthlink HMO,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Healthlink PPO,Healthlink PPO,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,HomeState Health Plan,HomeState Health Plan,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Humana Gold,Humana Gold,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Medicaid MO,Medicaid MO,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Medica,Medica,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Tricare,Tricare,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,UHC All Payer,UHC All Payer,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,UHC Exchange,UHC Exchange,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,UHC Medicaid,UHC Medicaid,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,UMR CPD,UMR CPD,55.09,,,,,,,per diem,55.09,55.09,"Per diem rate, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,UHC Medicare,UHC Medicare,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
"PROTECTOR MITT, FINGER CLOSED ",33140641,CDM,270,RC,,,,,,Inpatient,,,55.09,55.09,Wellcare,Wellcare,55.09,,,,,,,case rate,55.09,55.09,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
FALL MAT                      ,33140650,CDM,279,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Meritain Health PPO CPD,Meritain Health PPO CPD,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Aetna/Commercial Product,Aetna/Commercial Product,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Meritain Health CPD,Meritain Health CPD,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Starmark CPD,Starmark CPD,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Aetna Medicare,Aetna Medicare,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Ambetter ,Ambetter ,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Blue Access,Anthem Blue Access,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Blue Access Choice,Anthem Blue Access Choice,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Blue Preferred,Anthem Blue Preferred,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Pathway,Anthem Pathway,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Alliance,Anthem Alliance,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Anthem Medicare,Anthem Medicare,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Cigna,Cigna,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Cigna PPO,Cigna PPO,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Cigna Medicare Advantage,Cigna Medicare Advantage,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Essence,Essence,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Healthlink HMO,Healthlink HMO,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Healthlink PPO,Healthlink PPO,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,HomeState Health Plan,HomeState Health Plan,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Humana Gold,Humana Gold,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Medicaid MO,Medicaid MO,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Medica,Medica,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Tricare,Tricare,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,UHC All Payer,UHC All Payer,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,UHC Exchange,UHC Exchange,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,UHC Medicaid,UHC Medicaid,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,UMR CPD,UMR CPD,29.81,,,,,,,per diem,29.81,29.81,"Per diem rate, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,UHC Medicare,UHC Medicare,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
SCD MACHINE RENTAL DAILY      ,33140738,CDM,279,RC,,,,,,Inpatient,,,29.81,29.81,Wellcare,Wellcare,29.81,,,,,,,case rate,29.81,29.81,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
CPM MACHINE RENTAL DAILY      ,33140739,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Meritain Health PPO CPD,Meritain Health PPO CPD,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Aetna/Commercial Product,Aetna/Commercial Product,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Meritain Health CPD,Meritain Health CPD,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Starmark CPD,Starmark CPD,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Aetna Medicare,Aetna Medicare,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Ambetter ,Ambetter ,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Blue Access,Anthem Blue Access,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Blue Access Choice,Anthem Blue Access Choice,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Blue Preferred,Anthem Blue Preferred,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Pathway,Anthem Pathway,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Alliance,Anthem Alliance,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Anthem Medicare,Anthem Medicare,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Cigna,Cigna,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Cigna PPO,Cigna PPO,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Cigna Medicare Advantage,Cigna Medicare Advantage,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Essence,Essence,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Healthlink HMO,Healthlink HMO,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Healthlink PPO,Healthlink PPO,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,HomeState Health Plan,HomeState Health Plan,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Humana Gold,Humana Gold,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Medicaid MO,Medicaid MO,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Medica,Medica,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Tricare,Tricare,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,UHC All Payer,UHC All Payer,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,UHC Exchange,UHC Exchange,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,UHC Medicaid,UHC Medicaid,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,UMR CPD,UMR CPD,5.73,,,,,,,per diem,5.73,5.73,"Per diem rate, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,UHC Medicare,UHC Medicare,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
T-PUMP (K PAD) DAILY RENTAL   ,33140741,CDM,279,RC,,,,,,Inpatient,,,5.73,5.73,Wellcare,Wellcare,5.73,,,,,,,case rate,5.73,5.73,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Meritain Health PPO CPD,Meritain Health PPO CPD,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Aetna/Commercial Product,Aetna/Commercial Product,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Meritain Health CPD,Meritain Health CPD,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Starmark CPD,Starmark CPD,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Aetna Medicare,Aetna Medicare,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Ambetter ,Ambetter ,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Blue Access,Anthem Blue Access,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Blue Access Choice,Anthem Blue Access Choice,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Blue Preferred,Anthem Blue Preferred,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Pathway,Anthem Pathway,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Alliance,Anthem Alliance,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Anthem Medicare,Anthem Medicare,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Cigna,Cigna,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Cigna PPO,Cigna PPO,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Cigna Medicare Advantage,Cigna Medicare Advantage,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Essence,Essence,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Healthlink HMO,Healthlink HMO,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Healthlink PPO,Healthlink PPO,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,HomeState Health Plan,HomeState Health Plan,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Humana Gold,Humana Gold,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Medicaid MO,Medicaid MO,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Medica,Medica,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Tricare,Tricare,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,UHC All Payer,UHC All Payer,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,UHC Exchange,UHC Exchange,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,UHC Medicaid,UHC Medicaid,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,UMR CPD,UMR CPD,42.36,,,,,,,per diem,42.36,42.36,"Per diem rate, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,UHC Medicare,UHC Medicare,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
AIR MATTRESS DAILY RENTAL     ,33140742,CDM,279,RC,,,,,,Inpatient,,,42.36,42.36,Wellcare,Wellcare,42.36,,,,,,,case rate,42.36,42.36,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health PPO CPD,Meritain Health PPO CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/Commercial Product,Aetna/Commercial Product,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health CPD,Meritain Health CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Starmark CPD,Starmark CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna Medicare,Aetna Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Ambetter ,Ambetter ,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access,Anthem Blue Access,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access Choice,Anthem Blue Access Choice,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Preferred,Anthem Blue Preferred,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Pathway,Anthem Pathway,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Alliance,Anthem Alliance,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Medicare,Anthem Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna,Cigna,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna PPO,Cigna PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna Medicare Advantage,Cigna Medicare Advantage,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Essence,Essence,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink HMO,Healthlink HMO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink PPO,Healthlink PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,HomeState Health Plan,HomeState Health Plan,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Humana Gold,Humana Gold,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Medicaid MO,Medicaid MO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Medica,Medica,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Tricare,Tricare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC All Payer,UHC All Payer,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Exchange,UHC Exchange,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicaid,UHC Medicaid,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UMR CPD,UMR CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicare,UHC Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
ICE MACHINE DAILY RENTAL      ,33140744,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Wellcare,Wellcare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Meritain Health PPO CPD,Meritain Health PPO CPD,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Aetna/Commercial Product,Aetna/Commercial Product,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Meritain Health CPD,Meritain Health CPD,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Starmark CPD,Starmark CPD,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Aetna Medicare,Aetna Medicare,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Ambetter ,Ambetter ,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Blue Access,Anthem Blue Access,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Blue Access Choice,Anthem Blue Access Choice,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Blue Preferred,Anthem Blue Preferred,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Pathway,Anthem Pathway,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Alliance,Anthem Alliance,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Anthem Medicare,Anthem Medicare,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Cigna,Cigna,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Cigna PPO,Cigna PPO,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Cigna Medicare Advantage,Cigna Medicare Advantage,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Essence,Essence,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Healthlink HMO,Healthlink HMO,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Healthlink PPO,Healthlink PPO,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,HomeState Health Plan,HomeState Health Plan,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Humana Gold,Humana Gold,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Medicaid MO,Medicaid MO,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Medica,Medica,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Tricare,Tricare,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,UHC All Payer,UHC All Payer,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,UHC Exchange,UHC Exchange,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,UHC Medicaid,UHC Medicaid,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,UMR CPD,UMR CPD,153.63,,,,,,,per diem,153.63,153.63,"Per diem rate, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,UHC Medicare,UHC Medicare,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
BARIATRIC BED DAILY RENTAL    ,33140745,CDM,279,RC,,,,,,Inpatient,,,153.63,153.63,Wellcare,Wellcare,153.63,,,,,,,case rate,153.63,153.63,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Meritain Health PPO CPD,Meritain Health PPO CPD,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Aetna/Commercial Product,Aetna/Commercial Product,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Meritain Health CPD,Meritain Health CPD,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Starmark CPD,Starmark CPD,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Aetna Medicare,Aetna Medicare,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Ambetter ,Ambetter ,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Blue Access,Anthem Blue Access,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Blue Access Choice,Anthem Blue Access Choice,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Blue Preferred,Anthem Blue Preferred,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Pathway,Anthem Pathway,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Alliance,Anthem Alliance,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Anthem Medicare,Anthem Medicare,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Cigna,Cigna,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Cigna PPO,Cigna PPO,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Cigna Medicare Advantage,Cigna Medicare Advantage,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Essence,Essence,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Healthlink HMO,Healthlink HMO,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Healthlink PPO,Healthlink PPO,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,HomeState Health Plan,HomeState Health Plan,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Humana Gold,Humana Gold,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Medicaid MO,Medicaid MO,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Medica,Medica,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Tricare,Tricare,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,UHC All Payer,UHC All Payer,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,UHC Exchange,UHC Exchange,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,UHC Medicaid,UHC Medicaid,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,UMR CPD,UMR CPD,173.25,,,,,,,per diem,173.25,173.25,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,UHC Medicare,UHC Medicare,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFORM-1000LB ,33140746,CDM,279,RC,,,,,,Inpatient,,,173.25,173.25,Wellcare,Wellcare,173.25,,,,,,,case rate,173.25,173.25,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Meritain Health PPO CPD,Meritain Health PPO CPD,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Aetna/Commercial Product,Aetna/Commercial Product,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Meritain Health CPD,Meritain Health CPD,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Starmark CPD,Starmark CPD,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Aetna Medicare,Aetna Medicare,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Ambetter ,Ambetter ,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Blue Access,Anthem Blue Access,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Blue Access Choice,Anthem Blue Access Choice,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Blue Preferred,Anthem Blue Preferred,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Pathway,Anthem Pathway,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Alliance,Anthem Alliance,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Anthem Medicare,Anthem Medicare,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Cigna,Cigna,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Cigna PPO,Cigna PPO,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Cigna Medicare Advantage,Cigna Medicare Advantage,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Essence,Essence,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Healthlink HMO,Healthlink HMO,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Healthlink PPO,Healthlink PPO,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,HomeState Health Plan,HomeState Health Plan,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Humana Gold,Humana Gold,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Medicaid MO,Medicaid MO,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Medica,Medica,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Tricare,Tricare,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,UHC All Payer,UHC All Payer,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,UHC Exchange,UHC Exchange,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,UHC Medicaid,UHC Medicaid,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,UMR CPD,UMR CPD,44.38,,,,,,,per diem,44.38,44.38,"Per diem rate, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,UHC Medicare,UHC Medicare,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
TRIFLEX II TRAPEZE DAILY RENT ,33140747,CDM,279,RC,,,,,,Inpatient,,,44.38,44.38,Wellcare,Wellcare,44.38,,,,,,,case rate,44.38,44.38,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Meritain Health PPO CPD,Meritain Health PPO CPD,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Aetna/Commercial Product,Aetna/Commercial Product,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Meritain Health CPD,Meritain Health CPD,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Starmark CPD,Starmark CPD,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Aetna Medicare,Aetna Medicare,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Ambetter ,Ambetter ,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Blue Access,Anthem Blue Access,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Blue Access Choice,Anthem Blue Access Choice,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Blue Preferred,Anthem Blue Preferred,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Pathway,Anthem Pathway,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Alliance,Anthem Alliance,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Anthem Medicare,Anthem Medicare,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Cigna,Cigna,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Cigna PPO,Cigna PPO,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Cigna Medicare Advantage,Cigna Medicare Advantage,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Essence,Essence,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Healthlink HMO,Healthlink HMO,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Healthlink PPO,Healthlink PPO,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,HomeState Health Plan,HomeState Health Plan,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Humana Gold,Humana Gold,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Medicaid MO,Medicaid MO,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Medica,Medica,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Tricare,Tricare,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,UHC All Payer,UHC All Payer,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,UHC Exchange,UHC Exchange,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,UHC Medicaid,UHC Medicaid,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,UMR CPD,UMR CPD,78.75,,,,,,,per diem,78.75,78.75,"Per diem rate, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,UHC Medicare,UHC Medicare,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
STAGE IV BARIATRIC MATTRESS-48,33140748,CDM,279,RC,,,,,,Inpatient,,,78.75,78.75,Wellcare,Wellcare,78.75,,,,,,,case rate,78.75,78.75,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Meritain Health PPO CPD,Meritain Health PPO CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Aetna/Commercial Product,Aetna/Commercial Product,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Meritain Health CPD,Meritain Health CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Starmark CPD,Starmark CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Aetna Medicare,Aetna Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Ambetter ,Ambetter ,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access,Anthem Blue Access,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access Choice,Anthem Blue Access Choice,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Blue Preferred,Anthem Blue Preferred,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Pathway,Anthem Pathway,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Alliance,Anthem Alliance,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Anthem Medicare,Anthem Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Cigna,Cigna,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Cigna PPO,Cigna PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Cigna Medicare Advantage,Cigna Medicare Advantage,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Essence,Essence,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Healthlink HMO,Healthlink HMO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Healthlink PPO,Healthlink PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,HomeState Health Plan,HomeState Health Plan,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Humana Gold,Humana Gold,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Medicaid MO,Medicaid MO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Medica,Medica,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Tricare,Tricare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,UHC All Payer,UHC All Payer,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,UHC Exchange,UHC Exchange,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,UHC Medicaid,UHC Medicaid,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,UMR CPD,UMR CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,UHC Medicare,UHC Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
CONVERTIBLE WHEELCHAIR DAILY R,33140749,CDM,279,RC,,,,,,Inpatient,,,63,63,Wellcare,Wellcare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Meritain Health PPO CPD,Meritain Health PPO CPD,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Aetna/Commercial Product,Aetna/Commercial Product,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Meritain Health CPD,Meritain Health CPD,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Starmark CPD,Starmark CPD,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Aetna Medicare,Aetna Medicare,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Ambetter ,Ambetter ,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Blue Access,Anthem Blue Access,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Blue Access Choice,Anthem Blue Access Choice,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Blue Preferred,Anthem Blue Preferred,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Pathway,Anthem Pathway,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Alliance,Anthem Alliance,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Anthem Medicare,Anthem Medicare,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Cigna,Cigna,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Cigna PPO,Cigna PPO,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Cigna Medicare Advantage,Cigna Medicare Advantage,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Essence,Essence,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Healthlink HMO,Healthlink HMO,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Healthlink PPO,Healthlink PPO,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,HomeState Health Plan,HomeState Health Plan,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Humana Gold,Humana Gold,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Medicaid MO,Medicaid MO,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Medica,Medica,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Tricare,Tricare,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,UHC All Payer,UHC All Payer,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,UHC Exchange,UHC Exchange,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,UHC Medicaid,UHC Medicaid,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,UMR CPD,UMR CPD,165.75,,,,,,,per diem,165.75,165.75,"Per diem rate, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,UHC Medicare,UHC Medicare,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
WOUND VAC PUMP DAILY RENTAL   ,33140750,CDM,279,RC,,,,,,Inpatient,,,165.75,165.75,Wellcare,Wellcare,165.75,,,,,,,case rate,165.75,165.75,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health PPO CPD,Meritain Health PPO CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/Commercial Product,Aetna/Commercial Product,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health CPD,Meritain Health CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Starmark CPD,Starmark CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Aetna Medicare,Aetna Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Ambetter ,Ambetter ,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access,Anthem Blue Access,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access Choice,Anthem Blue Access Choice,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Preferred,Anthem Blue Preferred,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Pathway,Anthem Pathway,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Alliance,Anthem Alliance,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Medicare,Anthem Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna,Cigna,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna PPO,Cigna PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Cigna Medicare Advantage,Cigna Medicare Advantage,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Essence,Essence,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink HMO,Healthlink HMO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink PPO,Healthlink PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,HomeState Health Plan,HomeState Health Plan,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Humana Gold,Humana Gold,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Medicaid MO,Medicaid MO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Medica,Medica,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Tricare,Tricare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC All Payer,UHC All Payer,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Exchange,UHC Exchange,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicaid,UHC Medicaid,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UMR CPD,UMR CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicare,UHC Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
"REGENCY XL 2000 WHEELCHAIR 32""",33140752,CDM,279,RC,,,,,,Inpatient,,,31.5,31.5,Wellcare,Wellcare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Meritain Health PPO CPD,Meritain Health PPO CPD,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Aetna/Commercial Product,Aetna/Commercial Product,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Meritain Health CPD,Meritain Health CPD,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Starmark CPD,Starmark CPD,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Aetna Medicare,Aetna Medicare,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Ambetter ,Ambetter ,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Blue Access,Anthem Blue Access,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Blue Access Choice,Anthem Blue Access Choice,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Blue Preferred,Anthem Blue Preferred,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Pathway,Anthem Pathway,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Alliance,Anthem Alliance,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Anthem Medicare,Anthem Medicare,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Cigna,Cigna,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Cigna PPO,Cigna PPO,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Cigna Medicare Advantage,Cigna Medicare Advantage,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Essence,Essence,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Healthlink HMO,Healthlink HMO,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Healthlink PPO,Healthlink PPO,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,HomeState Health Plan,HomeState Health Plan,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Humana Gold,Humana Gold,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Medicaid MO,Medicaid MO,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Medica,Medica,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Tricare,Tricare,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,UHC All Payer,UHC All Payer,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,UHC Exchange,UHC Exchange,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,UHC Medicaid,UHC Medicaid,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,UMR CPD,UMR CPD,18.9,,,,,,,per diem,18.9,18.9,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,UHC Medicare,UHC Medicare,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE 26x20 RENTAL,33140753,CDM,279,RC,,,,,,Inpatient,,,18.9,18.9,Wellcare,Wellcare,18.9,,,,,,,case rate,18.9,18.9,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Meritain Health PPO CPD,Meritain Health PPO CPD,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Aetna/Commercial Product,Aetna/Commercial Product,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Meritain Health CPD,Meritain Health CPD,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Starmark CPD,Starmark CPD,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Aetna Medicare,Aetna Medicare,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Ambetter ,Ambetter ,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Blue Access,Anthem Blue Access,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Blue Access Choice,Anthem Blue Access Choice,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Blue Preferred,Anthem Blue Preferred,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Pathway,Anthem Pathway,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Alliance,Anthem Alliance,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Anthem Medicare,Anthem Medicare,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Cigna,Cigna,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Cigna PPO,Cigna PPO,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Cigna Medicare Advantage,Cigna Medicare Advantage,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Essence,Essence,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Healthlink HMO,Healthlink HMO,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Healthlink PPO,Healthlink PPO,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,HomeState Health Plan,HomeState Health Plan,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Humana Gold,Humana Gold,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Medicaid MO,Medicaid MO,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Medica,Medica,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Tricare,Tricare,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,UHC All Payer,UHC All Payer,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,UHC Exchange,UHC Exchange,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,UHC Medicaid,UHC Medicaid,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,UMR CPD,UMR CPD,189.17,,,,,,,per diem,189.17,189.17,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,UHC Medicare,UHC Medicare,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33140757,CDM,270,RC,,,,,,Inpatient,,,189.17,189.17,Wellcare,Wellcare,189.17,,,,,,,case rate,189.17,189.17,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Meritain Health PPO CPD,Meritain Health PPO CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna/Commercial Product,Aetna/Commercial Product,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Meritain Health CPD,Meritain Health CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Starmark CPD,Starmark CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna Medicare,Aetna Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Ambetter ,Ambetter ,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Access,Anthem Blue Access,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Access Choice,Anthem Blue Access Choice,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Preferred,Anthem Blue Preferred,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Pathway,Anthem Pathway,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Alliance,Anthem Alliance,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Medicare,Anthem Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna,Cigna,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna PPO,Cigna PPO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna Medicare Advantage,Cigna Medicare Advantage,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Essence,Essence,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthlink HMO,Healthlink HMO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthlink PPO,Healthlink PPO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,HomeState Health Plan,HomeState Health Plan,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Humana Gold,Humana Gold,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Medicaid MO,Medicaid MO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Medica,Medica,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Tricare,Tricare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC All Payer,UHC All Payer,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Exchange,UHC Exchange,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Medicaid,UHC Medicaid,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UMR CPD,UMR CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Medicare,UHC Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO SM RIGHT      ,33140758,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Wellcare,Wellcare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Meritain Health PPO CPD,Meritain Health PPO CPD,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Aetna/Commercial Product,Aetna/Commercial Product,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Meritain Health CPD,Meritain Health CPD,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Starmark CPD,Starmark CPD,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Aetna Medicare,Aetna Medicare,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Ambetter ,Ambetter ,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Blue Access,Anthem Blue Access,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Blue Access Choice,Anthem Blue Access Choice,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Blue Preferred,Anthem Blue Preferred,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Pathway,Anthem Pathway,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Alliance,Anthem Alliance,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Anthem Medicare,Anthem Medicare,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Cigna,Cigna,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Cigna PPO,Cigna PPO,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Cigna Medicare Advantage,Cigna Medicare Advantage,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Essence,Essence,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Healthlink HMO,Healthlink HMO,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Healthlink PPO,Healthlink PPO,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,HomeState Health Plan,HomeState Health Plan,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Humana Gold,Humana Gold,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Medicaid MO,Medicaid MO,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Medica,Medica,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Tricare,Tricare,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,UHC All Payer,UHC All Payer,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,UHC Exchange,UHC Exchange,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,UHC Medicaid,UHC Medicaid,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,UMR CPD,UMR CPD,22.66,,,,,,,per diem,22.66,22.66,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,UHC Medicare,UHC Medicare,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REG L LEFT      ,33140767,CDM,270,RC,,,,,,Inpatient,,,22.66,22.66,Wellcare,Wellcare,22.66,,,,,,,case rate,22.66,22.66,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health PPO CPD,Meritain Health PPO CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/Commercial Product,Aetna/Commercial Product,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health CPD,Meritain Health CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Starmark CPD,Starmark CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna Medicare,Aetna Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Ambetter ,Ambetter ,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access,Anthem Blue Access,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access Choice,Anthem Blue Access Choice,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Preferred,Anthem Blue Preferred,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Pathway,Anthem Pathway,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Alliance,Anthem Alliance,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Medicare,Anthem Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna,Cigna,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna PPO,Cigna PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna Medicare Advantage,Cigna Medicare Advantage,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Essence,Essence,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink HMO,Healthlink HMO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink PPO,Healthlink PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,HomeState Health Plan,HomeState Health Plan,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Humana Gold,Humana Gold,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medicaid MO,Medicaid MO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medica,Medica,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Tricare,Tricare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC All Payer,UHC All Payer,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Exchange,UHC Exchange,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicaid,UHC Medicaid,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UMR CPD,UMR CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicare,UHC Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS             ,33140857,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Wellcare,Wellcare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Meritain Health PPO CPD,Meritain Health PPO CPD,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Aetna/Commercial Product,Aetna/Commercial Product,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Meritain Health CPD,Meritain Health CPD,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Starmark CPD,Starmark CPD,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Aetna Medicare,Aetna Medicare,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Ambetter ,Ambetter ,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Blue Access,Anthem Blue Access,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Blue Access Choice,Anthem Blue Access Choice,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Blue Preferred,Anthem Blue Preferred,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Pathway,Anthem Pathway,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Alliance,Anthem Alliance,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Anthem Medicare,Anthem Medicare,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Cigna,Cigna,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Cigna PPO,Cigna PPO,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Cigna Medicare Advantage,Cigna Medicare Advantage,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Essence,Essence,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Healthlink HMO,Healthlink HMO,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Healthlink PPO,Healthlink PPO,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,HomeState Health Plan,HomeState Health Plan,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Humana Gold,Humana Gold,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Medicaid MO,Medicaid MO,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Medica,Medica,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Tricare,Tricare,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,UHC All Payer,UHC All Payer,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,UHC Exchange,UHC Exchange,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,UHC Medicaid,UHC Medicaid,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,UMR CPD,UMR CPD,1030.58,,,,,,,per diem,1030.58,1030.58,"Per diem rate, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,UHC Medicare,UHC Medicare,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
LEFT AFO                      ,33140858,CDM,274,RC,,,,,,Inpatient,,,1030.58,1030.58,Wellcare,Wellcare,1030.58,,,,,,,case rate,1030.58,1030.58,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Meritain Health PPO CPD,Meritain Health PPO CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Aetna/Commercial Product,Aetna/Commercial Product,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Meritain Health CPD,Meritain Health CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Starmark CPD,Starmark CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Aetna Medicare,Aetna Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Ambetter ,Ambetter ,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Blue Access,Anthem Blue Access,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Blue Access Choice,Anthem Blue Access Choice,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Blue Preferred,Anthem Blue Preferred,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Pathway,Anthem Pathway,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Alliance,Anthem Alliance,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Anthem Medicare,Anthem Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Cigna,Cigna,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Cigna PPO,Cigna PPO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Cigna Medicare Advantage,Cigna Medicare Advantage,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Essence,Essence,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Healthlink HMO,Healthlink HMO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Healthlink PPO,Healthlink PPO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,HomeState Health Plan,HomeState Health Plan,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Humana Gold,Humana Gold,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Medicaid MO,Medicaid MO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Medica,Medica,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Tricare,Tricare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,UHC All Payer,UHC All Payer,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,UHC Exchange,UHC Exchange,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,UHC Medicaid,UHC Medicaid,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,UMR CPD,UMR CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,UHC Medicare,UHC Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED          ,33140863,CDM,274,RC,,,,,,Inpatient,,,204.75,204.75,Wellcare,Wellcare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Meritain Health PPO CPD,Meritain Health PPO CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna/Commercial Product,Aetna/Commercial Product,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Meritain Health CPD,Meritain Health CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Starmark CPD,Starmark CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna Medicare,Aetna Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Ambetter ,Ambetter ,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Access,Anthem Blue Access,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Access Choice,Anthem Blue Access Choice,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Preferred,Anthem Blue Preferred,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Pathway,Anthem Pathway,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Alliance,Anthem Alliance,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Medicare,Anthem Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna,Cigna,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna PPO,Cigna PPO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna Medicare Advantage,Cigna Medicare Advantage,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Essence,Essence,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthlink HMO,Healthlink HMO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthlink PPO,Healthlink PPO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,HomeState Health Plan,HomeState Health Plan,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Humana Gold,Humana Gold,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Medicaid MO,Medicaid MO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Medica,Medica,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Tricare,Tricare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC All Payer,UHC All Payer,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Exchange,UHC Exchange,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Medicaid,UHC Medicaid,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UMR CPD,UMR CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Medicare,UHC Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG          ,33140864,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Wellcare,Wellcare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Meritain Health PPO CPD,Meritain Health PPO CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna/Commercial Product,Aetna/Commercial Product,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Meritain Health CPD,Meritain Health CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Starmark CPD,Starmark CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Aetna Medicare,Aetna Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Ambetter ,Ambetter ,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Access,Anthem Blue Access,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Access Choice,Anthem Blue Access Choice,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Blue Preferred,Anthem Blue Preferred,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Pathway,Anthem Pathway,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Alliance,Anthem Alliance,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Anthem Medicare,Anthem Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna,Cigna,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna PPO,Cigna PPO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Cigna Medicare Advantage,Cigna Medicare Advantage,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Essence,Essence,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthlink HMO,Healthlink HMO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Healthlink PPO,Healthlink PPO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,HomeState Health Plan,HomeState Health Plan,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Humana Gold,Humana Gold,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Medicaid MO,Medicaid MO,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Medica,Medica,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Tricare,Tricare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC All Payer,UHC All Payer,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Exchange,UHC Exchange,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Medicaid,UHC Medicaid,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UMR CPD,UMR CPD,214.99,,,,,,,per diem,214.99,214.99,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,UHC Medicare,UHC Medicare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG         ,33140865,CDM,274,RC,,,,,,Inpatient,,,214.99,214.99,Wellcare,Wellcare,214.99,,,,,,,case rate,214.99,214.99,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Meritain Health PPO CPD,Meritain Health PPO CPD,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Aetna/Commercial Product,Aetna/Commercial Product,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Meritain Health CPD,Meritain Health CPD,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Starmark CPD,Starmark CPD,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Aetna Medicare,Aetna Medicare,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Ambetter ,Ambetter ,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Blue Access,Anthem Blue Access,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Blue Access Choice,Anthem Blue Access Choice,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Blue Preferred,Anthem Blue Preferred,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Pathway,Anthem Pathway,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Alliance,Anthem Alliance,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Anthem Medicare,Anthem Medicare,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Cigna,Cigna,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Cigna PPO,Cigna PPO,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Cigna Medicare Advantage,Cigna Medicare Advantage,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Essence,Essence,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Healthlink HMO,Healthlink HMO,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Healthlink PPO,Healthlink PPO,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,HomeState Health Plan,HomeState Health Plan,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Humana Gold,Humana Gold,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Medicaid MO,Medicaid MO,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Medica,Medica,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Tricare,Tricare,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,UHC All Payer,UHC All Payer,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,UHC Exchange,UHC Exchange,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,UHC Medicaid,UHC Medicaid,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,UMR CPD,UMR CPD,195.04,,,,,,,per diem,195.04,195.04,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,UHC Medicare,UHC Medicare,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS         ,33140866,CDM,274,RC,,,,,,Inpatient,,,195.04,195.04,Wellcare,Wellcare,195.04,,,,,,,case rate,195.04,195.04,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Meritain Health PPO CPD,Meritain Health PPO CPD,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Aetna/Commercial Product,Aetna/Commercial Product,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Meritain Health CPD,Meritain Health CPD,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Starmark CPD,Starmark CPD,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Aetna Medicare,Aetna Medicare,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Ambetter ,Ambetter ,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Blue Access,Anthem Blue Access,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Blue Access Choice,Anthem Blue Access Choice,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Blue Preferred,Anthem Blue Preferred,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Pathway,Anthem Pathway,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Alliance,Anthem Alliance,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Anthem Medicare,Anthem Medicare,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Cigna,Cigna,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Cigna PPO,Cigna PPO,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Cigna Medicare Advantage,Cigna Medicare Advantage,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Essence,Essence,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Healthlink HMO,Healthlink HMO,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Healthlink PPO,Healthlink PPO,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,HomeState Health Plan,HomeState Health Plan,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Humana Gold,Humana Gold,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Medicaid MO,Medicaid MO,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Medica,Medica,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Tricare,Tricare,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,UHC All Payer,UHC All Payer,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,UHC Exchange,UHC Exchange,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,UHC Medicaid,UHC Medicaid,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,UMR CPD,UMR CPD,66.15,,,,,,,per diem,66.15,66.15,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,UHC Medicare,UHC Medicare,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140867,CDM,274,RC,,,,,,Inpatient,,,66.15,66.15,Wellcare,Wellcare,66.15,,,,,,,case rate,66.15,66.15,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Meritain Health PPO CPD,Meritain Health PPO CPD,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Aetna/Commercial Product,Aetna/Commercial Product,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Meritain Health CPD,Meritain Health CPD,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Starmark CPD,Starmark CPD,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Aetna Medicare,Aetna Medicare,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Ambetter ,Ambetter ,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Blue Access,Anthem Blue Access,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Blue Access Choice,Anthem Blue Access Choice,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Blue Preferred,Anthem Blue Preferred,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Pathway,Anthem Pathway,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Alliance,Anthem Alliance,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Anthem Medicare,Anthem Medicare,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Cigna,Cigna,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Cigna PPO,Cigna PPO,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Cigna Medicare Advantage,Cigna Medicare Advantage,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Essence,Essence,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Healthlink HMO,Healthlink HMO,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Healthlink PPO,Healthlink PPO,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,HomeState Health Plan,HomeState Health Plan,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Humana Gold,Humana Gold,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Medicaid MO,Medicaid MO,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Medica,Medica,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Tricare,Tricare,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,UHC All Payer,UHC All Payer,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,UHC Exchange,UHC Exchange,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,UHC Medicaid,UHC Medicaid,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,UMR CPD,UMR CPD,452.81,,,,,,,per diem,452.81,452.81,"Per diem rate, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,UHC Medicare,UHC Medicare,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
LUMBAR BRACE                  ,33140868,CDM,274,RC,,,,,,Inpatient,,,452.81,452.81,Wellcare,Wellcare,452.81,,,,,,,case rate,452.81,452.81,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health PPO CPD,Meritain Health PPO CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/Commercial Product,Aetna/Commercial Product,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health CPD,Meritain Health CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Starmark CPD,Starmark CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna Medicare,Aetna Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Ambetter ,Ambetter ,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access,Anthem Blue Access,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access Choice,Anthem Blue Access Choice,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Preferred,Anthem Blue Preferred,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Pathway,Anthem Pathway,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Alliance,Anthem Alliance,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Medicare,Anthem Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna,Cigna,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna PPO,Cigna PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna Medicare Advantage,Cigna Medicare Advantage,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Essence,Essence,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink HMO,Healthlink HMO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink PPO,Healthlink PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,HomeState Health Plan,HomeState Health Plan,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Humana Gold,Humana Gold,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medicaid MO,Medicaid MO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medica,Medica,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Tricare,Tricare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC All Payer,UHC All Payer,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Exchange,UHC Exchange,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicaid,UHC Medicaid,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UMR CPD,UMR CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicare,UHC Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO MED RT     ,33140869,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Wellcare,Wellcare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health PPO CPD,Meritain Health PPO CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/Commercial Product,Aetna/Commercial Product,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health CPD,Meritain Health CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Starmark CPD,Starmark CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna Medicare,Aetna Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Ambetter ,Ambetter ,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access,Anthem Blue Access,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access Choice,Anthem Blue Access Choice,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Preferred,Anthem Blue Preferred,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Pathway,Anthem Pathway,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Alliance,Anthem Alliance,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Medicare,Anthem Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna,Cigna,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna PPO,Cigna PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna Medicare Advantage,Cigna Medicare Advantage,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Essence,Essence,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink HMO,Healthlink HMO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink PPO,Healthlink PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,HomeState Health Plan,HomeState Health Plan,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Humana Gold,Humana Gold,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medicaid MO,Medicaid MO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medica,Medica,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Tricare,Tricare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC All Payer,UHC All Payer,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Exchange,UHC Exchange,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicaid,UHC Medicaid,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UMR CPD,UMR CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicare,UHC Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  RT     ,33140870,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Wellcare,Wellcare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health PPO CPD,Meritain Health PPO CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna/Commercial Product,Aetna/Commercial Product,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Meritain Health CPD,Meritain Health CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Starmark CPD,Starmark CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Aetna Medicare,Aetna Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Ambetter ,Ambetter ,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access,Anthem Blue Access,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Access Choice,Anthem Blue Access Choice,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Blue Preferred,Anthem Blue Preferred,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Pathway,Anthem Pathway,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Alliance,Anthem Alliance,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Anthem Medicare,Anthem Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna,Cigna,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna PPO,Cigna PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Cigna Medicare Advantage,Cigna Medicare Advantage,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Essence,Essence,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink HMO,Healthlink HMO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Healthlink PPO,Healthlink PPO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,HomeState Health Plan,HomeState Health Plan,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Humana Gold,Humana Gold,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medicaid MO,Medicaid MO,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Medica,Medica,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Tricare,Tricare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC All Payer,UHC All Payer,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Exchange,UHC Exchange,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicaid,UHC Medicaid,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UMR CPD,UMR CPD,157.5,,,,,,,per diem,157.5,157.5,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,UHC Medicare,UHC Medicare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHO LG  LT     ,33140871,CDM,274,RC,,,,,,Inpatient,,,157.5,157.5,Wellcare,Wellcare,157.5,,,,,,,case rate,157.5,157.5,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Meritain Health PPO CPD,Meritain Health PPO CPD,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Aetna/Commercial Product,Aetna/Commercial Product,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Meritain Health CPD,Meritain Health CPD,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Starmark CPD,Starmark CPD,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Aetna Medicare,Aetna Medicare,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Ambetter ,Ambetter ,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Blue Access,Anthem Blue Access,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Blue Access Choice,Anthem Blue Access Choice,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Blue Preferred,Anthem Blue Preferred,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Pathway,Anthem Pathway,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Alliance,Anthem Alliance,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Anthem Medicare,Anthem Medicare,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Cigna,Cigna,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Cigna PPO,Cigna PPO,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Cigna Medicare Advantage,Cigna Medicare Advantage,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Essence,Essence,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Healthlink HMO,Healthlink HMO,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Healthlink PPO,Healthlink PPO,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,HomeState Health Plan,HomeState Health Plan,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Humana Gold,Humana Gold,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Medicaid MO,Medicaid MO,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Medica,Medica,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Tricare,Tricare,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,UHC All Payer,UHC All Payer,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,UHC Exchange,UHC Exchange,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,UHC Medicaid,UHC Medicaid,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,UMR CPD,UMR CPD,151.2,,,,,,,per diem,151.2,151.2,"Per diem rate, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,UHC Medicare,UHC Medicare,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
BOOT                          ,33140872,CDM,274,RC,,,,,,Inpatient,,,151.2,151.2,Wellcare,Wellcare,151.2,,,,,,,case rate,151.2,151.2,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Meritain Health PPO CPD,Meritain Health PPO CPD,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Aetna/Commercial Product,Aetna/Commercial Product,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Meritain Health CPD,Meritain Health CPD,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Starmark CPD,Starmark CPD,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Aetna Medicare,Aetna Medicare,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Ambetter ,Ambetter ,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Blue Access,Anthem Blue Access,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Blue Access Choice,Anthem Blue Access Choice,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Blue Preferred,Anthem Blue Preferred,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Pathway,Anthem Pathway,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Alliance,Anthem Alliance,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Anthem Medicare,Anthem Medicare,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Cigna,Cigna,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Cigna PPO,Cigna PPO,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Cigna Medicare Advantage,Cigna Medicare Advantage,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Essence,Essence,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Healthlink HMO,Healthlink HMO,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Healthlink PPO,Healthlink PPO,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,HomeState Health Plan,HomeState Health Plan,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Humana Gold,Humana Gold,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Medicaid MO,Medicaid MO,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Medica,Medica,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Tricare,Tricare,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,UHC All Payer,UHC All Payer,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,UHC Exchange,UHC Exchange,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,UHC Medicaid,UHC Medicaid,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,UMR CPD,UMR CPD,173.03,,,,,,,per diem,173.03,173.03,"Per diem rate, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,UHC Medicare,UHC Medicare,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ASPEN COLLAR                  ,33140873,CDM,274,RC,,,,,,Inpatient,,,173.03,173.03,Wellcare,Wellcare,173.03,,,,,,,case rate,173.03,173.03,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Meritain Health PPO CPD,Meritain Health PPO CPD,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Aetna/Commercial Product,Aetna/Commercial Product,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Meritain Health CPD,Meritain Health CPD,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Starmark CPD,Starmark CPD,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Aetna Medicare,Aetna Medicare,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Ambetter ,Ambetter ,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Blue Access,Anthem Blue Access,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Blue Access Choice,Anthem Blue Access Choice,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Blue Preferred,Anthem Blue Preferred,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Pathway,Anthem Pathway,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Alliance,Anthem Alliance,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Anthem Medicare,Anthem Medicare,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Cigna,Cigna,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Cigna PPO,Cigna PPO,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Cigna Medicare Advantage,Cigna Medicare Advantage,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Essence,Essence,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Healthlink HMO,Healthlink HMO,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Healthlink PPO,Healthlink PPO,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,HomeState Health Plan,HomeState Health Plan,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Humana Gold,Humana Gold,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Medicaid MO,Medicaid MO,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Medica,Medica,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Tricare,Tricare,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,UHC All Payer,UHC All Payer,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,UHC Exchange,UHC Exchange,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,UHC Medicaid,UHC Medicaid,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,UMR CPD,UMR CPD,166.95,,,,,,,per diem,166.95,166.95,"Per diem rate, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,UHC Medicare,UHC Medicare,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
ROOKE BOOT LG                 ,33140874,CDM,274,RC,,,,,,Inpatient,,,166.95,166.95,Wellcare,Wellcare,166.95,,,,,,,case rate,166.95,166.95,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Meritain Health PPO CPD,Meritain Health PPO CPD,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Aetna/Commercial Product,Aetna/Commercial Product,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Meritain Health CPD,Meritain Health CPD,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Starmark CPD,Starmark CPD,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Aetna Medicare,Aetna Medicare,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Ambetter ,Ambetter ,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Blue Access,Anthem Blue Access,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Blue Access Choice,Anthem Blue Access Choice,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Blue Preferred,Anthem Blue Preferred,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Pathway,Anthem Pathway,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Alliance,Anthem Alliance,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Anthem Medicare,Anthem Medicare,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Cigna,Cigna,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Cigna PPO,Cigna PPO,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Cigna Medicare Advantage,Cigna Medicare Advantage,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Essence,Essence,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Healthlink HMO,Healthlink HMO,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Healthlink PPO,Healthlink PPO,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,HomeState Health Plan,HomeState Health Plan,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Humana Gold,Humana Gold,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Medicaid MO,Medicaid MO,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Medica,Medica,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Tricare,Tricare,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,UHC All Payer,UHC All Payer,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,UHC Exchange,UHC Exchange,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,UHC Medicaid,UHC Medicaid,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,UMR CPD,UMR CPD,37.96,,,,,,,per diem,37.96,37.96,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,UHC Medicare,UHC Medicare,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE CUT AWAY 12IN,33140879,CDM,270,RC,,,,,,Inpatient,,,37.96,37.96,Wellcare,Wellcare,37.96,,,,,,,case rate,37.96,37.96,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140881,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140882,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140883,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140884,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED     ,33140885,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140886,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140887,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140888,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Meritain Health PPO CPD,Meritain Health PPO CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna/Commercial Product,Aetna/Commercial Product,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Meritain Health CPD,Meritain Health CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Starmark CPD,Starmark CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna Medicare,Aetna Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Ambetter ,Ambetter ,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Access,Anthem Blue Access,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Access Choice,Anthem Blue Access Choice,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Preferred,Anthem Blue Preferred,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Pathway,Anthem Pathway,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Alliance,Anthem Alliance,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Medicare,Anthem Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna,Cigna,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna PPO,Cigna PPO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna Medicare Advantage,Cigna Medicare Advantage,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Essence,Essence,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthlink HMO,Healthlink HMO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthlink PPO,Healthlink PPO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,HomeState Health Plan,HomeState Health Plan,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Humana Gold,Humana Gold,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Medicaid MO,Medicaid MO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Medica,Medica,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Tricare,Tricare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC All Payer,UHC All Payer,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Exchange,UHC Exchange,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Medicaid,UHC Medicaid,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UMR CPD,UMR CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Medicare,UHC Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140893,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Wellcare,Wellcare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Meritain Health PPO CPD,Meritain Health PPO CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna/Commercial Product,Aetna/Commercial Product,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Meritain Health CPD,Meritain Health CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Starmark CPD,Starmark CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna Medicare,Aetna Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Ambetter ,Ambetter ,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Access,Anthem Blue Access,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Access Choice,Anthem Blue Access Choice,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Preferred,Anthem Blue Preferred,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Pathway,Anthem Pathway,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Alliance,Anthem Alliance,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Medicare,Anthem Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna,Cigna,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna PPO,Cigna PPO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna Medicare Advantage,Cigna Medicare Advantage,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Essence,Essence,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthlink HMO,Healthlink HMO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthlink PPO,Healthlink PPO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,HomeState Health Plan,HomeState Health Plan,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Humana Gold,Humana Gold,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Medicaid MO,Medicaid MO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Medica,Medica,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Tricare,Tricare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC All Payer,UHC All Payer,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Exchange,UHC Exchange,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Medicaid,UHC Medicaid,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UMR CPD,UMR CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Medicare,UHC Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140894,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Wellcare,Wellcare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health PPO CPD,Meritain Health PPO CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/Commercial Product,Aetna/Commercial Product,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health CPD,Meritain Health CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Starmark CPD,Starmark CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna Medicare,Aetna Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Ambetter ,Ambetter ,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access,Anthem Blue Access,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access Choice,Anthem Blue Access Choice,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Preferred,Anthem Blue Preferred,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Pathway,Anthem Pathway,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Alliance,Anthem Alliance,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Medicare,Anthem Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna,Cigna,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna PPO,Cigna PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna Medicare Advantage,Cigna Medicare Advantage,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Essence,Essence,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink HMO,Healthlink HMO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink PPO,Healthlink PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,HomeState Health Plan,HomeState Health Plan,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Humana Gold,Humana Gold,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medicaid MO,Medicaid MO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medica,Medica,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Tricare,Tricare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC All Payer,UHC All Payer,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Exchange,UHC Exchange,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicaid,UHC Medicaid,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UMR CPD,UMR CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicare,UHC Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140895,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Wellcare,Wellcare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health PPO CPD,Meritain Health PPO CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/Commercial Product,Aetna/Commercial Product,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health CPD,Meritain Health CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Starmark CPD,Starmark CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna Medicare,Aetna Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Ambetter ,Ambetter ,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access,Anthem Blue Access,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access Choice,Anthem Blue Access Choice,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Preferred,Anthem Blue Preferred,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Pathway,Anthem Pathway,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Alliance,Anthem Alliance,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Medicare,Anthem Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna,Cigna,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna PPO,Cigna PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna Medicare Advantage,Cigna Medicare Advantage,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Essence,Essence,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink HMO,Healthlink HMO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink PPO,Healthlink PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,HomeState Health Plan,HomeState Health Plan,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Humana Gold,Humana Gold,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medicaid MO,Medicaid MO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medica,Medica,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Tricare,Tricare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC All Payer,UHC All Payer,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Exchange,UHC Exchange,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicaid,UHC Medicaid,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UMR CPD,UMR CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicare,UHC Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE   ,33140896,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Wellcare,Wellcare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140897,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED     ,33140898,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140899,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140900,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Meritain Health PPO CPD,Meritain Health PPO CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna/Commercial Product,Aetna/Commercial Product,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Meritain Health CPD,Meritain Health CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Starmark CPD,Starmark CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna Medicare,Aetna Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Ambetter ,Ambetter ,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Access,Anthem Blue Access,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Access Choice,Anthem Blue Access Choice,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Preferred,Anthem Blue Preferred,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Pathway,Anthem Pathway,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Alliance,Anthem Alliance,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Medicare,Anthem Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna,Cigna,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna PPO,Cigna PPO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna Medicare Advantage,Cigna Medicare Advantage,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Essence,Essence,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthlink HMO,Healthlink HMO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthlink PPO,Healthlink PPO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,HomeState Health Plan,HomeState Health Plan,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Humana Gold,Humana Gold,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Medicaid MO,Medicaid MO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Medica,Medica,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Tricare,Tricare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC All Payer,UHC All Payer,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Exchange,UHC Exchange,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Medicaid,UHC Medicaid,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UMR CPD,UMR CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Medicare,UHC Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR          ,33140901,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Wellcare,Wellcare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Meritain Health PPO CPD,Meritain Health PPO CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna/Commercial Product,Aetna/Commercial Product,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Meritain Health CPD,Meritain Health CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Starmark CPD,Starmark CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna Medicare,Aetna Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Ambetter ,Ambetter ,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Access,Anthem Blue Access,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Access Choice,Anthem Blue Access Choice,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Preferred,Anthem Blue Preferred,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Pathway,Anthem Pathway,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Alliance,Anthem Alliance,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Medicare,Anthem Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna,Cigna,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna PPO,Cigna PPO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna Medicare Advantage,Cigna Medicare Advantage,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Essence,Essence,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthlink HMO,Healthlink HMO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthlink PPO,Healthlink PPO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,HomeState Health Plan,HomeState Health Plan,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Humana Gold,Humana Gold,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Medicaid MO,Medicaid MO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Medica,Medica,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Tricare,Tricare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC All Payer,UHC All Payer,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Exchange,UHC Exchange,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Medicaid,UHC Medicaid,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UMR CPD,UMR CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Medicare,UHC Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140902,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Wellcare,Wellcare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health PPO CPD,Meritain Health PPO CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/Commercial Product,Aetna/Commercial Product,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health CPD,Meritain Health CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Starmark CPD,Starmark CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna Medicare,Aetna Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Ambetter ,Ambetter ,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access,Anthem Blue Access,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access Choice,Anthem Blue Access Choice,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Preferred,Anthem Blue Preferred,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Pathway,Anthem Pathway,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Alliance,Anthem Alliance,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Medicare,Anthem Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna,Cigna,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna PPO,Cigna PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna Medicare Advantage,Cigna Medicare Advantage,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Essence,Essence,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink HMO,Healthlink HMO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink PPO,Healthlink PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,HomeState Health Plan,HomeState Health Plan,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Humana Gold,Humana Gold,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medicaid MO,Medicaid MO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medica,Medica,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Tricare,Tricare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC All Payer,UHC All Payer,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Exchange,UHC Exchange,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicaid,UHC Medicaid,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UMR CPD,UMR CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicare,UHC Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140903,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Wellcare,Wellcare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Meritain Health PPO CPD,Meritain Health PPO CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna/Commercial Product,Aetna/Commercial Product,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Meritain Health CPD,Meritain Health CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Starmark CPD,Starmark CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna Medicare,Aetna Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Ambetter ,Ambetter ,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Access,Anthem Blue Access,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Access Choice,Anthem Blue Access Choice,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Preferred,Anthem Blue Preferred,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Pathway,Anthem Pathway,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Alliance,Anthem Alliance,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Medicare,Anthem Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna,Cigna,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna PPO,Cigna PPO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna Medicare Advantage,Cigna Medicare Advantage,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Essence,Essence,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthlink HMO,Healthlink HMO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthlink PPO,Healthlink PPO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,HomeState Health Plan,HomeState Health Plan,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Humana Gold,Humana Gold,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Medicaid MO,Medicaid MO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Medica,Medica,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Tricare,Tricare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC All Payer,UHC All Payer,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Exchange,UHC Exchange,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Medicaid,UHC Medicaid,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UMR CPD,UMR CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Medicare,UHC Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE    ,33140904,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Wellcare,Wellcare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Meritain Health PPO CPD,Meritain Health PPO CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna/Commercial Product,Aetna/Commercial Product,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Meritain Health CPD,Meritain Health CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Starmark CPD,Starmark CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna Medicare,Aetna Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Ambetter ,Ambetter ,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Access,Anthem Blue Access,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Access Choice,Anthem Blue Access Choice,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Preferred,Anthem Blue Preferred,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Pathway,Anthem Pathway,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Alliance,Anthem Alliance,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Medicare,Anthem Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna,Cigna,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna PPO,Cigna PPO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna Medicare Advantage,Cigna Medicare Advantage,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Essence,Essence,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthlink HMO,Healthlink HMO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthlink PPO,Healthlink PPO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,HomeState Health Plan,HomeState Health Plan,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Humana Gold,Humana Gold,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Medicaid MO,Medicaid MO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Medica,Medica,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Tricare,Tricare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC All Payer,UHC All Payer,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Exchange,UHC Exchange,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Medicaid,UHC Medicaid,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UMR CPD,UMR CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Medicare,UHC Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140905,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Wellcare,Wellcare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL RIGHT,33140923,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS XL LEFT ,33140924,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG RIGHT,33140925,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS LG LEFT ,33140926,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED RIGH,33140927,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS MED LEFT,33140928,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM RIGHT,33140929,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health PPO CPD,Meritain Health PPO CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna/Commercial Product,Aetna/Commercial Product,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Meritain Health CPD,Meritain Health CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Starmark CPD,Starmark CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Aetna Medicare,Aetna Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Ambetter ,Ambetter ,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access,Anthem Blue Access,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Access Choice,Anthem Blue Access Choice,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Blue Preferred,Anthem Blue Preferred,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Pathway,Anthem Pathway,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Alliance,Anthem Alliance,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Anthem Medicare,Anthem Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna,Cigna,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna PPO,Cigna PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Cigna Medicare Advantage,Cigna Medicare Advantage,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Essence,Essence,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink HMO,Healthlink HMO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Healthlink PPO,Healthlink PPO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,HomeState Health Plan,HomeState Health Plan,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Humana Gold,Humana Gold,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medicaid MO,Medicaid MO,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Medica,Medica,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Tricare,Tricare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC All Payer,UHC All Payer,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Exchange,UHC Exchange,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicaid,UHC Medicaid,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UMR CPD,UMR CPD,163.8,,,,,,,per diem,163.8,163.8,"Per diem rate, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,UHC Medicare,UHC Medicare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
RESTING HAND ORTHOSIS SM LEFT ,33140930,CDM,270,RC,,,,,,Inpatient,,,163.8,163.8,Wellcare,Wellcare,163.8,,,,,,,case rate,163.8,163.8,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Meritain Health PPO CPD,Meritain Health PPO CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna/Commercial Product,Aetna/Commercial Product,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Meritain Health CPD,Meritain Health CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Starmark CPD,Starmark CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Aetna Medicare,Aetna Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Ambetter ,Ambetter ,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Access,Anthem Blue Access,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Access Choice,Anthem Blue Access Choice,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Blue Preferred,Anthem Blue Preferred,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Pathway,Anthem Pathway,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Alliance,Anthem Alliance,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Anthem Medicare,Anthem Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna,Cigna,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna PPO,Cigna PPO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Cigna Medicare Advantage,Cigna Medicare Advantage,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Essence,Essence,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthlink HMO,Healthlink HMO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Healthlink PPO,Healthlink PPO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,HomeState Health Plan,HomeState Health Plan,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Humana Gold,Humana Gold,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Medicaid MO,Medicaid MO,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Medica,Medica,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Tricare,Tricare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC All Payer,UHC All Payer,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Exchange,UHC Exchange,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Medicaid,UHC Medicaid,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UMR CPD,UMR CPD,16.57,,,,,,,per diem,16.57,16.57,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,UHC Medicare,UHC Medicare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL LEFT ,33140935,CDM,270,RC,,,,,,Inpatient,,,16.57,16.57,Wellcare,Wellcare,16.57,,,,,,,case rate,16.57,16.57,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Meritain Health PPO CPD,Meritain Health PPO CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna/Commercial Product,Aetna/Commercial Product,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Meritain Health CPD,Meritain Health CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Starmark CPD,Starmark CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Aetna Medicare,Aetna Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Ambetter ,Ambetter ,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Access,Anthem Blue Access,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Access Choice,Anthem Blue Access Choice,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Blue Preferred,Anthem Blue Preferred,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Pathway,Anthem Pathway,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Alliance,Anthem Alliance,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Anthem Medicare,Anthem Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna,Cigna,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna PPO,Cigna PPO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Cigna Medicare Advantage,Cigna Medicare Advantage,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Essence,Essence,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthlink HMO,Healthlink HMO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Healthlink PPO,Healthlink PPO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,HomeState Health Plan,HomeState Health Plan,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Humana Gold,Humana Gold,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Medicaid MO,Medicaid MO,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Medica,Medica,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Tricare,Tricare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC All Payer,UHC All Payer,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Exchange,UHC Exchange,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Medicaid,UHC Medicaid,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UMR CPD,UMR CPD,22.3,,,,,,,per diem,22.3,22.3,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,UHC Medicare,UHC Medicare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR XL RIGHT,33140936,CDM,270,RC,,,,,,Inpatient,,,22.3,22.3,Wellcare,Wellcare,22.3,,,,,,,case rate,22.3,22.3,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health PPO CPD,Meritain Health PPO CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/Commercial Product,Aetna/Commercial Product,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health CPD,Meritain Health CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Starmark CPD,Starmark CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna Medicare,Aetna Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Ambetter ,Ambetter ,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access,Anthem Blue Access,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access Choice,Anthem Blue Access Choice,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Preferred,Anthem Blue Preferred,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Pathway,Anthem Pathway,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Alliance,Anthem Alliance,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Medicare,Anthem Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna,Cigna,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna PPO,Cigna PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna Medicare Advantage,Cigna Medicare Advantage,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Essence,Essence,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink HMO,Healthlink HMO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink PPO,Healthlink PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,HomeState Health Plan,HomeState Health Plan,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Humana Gold,Humana Gold,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medicaid MO,Medicaid MO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medica,Medica,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Tricare,Tricare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC All Payer,UHC All Payer,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Exchange,UHC Exchange,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicaid,UHC Medicaid,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UMR CPD,UMR CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicare,UHC Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE LE,33140937,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Wellcare,Wellcare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health PPO CPD,Meritain Health PPO CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna/Commercial Product,Aetna/Commercial Product,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Meritain Health CPD,Meritain Health CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Starmark CPD,Starmark CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Aetna Medicare,Aetna Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Ambetter ,Ambetter ,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access,Anthem Blue Access,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Access Choice,Anthem Blue Access Choice,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Blue Preferred,Anthem Blue Preferred,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Pathway,Anthem Pathway,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Alliance,Anthem Alliance,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Anthem Medicare,Anthem Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna,Cigna,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna PPO,Cigna PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Cigna Medicare Advantage,Cigna Medicare Advantage,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Essence,Essence,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink HMO,Healthlink HMO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Healthlink PPO,Healthlink PPO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,HomeState Health Plan,HomeState Health Plan,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Humana Gold,Humana Gold,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medicaid MO,Medicaid MO,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Medica,Medica,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Tricare,Tricare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC All Payer,UHC All Payer,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Exchange,UHC Exchange,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicaid,UHC Medicaid,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UMR CPD,UMR CPD,15.15,,,,,,,per diem,15.15,15.15,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,UHC Medicare,UHC Medicare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR LARGE RI,33140938,CDM,270,RC,,,,,,Inpatient,,,15.15,15.15,Wellcare,Wellcare,15.15,,,,,,,case rate,15.15,15.15,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED LEFT,33140939,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR MED RIGH,33140940,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM LEFT ,33140941,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health PPO CPD,Meritain Health PPO CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna/Commercial Product,Aetna/Commercial Product,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Meritain Health CPD,Meritain Health CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Starmark CPD,Starmark CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Aetna Medicare,Aetna Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Ambetter ,Ambetter ,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access,Anthem Blue Access,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Access Choice,Anthem Blue Access Choice,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Blue Preferred,Anthem Blue Preferred,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Pathway,Anthem Pathway,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Alliance,Anthem Alliance,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Anthem Medicare,Anthem Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna,Cigna,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna PPO,Cigna PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Cigna Medicare Advantage,Cigna Medicare Advantage,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Essence,Essence,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink HMO,Healthlink HMO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Healthlink PPO,Healthlink PPO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,HomeState Health Plan,HomeState Health Plan,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Humana Gold,Humana Gold,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medicaid MO,Medicaid MO,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Medica,Medica,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Tricare,Tricare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC All Payer,UHC All Payer,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Exchange,UHC Exchange,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicaid,UHC Medicaid,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UMR CPD,UMR CPD,15.72,,,,,,,per diem,15.72,15.72,"Per diem rate, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,UHC Medicare,UHC Medicare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
WRIST SPLINTS REGULAR SM RIGHT,33140942,CDM,270,RC,,,,,,Inpatient,,,15.72,15.72,Wellcare,Wellcare,15.72,,,,,,,case rate,15.72,15.72,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Meritain Health PPO CPD,Meritain Health PPO CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna/Commercial Product,Aetna/Commercial Product,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Meritain Health CPD,Meritain Health CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Starmark CPD,Starmark CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Aetna Medicare,Aetna Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Ambetter ,Ambetter ,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Access,Anthem Blue Access,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Access Choice,Anthem Blue Access Choice,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Blue Preferred,Anthem Blue Preferred,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Pathway,Anthem Pathway,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Alliance,Anthem Alliance,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Anthem Medicare,Anthem Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna,Cigna,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna PPO,Cigna PPO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Cigna Medicare Advantage,Cigna Medicare Advantage,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Essence,Essence,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthlink HMO,Healthlink HMO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Healthlink PPO,Healthlink PPO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,HomeState Health Plan,HomeState Health Plan,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Humana Gold,Humana Gold,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Medicaid MO,Medicaid MO,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Medica,Medica,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Tricare,Tricare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC All Payer,UHC All Payer,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Exchange,UHC Exchange,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Medicaid,UHC Medicaid,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UMR CPD,UMR CPD,8.79,,,,,,,per diem,8.79,8.79,"Per diem rate, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,UHC Medicare,UHC Medicare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
SOFT CERVICAL COLLAR ORT130105,33140943,CDM,270,RC,,,,,,Inpatient,,,8.79,8.79,Wellcare,Wellcare,8.79,,,,,,,case rate,8.79,8.79,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Meritain Health PPO CPD,Meritain Health PPO CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna/Commercial Product,Aetna/Commercial Product,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Meritain Health CPD,Meritain Health CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Starmark CPD,Starmark CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Aetna Medicare,Aetna Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Ambetter ,Ambetter ,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Access,Anthem Blue Access,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Access Choice,Anthem Blue Access Choice,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Blue Preferred,Anthem Blue Preferred,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Pathway,Anthem Pathway,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Alliance,Anthem Alliance,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Anthem Medicare,Anthem Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna,Cigna,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna PPO,Cigna PPO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Cigna Medicare Advantage,Cigna Medicare Advantage,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Essence,Essence,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthlink HMO,Healthlink HMO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Healthlink PPO,Healthlink PPO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,HomeState Health Plan,HomeState Health Plan,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Humana Gold,Humana Gold,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Medicaid MO,Medicaid MO,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Medica,Medica,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Tricare,Tricare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC All Payer,UHC All Payer,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Exchange,UHC Exchange,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Medicaid,UHC Medicaid,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UMR CPD,UMR CPD,46.37,,,,,,,per diem,46.37,46.37,"Per diem rate, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,UHC Medicare,UHC Medicare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
ASPEN COLLAR PADS REPLACEMENT ,33140944,CDM,270,RC,,,,,,Inpatient,,,46.37,46.37,Wellcare,Wellcare,46.37,,,,,,,case rate,46.37,46.37,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health PPO CPD,Meritain Health PPO CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/Commercial Product,Aetna/Commercial Product,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health CPD,Meritain Health CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Starmark CPD,Starmark CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna Medicare,Aetna Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Ambetter ,Ambetter ,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access,Anthem Blue Access,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access Choice,Anthem Blue Access Choice,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Preferred,Anthem Blue Preferred,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Pathway,Anthem Pathway,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Alliance,Anthem Alliance,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Medicare,Anthem Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna,Cigna,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna PPO,Cigna PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna Medicare Advantage,Cigna Medicare Advantage,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Essence,Essence,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink HMO,Healthlink HMO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink PPO,Healthlink PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,HomeState Health Plan,HomeState Health Plan,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Humana Gold,Humana Gold,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medicaid MO,Medicaid MO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medica,Medica,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Tricare,Tricare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC All Payer,UHC All Payer,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Exchange,UHC Exchange,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicaid,UHC Medicaid,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UMR CPD,UMR CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicare,UHC Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT MED 09MP-M   ,33140945,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Wellcare,Wellcare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health PPO CPD,Meritain Health PPO CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/Commercial Product,Aetna/Commercial Product,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health CPD,Meritain Health CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Starmark CPD,Starmark CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna Medicare,Aetna Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Ambetter ,Ambetter ,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access,Anthem Blue Access,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access Choice,Anthem Blue Access Choice,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Preferred,Anthem Blue Preferred,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Pathway,Anthem Pathway,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Alliance,Anthem Alliance,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Medicare,Anthem Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna,Cigna,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna PPO,Cigna PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna Medicare Advantage,Cigna Medicare Advantage,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Essence,Essence,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink HMO,Healthlink HMO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink PPO,Healthlink PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,HomeState Health Plan,HomeState Health Plan,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Humana Gold,Humana Gold,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medicaid MO,Medicaid MO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medica,Medica,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Tricare,Tricare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC All Payer,UHC All Payer,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Exchange,UHC Exchange,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicaid,UHC Medicaid,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UMR CPD,UMR CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicare,UHC Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT LRG 09MP-L   ,33140946,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Wellcare,Wellcare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health PPO CPD,Meritain Health PPO CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna/Commercial Product,Aetna/Commercial Product,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Meritain Health CPD,Meritain Health CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Starmark CPD,Starmark CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Aetna Medicare,Aetna Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Ambetter ,Ambetter ,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access,Anthem Blue Access,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Access Choice,Anthem Blue Access Choice,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Blue Preferred,Anthem Blue Preferred,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Pathway,Anthem Pathway,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Alliance,Anthem Alliance,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Anthem Medicare,Anthem Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna,Cigna,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna PPO,Cigna PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Cigna Medicare Advantage,Cigna Medicare Advantage,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Essence,Essence,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink HMO,Healthlink HMO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Healthlink PPO,Healthlink PPO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,HomeState Health Plan,HomeState Health Plan,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Humana Gold,Humana Gold,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medicaid MO,Medicaid MO,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Medica,Medica,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Tricare,Tricare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC All Payer,UHC All Payer,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Exchange,UHC Exchange,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicaid,UHC Medicaid,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UMR CPD,UMR CPD,203.18,,,,,,,per diem,203.18,203.18,"Per diem rate, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,UHC Medicare,UHC Medicare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
MULTI PODUS BOOT XLRG 09MP-XL ,33140947,CDM,270,RC,,,,,,Inpatient,,,203.18,203.18,Wellcare,Wellcare,203.18,,,,,,,case rate,203.18,203.18,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Meritain Health PPO CPD,Meritain Health PPO CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna/Commercial Product,Aetna/Commercial Product,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Meritain Health CPD,Meritain Health CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Starmark CPD,Starmark CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Aetna Medicare,Aetna Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Ambetter ,Ambetter ,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Access,Anthem Blue Access,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Access Choice,Anthem Blue Access Choice,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Blue Preferred,Anthem Blue Preferred,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Pathway,Anthem Pathway,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Alliance,Anthem Alliance,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Anthem Medicare,Anthem Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna,Cigna,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna PPO,Cigna PPO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Cigna Medicare Advantage,Cigna Medicare Advantage,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Essence,Essence,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthlink HMO,Healthlink HMO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Healthlink PPO,Healthlink PPO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,HomeState Health Plan,HomeState Health Plan,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Humana Gold,Humana Gold,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Medicaid MO,Medicaid MO,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Medica,Medica,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Tricare,Tricare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC All Payer,UHC All Payer,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Exchange,UHC Exchange,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Medicaid,UHC Medicaid,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UMR CPD,UMR CPD,280.35,,,,,,,per diem,280.35,280.35,"Per diem rate, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,UHC Medicare,UHC Medicare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
CONTROL FIT LSO BACK BRACE 451,33140948,CDM,270,RC,,,,,,Inpatient,,,280.35,280.35,Wellcare,Wellcare,280.35,,,,,,,case rate,280.35,280.35,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Meritain Health PPO CPD,Meritain Health PPO CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna/Commercial Product,Aetna/Commercial Product,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Meritain Health CPD,Meritain Health CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Starmark CPD,Starmark CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Aetna Medicare,Aetna Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Ambetter ,Ambetter ,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Access,Anthem Blue Access,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Access Choice,Anthem Blue Access Choice,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Blue Preferred,Anthem Blue Preferred,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Pathway,Anthem Pathway,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Alliance,Anthem Alliance,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Anthem Medicare,Anthem Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna,Cigna,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna PPO,Cigna PPO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Cigna Medicare Advantage,Cigna Medicare Advantage,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Essence,Essence,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthlink HMO,Healthlink HMO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Healthlink PPO,Healthlink PPO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,HomeState Health Plan,HomeState Health Plan,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Humana Gold,Humana Gold,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Medicaid MO,Medicaid MO,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Medica,Medica,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Tricare,Tricare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC All Payer,UHC All Payer,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Exchange,UHC Exchange,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Medicaid,UHC Medicaid,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UMR CPD,UMR CPD,97.62,,,,,,,per diem,97.62,97.62,"Per diem rate, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,UHC Medicare,UHC Medicare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
ASPEN COLLAR SDJ7983287       ,33140949,CDM,270,RC,,,,,,Inpatient,,,97.62,97.62,Wellcare,Wellcare,97.62,,,,,,,case rate,97.62,97.62,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health PPO CPD,Meritain Health PPO CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/Commercial Product,Aetna/Commercial Product,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health CPD,Meritain Health CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Starmark CPD,Starmark CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna Medicare,Aetna Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Ambetter ,Ambetter ,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access,Anthem Blue Access,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access Choice,Anthem Blue Access Choice,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Preferred,Anthem Blue Preferred,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Pathway,Anthem Pathway,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Alliance,Anthem Alliance,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Medicare,Anthem Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna,Cigna,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna PPO,Cigna PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna Medicare Advantage,Cigna Medicare Advantage,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Essence,Essence,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink HMO,Healthlink HMO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink PPO,Healthlink PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,HomeState Health Plan,HomeState Health Plan,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Humana Gold,Humana Gold,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Medicaid MO,Medicaid MO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Medica,Medica,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Tricare,Tricare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC All Payer,UHC All Payer,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Exchange,UHC Exchange,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicaid,UHC Medicaid,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UMR CPD,UMR CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicare,UHC Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE SML-MED  ,33142067,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Wellcare,Wellcare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health PPO CPD,Meritain Health PPO CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna/Commercial Product,Aetna/Commercial Product,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Meritain Health CPD,Meritain Health CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Starmark CPD,Starmark CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Aetna Medicare,Aetna Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Ambetter ,Ambetter ,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access,Anthem Blue Access,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Access Choice,Anthem Blue Access Choice,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Blue Preferred,Anthem Blue Preferred,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Pathway,Anthem Pathway,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Alliance,Anthem Alliance,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Anthem Medicare,Anthem Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna,Cigna,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna PPO,Cigna PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Cigna Medicare Advantage,Cigna Medicare Advantage,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Essence,Essence,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink HMO,Healthlink HMO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Healthlink PPO,Healthlink PPO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,HomeState Health Plan,HomeState Health Plan,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Humana Gold,Humana Gold,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Medicaid MO,Medicaid MO,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Medica,Medica,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Tricare,Tricare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC All Payer,UHC All Payer,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Exchange,UHC Exchange,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicaid,UHC Medicaid,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UMR CPD,UMR CPD,40.82,,,,,,,per diem,40.82,40.82,"Per diem rate, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,UHC Medicare,UHC Medicare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
PROTECTIVE SURE CARE LGE      ,33142068,CDM,270,RC,,,,,,Inpatient,,,40.82,40.82,Wellcare,Wellcare,40.82,,,,,,,case rate,40.82,40.82,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Meritain Health PPO CPD,Meritain Health PPO CPD,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Aetna/Commercial Product,Aetna/Commercial Product,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Meritain Health CPD,Meritain Health CPD,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Starmark CPD,Starmark CPD,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Aetna Medicare,Aetna Medicare,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Ambetter ,Ambetter ,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Blue Access,Anthem Blue Access,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Blue Access Choice,Anthem Blue Access Choice,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Blue Preferred,Anthem Blue Preferred,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Pathway,Anthem Pathway,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Alliance,Anthem Alliance,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Anthem Medicare,Anthem Medicare,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Cigna,Cigna,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Cigna PPO,Cigna PPO,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Cigna Medicare Advantage,Cigna Medicare Advantage,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Essence,Essence,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Healthlink HMO,Healthlink HMO,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Healthlink PPO,Healthlink PPO,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,HomeState Health Plan,HomeState Health Plan,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Humana Gold,Humana Gold,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Medicaid MO,Medicaid MO,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Medica,Medica,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Tricare,Tricare,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,UHC All Payer,UHC All Payer,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,UHC Exchange,UHC Exchange,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,UHC Medicaid,UHC Medicaid,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,UMR CPD,UMR CPD,3.9,,,,,,,per diem,3.9,3.9,"Per diem rate, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,UHC Medicare,UHC Medicare,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
ARMBOARD DISP ADULT           ,33142086,CDM,270,RC,,,,,,Inpatient,,,3.9,3.9,Wellcare,Wellcare,3.9,,,,,,,case rate,3.9,3.9,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Meritain Health PPO CPD,Meritain Health PPO CPD,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Aetna/Commercial Product,Aetna/Commercial Product,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Meritain Health CPD,Meritain Health CPD,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Starmark CPD,Starmark CPD,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Aetna Medicare,Aetna Medicare,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Ambetter ,Ambetter ,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Blue Access,Anthem Blue Access,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Blue Access Choice,Anthem Blue Access Choice,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Blue Preferred,Anthem Blue Preferred,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Pathway,Anthem Pathway,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Alliance,Anthem Alliance,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Anthem Medicare,Anthem Medicare,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Cigna,Cigna,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Cigna PPO,Cigna PPO,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Cigna Medicare Advantage,Cigna Medicare Advantage,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Essence,Essence,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Healthlink HMO,Healthlink HMO,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Healthlink PPO,Healthlink PPO,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,HomeState Health Plan,HomeState Health Plan,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Humana Gold,Humana Gold,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Medicaid MO,Medicaid MO,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Medica,Medica,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Tricare,Tricare,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,UHC All Payer,UHC All Payer,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,UHC Exchange,UHC Exchange,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,UHC Medicaid,UHC Medicaid,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,UMR CPD,UMR CPD,124.54,,,,,,,per diem,124.54,124.54,"Per diem rate, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,UHC Medicare,UHC Medicare,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
COLLAR SET ASPEN ADULT REGULAR,33142145,CDM,270,RC,,,,,,Inpatient,,,124.54,124.54,Wellcare,Wellcare,124.54,,,,,,,case rate,124.54,124.54,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Meritain Health PPO CPD,Meritain Health PPO CPD,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Aetna/Commercial Product,Aetna/Commercial Product,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Meritain Health CPD,Meritain Health CPD,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Starmark CPD,Starmark CPD,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Aetna Medicare,Aetna Medicare,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Ambetter ,Ambetter ,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Blue Access,Anthem Blue Access,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Blue Access Choice,Anthem Blue Access Choice,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Blue Preferred,Anthem Blue Preferred,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Pathway,Anthem Pathway,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Alliance,Anthem Alliance,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Anthem Medicare,Anthem Medicare,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Cigna,Cigna,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Cigna PPO,Cigna PPO,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Cigna Medicare Advantage,Cigna Medicare Advantage,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Essence,Essence,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Healthlink HMO,Healthlink HMO,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Healthlink PPO,Healthlink PPO,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,HomeState Health Plan,HomeState Health Plan,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Humana Gold,Humana Gold,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Medicaid MO,Medicaid MO,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Medica,Medica,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Tricare,Tricare,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,UHC All Payer,UHC All Payer,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,UHC Exchange,UHC Exchange,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,UHC Medicaid,UHC Medicaid,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,UMR CPD,UMR CPD,18.98,,,,,,,per diem,18.98,18.98,"Per diem rate, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,UHC Medicare,UHC Medicare,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
"ABDOMINAL BINDER XL 46-62""    ",33142154,CDM,270,RC,,,,,,Inpatient,,,18.98,18.98,Wellcare,Wellcare,18.98,,,,,,,case rate,18.98,18.98,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Meritain Health PPO CPD,Meritain Health PPO CPD,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Aetna/Commercial Product,Aetna/Commercial Product,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Meritain Health CPD,Meritain Health CPD,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Starmark CPD,Starmark CPD,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Aetna Medicare,Aetna Medicare,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Ambetter ,Ambetter ,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Blue Access,Anthem Blue Access,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Blue Access Choice,Anthem Blue Access Choice,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Blue Preferred,Anthem Blue Preferred,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Pathway,Anthem Pathway,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Alliance,Anthem Alliance,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Anthem Medicare,Anthem Medicare,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Cigna,Cigna,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Cigna PPO,Cigna PPO,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Cigna Medicare Advantage,Cigna Medicare Advantage,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Essence,Essence,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Healthlink HMO,Healthlink HMO,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Healthlink PPO,Healthlink PPO,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,HomeState Health Plan,HomeState Health Plan,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Humana Gold,Humana Gold,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Medicaid MO,Medicaid MO,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Medica,Medica,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Tricare,Tricare,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,UHC All Payer,UHC All Payer,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,UHC Exchange,UHC Exchange,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,UHC Medicaid,UHC Medicaid,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,UMR CPD,UMR CPD,13,,,,,,,per diem,13,13,"Per diem rate, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,UHC Medicare,UHC Medicare,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
LAMBS WOOL # 617582           ,33142175,CDM,270,RC,,,,,,Inpatient,,,13,13,Wellcare,Wellcare,13,,,,,,,case rate,13,13,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Meritain Health PPO CPD,Meritain Health PPO CPD,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Aetna/Commercial Product,Aetna/Commercial Product,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Meritain Health CPD,Meritain Health CPD,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Starmark CPD,Starmark CPD,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Aetna Medicare,Aetna Medicare,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Ambetter ,Ambetter ,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Blue Access,Anthem Blue Access,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Blue Access Choice,Anthem Blue Access Choice,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Blue Preferred,Anthem Blue Preferred,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Pathway,Anthem Pathway,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Alliance,Anthem Alliance,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Anthem Medicare,Anthem Medicare,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Cigna,Cigna,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Cigna PPO,Cigna PPO,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Cigna Medicare Advantage,Cigna Medicare Advantage,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Essence,Essence,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Healthlink HMO,Healthlink HMO,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Healthlink PPO,Healthlink PPO,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,HomeState Health Plan,HomeState Health Plan,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Humana Gold,Humana Gold,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Medicaid MO,Medicaid MO,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Medica,Medica,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Tricare,Tricare,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,UHC All Payer,UHC All Payer,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,UHC Exchange,UHC Exchange,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,UHC Medicaid,UHC Medicaid,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,UMR CPD,UMR CPD,5.46,,,,,,,per diem,5.46,5.46,"Per diem rate, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,UHC Medicare,UHC Medicare,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
"FOOTWEAR, BARIATRIC CARDINAL  ",33142192,CDM,270,RC,,,,,,Inpatient,,,5.46,5.46,Wellcare,Wellcare,5.46,,,,,,,case rate,5.46,5.46,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Meritain Health PPO CPD,Meritain Health PPO CPD,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Aetna/Commercial Product,Aetna/Commercial Product,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Meritain Health CPD,Meritain Health CPD,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Starmark CPD,Starmark CPD,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Aetna Medicare,Aetna Medicare,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Ambetter ,Ambetter ,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Blue Access,Anthem Blue Access,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Blue Access Choice,Anthem Blue Access Choice,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Blue Preferred,Anthem Blue Preferred,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Pathway,Anthem Pathway,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Alliance,Anthem Alliance,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Anthem Medicare,Anthem Medicare,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Cigna,Cigna,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Cigna PPO,Cigna PPO,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Cigna Medicare Advantage,Cigna Medicare Advantage,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Essence,Essence,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Healthlink HMO,Healthlink HMO,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Healthlink PPO,Healthlink PPO,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,HomeState Health Plan,HomeState Health Plan,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Humana Gold,Humana Gold,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Medicaid MO,Medicaid MO,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Medica,Medica,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Tricare,Tricare,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,UHC All Payer,UHC All Payer,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,UHC Exchange,UHC Exchange,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,UHC Medicaid,UHC Medicaid,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,UMR CPD,UMR CPD,24.44,,,,,,,per diem,24.44,24.44,"Per diem rate, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,UHC Medicare,UHC Medicare,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
ABD BINDER 62IN-74IN CARDINAL ,33142193,CDM,270,RC,,,,,,Inpatient,,,24.44,24.44,Wellcare,Wellcare,24.44,,,,,,,case rate,24.44,24.44,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Meritain Health PPO CPD,Meritain Health PPO CPD,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Aetna/Commercial Product,Aetna/Commercial Product,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Meritain Health CPD,Meritain Health CPD,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Starmark CPD,Starmark CPD,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Aetna Medicare,Aetna Medicare,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Ambetter ,Ambetter ,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Blue Access,Anthem Blue Access,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Blue Access Choice,Anthem Blue Access Choice,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Blue Preferred,Anthem Blue Preferred,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Pathway,Anthem Pathway,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Alliance,Anthem Alliance,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Anthem Medicare,Anthem Medicare,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Cigna,Cigna,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Cigna PPO,Cigna PPO,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Cigna Medicare Advantage,Cigna Medicare Advantage,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Essence,Essence,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Healthlink HMO,Healthlink HMO,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Healthlink PPO,Healthlink PPO,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,HomeState Health Plan,HomeState Health Plan,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Humana Gold,Humana Gold,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Medicaid MO,Medicaid MO,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Medica,Medica,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Tricare,Tricare,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,UHC All Payer,UHC All Payer,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,UHC Exchange,UHC Exchange,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,UHC Medicaid,UHC Medicaid,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,UMR CPD,UMR CPD,134.68,,,,,,,per diem,134.68,134.68,"Per diem rate, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,UHC Medicare,UHC Medicare,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
2XL SLING                     ,33142203,CDM,270,RC,,,,,,Inpatient,,,134.68,134.68,Wellcare,Wellcare,134.68,,,,,,,case rate,134.68,134.68,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Meritain Health PPO CPD,Meritain Health PPO CPD,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Aetna/Commercial Product,Aetna/Commercial Product,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Meritain Health CPD,Meritain Health CPD,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Starmark CPD,Starmark CPD,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Aetna Medicare,Aetna Medicare,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Ambetter ,Ambetter ,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Blue Access,Anthem Blue Access,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Blue Access Choice,Anthem Blue Access Choice,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Blue Preferred,Anthem Blue Preferred,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Pathway,Anthem Pathway,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Alliance,Anthem Alliance,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Anthem Medicare,Anthem Medicare,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Cigna,Cigna,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Cigna PPO,Cigna PPO,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Cigna Medicare Advantage,Cigna Medicare Advantage,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Essence,Essence,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Healthlink HMO,Healthlink HMO,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Healthlink PPO,Healthlink PPO,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,HomeState Health Plan,HomeState Health Plan,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Humana Gold,Humana Gold,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Medicaid MO,Medicaid MO,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Medica,Medica,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Tricare,Tricare,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,UHC All Payer,UHC All Payer,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,UHC Exchange,UHC Exchange,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,UHC Medicaid,UHC Medicaid,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,UMR CPD,UMR CPD,94.9,,,,,,,per diem,94.9,94.9,"Per diem rate, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,UHC Medicare,UHC Medicare,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
HEEL PROTECTOR                ,33142299,CDM,270,RC,,,,,,Inpatient,,,94.9,94.9,Wellcare,Wellcare,94.9,,,,,,,case rate,94.9,94.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Meritain Health PPO CPD,Meritain Health PPO CPD,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Aetna/Commercial Product,Aetna/Commercial Product,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Meritain Health CPD,Meritain Health CPD,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Starmark CPD,Starmark CPD,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Aetna Medicare,Aetna Medicare,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Ambetter ,Ambetter ,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Blue Access,Anthem Blue Access,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Blue Access Choice,Anthem Blue Access Choice,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Blue Preferred,Anthem Blue Preferred,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Pathway,Anthem Pathway,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Alliance,Anthem Alliance,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Anthem Medicare,Anthem Medicare,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Cigna,Cigna,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Cigna PPO,Cigna PPO,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Cigna Medicare Advantage,Cigna Medicare Advantage,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Essence,Essence,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Healthlink HMO,Healthlink HMO,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Healthlink PPO,Healthlink PPO,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,HomeState Health Plan,HomeState Health Plan,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Humana Gold,Humana Gold,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Medicaid MO,Medicaid MO,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Medica,Medica,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Tricare,Tricare,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,UHC All Payer,UHC All Payer,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,UHC Exchange,UHC Exchange,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,UHC Medicaid,UHC Medicaid,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,UMR CPD,UMR CPD,88.66,,,,,,,per diem,88.66,88.66,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,UHC Medicare,UHC Medicare,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL                ,33142300,CDM,270,RC,,,,,,Inpatient,,,88.66,88.66,Wellcare,Wellcare,88.66,,,,,,,case rate,88.66,88.66,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Meritain Health PPO CPD,Meritain Health PPO CPD,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Aetna/Commercial Product,Aetna/Commercial Product,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Meritain Health CPD,Meritain Health CPD,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Starmark CPD,Starmark CPD,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Aetna Medicare,Aetna Medicare,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Ambetter ,Ambetter ,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Blue Access,Anthem Blue Access,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Blue Access Choice,Anthem Blue Access Choice,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Blue Preferred,Anthem Blue Preferred,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Pathway,Anthem Pathway,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Alliance,Anthem Alliance,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Anthem Medicare,Anthem Medicare,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Cigna,Cigna,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Cigna PPO,Cigna PPO,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Cigna Medicare Advantage,Cigna Medicare Advantage,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Essence,Essence,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Healthlink HMO,Healthlink HMO,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Healthlink PPO,Healthlink PPO,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,HomeState Health Plan,HomeState Health Plan,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Humana Gold,Humana Gold,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Medicaid MO,Medicaid MO,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Medica,Medica,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Tricare,Tricare,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,UHC All Payer,UHC All Payer,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,UHC Exchange,UHC Exchange,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,UHC Medicaid,UHC Medicaid,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,UMR CPD,UMR CPD,5.2,,,,,,,per diem,5.2,5.2,"Per diem rate, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,UHC Medicare,UHC Medicare,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
KENDALL SAFE T VAC 12 # 31279 ,33142319,CDM,279,RC,,,,,,Inpatient,,,5.2,5.2,Wellcare,Wellcare,5.2,,,,,,,case rate,5.2,5.2,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Meritain Health PPO CPD,Meritain Health PPO CPD,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Aetna/Commercial Product,Aetna/Commercial Product,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Meritain Health CPD,Meritain Health CPD,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Starmark CPD,Starmark CPD,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Aetna Medicare,Aetna Medicare,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Ambetter ,Ambetter ,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Blue Access,Anthem Blue Access,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Blue Access Choice,Anthem Blue Access Choice,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Blue Preferred,Anthem Blue Preferred,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Pathway,Anthem Pathway,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Alliance,Anthem Alliance,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Anthem Medicare,Anthem Medicare,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Cigna,Cigna,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Cigna PPO,Cigna PPO,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Cigna Medicare Advantage,Cigna Medicare Advantage,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Essence,Essence,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Healthlink HMO,Healthlink HMO,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Healthlink PPO,Healthlink PPO,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,HomeState Health Plan,HomeState Health Plan,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Humana Gold,Humana Gold,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Medicaid MO,Medicaid MO,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Medica,Medica,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Tricare,Tricare,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,UHC All Payer,UHC All Payer,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,UHC Exchange,UHC Exchange,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,UHC Medicaid,UHC Medicaid,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,UMR CPD,UMR CPD,30.16,,,,,,,per diem,30.16,30.16,"Per diem rate, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,UHC Medicare,UHC Medicare,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
F&P CIRCUIT # RT202           ,33142324,CDM,279,RC,,,,,,Inpatient,,,30.16,30.16,Wellcare,Wellcare,30.16,,,,,,,case rate,30.16,30.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Meritain Health PPO CPD,Meritain Health PPO CPD,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Aetna/Commercial Product,Aetna/Commercial Product,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Meritain Health CPD,Meritain Health CPD,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Starmark CPD,Starmark CPD,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Aetna Medicare,Aetna Medicare,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Ambetter ,Ambetter ,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Blue Access,Anthem Blue Access,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Blue Access Choice,Anthem Blue Access Choice,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Blue Preferred,Anthem Blue Preferred,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Pathway,Anthem Pathway,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Alliance,Anthem Alliance,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Anthem Medicare,Anthem Medicare,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Cigna,Cigna,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Cigna PPO,Cigna PPO,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Cigna Medicare Advantage,Cigna Medicare Advantage,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Essence,Essence,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Healthlink HMO,Healthlink HMO,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Healthlink PPO,Healthlink PPO,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,HomeState Health Plan,HomeState Health Plan,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Humana Gold,Humana Gold,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Medicaid MO,Medicaid MO,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Medica,Medica,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Tricare,Tricare,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,UHC All Payer,UHC All Payer,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,UHC Exchange,UHC Exchange,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,UHC Medicaid,UHC Medicaid,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,UMR CPD,UMR CPD,186.16,,,,,,,per diem,186.16,186.16,"Per diem rate, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,UHC Medicare,UHC Medicare,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
DAYS BARIATRIC QUAD CANE      ,33142406,CDM,279,RC,,,,,,Inpatient,,,186.16,186.16,Wellcare,Wellcare,186.16,,,,,,,case rate,186.16,186.16,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Meritain Health PPO CPD,Meritain Health PPO CPD,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Aetna/Commercial Product,Aetna/Commercial Product,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Meritain Health CPD,Meritain Health CPD,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Starmark CPD,Starmark CPD,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Aetna Medicare,Aetna Medicare,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Ambetter ,Ambetter ,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Blue Access,Anthem Blue Access,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Blue Access Choice,Anthem Blue Access Choice,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Blue Preferred,Anthem Blue Preferred,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Pathway,Anthem Pathway,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Alliance,Anthem Alliance,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Anthem Medicare,Anthem Medicare,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Cigna,Cigna,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Cigna PPO,Cigna PPO,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Cigna Medicare Advantage,Cigna Medicare Advantage,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Essence,Essence,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Healthlink HMO,Healthlink HMO,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Healthlink PPO,Healthlink PPO,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,HomeState Health Plan,HomeState Health Plan,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Humana Gold,Humana Gold,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Medicaid MO,Medicaid MO,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Medica,Medica,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Tricare,Tricare,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,UHC All Payer,UHC All Payer,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,UHC Exchange,UHC Exchange,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,UHC Medicaid,UHC Medicaid,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,UMR CPD,UMR CPD,21.06,,,,,,,per diem,21.06,21.06,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,UHC Medicare,UHC Medicare,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 30-45IN      ,33142410,CDM,270,RC,,,,,,Inpatient,,,21.06,21.06,Wellcare,Wellcare,21.06,,,,,,,case rate,21.06,21.06,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Meritain Health PPO CPD,Meritain Health PPO CPD,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Aetna/Commercial Product,Aetna/Commercial Product,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Meritain Health CPD,Meritain Health CPD,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Starmark CPD,Starmark CPD,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Aetna Medicare,Aetna Medicare,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Ambetter ,Ambetter ,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Blue Access,Anthem Blue Access,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Blue Access Choice,Anthem Blue Access Choice,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Blue Preferred,Anthem Blue Preferred,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Pathway,Anthem Pathway,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Alliance,Anthem Alliance,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Anthem Medicare,Anthem Medicare,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Cigna,Cigna,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Cigna PPO,Cigna PPO,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Cigna Medicare Advantage,Cigna Medicare Advantage,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Essence,Essence,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Healthlink HMO,Healthlink HMO,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Healthlink PPO,Healthlink PPO,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,HomeState Health Plan,HomeState Health Plan,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Humana Gold,Humana Gold,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Medicaid MO,Medicaid MO,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Medica,Medica,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Tricare,Tricare,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,UHC All Payer,UHC All Payer,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,UHC Exchange,UHC Exchange,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,UHC Medicaid,UHC Medicaid,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,UMR CPD,UMR CPD,181.48,,,,,,,per diem,181.48,181.48,"Per diem rate, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,UHC Medicare,UHC Medicare,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
BARIATRIC QUAD CANE LARGE BASE,33142444,CDM,279,RC,,,,,,Inpatient,,,181.48,181.48,Wellcare,Wellcare,181.48,,,,,,,case rate,181.48,181.48,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health PPO CPD,Meritain Health PPO CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/Commercial Product,Aetna/Commercial Product,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health CPD,Meritain Health CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Starmark CPD,Starmark CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna Medicare,Aetna Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Ambetter ,Ambetter ,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access,Anthem Blue Access,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access Choice,Anthem Blue Access Choice,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Preferred,Anthem Blue Preferred,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Pathway,Anthem Pathway,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Alliance,Anthem Alliance,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Medicare,Anthem Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna,Cigna,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna PPO,Cigna PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna Medicare Advantage,Cigna Medicare Advantage,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Essence,Essence,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink HMO,Healthlink HMO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink PPO,Healthlink PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,HomeState Health Plan,HomeState Health Plan,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Humana Gold,Humana Gold,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medicaid MO,Medicaid MO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medica,Medica,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Tricare,Tricare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC All Payer,UHC All Payer,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Exchange,UHC Exchange,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicaid,UHC Medicaid,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UMR CPD,UMR CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicare,UHC Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LS   ",33142446,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Wellcare,Wellcare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health PPO CPD,Meritain Health PPO CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/Commercial Product,Aetna/Commercial Product,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health CPD,Meritain Health CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Starmark CPD,Starmark CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna Medicare,Aetna Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Ambetter ,Ambetter ,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access,Anthem Blue Access,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access Choice,Anthem Blue Access Choice,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Preferred,Anthem Blue Preferred,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Pathway,Anthem Pathway,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Alliance,Anthem Alliance,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Medicare,Anthem Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna,Cigna,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna PPO,Cigna PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna Medicare Advantage,Cigna Medicare Advantage,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Essence,Essence,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink HMO,Healthlink HMO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink PPO,Healthlink PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,HomeState Health Plan,HomeState Health Plan,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Humana Gold,Humana Gold,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medicaid MO,Medicaid MO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medica,Medica,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Tricare,Tricare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC All Payer,UHC All Payer,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Exchange,UHC Exchange,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicaid,UHC Medicaid,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UMR CPD,UMR CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicare,UHC Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RS   ",33142447,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Wellcare,Wellcare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Meritain Health PPO CPD,Meritain Health PPO CPD,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Aetna/Commercial Product,Aetna/Commercial Product,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Meritain Health CPD,Meritain Health CPD,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Starmark CPD,Starmark CPD,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Aetna Medicare,Aetna Medicare,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Ambetter ,Ambetter ,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Blue Access,Anthem Blue Access,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Blue Access Choice,Anthem Blue Access Choice,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Blue Preferred,Anthem Blue Preferred,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Pathway,Anthem Pathway,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Alliance,Anthem Alliance,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Anthem Medicare,Anthem Medicare,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Cigna,Cigna,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Cigna PPO,Cigna PPO,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Cigna Medicare Advantage,Cigna Medicare Advantage,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Essence,Essence,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Healthlink HMO,Healthlink HMO,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Healthlink PPO,Healthlink PPO,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,HomeState Health Plan,HomeState Health Plan,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Humana Gold,Humana Gold,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Medicaid MO,Medicaid MO,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Medica,Medica,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Tricare,Tricare,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,UHC All Payer,UHC All Payer,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,UHC Exchange,UHC Exchange,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,UHC Medicaid,UHC Medicaid,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,UMR CPD,UMR CPD,12.09,,,,,,,per diem,12.09,12.09,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,UHC Medicare,UHC Medicare,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142448,CDM,270,RC,,,,,,Inpatient,,,12.09,12.09,Wellcare,Wellcare,12.09,,,,,,,case rate,12.09,12.09,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health PPO CPD,Meritain Health PPO CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/Commercial Product,Aetna/Commercial Product,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health CPD,Meritain Health CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Starmark CPD,Starmark CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna Medicare,Aetna Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Ambetter ,Ambetter ,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access,Anthem Blue Access,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access Choice,Anthem Blue Access Choice,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Preferred,Anthem Blue Preferred,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Pathway,Anthem Pathway,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Alliance,Anthem Alliance,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Medicare,Anthem Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna,Cigna,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna PPO,Cigna PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna Medicare Advantage,Cigna Medicare Advantage,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Essence,Essence,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink HMO,Healthlink HMO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink PPO,Healthlink PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,HomeState Health Plan,HomeState Health Plan,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Humana Gold,Humana Gold,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medicaid MO,Medicaid MO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medica,Medica,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Tricare,Tricare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC All Payer,UHC All Payer,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Exchange,UHC Exchange,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicaid,UHC Medicaid,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UMR CPD,UMR CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicare,UHC Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LM   ",33142449,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Wellcare,Wellcare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health PPO CPD,Meritain Health PPO CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/Commercial Product,Aetna/Commercial Product,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health CPD,Meritain Health CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Starmark CPD,Starmark CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna Medicare,Aetna Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Ambetter ,Ambetter ,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access,Anthem Blue Access,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access Choice,Anthem Blue Access Choice,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Preferred,Anthem Blue Preferred,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Pathway,Anthem Pathway,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Alliance,Anthem Alliance,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Medicare,Anthem Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna,Cigna,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna PPO,Cigna PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna Medicare Advantage,Cigna Medicare Advantage,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Essence,Essence,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink HMO,Healthlink HMO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink PPO,Healthlink PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,HomeState Health Plan,HomeState Health Plan,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Humana Gold,Humana Gold,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medicaid MO,Medicaid MO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medica,Medica,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Tricare,Tricare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC All Payer,UHC All Payer,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Exchange,UHC Exchange,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicaid,UHC Medicaid,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UMR CPD,UMR CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicare,UHC Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST LL   ",33142450,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Wellcare,Wellcare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health PPO CPD,Meritain Health PPO CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna/Commercial Product,Aetna/Commercial Product,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Meritain Health CPD,Meritain Health CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Starmark CPD,Starmark CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Aetna Medicare,Aetna Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Ambetter ,Ambetter ,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access,Anthem Blue Access,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Access Choice,Anthem Blue Access Choice,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Blue Preferred,Anthem Blue Preferred,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Pathway,Anthem Pathway,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Alliance,Anthem Alliance,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Anthem Medicare,Anthem Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna,Cigna,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna PPO,Cigna PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Cigna Medicare Advantage,Cigna Medicare Advantage,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Essence,Essence,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink HMO,Healthlink HMO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Healthlink PPO,Healthlink PPO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,HomeState Health Plan,HomeState Health Plan,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Humana Gold,Humana Gold,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medicaid MO,Medicaid MO,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Medica,Medica,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Tricare,Tricare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC All Payer,UHC All Payer,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Exchange,UHC Exchange,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicaid,UHC Medicaid,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UMR CPD,UMR CPD,22.62,,,,,,,per diem,22.62,22.62,"Per diem rate, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,UHC Medicare,UHC Medicare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
"COMPRESSION GLOVE, WRIST RL   ",33142451,CDM,270,RC,,,,,,Inpatient,,,22.62,22.62,Wellcare,Wellcare,22.62,,,,,,,case rate,22.62,22.62,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Meritain Health PPO CPD,Meritain Health PPO CPD,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Aetna/Commercial Product,Aetna/Commercial Product,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Meritain Health CPD,Meritain Health CPD,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Starmark CPD,Starmark CPD,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Aetna Medicare,Aetna Medicare,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Ambetter ,Ambetter ,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Blue Access,Anthem Blue Access,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Blue Access Choice,Anthem Blue Access Choice,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Blue Preferred,Anthem Blue Preferred,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Pathway,Anthem Pathway,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Alliance,Anthem Alliance,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Anthem Medicare,Anthem Medicare,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Cigna,Cigna,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Cigna PPO,Cigna PPO,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Cigna Medicare Advantage,Cigna Medicare Advantage,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Essence,Essence,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Healthlink HMO,Healthlink HMO,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Healthlink PPO,Healthlink PPO,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,HomeState Health Plan,HomeState Health Plan,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Humana Gold,Humana Gold,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Medicaid MO,Medicaid MO,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Medica,Medica,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Tricare,Tricare,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,UHC All Payer,UHC All Payer,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,UHC Exchange,UHC Exchange,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,UHC Medicaid,UHC Medicaid,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,UMR CPD,UMR CPD,2.34,,,,,,,per diem,2.34,2.34,"Per diem rate, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,UHC Medicare,UHC Medicare,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP W/CLIK TITE CONNECTOR  ,33142454,CDM,279,RC,,,,,,Inpatient,,,2.34,2.34,Wellcare,Wellcare,2.34,,,,,,,case rate,2.34,2.34,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Meritain Health PPO CPD,Meritain Health PPO CPD,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Aetna/Commercial Product,Aetna/Commercial Product,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Meritain Health CPD,Meritain Health CPD,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Starmark CPD,Starmark CPD,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Aetna Medicare,Aetna Medicare,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Ambetter ,Ambetter ,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Blue Access,Anthem Blue Access,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Blue Access Choice,Anthem Blue Access Choice,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Blue Preferred,Anthem Blue Preferred,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Pathway,Anthem Pathway,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Alliance,Anthem Alliance,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Anthem Medicare,Anthem Medicare,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Cigna,Cigna,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Cigna PPO,Cigna PPO,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Cigna Medicare Advantage,Cigna Medicare Advantage,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Essence,Essence,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Healthlink HMO,Healthlink HMO,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Healthlink PPO,Healthlink PPO,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,HomeState Health Plan,HomeState Health Plan,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Humana Gold,Humana Gold,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Medicaid MO,Medicaid MO,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Medica,Medica,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Tricare,Tricare,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,UHC All Payer,UHC All Payer,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,UHC Exchange,UHC Exchange,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,UHC Medicaid,UHC Medicaid,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,UMR CPD,UMR CPD,2.6,,,,,,,per diem,2.6,2.6,"Per diem rate, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,UHC Medicare,UHC Medicare,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
T-PUMP CLASSIC #TP25          ,33142459,CDM,279,RC,,,,,,Inpatient,,,2.6,2.6,Wellcare,Wellcare,2.6,,,,,,,case rate,2.6,2.6,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Meritain Health PPO CPD,Meritain Health PPO CPD,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Aetna/Commercial Product,Aetna/Commercial Product,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Meritain Health CPD,Meritain Health CPD,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Starmark CPD,Starmark CPD,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Aetna Medicare,Aetna Medicare,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Ambetter ,Ambetter ,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Blue Access,Anthem Blue Access,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Blue Access Choice,Anthem Blue Access Choice,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Blue Preferred,Anthem Blue Preferred,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Pathway,Anthem Pathway,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Alliance,Anthem Alliance,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Anthem Medicare,Anthem Medicare,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Cigna,Cigna,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Cigna PPO,Cigna PPO,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Cigna Medicare Advantage,Cigna Medicare Advantage,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Essence,Essence,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Healthlink HMO,Healthlink HMO,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Healthlink PPO,Healthlink PPO,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,HomeState Health Plan,HomeState Health Plan,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Humana Gold,Humana Gold,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Medicaid MO,Medicaid MO,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Medica,Medica,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Tricare,Tricare,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,UHC All Payer,UHC All Payer,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,UHC Exchange,UHC Exchange,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,UHC Medicaid,UHC Medicaid,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,UMR CPD,UMR CPD,454.22,,,,,,,per diem,454.22,454.22,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,UHC Medicare,UHC Medicare,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB #4621001601 ,33142460,CDM,279,RC,,,,,,Inpatient,,,454.22,454.22,Wellcare,Wellcare,454.22,,,,,,,case rate,454.22,454.22,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Meritain Health PPO CPD,Meritain Health PPO CPD,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Aetna/Commercial Product,Aetna/Commercial Product,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Meritain Health CPD,Meritain Health CPD,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Starmark CPD,Starmark CPD,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Aetna Medicare,Aetna Medicare,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Ambetter ,Ambetter ,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Blue Access,Anthem Blue Access,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Blue Access Choice,Anthem Blue Access Choice,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Blue Preferred,Anthem Blue Preferred,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Pathway,Anthem Pathway,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Alliance,Anthem Alliance,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Anthem Medicare,Anthem Medicare,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Cigna,Cigna,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Cigna PPO,Cigna PPO,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Cigna Medicare Advantage,Cigna Medicare Advantage,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Essence,Essence,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Healthlink HMO,Healthlink HMO,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Healthlink PPO,Healthlink PPO,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,HomeState Health Plan,HomeState Health Plan,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Humana Gold,Humana Gold,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Medicaid MO,Medicaid MO,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Medica,Medica,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Tricare,Tricare,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,UHC All Payer,UHC All Payer,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,UHC Exchange,UHC Exchange,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,UHC Medicaid,UHC Medicaid,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,UMR CPD,UMR CPD,3.38,,,,,,,per diem,3.38,3.38,"Per diem rate, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,UHC Medicare,UHC Medicare,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
T-PUMP PROFESSIONAL #TP700    ,33142461,CDM,279,RC,,,,,,Inpatient,,,3.38,3.38,Wellcare,Wellcare,3.38,,,,,,,case rate,3.38,3.38,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Meritain Health PPO CPD,Meritain Health PPO CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna/Commercial Product,Aetna/Commercial Product,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Meritain Health CPD,Meritain Health CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Starmark CPD,Starmark CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Aetna Medicare,Aetna Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Ambetter ,Ambetter ,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Access,Anthem Blue Access,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Access Choice,Anthem Blue Access Choice,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Blue Preferred,Anthem Blue Preferred,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Pathway,Anthem Pathway,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Alliance,Anthem Alliance,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Anthem Medicare,Anthem Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna,Cigna,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna PPO,Cigna PPO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Cigna Medicare Advantage,Cigna Medicare Advantage,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Essence,Essence,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthlink HMO,Healthlink HMO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Healthlink PPO,Healthlink PPO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,HomeState Health Plan,HomeState Health Plan,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Humana Gold,Humana Gold,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Medicaid MO,Medicaid MO,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Medica,Medica,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Tricare,Tricare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC All Payer,UHC All Payer,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Exchange,UHC Exchange,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Medicaid,UHC Medicaid,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UMR CPD,UMR CPD,81.12,,,,,,,per diem,81.12,81.12,"Per diem rate, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,UHC Medicare,UHC Medicare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
AIR 2 LAL/PULSATE MATTRESS    ,33142462,CDM,279,RC,,,,,,Inpatient,,,81.12,81.12,Wellcare,Wellcare,81.12,,,,,,,case rate,81.12,81.12,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Meritain Health PPO CPD,Meritain Health PPO CPD,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Aetna/Commercial Product,Aetna/Commercial Product,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Meritain Health CPD,Meritain Health CPD,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Starmark CPD,Starmark CPD,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Aetna Medicare,Aetna Medicare,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Ambetter ,Ambetter ,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Blue Access,Anthem Blue Access,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Blue Access Choice,Anthem Blue Access Choice,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Blue Preferred,Anthem Blue Preferred,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Pathway,Anthem Pathway,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Alliance,Anthem Alliance,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Anthem Medicare,Anthem Medicare,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Cigna,Cigna,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Cigna PPO,Cigna PPO,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Cigna Medicare Advantage,Cigna Medicare Advantage,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Essence,Essence,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Healthlink HMO,Healthlink HMO,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Healthlink PPO,Healthlink PPO,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,HomeState Health Plan,HomeState Health Plan,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Humana Gold,Humana Gold,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Medicaid MO,Medicaid MO,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Medica,Medica,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Tricare,Tricare,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,UHC All Payer,UHC All Payer,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,UHC Exchange,UHC Exchange,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,UHC Medicaid,UHC Medicaid,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,UMR CPD,UMR CPD,48.95,,,,,,,per diem,48.95,48.95,"Per diem rate, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,UHC Medicare,UHC Medicare,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
BED EXTENDER FOR S3 BED #     ,33142463,CDM,279,RC,,,,,,Inpatient,,,48.95,48.95,Wellcare,Wellcare,48.95,,,,,,,case rate,48.95,48.95,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Meritain Health PPO CPD,Meritain Health PPO CPD,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Aetna/Commercial Product,Aetna/Commercial Product,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Meritain Health CPD,Meritain Health CPD,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Starmark CPD,Starmark CPD,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Aetna Medicare,Aetna Medicare,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Ambetter ,Ambetter ,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Blue Access,Anthem Blue Access,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Blue Access Choice,Anthem Blue Access Choice,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Blue Preferred,Anthem Blue Preferred,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Pathway,Anthem Pathway,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Alliance,Anthem Alliance,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Anthem Medicare,Anthem Medicare,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Cigna,Cigna,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Cigna PPO,Cigna PPO,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Cigna Medicare Advantage,Cigna Medicare Advantage,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Essence,Essence,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Healthlink HMO,Healthlink HMO,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Healthlink PPO,Healthlink PPO,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,HomeState Health Plan,HomeState Health Plan,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Humana Gold,Humana Gold,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Medicaid MO,Medicaid MO,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Medica,Medica,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Tricare,Tricare,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,UHC All Payer,UHC All Payer,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,UHC Exchange,UHC Exchange,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,UHC Medicaid,UHC Medicaid,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,UMR CPD,UMR CPD,14.56,,,,,,,per diem,14.56,14.56,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,UHC Medicare,UHC Medicare,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM >MONTH R,33142464,CDM,279,RC,,,,,,Inpatient,,,14.56,14.56,Wellcare,Wellcare,14.56,,,,,,,case rate,14.56,14.56,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Meritain Health PPO CPD,Meritain Health PPO CPD,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Aetna/Commercial Product,Aetna/Commercial Product,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Meritain Health CPD,Meritain Health CPD,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Starmark CPD,Starmark CPD,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Aetna Medicare,Aetna Medicare,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Ambetter ,Ambetter ,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Blue Access,Anthem Blue Access,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Blue Access Choice,Anthem Blue Access Choice,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Blue Preferred,Anthem Blue Preferred,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Pathway,Anthem Pathway,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Alliance,Anthem Alliance,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Anthem Medicare,Anthem Medicare,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Cigna,Cigna,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Cigna PPO,Cigna PPO,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Cigna Medicare Advantage,Cigna Medicare Advantage,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Essence,Essence,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Healthlink HMO,Healthlink HMO,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Healthlink PPO,Healthlink PPO,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,HomeState Health Plan,HomeState Health Plan,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Humana Gold,Humana Gold,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Medicaid MO,Medicaid MO,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Medica,Medica,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Tricare,Tricare,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,UHC All Payer,UHC All Payer,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,UHC Exchange,UHC Exchange,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,UHC Medicaid,UHC Medicaid,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,UMR CPD,UMR CPD,18.2,,,,,,,per diem,18.2,18.2,"Per diem rate, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,UHC Medicare,UHC Medicare,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
OPTIMA LOWER LIMB CPM DAILY RE,33142465,CDM,279,RC,,,,,,Inpatient,,,18.2,18.2,Wellcare,Wellcare,18.2,,,,,,,case rate,18.2,18.2,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Meritain Health PPO CPD,Meritain Health PPO CPD,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Aetna/Commercial Product,Aetna/Commercial Product,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Meritain Health CPD,Meritain Health CPD,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Starmark CPD,Starmark CPD,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Aetna Medicare,Aetna Medicare,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Ambetter ,Ambetter ,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Blue Access,Anthem Blue Access,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Blue Access Choice,Anthem Blue Access Choice,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Blue Preferred,Anthem Blue Preferred,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Pathway,Anthem Pathway,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Alliance,Anthem Alliance,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Anthem Medicare,Anthem Medicare,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Cigna,Cigna,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Cigna PPO,Cigna PPO,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Cigna Medicare Advantage,Cigna Medicare Advantage,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Essence,Essence,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Healthlink HMO,Healthlink HMO,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Healthlink PPO,Healthlink PPO,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,HomeState Health Plan,HomeState Health Plan,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Humana Gold,Humana Gold,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Medicaid MO,Medicaid MO,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Medica,Medica,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Tricare,Tricare,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,UHC All Payer,UHC All Payer,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,UHC Exchange,UHC Exchange,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,UHC Medicaid,UHC Medicaid,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,UMR CPD,UMR CPD,431.34,,,,,,,per diem,431.34,431.34,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,UHC Medicare,UHC Medicare,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY RE,33142466,CDM,279,RC,,,,,,Inpatient,,,431.34,431.34,Wellcare,Wellcare,431.34,,,,,,,case rate,431.34,431.34,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Meritain Health PPO CPD,Meritain Health PPO CPD,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Aetna/Commercial Product,Aetna/Commercial Product,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Meritain Health CPD,Meritain Health CPD,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Starmark CPD,Starmark CPD,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Aetna Medicare,Aetna Medicare,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Ambetter ,Ambetter ,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Blue Access,Anthem Blue Access,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Blue Access Choice,Anthem Blue Access Choice,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Blue Preferred,Anthem Blue Preferred,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Pathway,Anthem Pathway,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Alliance,Anthem Alliance,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Anthem Medicare,Anthem Medicare,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Cigna,Cigna,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Cigna PPO,Cigna PPO,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Cigna Medicare Advantage,Cigna Medicare Advantage,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Essence,Essence,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Healthlink HMO,Healthlink HMO,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Healthlink PPO,Healthlink PPO,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,HomeState Health Plan,HomeState Health Plan,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Humana Gold,Humana Gold,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Medicaid MO,Medicaid MO,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Medica,Medica,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Tricare,Tricare,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,UHC All Payer,UHC All Payer,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,UHC Exchange,UHC Exchange,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,UHC Medicaid,UHC Medicaid,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,UMR CPD,UMR CPD,1565.2,,,,,,,per diem,1565.2,1565.2,"Per diem rate, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,UHC Medicare,UHC Medicare,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP MACHINE RENTAL DAILY    ,33142468,CDM,279,RC,,,,,,Inpatient,,,1565.2,1565.2,Wellcare,Wellcare,1565.2,,,,,,,case rate,1565.2,1565.2,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Meritain Health PPO CPD,Meritain Health PPO CPD,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Aetna/Commercial Product,Aetna/Commercial Product,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Meritain Health CPD,Meritain Health CPD,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Starmark CPD,Starmark CPD,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Aetna Medicare,Aetna Medicare,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Ambetter ,Ambetter ,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Blue Access,Anthem Blue Access,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Blue Access Choice,Anthem Blue Access Choice,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Blue Preferred,Anthem Blue Preferred,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Pathway,Anthem Pathway,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Alliance,Anthem Alliance,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Anthem Medicare,Anthem Medicare,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Cigna,Cigna,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Cigna PPO,Cigna PPO,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Cigna Medicare Advantage,Cigna Medicare Advantage,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Essence,Essence,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Healthlink HMO,Healthlink HMO,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Healthlink PPO,Healthlink PPO,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,HomeState Health Plan,HomeState Health Plan,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Humana Gold,Humana Gold,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Medicaid MO,Medicaid MO,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Medica,Medica,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Tricare,Tricare,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,UHC All Payer,UHC All Payer,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,UHC Exchange,UHC Exchange,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,UHC Medicaid,UHC Medicaid,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,UMR CPD,UMR CPD,98.03,,,,,,,per diem,98.03,98.03,"Per diem rate, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,UHC Medicare,UHC Medicare,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
BIPAP HUMIDIFER RENTAL        ,33142469,CDM,279,RC,,,,,,Inpatient,,,98.03,98.03,Wellcare,Wellcare,98.03,,,,,,,case rate,98.03,98.03,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP MACHINE RENTAL           ,33142471,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Meritain Health PPO CPD,Meritain Health PPO CPD,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Aetna/Commercial Product,Aetna/Commercial Product,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Meritain Health CPD,Meritain Health CPD,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Starmark CPD,Starmark CPD,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Aetna Medicare,Aetna Medicare,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Ambetter ,Ambetter ,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Blue Access,Anthem Blue Access,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Blue Access Choice,Anthem Blue Access Choice,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Blue Preferred,Anthem Blue Preferred,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Pathway,Anthem Pathway,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Alliance,Anthem Alliance,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Anthem Medicare,Anthem Medicare,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Cigna,Cigna,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Cigna PPO,Cigna PPO,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Cigna Medicare Advantage,Cigna Medicare Advantage,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Essence,Essence,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Healthlink HMO,Healthlink HMO,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Healthlink PPO,Healthlink PPO,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,HomeState Health Plan,HomeState Health Plan,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Humana Gold,Humana Gold,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Medicaid MO,Medicaid MO,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Medica,Medica,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Tricare,Tricare,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,UHC All Payer,UHC All Payer,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,UHC Exchange,UHC Exchange,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,UHC Medicaid,UHC Medicaid,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,UMR CPD,UMR CPD,185.38,,,,,,,per diem,185.38,185.38,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,UHC Medicare,UHC Medicare,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFER                ,33142472,CDM,279,RC,,,,,,Inpatient,,,185.38,185.38,Wellcare,Wellcare,185.38,,,,,,,case rate,185.38,185.38,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Meritain Health PPO CPD,Meritain Health PPO CPD,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Aetna/Commercial Product,Aetna/Commercial Product,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Meritain Health CPD,Meritain Health CPD,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Starmark CPD,Starmark CPD,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Aetna Medicare,Aetna Medicare,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Ambetter ,Ambetter ,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Blue Access,Anthem Blue Access,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Blue Access Choice,Anthem Blue Access Choice,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Blue Preferred,Anthem Blue Preferred,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Pathway,Anthem Pathway,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Alliance,Anthem Alliance,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Anthem Medicare,Anthem Medicare,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Cigna,Cigna,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Cigna PPO,Cigna PPO,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Cigna Medicare Advantage,Cigna Medicare Advantage,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Essence,Essence,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Healthlink HMO,Healthlink HMO,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Healthlink PPO,Healthlink PPO,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,HomeState Health Plan,HomeState Health Plan,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Humana Gold,Humana Gold,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Medicaid MO,Medicaid MO,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Medica,Medica,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Tricare,Tricare,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,UHC All Payer,UHC All Payer,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,UHC Exchange,UHC Exchange,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,UHC Medicaid,UHC Medicaid,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,UMR CPD,UMR CPD,42.12,,,,,,,per diem,42.12,42.12,"Per diem rate, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,UHC Medicare,UHC Medicare,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
MULTIPAD TP200 13X8           ,33142473,CDM,270,RC,,,,,,Inpatient,,,42.12,42.12,Wellcare,Wellcare,42.12,,,,,,,case rate,42.12,42.12,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Meritain Health PPO CPD,Meritain Health PPO CPD,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Aetna/Commercial Product,Aetna/Commercial Product,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Meritain Health CPD,Meritain Health CPD,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Starmark CPD,Starmark CPD,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Aetna Medicare,Aetna Medicare,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Ambetter ,Ambetter ,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Blue Access,Anthem Blue Access,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Blue Access Choice,Anthem Blue Access Choice,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Blue Preferred,Anthem Blue Preferred,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Pathway,Anthem Pathway,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Alliance,Anthem Alliance,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Anthem Medicare,Anthem Medicare,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Cigna,Cigna,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Cigna PPO,Cigna PPO,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Cigna Medicare Advantage,Cigna Medicare Advantage,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Essence,Essence,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Healthlink HMO,Healthlink HMO,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Healthlink PPO,Healthlink PPO,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,HomeState Health Plan,HomeState Health Plan,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Humana Gold,Humana Gold,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Medicaid MO,Medicaid MO,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Medica,Medica,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Tricare,Tricare,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,UHC All Payer,UHC All Payer,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,UHC Exchange,UHC Exchange,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,UHC Medicaid,UHC Medicaid,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,UMR CPD,UMR CPD,1340,,,,,,,per diem,1340,1340,"Per diem rate, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,UHC Medicare,UHC Medicare,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO PLASTIC W ANK JNT CUSTOM  ,33142478,CDM,279,RC,L1970,HCPCS,,,,Inpatient,,,1340,1340,Wellcare,Wellcare,1340,,,,,,,case rate,1340,1340,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Meritain Health PPO CPD,Meritain Health PPO CPD,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Aetna/Commercial Product,Aetna/Commercial Product,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Meritain Health CPD,Meritain Health CPD,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Starmark CPD,Starmark CPD,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Aetna Medicare,Aetna Medicare,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Ambetter ,Ambetter ,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Blue Access,Anthem Blue Access,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Blue Access Choice,Anthem Blue Access Choice,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Blue Preferred,Anthem Blue Preferred,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Pathway,Anthem Pathway,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Alliance,Anthem Alliance,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Anthem Medicare,Anthem Medicare,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Cigna,Cigna,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Cigna PPO,Cigna PPO,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Cigna Medicare Advantage,Cigna Medicare Advantage,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Essence,Essence,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Healthlink HMO,Healthlink HMO,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Healthlink PPO,Healthlink PPO,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,HomeState Health Plan,HomeState Health Plan,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Humana Gold,Humana Gold,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Medicaid MO,Medicaid MO,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Medica,Medica,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Tricare,Tricare,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,UHC All Payer,UHC All Payer,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,UHC Exchange,UHC Exchange,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,UHC Medicaid,UHC Medicaid,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,UMR CPD,UMR CPD,1096,,,,,,,per diem,1096,1096,"Per diem rate, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,UHC Medicare,UHC Medicare,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SOLID POSTERIOR ANK CUSTOM,33142479,CDM,279,RC,L1960,HCPCS,,,,Inpatient,,,1096,1096,Wellcare,Wellcare,1096,,,,,,,case rate,1096,1096,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Meritain Health PPO CPD,Meritain Health PPO CPD,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Aetna/Commercial Product,Aetna/Commercial Product,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Meritain Health CPD,Meritain Health CPD,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Starmark CPD,Starmark CPD,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Aetna Medicare,Aetna Medicare,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Ambetter ,Ambetter ,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Blue Access,Anthem Blue Access,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Blue Access Choice,Anthem Blue Access Choice,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Blue Preferred,Anthem Blue Preferred,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Pathway,Anthem Pathway,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Alliance,Anthem Alliance,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Anthem Medicare,Anthem Medicare,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Cigna,Cigna,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Cigna PPO,Cigna PPO,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Cigna Medicare Advantage,Cigna Medicare Advantage,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Essence,Essence,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Healthlink HMO,Healthlink HMO,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Healthlink PPO,Healthlink PPO,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,HomeState Health Plan,HomeState Health Plan,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Humana Gold,Humana Gold,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Medicaid MO,Medicaid MO,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Medica,Medica,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Tricare,Tricare,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,UHC All Payer,UHC All Payer,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,UHC Exchange,UHC Exchange,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,UHC Medicaid,UHC Medicaid,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,UMR CPD,UMR CPD,1506,,,,,,,per diem,1506,1506,"Per diem rate, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,UHC Medicare,UHC Medicare,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
AFO SPIRAL PLAST/OTHER PREFAB ,33142480,CDM,279,RC,L1951,HCPCS,,,,Inpatient,,,1506,1506,Wellcare,Wellcare,1506,,,,,,,case rate,1506,1506,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Meritain Health PPO CPD,Meritain Health PPO CPD,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Aetna/Commercial Product,Aetna/Commercial Product,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Meritain Health CPD,Meritain Health CPD,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Starmark CPD,Starmark CPD,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Aetna Medicare,Aetna Medicare,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Ambetter ,Ambetter ,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Blue Access,Anthem Blue Access,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Blue Access Choice,Anthem Blue Access Choice,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Blue Preferred,Anthem Blue Preferred,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Pathway,Anthem Pathway,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Alliance,Anthem Alliance,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Anthem Medicare,Anthem Medicare,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Cigna,Cigna,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Cigna PPO,Cigna PPO,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Cigna Medicare Advantage,Cigna Medicare Advantage,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Essence,Essence,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Healthlink HMO,Healthlink HMO,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Healthlink PPO,Healthlink PPO,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,HomeState Health Plan,HomeState Health Plan,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Humana Gold,Humana Gold,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Medicaid MO,Medicaid MO,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Medica,Medica,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Tricare,Tricare,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,UHC All Payer,UHC All Payer,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,UHC Exchange,UHC Exchange,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,UHC Medicaid,UHC Medicaid,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,UMR CPD,UMR CPD,92.09,,,,,,,per diem,92.09,92.09,"Per diem rate, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,UHC Medicare,UHC Medicare,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
SHOE LIFT HEEL/SOLE NEO INCH  ,33142481,CDM,279,RC,L3310,CPT,L3310,HCPCS,,Inpatient,,,92.09,92.09,Wellcare,Wellcare,92.09,,,,,,,case rate,92.09,92.09,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Meritain Health PPO CPD,Meritain Health PPO CPD,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Aetna/Commercial Product,Aetna/Commercial Product,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Meritain Health CPD,Meritain Health CPD,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Starmark CPD,Starmark CPD,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Aetna Medicare,Aetna Medicare,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Ambetter ,Ambetter ,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Blue Access,Anthem Blue Access,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Blue Access Choice,Anthem Blue Access Choice,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Blue Preferred,Anthem Blue Preferred,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Pathway,Anthem Pathway,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Alliance,Anthem Alliance,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Anthem Medicare,Anthem Medicare,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Cigna,Cigna,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Cigna PPO,Cigna PPO,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Cigna Medicare Advantage,Cigna Medicare Advantage,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Essence,Essence,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Healthlink HMO,Healthlink HMO,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Healthlink PPO,Healthlink PPO,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,HomeState Health Plan,HomeState Health Plan,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Humana Gold,Humana Gold,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Medicaid MO,Medicaid MO,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Medica,Medica,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Tricare,Tricare,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,UHC All Payer,UHC All Payer,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,UHC Exchange,UHC Exchange,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,UHC Medicaid,UHC Medicaid,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,UMR CPD,UMR CPD,592.59,,,,,,,per diem,592.59,592.59,"Per diem rate, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,UHC Medicare,UHC Medicare,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
KO DBL UPRT JNT MLDED PREFB   ,33142482,CDM,274,RC,L1845,HCPCS,,,,Inpatient,,,592.59,592.59,Wellcare,Wellcare,592.59,,,,,,,case rate,592.59,592.59,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Meritain Health PPO CPD,Meritain Health PPO CPD,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Aetna/Commercial Product,Aetna/Commercial Product,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Meritain Health CPD,Meritain Health CPD,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Starmark CPD,Starmark CPD,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Aetna Medicare,Aetna Medicare,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Ambetter ,Ambetter ,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Blue Access,Anthem Blue Access,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Blue Access Choice,Anthem Blue Access Choice,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Blue Preferred,Anthem Blue Preferred,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Pathway,Anthem Pathway,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Alliance,Anthem Alliance,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Anthem Medicare,Anthem Medicare,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Cigna,Cigna,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Cigna PPO,Cigna PPO,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Cigna Medicare Advantage,Cigna Medicare Advantage,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Essence,Essence,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Healthlink HMO,Healthlink HMO,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Healthlink PPO,Healthlink PPO,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,HomeState Health Plan,HomeState Health Plan,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Humana Gold,Humana Gold,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Medicaid MO,Medicaid MO,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Medica,Medica,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Tricare,Tricare,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,UHC All Payer,UHC All Payer,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,UHC Exchange,UHC Exchange,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,UHC Medicaid,UHC Medicaid,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,UMR CPD,UMR CPD,436.5,,,,,,,per diem,436.5,436.5,"Per diem rate, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,UHC Medicare,UHC Medicare,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
AFO/PRAFO STATIC              ,33142483,CDM,279,RC,L4396,CPT,L4396,HCPCS,,Inpatient,,,436.5,436.5,Wellcare,Wellcare,436.5,,,,,,,case rate,436.5,436.5,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Meritain Health PPO CPD,Meritain Health PPO CPD,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Aetna/Commercial Product,Aetna/Commercial Product,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Meritain Health CPD,Meritain Health CPD,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Starmark CPD,Starmark CPD,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Aetna Medicare,Aetna Medicare,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Ambetter ,Ambetter ,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Blue Access,Anthem Blue Access,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Blue Access Choice,Anthem Blue Access Choice,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Blue Preferred,Anthem Blue Preferred,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Pathway,Anthem Pathway,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Alliance,Anthem Alliance,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Anthem Medicare,Anthem Medicare,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Cigna,Cigna,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Cigna PPO,Cigna PPO,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Cigna Medicare Advantage,Cigna Medicare Advantage,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Essence,Essence,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Healthlink HMO,Healthlink HMO,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Healthlink PPO,Healthlink PPO,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,HomeState Health Plan,HomeState Health Plan,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Humana Gold,Humana Gold,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Medicaid MO,Medicaid MO,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Medica,Medica,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Tricare,Tricare,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,UHC All Payer,UHC All Payer,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,UHC Exchange,UHC Exchange,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,UHC Medicaid,UHC Medicaid,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,UMR CPD,UMR CPD,64.93,,,,,,,per diem,64.93,64.93,"Per diem rate, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,UHC Medicare,UHC Medicare,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"CERV COLLAR, MIAMI J/ASPEN    ",33142485,CDM,274,RC,E1399,CPT,E1399,HCPCS,,Inpatient,,,64.93,64.93,Wellcare,Wellcare,64.93,,,,,,,case rate,64.93,64.93,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Meritain Health PPO CPD,Meritain Health PPO CPD,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Aetna/Commercial Product,Aetna/Commercial Product,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Meritain Health CPD,Meritain Health CPD,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Starmark CPD,Starmark CPD,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Aetna Medicare,Aetna Medicare,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Ambetter ,Ambetter ,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Blue Access,Anthem Blue Access,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Blue Access Choice,Anthem Blue Access Choice,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Blue Preferred,Anthem Blue Preferred,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Pathway,Anthem Pathway,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Alliance,Anthem Alliance,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Anthem Medicare,Anthem Medicare,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Cigna,Cigna,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Cigna PPO,Cigna PPO,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Cigna Medicare Advantage,Cigna Medicare Advantage,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Essence,Essence,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Healthlink HMO,Healthlink HMO,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Healthlink PPO,Healthlink PPO,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,HomeState Health Plan,HomeState Health Plan,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Humana Gold,Humana Gold,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Medicaid MO,Medicaid MO,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Medica,Medica,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Tricare,Tricare,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,UHC All Payer,UHC All Payer,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,UHC Exchange,UHC Exchange,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,UHC Medicaid,UHC Medicaid,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,UMR CPD,UMR CPD,111.3,,,,,,,per diem,111.3,111.3,"Per diem rate, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,UHC Medicare,UHC Medicare,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
"HEADMASTER COLLER, PER EA, OTS",33142486,CDM,274,RC,L0160,CPT,L0160,HCPCS,,Inpatient,,,111.3,111.3,Wellcare,Wellcare,111.3,,,,,,,case rate,111.3,111.3,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Meritain Health PPO CPD,Meritain Health PPO CPD,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Aetna/Commercial Product,Aetna/Commercial Product,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Meritain Health CPD,Meritain Health CPD,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Starmark CPD,Starmark CPD,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Aetna Medicare,Aetna Medicare,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Ambetter ,Ambetter ,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Blue Access,Anthem Blue Access,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Blue Access Choice,Anthem Blue Access Choice,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Blue Preferred,Anthem Blue Preferred,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Pathway,Anthem Pathway,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Alliance,Anthem Alliance,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Anthem Medicare,Anthem Medicare,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Cigna,Cigna,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Cigna PPO,Cigna PPO,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Cigna Medicare Advantage,Cigna Medicare Advantage,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Essence,Essence,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Healthlink HMO,Healthlink HMO,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Healthlink PPO,Healthlink PPO,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,HomeState Health Plan,HomeState Health Plan,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Humana Gold,Humana Gold,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Medicaid MO,Medicaid MO,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Medica,Medica,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Tricare,Tricare,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,UHC All Payer,UHC All Payer,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,UHC Exchange,UHC Exchange,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,UHC Medicaid,UHC Medicaid,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,UMR CPD,UMR CPD,1840,,,,,,,per diem,1840,1840,"Per diem rate, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,UHC Medicare,UHC Medicare,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
PREFAB CARBON FIB AFO W/ANT   ,33142487,CDM,274,RC,L1932,CPT,L1932,HCPCS,,Inpatient,,,1840,1840,Wellcare,Wellcare,1840,,,,,,,case rate,1840,1840,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Meritain Health PPO CPD,Meritain Health PPO CPD,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Aetna/Commercial Product,Aetna/Commercial Product,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Meritain Health CPD,Meritain Health CPD,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Starmark CPD,Starmark CPD,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Aetna Medicare,Aetna Medicare,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Ambetter ,Ambetter ,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Blue Access,Anthem Blue Access,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Blue Access Choice,Anthem Blue Access Choice,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Blue Preferred,Anthem Blue Preferred,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Pathway,Anthem Pathway,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Alliance,Anthem Alliance,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Anthem Medicare,Anthem Medicare,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Cigna,Cigna,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Cigna PPO,Cigna PPO,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Cigna Medicare Advantage,Cigna Medicare Advantage,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Essence,Essence,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Healthlink HMO,Healthlink HMO,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Healthlink PPO,Healthlink PPO,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,HomeState Health Plan,HomeState Health Plan,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Humana Gold,Humana Gold,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Medicaid MO,Medicaid MO,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Medica,Medica,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Tricare,Tricare,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,UHC All Payer,UHC All Payer,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,UHC Exchange,UHC Exchange,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,UHC Medicaid,UHC Medicaid,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,UMR CPD,UMR CPD,101.15,,,,,,,per diem,101.15,101.15,"Per diem rate, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,UHC Medicare,UHC Medicare,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
SHOE/BOOT SURG POST OP AMBULTR,33142489,CDM,274,RC,L3260,CPT,L3260,HCPCS,,Inpatient,,,101.15,101.15,Wellcare,Wellcare,101.15,,,,,,,case rate,101.15,101.15,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Meritain Health PPO CPD,Meritain Health PPO CPD,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Aetna/Commercial Product,Aetna/Commercial Product,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Meritain Health CPD,Meritain Health CPD,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Starmark CPD,Starmark CPD,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Aetna Medicare,Aetna Medicare,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Ambetter ,Ambetter ,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Blue Access,Anthem Blue Access,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Blue Access Choice,Anthem Blue Access Choice,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Blue Preferred,Anthem Blue Preferred,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Pathway,Anthem Pathway,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Alliance,Anthem Alliance,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Anthem Medicare,Anthem Medicare,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Cigna,Cigna,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Cigna PPO,Cigna PPO,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Cigna Medicare Advantage,Cigna Medicare Advantage,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Essence,Essence,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Healthlink HMO,Healthlink HMO,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Healthlink PPO,Healthlink PPO,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,HomeState Health Plan,HomeState Health Plan,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Humana Gold,Humana Gold,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Medicaid MO,Medicaid MO,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Medica,Medica,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Tricare,Tricare,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,UHC All Payer,UHC All Payer,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,UHC Exchange,UHC Exchange,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,UHC Medicaid,UHC Medicaid,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,UMR CPD,UMR CPD,18.55,,,,,,,per diem,18.55,18.55,"Per diem rate, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,UHC Medicare,UHC Medicare,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
REPLACEMENT PAD ASPEN         ,33142490,CDM,274,RC,L4210,CPT,L4210,HCPCS,,Inpatient,,,18.55,18.55,Wellcare,Wellcare,18.55,,,,,,,case rate,18.55,18.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Meritain Health PPO CPD,Meritain Health PPO CPD,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Aetna/Commercial Product,Aetna/Commercial Product,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Meritain Health CPD,Meritain Health CPD,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Starmark CPD,Starmark CPD,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Aetna Medicare,Aetna Medicare,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Ambetter ,Ambetter ,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Blue Access,Anthem Blue Access,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Blue Access Choice,Anthem Blue Access Choice,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Blue Preferred,Anthem Blue Preferred,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Pathway,Anthem Pathway,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Alliance,Anthem Alliance,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Anthem Medicare,Anthem Medicare,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Cigna,Cigna,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Cigna PPO,Cigna PPO,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Cigna Medicare Advantage,Cigna Medicare Advantage,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Essence,Essence,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Healthlink HMO,Healthlink HMO,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Healthlink PPO,Healthlink PPO,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,HomeState Health Plan,HomeState Health Plan,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Humana Gold,Humana Gold,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Medicaid MO,Medicaid MO,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Medica,Medica,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Tricare,Tricare,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,UHC All Payer,UHC All Payer,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,UHC Exchange,UHC Exchange,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,UHC Medicaid,UHC Medicaid,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,UMR CPD,UMR CPD,74.55,,,,,,,per diem,74.55,74.55,"Per diem rate, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,UHC Medicare,UHC Medicare,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
"SPLINT, FOOT, METAL ALL SIZES ",33142491,CDM,274,RC,,,,,,Inpatient,,,74.55,74.55,Wellcare,Wellcare,74.55,,,,,,,case rate,74.55,74.55,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Meritain Health PPO CPD,Meritain Health PPO CPD,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Aetna/Commercial Product,Aetna/Commercial Product,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Meritain Health CPD,Meritain Health CPD,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Starmark CPD,Starmark CPD,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Aetna Medicare,Aetna Medicare,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Ambetter ,Ambetter ,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Blue Access,Anthem Blue Access,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Blue Access Choice,Anthem Blue Access Choice,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Blue Preferred,Anthem Blue Preferred,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Pathway,Anthem Pathway,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Alliance,Anthem Alliance,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Anthem Medicare,Anthem Medicare,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Cigna,Cigna,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Cigna PPO,Cigna PPO,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Cigna Medicare Advantage,Cigna Medicare Advantage,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Essence,Essence,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Healthlink HMO,Healthlink HMO,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Healthlink PPO,Healthlink PPO,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,HomeState Health Plan,HomeState Health Plan,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Humana Gold,Humana Gold,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Medicaid MO,Medicaid MO,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Medica,Medica,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Tricare,Tricare,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,UHC All Payer,UHC All Payer,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,UHC Exchange,UHC Exchange,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,UHC Medicaid,UHC Medicaid,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,UMR CPD,UMR CPD,413,,,,,,,per diem,413,413,"Per diem rate, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,UHC Medicare,UHC Medicare,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
AFO PLASTIC - OTHER CUSTOM    ,33142494,CDM,274,RC,L1940,CPT,L1940,HCPCS,,Inpatient,,,413,413,Wellcare,Wellcare,413,,,,,,,case rate,413,413,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Meritain Health PPO CPD,Meritain Health PPO CPD,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Aetna/Commercial Product,Aetna/Commercial Product,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Meritain Health CPD,Meritain Health CPD,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Starmark CPD,Starmark CPD,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Aetna Medicare,Aetna Medicare,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Ambetter ,Ambetter ,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Blue Access,Anthem Blue Access,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Blue Access Choice,Anthem Blue Access Choice,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Blue Preferred,Anthem Blue Preferred,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Pathway,Anthem Pathway,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Alliance,Anthem Alliance,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Anthem Medicare,Anthem Medicare,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Cigna,Cigna,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Cigna PPO,Cigna PPO,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Cigna Medicare Advantage,Cigna Medicare Advantage,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Essence,Essence,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Healthlink HMO,Healthlink HMO,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Healthlink PPO,Healthlink PPO,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,HomeState Health Plan,HomeState Health Plan,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Humana Gold,Humana Gold,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Medicaid MO,Medicaid MO,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Medica,Medica,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Tricare,Tricare,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,UHC All Payer,UHC All Payer,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,UHC Exchange,UHC Exchange,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,UHC Medicaid,UHC Medicaid,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,UMR CPD,UMR CPD,21.2,,,,,,,per diem,21.2,21.2,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,UHC Medicare,UHC Medicare,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 3 PANEL      ,33144027,CDM,270,RC,,,,,,Inpatient,,,21.2,21.2,Wellcare,Wellcare,21.2,,,,,,,case rate,21.2,21.2,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Meritain Health PPO CPD,Meritain Health PPO CPD,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Aetna/Commercial Product,Aetna/Commercial Product,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Meritain Health CPD,Meritain Health CPD,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Starmark CPD,Starmark CPD,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Aetna Medicare,Aetna Medicare,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Ambetter ,Ambetter ,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Blue Access,Anthem Blue Access,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Blue Access Choice,Anthem Blue Access Choice,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Blue Preferred,Anthem Blue Preferred,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Pathway,Anthem Pathway,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Alliance,Anthem Alliance,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Anthem Medicare,Anthem Medicare,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Cigna,Cigna,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Cigna PPO,Cigna PPO,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Cigna Medicare Advantage,Cigna Medicare Advantage,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Essence,Essence,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Healthlink HMO,Healthlink HMO,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Healthlink PPO,Healthlink PPO,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,HomeState Health Plan,HomeState Health Plan,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Humana Gold,Humana Gold,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Medicaid MO,Medicaid MO,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Medica,Medica,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Tricare,Tricare,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,UHC All Payer,UHC All Payer,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,UHC Exchange,UHC Exchange,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,UHC Medicaid,UHC Medicaid,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,UMR CPD,UMR CPD,22.74,,,,,,,per diem,22.74,22.74,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,UHC Medicare,UHC Medicare,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 4 PANEL      ,33144028,CDM,270,RC,,,,,,Inpatient,,,22.74,22.74,Wellcare,Wellcare,22.74,,,,,,,case rate,22.74,22.74,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Meritain Health PPO CPD,Meritain Health PPO CPD,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Aetna/Commercial Product,Aetna/Commercial Product,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Meritain Health CPD,Meritain Health CPD,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Starmark CPD,Starmark CPD,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Aetna Medicare,Aetna Medicare,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Ambetter ,Ambetter ,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Blue Access,Anthem Blue Access,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Blue Access Choice,Anthem Blue Access Choice,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Blue Preferred,Anthem Blue Preferred,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Pathway,Anthem Pathway,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Alliance,Anthem Alliance,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Anthem Medicare,Anthem Medicare,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Cigna,Cigna,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Cigna PPO,Cigna PPO,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Cigna Medicare Advantage,Cigna Medicare Advantage,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Essence,Essence,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Healthlink HMO,Healthlink HMO,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Healthlink PPO,Healthlink PPO,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,HomeState Health Plan,HomeState Health Plan,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Humana Gold,Humana Gold,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Medicaid MO,Medicaid MO,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Medica,Medica,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Tricare,Tricare,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,UHC All Payer,UHC All Payer,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,UHC Exchange,UHC Exchange,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,UHC Medicaid,UHC Medicaid,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,UMR CPD,UMR CPD,69.09,,,,,,,per diem,69.09,69.09,"Per diem rate, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,UHC Medicare,UHC Medicare,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
SEAT CUSHION WAFFLE           ,33144050,CDM,279,RC,,,,,,Inpatient,,,69.09,69.09,Wellcare,Wellcare,69.09,,,,,,,case rate,69.09,69.09,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Meritain Health PPO CPD,Meritain Health PPO CPD,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Aetna/Commercial Product,Aetna/Commercial Product,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Meritain Health CPD,Meritain Health CPD,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Starmark CPD,Starmark CPD,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Aetna Medicare,Aetna Medicare,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Ambetter ,Ambetter ,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Blue Access,Anthem Blue Access,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Blue Access Choice,Anthem Blue Access Choice,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Blue Preferred,Anthem Blue Preferred,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Pathway,Anthem Pathway,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Alliance,Anthem Alliance,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Anthem Medicare,Anthem Medicare,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Cigna,Cigna,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Cigna PPO,Cigna PPO,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Cigna Medicare Advantage,Cigna Medicare Advantage,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Essence,Essence,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Healthlink HMO,Healthlink HMO,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Healthlink PPO,Healthlink PPO,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,HomeState Health Plan,HomeState Health Plan,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Humana Gold,Humana Gold,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Medicaid MO,Medicaid MO,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Medica,Medica,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Tricare,Tricare,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,UHC All Payer,UHC All Payer,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,UHC Exchange,UHC Exchange,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,UHC Medicaid,UHC Medicaid,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,UMR CPD,UMR CPD,137.23,,,,,,,per diem,137.23,137.23,"Per diem rate, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,UHC Medicare,UHC Medicare,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
PODUS BOOT                    ,33144088,CDM,270,RC,,,,,,Inpatient,,,137.23,137.23,Wellcare,Wellcare,137.23,,,,,,,case rate,137.23,137.23,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Meritain Health PPO CPD,Meritain Health PPO CPD,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Aetna/Commercial Product,Aetna/Commercial Product,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Meritain Health CPD,Meritain Health CPD,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Starmark CPD,Starmark CPD,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Aetna Medicare,Aetna Medicare,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Ambetter ,Ambetter ,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Blue Access,Anthem Blue Access,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Blue Access Choice,Anthem Blue Access Choice,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Blue Preferred,Anthem Blue Preferred,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Pathway,Anthem Pathway,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Alliance,Anthem Alliance,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Anthem Medicare,Anthem Medicare,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Cigna,Cigna,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Cigna PPO,Cigna PPO,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Cigna Medicare Advantage,Cigna Medicare Advantage,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Essence,Essence,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Healthlink HMO,Healthlink HMO,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Healthlink PPO,Healthlink PPO,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,HomeState Health Plan,HomeState Health Plan,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Humana Gold,Humana Gold,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Medicaid MO,Medicaid MO,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Medica,Medica,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Tricare,Tricare,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,UHC All Payer,UHC All Payer,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,UHC Exchange,UHC Exchange,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,UHC Medicaid,UHC Medicaid,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,UMR CPD,UMR CPD,94.76,,,,,,,per diem,94.76,94.76,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,UHC Medicare,UHC Medicare,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE W/PUMP        ,33144092,CDM,279,RC,,,,,,Inpatient,,,94.76,94.76,Wellcare,Wellcare,94.76,,,,,,,case rate,94.76,94.76,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Meritain Health PPO CPD,Meritain Health PPO CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna/Commercial Product,Aetna/Commercial Product,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Meritain Health CPD,Meritain Health CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Starmark CPD,Starmark CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna Medicare,Aetna Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Ambetter ,Ambetter ,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Access,Anthem Blue Access,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Access Choice,Anthem Blue Access Choice,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Preferred,Anthem Blue Preferred,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Pathway,Anthem Pathway,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Alliance,Anthem Alliance,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Medicare,Anthem Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna,Cigna,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna PPO,Cigna PPO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna Medicare Advantage,Cigna Medicare Advantage,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Essence,Essence,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthlink HMO,Healthlink HMO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthlink PPO,Healthlink PPO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,HomeState Health Plan,HomeState Health Plan,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Humana Gold,Humana Gold,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Medicaid MO,Medicaid MO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Medica,Medica,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Tricare,Tricare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC All Payer,UHC All Payer,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Exchange,UHC Exchange,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Medicaid,UHC Medicaid,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UMR CPD,UMR CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Medicare,UHC Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOE SEMI RIGID       ,33144093,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Wellcare,Wellcare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Meritain Health PPO CPD,Meritain Health PPO CPD,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Aetna/Commercial Product,Aetna/Commercial Product,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Meritain Health CPD,Meritain Health CPD,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Starmark CPD,Starmark CPD,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Aetna Medicare,Aetna Medicare,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Ambetter ,Ambetter ,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Blue Access,Anthem Blue Access,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Blue Access Choice,Anthem Blue Access Choice,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Blue Preferred,Anthem Blue Preferred,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Pathway,Anthem Pathway,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Alliance,Anthem Alliance,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Anthem Medicare,Anthem Medicare,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Cigna,Cigna,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Cigna PPO,Cigna PPO,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Cigna Medicare Advantage,Cigna Medicare Advantage,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Essence,Essence,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Healthlink HMO,Healthlink HMO,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Healthlink PPO,Healthlink PPO,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,HomeState Health Plan,HomeState Health Plan,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Humana Gold,Humana Gold,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Medicaid MO,Medicaid MO,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Medica,Medica,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Tricare,Tricare,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,UHC All Payer,UHC All Payer,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,UHC Exchange,UHC Exchange,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,UHC Medicaid,UHC Medicaid,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,UMR CPD,UMR CPD,291.49,,,,,,,per diem,291.49,291.49,"Per diem rate, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,UHC Medicare,UHC Medicare,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
BOOT WAFFLE                   ,33144094,CDM,270,RC,,,,,,Inpatient,,,291.49,291.49,Wellcare,Wellcare,291.49,,,,,,,case rate,291.49,291.49,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Meritain Health PPO CPD,Meritain Health PPO CPD,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Aetna/Commercial Product,Aetna/Commercial Product,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Meritain Health CPD,Meritain Health CPD,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Starmark CPD,Starmark CPD,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Aetna Medicare,Aetna Medicare,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Ambetter ,Ambetter ,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Blue Access,Anthem Blue Access,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Blue Access Choice,Anthem Blue Access Choice,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Blue Preferred,Anthem Blue Preferred,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Pathway,Anthem Pathway,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Alliance,Anthem Alliance,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Anthem Medicare,Anthem Medicare,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Cigna,Cigna,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Cigna PPO,Cigna PPO,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Cigna Medicare Advantage,Cigna Medicare Advantage,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Essence,Essence,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Healthlink HMO,Healthlink HMO,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Healthlink PPO,Healthlink PPO,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,HomeState Health Plan,HomeState Health Plan,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Humana Gold,Humana Gold,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Medicaid MO,Medicaid MO,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Medica,Medica,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Tricare,Tricare,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,UHC All Payer,UHC All Payer,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,UHC Exchange,UHC Exchange,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,UHC Medicaid,UHC Medicaid,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,UMR CPD,UMR CPD,34.87,,,,,,,per diem,34.87,34.87,"Per diem rate, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,UHC Medicare,UHC Medicare,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
ISOTONER THERAPUTIC GLOVE     ,33144102,CDM,270,RC,,,,,,Inpatient,,,34.87,34.87,Wellcare,Wellcare,34.87,,,,,,,case rate,34.87,34.87,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Meritain Health PPO CPD,Meritain Health PPO CPD,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Aetna/Commercial Product,Aetna/Commercial Product,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Meritain Health CPD,Meritain Health CPD,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Starmark CPD,Starmark CPD,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Aetna Medicare,Aetna Medicare,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Ambetter ,Ambetter ,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Blue Access,Anthem Blue Access,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Blue Access Choice,Anthem Blue Access Choice,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Blue Preferred,Anthem Blue Preferred,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Pathway,Anthem Pathway,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Alliance,Anthem Alliance,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Anthem Medicare,Anthem Medicare,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Cigna,Cigna,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Cigna PPO,Cigna PPO,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Cigna Medicare Advantage,Cigna Medicare Advantage,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Essence,Essence,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Healthlink HMO,Healthlink HMO,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Healthlink PPO,Healthlink PPO,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,HomeState Health Plan,HomeState Health Plan,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Humana Gold,Humana Gold,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Medicaid MO,Medicaid MO,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Medica,Medica,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Tricare,Tricare,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,UHC All Payer,UHC All Payer,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,UHC Exchange,UHC Exchange,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,UHC Medicaid,UHC Medicaid,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,UMR CPD,UMR CPD,99.34,,,,,,,per diem,99.34,99.34,"Per diem rate, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,UHC Medicare,UHC Medicare,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
"COLLAR, ATLAS ADULT REGULAR   ",33144199,CDM,270,RC,,,,,,Inpatient,,,99.34,99.34,Wellcare,Wellcare,99.34,,,,,,,case rate,99.34,99.34,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Meritain Health PPO CPD,Meritain Health PPO CPD,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Aetna/Commercial Product,Aetna/Commercial Product,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Meritain Health CPD,Meritain Health CPD,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Starmark CPD,Starmark CPD,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Aetna Medicare,Aetna Medicare,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Ambetter ,Ambetter ,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Blue Access,Anthem Blue Access,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Blue Access Choice,Anthem Blue Access Choice,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Blue Preferred,Anthem Blue Preferred,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Pathway,Anthem Pathway,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Alliance,Anthem Alliance,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Anthem Medicare,Anthem Medicare,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Cigna,Cigna,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Cigna PPO,Cigna PPO,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Cigna Medicare Advantage,Cigna Medicare Advantage,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Essence,Essence,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Healthlink HMO,Healthlink HMO,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Healthlink PPO,Healthlink PPO,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,HomeState Health Plan,HomeState Health Plan,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Humana Gold,Humana Gold,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Medicaid MO,Medicaid MO,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Medica,Medica,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Tricare,Tricare,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,UHC All Payer,UHC All Payer,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,UHC Exchange,UHC Exchange,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,UHC Medicaid,UHC Medicaid,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,UMR CPD,UMR CPD,102.07,,,,,,,per diem,102.07,102.07,"Per diem rate, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,UHC Medicare,UHC Medicare,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
HEEL/ELBOW PROTECTOR          ,33144200,CDM,270,RC,,,,,,Inpatient,,,102.07,102.07,Wellcare,Wellcare,102.07,,,,,,,case rate,102.07,102.07,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Meritain Health PPO CPD,Meritain Health PPO CPD,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Aetna/Commercial Product,Aetna/Commercial Product,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Meritain Health CPD,Meritain Health CPD,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Starmark CPD,Starmark CPD,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Aetna Medicare,Aetna Medicare,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Ambetter ,Ambetter ,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Blue Access,Anthem Blue Access,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Blue Access Choice,Anthem Blue Access Choice,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Blue Preferred,Anthem Blue Preferred,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Pathway,Anthem Pathway,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Alliance,Anthem Alliance,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Anthem Medicare,Anthem Medicare,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Cigna,Cigna,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Cigna PPO,Cigna PPO,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Cigna Medicare Advantage,Cigna Medicare Advantage,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Essence,Essence,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Healthlink HMO,Healthlink HMO,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Healthlink PPO,Healthlink PPO,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,HomeState Health Plan,HomeState Health Plan,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Humana Gold,Humana Gold,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Medicaid MO,Medicaid MO,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Medica,Medica,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Tricare,Tricare,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,UHC All Payer,UHC All Payer,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,UHC Exchange,UHC Exchange,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,UHC Medicaid,UHC Medicaid,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,UMR CPD,UMR CPD,163.57,,,,,,,per diem,163.57,163.57,"Per diem rate, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,UHC Medicare,UHC Medicare,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
AIRCAST RIGHT LARGE           ,33144201,CDM,270,RC,,,,,,Inpatient,,,163.57,163.57,Wellcare,Wellcare,163.57,,,,,,,case rate,163.57,163.57,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Meritain Health PPO CPD,Meritain Health PPO CPD,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Aetna/Commercial Product,Aetna/Commercial Product,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Meritain Health CPD,Meritain Health CPD,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Starmark CPD,Starmark CPD,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Aetna Medicare,Aetna Medicare,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Ambetter ,Ambetter ,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Blue Access,Anthem Blue Access,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Blue Access Choice,Anthem Blue Access Choice,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Blue Preferred,Anthem Blue Preferred,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Pathway,Anthem Pathway,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Alliance,Anthem Alliance,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Anthem Medicare,Anthem Medicare,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Cigna,Cigna,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Cigna PPO,Cigna PPO,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Cigna Medicare Advantage,Cigna Medicare Advantage,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Essence,Essence,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Healthlink HMO,Healthlink HMO,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Healthlink PPO,Healthlink PPO,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,HomeState Health Plan,HomeState Health Plan,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Humana Gold,Humana Gold,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Medicaid MO,Medicaid MO,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Medica,Medica,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Tricare,Tricare,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,UHC All Payer,UHC All Payer,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,UHC Exchange,UHC Exchange,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,UHC Medicaid,UHC Medicaid,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,UMR CPD,UMR CPD,12.83,,,,,,,per diem,12.83,12.83,"Per diem rate, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,UHC Medicare,UHC Medicare,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
"SLING, ARM, DEEP POCKET W/NECK",33144202,CDM,270,RC,,,,,,Inpatient,,,12.83,12.83,Wellcare,Wellcare,12.83,,,,,,,case rate,12.83,12.83,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health PPO CPD,Meritain Health PPO CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/Commercial Product,Aetna/Commercial Product,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health CPD,Meritain Health CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Starmark CPD,Starmark CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna Medicare,Aetna Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Ambetter ,Ambetter ,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access,Anthem Blue Access,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access Choice,Anthem Blue Access Choice,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Preferred,Anthem Blue Preferred,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Pathway,Anthem Pathway,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Alliance,Anthem Alliance,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Medicare,Anthem Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna,Cigna,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna PPO,Cigna PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna Medicare Advantage,Cigna Medicare Advantage,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Essence,Essence,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink HMO,Healthlink HMO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink PPO,Healthlink PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,HomeState Health Plan,HomeState Health Plan,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Humana Gold,Humana Gold,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medicaid MO,Medicaid MO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medica,Medica,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Tricare,Tricare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC All Payer,UHC All Payer,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Exchange,UHC Exchange,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicaid,UHC Medicaid,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UMR CPD,UMR CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicare,UHC Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33144219,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Wellcare,Wellcare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Meritain Health PPO CPD,Meritain Health PPO CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna/Commercial Product,Aetna/Commercial Product,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Meritain Health CPD,Meritain Health CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Starmark CPD,Starmark CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna Medicare,Aetna Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Ambetter ,Ambetter ,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Access,Anthem Blue Access,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Access Choice,Anthem Blue Access Choice,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Preferred,Anthem Blue Preferred,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Pathway,Anthem Pathway,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Alliance,Anthem Alliance,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Medicare,Anthem Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna,Cigna,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna PPO,Cigna PPO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna Medicare Advantage,Cigna Medicare Advantage,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Essence,Essence,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthlink HMO,Healthlink HMO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthlink PPO,Healthlink PPO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,HomeState Health Plan,HomeState Health Plan,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Humana Gold,Humana Gold,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Medicaid MO,Medicaid MO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Medica,Medica,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Tricare,Tricare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC All Payer,UHC All Payer,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Exchange,UHC Exchange,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Medicaid,UHC Medicaid,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UMR CPD,UMR CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Medicare,UHC Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880)  ,33144220,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Wellcare,Wellcare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Meritain Health PPO CPD,Meritain Health PPO CPD,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Aetna/Commercial Product,Aetna/Commercial Product,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Meritain Health CPD,Meritain Health CPD,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Starmark CPD,Starmark CPD,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Aetna Medicare,Aetna Medicare,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Ambetter ,Ambetter ,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Blue Access,Anthem Blue Access,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Blue Access Choice,Anthem Blue Access Choice,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Blue Preferred,Anthem Blue Preferred,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Pathway,Anthem Pathway,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Alliance,Anthem Alliance,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Anthem Medicare,Anthem Medicare,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Cigna,Cigna,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Cigna PPO,Cigna PPO,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Cigna Medicare Advantage,Cigna Medicare Advantage,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Essence,Essence,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Healthlink HMO,Healthlink HMO,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Healthlink PPO,Healthlink PPO,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,HomeState Health Plan,HomeState Health Plan,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Humana Gold,Humana Gold,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Medicaid MO,Medicaid MO,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Medica,Medica,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Tricare,Tricare,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,UHC All Payer,UHC All Payer,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,UHC Exchange,UHC Exchange,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,UHC Medicaid,UHC Medicaid,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,UMR CPD,UMR CPD,25.13,,,,,,,per diem,25.13,25.13,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,UHC Medicare,UHC Medicare,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL      ,33144221,CDM,279,RC,,,,,,Inpatient,,,25.13,25.13,Wellcare,Wellcare,25.13,,,,,,,case rate,25.13,25.13,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Meritain Health PPO CPD,Meritain Health PPO CPD,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Aetna/Commercial Product,Aetna/Commercial Product,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Meritain Health CPD,Meritain Health CPD,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Starmark CPD,Starmark CPD,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Aetna Medicare,Aetna Medicare,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Ambetter ,Ambetter ,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Blue Access,Anthem Blue Access,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Blue Access Choice,Anthem Blue Access Choice,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Blue Preferred,Anthem Blue Preferred,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Pathway,Anthem Pathway,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Alliance,Anthem Alliance,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Anthem Medicare,Anthem Medicare,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Cigna,Cigna,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Cigna PPO,Cigna PPO,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Cigna Medicare Advantage,Cigna Medicare Advantage,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Essence,Essence,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Healthlink HMO,Healthlink HMO,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Healthlink PPO,Healthlink PPO,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,HomeState Health Plan,HomeState Health Plan,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Humana Gold,Humana Gold,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Medicaid MO,Medicaid MO,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Medica,Medica,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Tricare,Tricare,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,UHC All Payer,UHC All Payer,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,UHC Exchange,UHC Exchange,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,UHC Medicaid,UHC Medicaid,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,UMR CPD,UMR CPD,152.31,,,,,,,per diem,152.31,152.31,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,UHC Medicare,UHC Medicare,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED   ,33144222,CDM,279,RC,,,,,,Inpatient,,,152.31,152.31,Wellcare,Wellcare,152.31,,,,,,,case rate,152.31,152.31,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Meritain Health PPO CPD,Meritain Health PPO CPD,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Aetna/Commercial Product,Aetna/Commercial Product,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Meritain Health CPD,Meritain Health CPD,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Starmark CPD,Starmark CPD,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Aetna Medicare,Aetna Medicare,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Ambetter ,Ambetter ,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Blue Access,Anthem Blue Access,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Blue Access Choice,Anthem Blue Access Choice,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Blue Preferred,Anthem Blue Preferred,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Pathway,Anthem Pathway,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Alliance,Anthem Alliance,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Anthem Medicare,Anthem Medicare,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Cigna,Cigna,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Cigna PPO,Cigna PPO,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Cigna Medicare Advantage,Cigna Medicare Advantage,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Essence,Essence,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Healthlink HMO,Healthlink HMO,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Healthlink PPO,Healthlink PPO,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,HomeState Health Plan,HomeState Health Plan,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Humana Gold,Humana Gold,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Medicaid MO,Medicaid MO,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Medica,Medica,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Tricare,Tricare,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,UHC All Payer,UHC All Payer,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,UHC Exchange,UHC Exchange,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,UHC Medicaid,UHC Medicaid,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,UMR CPD,UMR CPD,88.98,,,,,,,per diem,88.98,88.98,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,UHC Medicare,UHC Medicare,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER  ,33144223,CDM,279,RC,,,,,,Inpatient,,,88.98,88.98,Wellcare,Wellcare,88.98,,,,,,,case rate,88.98,88.98,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health PPO CPD,Meritain Health PPO CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/Commercial Product,Aetna/Commercial Product,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health CPD,Meritain Health CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Starmark CPD,Starmark CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna Medicare,Aetna Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Ambetter ,Ambetter ,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access,Anthem Blue Access,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access Choice,Anthem Blue Access Choice,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Preferred,Anthem Blue Preferred,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Pathway,Anthem Pathway,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Alliance,Anthem Alliance,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Medicare,Anthem Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna,Cigna,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna PPO,Cigna PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna Medicare Advantage,Cigna Medicare Advantage,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Essence,Essence,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink HMO,Healthlink HMO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink PPO,Healthlink PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,HomeState Health Plan,HomeState Health Plan,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Humana Gold,Humana Gold,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medicaid MO,Medicaid MO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medica,Medica,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Tricare,Tricare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC All Payer,UHC All Payer,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Exchange,UHC Exchange,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicaid,UHC Medicaid,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UMR CPD,UMR CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicare,UHC Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY  ,33144224,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Wellcare,Wellcare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Meritain Health PPO CPD,Meritain Health PPO CPD,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Aetna/Commercial Product,Aetna/Commercial Product,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Meritain Health CPD,Meritain Health CPD,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Starmark CPD,Starmark CPD,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Aetna Medicare,Aetna Medicare,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Ambetter ,Ambetter ,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Blue Access,Anthem Blue Access,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Blue Access Choice,Anthem Blue Access Choice,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Blue Preferred,Anthem Blue Preferred,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Pathway,Anthem Pathway,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Alliance,Anthem Alliance,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Anthem Medicare,Anthem Medicare,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Cigna,Cigna,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Cigna PPO,Cigna PPO,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Cigna Medicare Advantage,Cigna Medicare Advantage,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Essence,Essence,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Healthlink HMO,Healthlink HMO,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Healthlink PPO,Healthlink PPO,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,HomeState Health Plan,HomeState Health Plan,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Humana Gold,Humana Gold,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Medicaid MO,Medicaid MO,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Medica,Medica,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Tricare,Tricare,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,UHC All Payer,UHC All Payer,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,UHC Exchange,UHC Exchange,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,UHC Medicaid,UHC Medicaid,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,UMR CPD,UMR CPD,178.48,,,,,,,per diem,178.48,178.48,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,UHC Medicare,UHC Medicare,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33144225,CDM,279,RC,,,,,,Inpatient,,,178.48,178.48,Wellcare,Wellcare,178.48,,,,,,,case rate,178.48,178.48,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Meritain Health PPO CPD,Meritain Health PPO CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna/Commercial Product,Aetna/Commercial Product,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Meritain Health CPD,Meritain Health CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Starmark CPD,Starmark CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna Medicare,Aetna Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Ambetter ,Ambetter ,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Access,Anthem Blue Access,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Access Choice,Anthem Blue Access Choice,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Preferred,Anthem Blue Preferred,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Pathway,Anthem Pathway,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Alliance,Anthem Alliance,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Medicare,Anthem Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna,Cigna,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna PPO,Cigna PPO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna Medicare Advantage,Cigna Medicare Advantage,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Essence,Essence,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthlink HMO,Healthlink HMO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthlink PPO,Healthlink PPO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,HomeState Health Plan,HomeState Health Plan,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Humana Gold,Humana Gold,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Medicaid MO,Medicaid MO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Medica,Medica,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Tricare,Tricare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC All Payer,UHC All Payer,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Exchange,UHC Exchange,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Medicaid,UHC Medicaid,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UMR CPD,UMR CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Medicare,UHC Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR        ,33144226,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Wellcare,Wellcare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Meritain Health PPO CPD,Meritain Health PPO CPD,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Aetna/Commercial Product,Aetna/Commercial Product,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Meritain Health CPD,Meritain Health CPD,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Starmark CPD,Starmark CPD,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Aetna Medicare,Aetna Medicare,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Ambetter ,Ambetter ,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Blue Access,Anthem Blue Access,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Blue Access Choice,Anthem Blue Access Choice,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Blue Preferred,Anthem Blue Preferred,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Pathway,Anthem Pathway,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Alliance,Anthem Alliance,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Anthem Medicare,Anthem Medicare,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Cigna,Cigna,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Cigna PPO,Cigna PPO,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Cigna Medicare Advantage,Cigna Medicare Advantage,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Essence,Essence,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Healthlink HMO,Healthlink HMO,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Healthlink PPO,Healthlink PPO,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,HomeState Health Plan,HomeState Health Plan,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Humana Gold,Humana Gold,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Medicaid MO,Medicaid MO,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Medica,Medica,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Tricare,Tricare,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,UHC All Payer,UHC All Payer,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,UHC Exchange,UHC Exchange,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,UHC Medicaid,UHC Medicaid,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,UMR CPD,UMR CPD,14.14,,,,,,,per diem,14.14,14.14,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,UHC Medicare,UHC Medicare,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33144227,CDM,279,RC,,,,,,Inpatient,,,14.14,14.14,Wellcare,Wellcare,14.14,,,,,,,case rate,14.14,14.14,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Meritain Health PPO CPD,Meritain Health PPO CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna/Commercial Product,Aetna/Commercial Product,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Meritain Health CPD,Meritain Health CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Starmark CPD,Starmark CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Aetna Medicare,Aetna Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Ambetter ,Ambetter ,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Access,Anthem Blue Access,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Access Choice,Anthem Blue Access Choice,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Blue Preferred,Anthem Blue Preferred,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Pathway,Anthem Pathway,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Alliance,Anthem Alliance,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Anthem Medicare,Anthem Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna,Cigna,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna PPO,Cigna PPO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Cigna Medicare Advantage,Cigna Medicare Advantage,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Essence,Essence,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthlink HMO,Healthlink HMO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Healthlink PPO,Healthlink PPO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,HomeState Health Plan,HomeState Health Plan,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Humana Gold,Humana Gold,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Medicaid MO,Medicaid MO,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Medica,Medica,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Tricare,Tricare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC All Payer,UHC All Payer,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Exchange,UHC Exchange,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Medicaid,UHC Medicaid,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UMR CPD,UMR CPD,113.85,,,,,,,per diem,113.85,113.85,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,UHC Medicare,UHC Medicare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33144228,CDM,279,RC,,,,,,Inpatient,,,113.85,113.85,Wellcare,Wellcare,113.85,,,,,,,case rate,113.85,113.85,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health PPO CPD,Meritain Health PPO CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/Commercial Product,Aetna/Commercial Product,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health CPD,Meritain Health CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Starmark CPD,Starmark CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna Medicare,Aetna Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Ambetter ,Ambetter ,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access,Anthem Blue Access,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access Choice,Anthem Blue Access Choice,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Preferred,Anthem Blue Preferred,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Pathway,Anthem Pathway,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Alliance,Anthem Alliance,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Medicare,Anthem Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna,Cigna,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna PPO,Cigna PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna Medicare Advantage,Cigna Medicare Advantage,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Essence,Essence,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink HMO,Healthlink HMO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink PPO,Healthlink PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,HomeState Health Plan,HomeState Health Plan,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Humana Gold,Humana Gold,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medicaid MO,Medicaid MO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medica,Medica,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Tricare,Tricare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC All Payer,UHC All Payer,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Exchange,UHC Exchange,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicaid,UHC Medicaid,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UMR CPD,UMR CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicare,UHC Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR   ,33144229,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Wellcare,Wellcare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Meritain Health PPO CPD,Meritain Health PPO CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna/Commercial Product,Aetna/Commercial Product,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Meritain Health CPD,Meritain Health CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Starmark CPD,Starmark CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna Medicare,Aetna Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Ambetter ,Ambetter ,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Access,Anthem Blue Access,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Access Choice,Anthem Blue Access Choice,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Preferred,Anthem Blue Preferred,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Pathway,Anthem Pathway,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Alliance,Anthem Alliance,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Medicare,Anthem Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna,Cigna,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna PPO,Cigna PPO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna Medicare Advantage,Cigna Medicare Advantage,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Essence,Essence,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthlink HMO,Healthlink HMO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthlink PPO,Healthlink PPO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,HomeState Health Plan,HomeState Health Plan,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Humana Gold,Humana Gold,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Medicaid MO,Medicaid MO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Medica,Medica,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Tricare,Tricare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC All Payer,UHC All Payer,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Exchange,UHC Exchange,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Medicaid,UHC Medicaid,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UMR CPD,UMR CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Medicare,UHC Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARI WHEELCHAIR W/ELECT       ,33144230,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Wellcare,Wellcare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Meritain Health PPO CPD,Meritain Health PPO CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna/Commercial Product,Aetna/Commercial Product,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Meritain Health CPD,Meritain Health CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Starmark CPD,Starmark CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Aetna Medicare,Aetna Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Ambetter ,Ambetter ,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Access,Anthem Blue Access,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Access Choice,Anthem Blue Access Choice,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Blue Preferred,Anthem Blue Preferred,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Pathway,Anthem Pathway,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Alliance,Anthem Alliance,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Anthem Medicare,Anthem Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna,Cigna,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna PPO,Cigna PPO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Cigna Medicare Advantage,Cigna Medicare Advantage,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Essence,Essence,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthlink HMO,Healthlink HMO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Healthlink PPO,Healthlink PPO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,HomeState Health Plan,HomeState Health Plan,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Humana Gold,Humana Gold,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Medicaid MO,Medicaid MO,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Medica,Medica,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Tricare,Tricare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC All Payer,UHC All Payer,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Exchange,UHC Exchange,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Medicaid,UHC Medicaid,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UMR CPD,UMR CPD,101.28,,,,,,,per diem,101.28,101.28,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,UHC Medicare,UHC Medicare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW     ,33144231,CDM,279,RC,,,,,,Inpatient,,,101.28,101.28,Wellcare,Wellcare,101.28,,,,,,,case rate,101.28,101.28,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Meritain Health PPO CPD,Meritain Health PPO CPD,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Aetna/Commercial Product,Aetna/Commercial Product,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Meritain Health CPD,Meritain Health CPD,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Starmark CPD,Starmark CPD,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Aetna Medicare,Aetna Medicare,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Ambetter ,Ambetter ,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Blue Access,Anthem Blue Access,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Blue Access Choice,Anthem Blue Access Choice,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Blue Preferred,Anthem Blue Preferred,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Pathway,Anthem Pathway,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Alliance,Anthem Alliance,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Anthem Medicare,Anthem Medicare,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Cigna,Cigna,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Cigna PPO,Cigna PPO,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Cigna Medicare Advantage,Cigna Medicare Advantage,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Essence,Essence,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Healthlink HMO,Healthlink HMO,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Healthlink PPO,Healthlink PPO,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,HomeState Health Plan,HomeState Health Plan,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Humana Gold,Humana Gold,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Medicaid MO,Medicaid MO,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Medica,Medica,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Tricare,Tricare,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,UHC All Payer,UHC All Payer,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,UHC Exchange,UHC Exchange,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,UHC Medicaid,UHC Medicaid,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,UMR CPD,UMR CPD,203.08,,,,,,,per diem,203.08,203.08,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,UHC Medicare,UHC Medicare,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB PLATFORM,33144232,CDM,279,RC,,,,,,Inpatient,,,203.08,203.08,Wellcare,Wellcare,203.08,,,,,,,case rate,203.08,203.08,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Meritain Health PPO CPD,Meritain Health PPO CPD,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Aetna/Commercial Product,Aetna/Commercial Product,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Meritain Health CPD,Meritain Health CPD,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Starmark CPD,Starmark CPD,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Aetna Medicare,Aetna Medicare,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Ambetter ,Ambetter ,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Blue Access,Anthem Blue Access,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Blue Access Choice,Anthem Blue Access Choice,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Blue Preferred,Anthem Blue Preferred,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Pathway,Anthem Pathway,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Alliance,Anthem Alliance,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Anthem Medicare,Anthem Medicare,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Cigna,Cigna,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Cigna PPO,Cigna PPO,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Cigna Medicare Advantage,Cigna Medicare Advantage,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Essence,Essence,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Healthlink HMO,Healthlink HMO,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Healthlink PPO,Healthlink PPO,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,HomeState Health Plan,HomeState Health Plan,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Humana Gold,Humana Gold,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Medicaid MO,Medicaid MO,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Medica,Medica,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Tricare,Tricare,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,UHC All Payer,UHC All Payer,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,UHC Exchange,UHC Exchange,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,UHC Medicaid,UHC Medicaid,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,UMR CPD,UMR CPD,4537.15,,,,,,,per diem,4537.15,4537.15,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,UHC Medicare,UHC Medicare,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM    ,33144233,CDM,279,RC,,,,,,Inpatient,,,4537.15,4537.15,Wellcare,Wellcare,4537.15,,,,,,,case rate,4537.15,4537.15,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Meritain Health PPO CPD,Meritain Health PPO CPD,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Aetna/Commercial Product,Aetna/Commercial Product,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Meritain Health CPD,Meritain Health CPD,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Starmark CPD,Starmark CPD,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Aetna Medicare,Aetna Medicare,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Ambetter ,Ambetter ,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Blue Access,Anthem Blue Access,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Blue Access Choice,Anthem Blue Access Choice,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Blue Preferred,Anthem Blue Preferred,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Pathway,Anthem Pathway,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Alliance,Anthem Alliance,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Anthem Medicare,Anthem Medicare,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Cigna,Cigna,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Cigna PPO,Cigna PPO,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Cigna Medicare Advantage,Cigna Medicare Advantage,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Essence,Essence,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Healthlink HMO,Healthlink HMO,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Healthlink PPO,Healthlink PPO,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,HomeState Health Plan,HomeState Health Plan,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Humana Gold,Humana Gold,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Medicaid MO,Medicaid MO,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Medica,Medica,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Tricare,Tricare,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,UHC All Payer,UHC All Payer,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,UHC Exchange,UHC Exchange,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,UHC Medicaid,UHC Medicaid,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,UMR CPD,UMR CPD,25.65,,,,,,,per diem,25.65,25.65,"Per diem rate, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,UHC Medicare,UHC Medicare,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
FULL FRAME TRAPEZE ASSEMBLY   ,33144234,CDM,279,RC,,,,,,Inpatient,,,25.65,25.65,Wellcare,Wellcare,25.65,,,,,,,case rate,25.65,25.65,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Meritain Health PPO CPD,Meritain Health PPO CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna/Commercial Product,Aetna/Commercial Product,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Meritain Health CPD,Meritain Health CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Starmark CPD,Starmark CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna Medicare,Aetna Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Ambetter ,Ambetter ,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Access,Anthem Blue Access,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Access Choice,Anthem Blue Access Choice,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Preferred,Anthem Blue Preferred,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Pathway,Anthem Pathway,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Alliance,Anthem Alliance,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Medicare,Anthem Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna,Cigna,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna PPO,Cigna PPO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna Medicare Advantage,Cigna Medicare Advantage,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Essence,Essence,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthlink HMO,Healthlink HMO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthlink PPO,Healthlink PPO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,HomeState Health Plan,HomeState Health Plan,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Humana Gold,Humana Gold,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Medicaid MO,Medicaid MO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Medica,Medica,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Tricare,Tricare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC All Payer,UHC All Payer,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Exchange,UHC Exchange,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Medicaid,UHC Medicaid,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UMR CPD,UMR CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Medicare,UHC Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33144235,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Wellcare,Wellcare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health PPO CPD,Meritain Health PPO CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/Commercial Product,Aetna/Commercial Product,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health CPD,Meritain Health CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Starmark CPD,Starmark CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna Medicare,Aetna Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Ambetter ,Ambetter ,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access,Anthem Blue Access,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access Choice,Anthem Blue Access Choice,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Preferred,Anthem Blue Preferred,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Pathway,Anthem Pathway,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Alliance,Anthem Alliance,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Medicare,Anthem Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna,Cigna,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna PPO,Cigna PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna Medicare Advantage,Cigna Medicare Advantage,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Essence,Essence,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink HMO,Healthlink HMO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink PPO,Healthlink PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,HomeState Health Plan,HomeState Health Plan,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Humana Gold,Humana Gold,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medicaid MO,Medicaid MO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medica,Medica,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Tricare,Tricare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC All Payer,UHC All Payer,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Exchange,UHC Exchange,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicaid,UHC Medicaid,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UMR CPD,UMR CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicare,UHC Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33144236,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Wellcare,Wellcare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Meritain Health PPO CPD,Meritain Health PPO CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna/Commercial Product,Aetna/Commercial Product,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Meritain Health CPD,Meritain Health CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Starmark CPD,Starmark CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Aetna Medicare,Aetna Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Ambetter ,Ambetter ,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Access,Anthem Blue Access,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Access Choice,Anthem Blue Access Choice,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Blue Preferred,Anthem Blue Preferred,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Pathway,Anthem Pathway,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Alliance,Anthem Alliance,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Anthem Medicare,Anthem Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna,Cigna,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna PPO,Cigna PPO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Cigna Medicare Advantage,Cigna Medicare Advantage,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Essence,Essence,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthlink HMO,Healthlink HMO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Healthlink PPO,Healthlink PPO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,HomeState Health Plan,HomeState Health Plan,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Humana Gold,Humana Gold,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Medicaid MO,Medicaid MO,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Medica,Medica,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Tricare,Tricare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC All Payer,UHC All Payer,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Exchange,UHC Exchange,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Medicaid,UHC Medicaid,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UMR CPD,UMR CPD,60.98,,,,,,,per diem,60.98,60.98,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,UHC Medicare,UHC Medicare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb    ,33144237,CDM,279,RC,,,,,,Inpatient,,,60.98,60.98,Wellcare,Wellcare,60.98,,,,,,,case rate,60.98,60.98,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health PPO CPD,Meritain Health PPO CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/Commercial Product,Aetna/Commercial Product,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health CPD,Meritain Health CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Starmark CPD,Starmark CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna Medicare,Aetna Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Ambetter ,Ambetter ,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access,Anthem Blue Access,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access Choice,Anthem Blue Access Choice,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Preferred,Anthem Blue Preferred,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Pathway,Anthem Pathway,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Alliance,Anthem Alliance,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Medicare,Anthem Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna,Cigna,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna PPO,Cigna PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna Medicare Advantage,Cigna Medicare Advantage,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Essence,Essence,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink HMO,Healthlink HMO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink PPO,Healthlink PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,HomeState Health Plan,HomeState Health Plan,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Humana Gold,Humana Gold,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medicaid MO,Medicaid MO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medica,Medica,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Tricare,Tricare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC All Payer,UHC All Payer,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Exchange,UHC Exchange,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicaid,UHC Medicaid,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UMR CPD,UMR CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicare,UHC Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33144239,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Wellcare,Wellcare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Meritain Health PPO CPD,Meritain Health PPO CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna/Commercial Product,Aetna/Commercial Product,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Meritain Health CPD,Meritain Health CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Starmark CPD,Starmark CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna Medicare,Aetna Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Ambetter ,Ambetter ,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Access,Anthem Blue Access,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Access Choice,Anthem Blue Access Choice,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Preferred,Anthem Blue Preferred,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Pathway,Anthem Pathway,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Alliance,Anthem Alliance,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Medicare,Anthem Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna,Cigna,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna PPO,Cigna PPO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna Medicare Advantage,Cigna Medicare Advantage,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Essence,Essence,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthlink HMO,Healthlink HMO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthlink PPO,Healthlink PPO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,HomeState Health Plan,HomeState Health Plan,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Humana Gold,Humana Gold,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Medicaid MO,Medicaid MO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Medica,Medica,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Tricare,Tricare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC All Payer,UHC All Payer,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Exchange,UHC Exchange,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Medicaid,UHC Medicaid,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,UMR CPD,UMR CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Medicare,UHC Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED  ,33144240,CDM,279,RC,,,,,,Inpatient,,,190,190,Wellcare,Wellcare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health PPO CPD,Meritain Health PPO CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/Commercial Product,Aetna/Commercial Product,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health CPD,Meritain Health CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Starmark CPD,Starmark CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna Medicare,Aetna Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Ambetter ,Ambetter ,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access,Anthem Blue Access,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access Choice,Anthem Blue Access Choice,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Preferred,Anthem Blue Preferred,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Pathway,Anthem Pathway,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Alliance,Anthem Alliance,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Medicare,Anthem Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna,Cigna,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna PPO,Cigna PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna Medicare Advantage,Cigna Medicare Advantage,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Essence,Essence,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink HMO,Healthlink HMO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink PPO,Healthlink PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,HomeState Health Plan,HomeState Health Plan,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Humana Gold,Humana Gold,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medicaid MO,Medicaid MO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medica,Medica,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Tricare,Tricare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC All Payer,UHC All Payer,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Exchange,UHC Exchange,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicaid,UHC Medicaid,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UMR CPD,UMR CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicare,UHC Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY     ,33144241,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Wellcare,Wellcare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Meritain Health PPO CPD,Meritain Health PPO CPD,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Aetna/Commercial Product,Aetna/Commercial Product,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Meritain Health CPD,Meritain Health CPD,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Starmark CPD,Starmark CPD,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Aetna Medicare,Aetna Medicare,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Ambetter ,Ambetter ,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Blue Access,Anthem Blue Access,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Blue Access Choice,Anthem Blue Access Choice,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Blue Preferred,Anthem Blue Preferred,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Pathway,Anthem Pathway,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Alliance,Anthem Alliance,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Anthem Medicare,Anthem Medicare,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Cigna,Cigna,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Cigna PPO,Cigna PPO,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Cigna Medicare Advantage,Cigna Medicare Advantage,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Essence,Essence,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Healthlink HMO,Healthlink HMO,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Healthlink PPO,Healthlink PPO,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,HomeState Health Plan,HomeState Health Plan,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Humana Gold,Humana Gold,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Medicaid MO,Medicaid MO,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Medica,Medica,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Tricare,Tricare,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,UHC All Payer,UHC All Payer,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,UHC Exchange,UHC Exchange,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,UHC Medicaid,UHC Medicaid,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,UMR CPD,UMR CPD,20.15,,,,,,,per diem,20.15,20.15,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,UHC Medicare,UHC Medicare,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33144242,CDM,279,RC,,,,,,Inpatient,,,20.15,20.15,Wellcare,Wellcare,20.15,,,,,,,case rate,20.15,20.15,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health PPO CPD,Meritain Health PPO CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/Commercial Product,Aetna/Commercial Product,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health CPD,Meritain Health CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Starmark CPD,Starmark CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna Medicare,Aetna Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Ambetter ,Ambetter ,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access,Anthem Blue Access,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access Choice,Anthem Blue Access Choice,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Preferred,Anthem Blue Preferred,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Pathway,Anthem Pathway,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Alliance,Anthem Alliance,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Medicare,Anthem Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna,Cigna,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna PPO,Cigna PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna Medicare Advantage,Cigna Medicare Advantage,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Essence,Essence,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink HMO,Healthlink HMO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink PPO,Healthlink PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,HomeState Health Plan,HomeState Health Plan,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Humana Gold,Humana Gold,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medicaid MO,Medicaid MO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medica,Medica,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Tricare,Tricare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC All Payer,UHC All Payer,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Exchange,UHC Exchange,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicaid,UHC Medicaid,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UMR CPD,UMR CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicare,UHC Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS        ,33144243,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Wellcare,Wellcare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Meritain Health PPO CPD,Meritain Health PPO CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna/Commercial Product,Aetna/Commercial Product,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Meritain Health CPD,Meritain Health CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Starmark CPD,Starmark CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna Medicare,Aetna Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Ambetter ,Ambetter ,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Access,Anthem Blue Access,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Access Choice,Anthem Blue Access Choice,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Preferred,Anthem Blue Preferred,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Pathway,Anthem Pathway,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Alliance,Anthem Alliance,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Medicare,Anthem Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna,Cigna,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna PPO,Cigna PPO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna Medicare Advantage,Cigna Medicare Advantage,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Essence,Essence,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthlink HMO,Healthlink HMO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthlink PPO,Healthlink PPO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,HomeState Health Plan,HomeState Health Plan,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Humana Gold,Humana Gold,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Medicaid MO,Medicaid MO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Medica,Medica,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Tricare,Tricare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC All Payer,UHC All Payer,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Exchange,UHC Exchange,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Medicaid,UHC Medicaid,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UMR CPD,UMR CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Medicare,UHC Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION   ",33144245,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Wellcare,Wellcare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Meritain Health PPO CPD,Meritain Health PPO CPD,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Aetna/Commercial Product,Aetna/Commercial Product,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Meritain Health CPD,Meritain Health CPD,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Starmark CPD,Starmark CPD,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Aetna Medicare,Aetna Medicare,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Ambetter ,Ambetter ,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Blue Access,Anthem Blue Access,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Blue Access Choice,Anthem Blue Access Choice,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Blue Preferred,Anthem Blue Preferred,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Pathway,Anthem Pathway,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Alliance,Anthem Alliance,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Anthem Medicare,Anthem Medicare,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Cigna,Cigna,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Cigna PPO,Cigna PPO,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Cigna Medicare Advantage,Cigna Medicare Advantage,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Essence,Essence,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Healthlink HMO,Healthlink HMO,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Healthlink PPO,Healthlink PPO,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,HomeState Health Plan,HomeState Health Plan,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Humana Gold,Humana Gold,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Medicaid MO,Medicaid MO,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Medica,Medica,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Tricare,Tricare,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,UHC All Payer,UHC All Payer,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,UHC Exchange,UHC Exchange,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,UHC Medicaid,UHC Medicaid,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,UMR CPD,UMR CPD,195.49,,,,,,,per diem,195.49,195.49,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,UHC Medicare,UHC Medicare,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED  ,33144246,CDM,279,RC,,,,,,Inpatient,,,195.49,195.49,Wellcare,Wellcare,195.49,,,,,,,case rate,195.49,195.49,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health PPO CPD,Meritain Health PPO CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/Commercial Product,Aetna/Commercial Product,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health CPD,Meritain Health CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Starmark CPD,Starmark CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna Medicare,Aetna Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Ambetter ,Ambetter ,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access,Anthem Blue Access,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access Choice,Anthem Blue Access Choice,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Preferred,Anthem Blue Preferred,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Pathway,Anthem Pathway,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Alliance,Anthem Alliance,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Medicare,Anthem Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna,Cigna,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna PPO,Cigna PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna Medicare Advantage,Cigna Medicare Advantage,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Essence,Essence,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink HMO,Healthlink HMO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink PPO,Healthlink PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,HomeState Health Plan,HomeState Health Plan,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Humana Gold,Humana Gold,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medicaid MO,Medicaid MO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medica,Medica,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Tricare,Tricare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC All Payer,UHC All Payer,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Exchange,UHC Exchange,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicaid,UHC Medicaid,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UMR CPD,UMR CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicare,UHC Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33144247,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Wellcare,Wellcare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health PPO CPD,Meritain Health PPO CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/Commercial Product,Aetna/Commercial Product,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health CPD,Meritain Health CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Starmark CPD,Starmark CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna Medicare,Aetna Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Ambetter ,Ambetter ,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access,Anthem Blue Access,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access Choice,Anthem Blue Access Choice,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Preferred,Anthem Blue Preferred,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Pathway,Anthem Pathway,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Alliance,Anthem Alliance,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Medicare,Anthem Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna,Cigna,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna PPO,Cigna PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna Medicare Advantage,Cigna Medicare Advantage,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Essence,Essence,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink HMO,Healthlink HMO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink PPO,Healthlink PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,HomeState Health Plan,HomeState Health Plan,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Humana Gold,Humana Gold,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medicaid MO,Medicaid MO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medica,Medica,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Tricare,Tricare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC All Payer,UHC All Payer,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Exchange,UHC Exchange,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicaid,UHC Medicaid,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UMR CPD,UMR CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicare,UHC Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY  ,33144248,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Wellcare,Wellcare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Meritain Health PPO CPD,Meritain Health PPO CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna/Commercial Product,Aetna/Commercial Product,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Meritain Health CPD,Meritain Health CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Starmark CPD,Starmark CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Aetna Medicare,Aetna Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Ambetter ,Ambetter ,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Access,Anthem Blue Access,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Access Choice,Anthem Blue Access Choice,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Blue Preferred,Anthem Blue Preferred,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Pathway,Anthem Pathway,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Alliance,Anthem Alliance,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Anthem Medicare,Anthem Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna,Cigna,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna PPO,Cigna PPO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Cigna Medicare Advantage,Cigna Medicare Advantage,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Essence,Essence,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthlink HMO,Healthlink HMO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Healthlink PPO,Healthlink PPO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,HomeState Health Plan,HomeState Health Plan,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Humana Gold,Humana Gold,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Medicaid MO,Medicaid MO,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Medica,Medica,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Tricare,Tricare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC All Payer,UHC All Payer,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Exchange,UHC Exchange,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Medicaid,UHC Medicaid,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UMR CPD,UMR CPD,8.64,,,,,,,per diem,8.64,8.64,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,UHC Medicare,UHC Medicare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33144250,CDM,279,RC,,,,,,Inpatient,,,8.64,8.64,Wellcare,Wellcare,8.64,,,,,,,case rate,8.64,8.64,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health PPO CPD,Meritain Health PPO CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/Commercial Product,Aetna/Commercial Product,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health CPD,Meritain Health CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Starmark CPD,Starmark CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna Medicare,Aetna Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Ambetter ,Ambetter ,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access,Anthem Blue Access,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access Choice,Anthem Blue Access Choice,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Preferred,Anthem Blue Preferred,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Pathway,Anthem Pathway,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Alliance,Anthem Alliance,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Medicare,Anthem Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna,Cigna,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna PPO,Cigna PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna Medicare Advantage,Cigna Medicare Advantage,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Essence,Essence,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink HMO,Healthlink HMO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink PPO,Healthlink PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,HomeState Health Plan,HomeState Health Plan,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Humana Gold,Humana Gold,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medicaid MO,Medicaid MO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medica,Medica,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Tricare,Tricare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC All Payer,UHC All Payer,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Exchange,UHC Exchange,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicaid,UHC Medicaid,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UMR CPD,UMR CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicare,UHC Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33144251,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Wellcare,Wellcare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health PPO CPD,Meritain Health PPO CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/Commercial Product,Aetna/Commercial Product,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health CPD,Meritain Health CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Starmark CPD,Starmark CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna Medicare,Aetna Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Ambetter ,Ambetter ,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access,Anthem Blue Access,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access Choice,Anthem Blue Access Choice,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Preferred,Anthem Blue Preferred,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Pathway,Anthem Pathway,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Alliance,Anthem Alliance,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Medicare,Anthem Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna,Cigna,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna PPO,Cigna PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna Medicare Advantage,Cigna Medicare Advantage,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Essence,Essence,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink HMO,Healthlink HMO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink PPO,Healthlink PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,HomeState Health Plan,HomeState Health Plan,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Humana Gold,Humana Gold,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medicaid MO,Medicaid MO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medica,Medica,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Tricare,Tricare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC All Payer,UHC All Payer,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Exchange,UHC Exchange,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicaid,UHC Medicaid,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UMR CPD,UMR CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicare,UHC Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVERLAY MATTRESS ,33144252,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Wellcare,Wellcare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Meritain Health PPO CPD,Meritain Health PPO CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna/Commercial Product,Aetna/Commercial Product,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Meritain Health CPD,Meritain Health CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Starmark CPD,Starmark CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Aetna Medicare,Aetna Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Ambetter ,Ambetter ,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Access,Anthem Blue Access,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Access Choice,Anthem Blue Access Choice,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Blue Preferred,Anthem Blue Preferred,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Pathway,Anthem Pathway,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Alliance,Anthem Alliance,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Anthem Medicare,Anthem Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna,Cigna,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna PPO,Cigna PPO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Cigna Medicare Advantage,Cigna Medicare Advantage,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Essence,Essence,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthlink HMO,Healthlink HMO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Healthlink PPO,Healthlink PPO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,HomeState Health Plan,HomeState Health Plan,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Humana Gold,Humana Gold,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Medicaid MO,Medicaid MO,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Medica,Medica,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Tricare,Tricare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC All Payer,UHC All Payer,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Exchange,UHC Exchange,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Medicaid,UHC Medicaid,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UMR CPD,UMR CPD,40.83,,,,,,,per diem,40.83,40.83,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,UHC Medicare,UHC Medicare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY    ,33144253,CDM,279,RC,,,,,,Inpatient,,,40.83,40.83,Wellcare,Wellcare,40.83,,,,,,,case rate,40.83,40.83,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health PPO CPD,Meritain Health PPO CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/Commercial Product,Aetna/Commercial Product,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health CPD,Meritain Health CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Starmark CPD,Starmark CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna Medicare,Aetna Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Ambetter ,Ambetter ,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access,Anthem Blue Access,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access Choice,Anthem Blue Access Choice,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Preferred,Anthem Blue Preferred,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Pathway,Anthem Pathway,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Alliance,Anthem Alliance,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Medicare,Anthem Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna,Cigna,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna PPO,Cigna PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna Medicare Advantage,Cigna Medicare Advantage,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Essence,Essence,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink HMO,Healthlink HMO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink PPO,Healthlink PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,HomeState Health Plan,HomeState Health Plan,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Humana Gold,Humana Gold,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medicaid MO,Medicaid MO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medica,Medica,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Tricare,Tricare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC All Payer,UHC All Payer,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Exchange,UHC Exchange,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicaid,UHC Medicaid,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UMR CPD,UMR CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicare,UHC Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33144254,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Wellcare,Wellcare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Meritain Health PPO CPD,Meritain Health PPO CPD,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Aetna/Commercial Product,Aetna/Commercial Product,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Meritain Health CPD,Meritain Health CPD,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Starmark CPD,Starmark CPD,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Aetna Medicare,Aetna Medicare,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Ambetter ,Ambetter ,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Blue Access,Anthem Blue Access,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Blue Access Choice,Anthem Blue Access Choice,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Blue Preferred,Anthem Blue Preferred,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Pathway,Anthem Pathway,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Alliance,Anthem Alliance,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Anthem Medicare,Anthem Medicare,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Cigna,Cigna,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Cigna PPO,Cigna PPO,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Cigna Medicare Advantage,Cigna Medicare Advantage,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Essence,Essence,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Healthlink HMO,Healthlink HMO,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Healthlink PPO,Healthlink PPO,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,HomeState Health Plan,HomeState Health Plan,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Humana Gold,Humana Gold,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Medicaid MO,Medicaid MO,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Medica,Medica,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Tricare,Tricare,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,UHC All Payer,UHC All Payer,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,UHC Exchange,UHC Exchange,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,UHC Medicaid,UHC Medicaid,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,UMR CPD,UMR CPD,304.1,,,,,,,per diem,304.1,304.1,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,UHC Medicare,UHC Medicare,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33144255,CDM,279,RC,,,,,,Inpatient,,,304.1,304.1,Wellcare,Wellcare,304.1,,,,,,,case rate,304.1,304.1,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Meritain Health PPO CPD,Meritain Health PPO CPD,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Aetna/Commercial Product,Aetna/Commercial Product,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Meritain Health CPD,Meritain Health CPD,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Starmark CPD,Starmark CPD,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Aetna Medicare,Aetna Medicare,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Ambetter ,Ambetter ,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Blue Access,Anthem Blue Access,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Blue Access Choice,Anthem Blue Access Choice,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Blue Preferred,Anthem Blue Preferred,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Pathway,Anthem Pathway,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Alliance,Anthem Alliance,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Anthem Medicare,Anthem Medicare,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Cigna,Cigna,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Cigna PPO,Cigna PPO,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Cigna Medicare Advantage,Cigna Medicare Advantage,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Essence,Essence,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Healthlink HMO,Healthlink HMO,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Healthlink PPO,Healthlink PPO,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,HomeState Health Plan,HomeState Health Plan,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Humana Gold,Humana Gold,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Medicaid MO,Medicaid MO,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Medica,Medica,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Tricare,Tricare,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,UHC All Payer,UHC All Payer,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,UHC Exchange,UHC Exchange,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,UHC Medicaid,UHC Medicaid,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,UMR CPD,UMR CPD,64.64,,,,,,,per diem,64.64,64.64,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,UHC Medicare,UHC Medicare,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33144256,CDM,279,RC,,,,,,Inpatient,,,64.64,64.64,Wellcare,Wellcare,64.64,,,,,,,case rate,64.64,64.64,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Meritain Health PPO CPD,Meritain Health PPO CPD,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Aetna/Commercial Product,Aetna/Commercial Product,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Meritain Health CPD,Meritain Health CPD,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Starmark CPD,Starmark CPD,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Aetna Medicare,Aetna Medicare,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Ambetter ,Ambetter ,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Blue Access,Anthem Blue Access,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Blue Access Choice,Anthem Blue Access Choice,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Blue Preferred,Anthem Blue Preferred,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Pathway,Anthem Pathway,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Alliance,Anthem Alliance,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Anthem Medicare,Anthem Medicare,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Cigna,Cigna,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Cigna PPO,Cigna PPO,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Cigna Medicare Advantage,Cigna Medicare Advantage,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Essence,Essence,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Healthlink HMO,Healthlink HMO,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Healthlink PPO,Healthlink PPO,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,HomeState Health Plan,HomeState Health Plan,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Humana Gold,Humana Gold,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Medicaid MO,Medicaid MO,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Medica,Medica,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Tricare,Tricare,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,UHC All Payer,UHC All Payer,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,UHC Exchange,UHC Exchange,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,UHC Medicaid,UHC Medicaid,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,UMR CPD,UMR CPD,608.19,,,,,,,per diem,608.19,608.19,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,UHC Medicare,UHC Medicare,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE   ,33144257,CDM,279,RC,,,,,,Inpatient,,,608.19,608.19,Wellcare,Wellcare,608.19,,,,,,,case rate,608.19,608.19,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health PPO CPD,Meritain Health PPO CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/Commercial Product,Aetna/Commercial Product,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health CPD,Meritain Health CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Starmark CPD,Starmark CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna Medicare,Aetna Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Ambetter ,Ambetter ,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access,Anthem Blue Access,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access Choice,Anthem Blue Access Choice,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Preferred,Anthem Blue Preferred,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Pathway,Anthem Pathway,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Alliance,Anthem Alliance,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Medicare,Anthem Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna,Cigna,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna PPO,Cigna PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna Medicare Advantage,Cigna Medicare Advantage,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Essence,Essence,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink HMO,Healthlink HMO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink PPO,Healthlink PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,HomeState Health Plan,HomeState Health Plan,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Humana Gold,Humana Gold,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medicaid MO,Medicaid MO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medica,Medica,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Tricare,Tricare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC All Payer,UHC All Payer,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Exchange,UHC Exchange,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicaid,UHC Medicaid,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UMR CPD,UMR CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicare,UHC Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33144258,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Wellcare,Wellcare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health PPO CPD,Meritain Health PPO CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/Commercial Product,Aetna/Commercial Product,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health CPD,Meritain Health CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Starmark CPD,Starmark CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna Medicare,Aetna Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Ambetter ,Ambetter ,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access,Anthem Blue Access,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access Choice,Anthem Blue Access Choice,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Preferred,Anthem Blue Preferred,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Pathway,Anthem Pathway,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Alliance,Anthem Alliance,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Medicare,Anthem Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna,Cigna,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna PPO,Cigna PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna Medicare Advantage,Cigna Medicare Advantage,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Essence,Essence,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink HMO,Healthlink HMO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink PPO,Healthlink PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,HomeState Health Plan,HomeState Health Plan,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Humana Gold,Humana Gold,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medicaid MO,Medicaid MO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medica,Medica,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Tricare,Tricare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC All Payer,UHC All Payer,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Exchange,UHC Exchange,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicaid,UHC Medicaid,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UMR CPD,UMR CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicare,UHC Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33144259,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Wellcare,Wellcare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Meritain Health PPO CPD,Meritain Health PPO CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna/Commercial Product,Aetna/Commercial Product,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Meritain Health CPD,Meritain Health CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Starmark CPD,Starmark CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna Medicare,Aetna Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Ambetter ,Ambetter ,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Access,Anthem Blue Access,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Access Choice,Anthem Blue Access Choice,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Preferred,Anthem Blue Preferred,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Pathway,Anthem Pathway,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Alliance,Anthem Alliance,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Medicare,Anthem Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna,Cigna,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna PPO,Cigna PPO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna Medicare Advantage,Cigna Medicare Advantage,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Essence,Essence,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthlink HMO,Healthlink HMO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthlink PPO,Healthlink PPO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,HomeState Health Plan,HomeState Health Plan,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Humana Gold,Humana Gold,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Medicaid MO,Medicaid MO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Medica,Medica,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Tricare,Tricare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC All Payer,UHC All Payer,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Exchange,UHC Exchange,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Medicaid,UHC Medicaid,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UMR CPD,UMR CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Medicare,UHC Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144260,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Wellcare,Wellcare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Meritain Health PPO CPD,Meritain Health PPO CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna/Commercial Product,Aetna/Commercial Product,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Meritain Health CPD,Meritain Health CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Starmark CPD,Starmark CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna Medicare,Aetna Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Ambetter ,Ambetter ,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Access,Anthem Blue Access,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Access Choice,Anthem Blue Access Choice,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Preferred,Anthem Blue Preferred,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Pathway,Anthem Pathway,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Alliance,Anthem Alliance,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Medicare,Anthem Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna,Cigna,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna PPO,Cigna PPO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna Medicare Advantage,Cigna Medicare Advantage,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Essence,Essence,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthlink HMO,Healthlink HMO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthlink PPO,Healthlink PPO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,HomeState Health Plan,HomeState Health Plan,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Humana Gold,Humana Gold,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Medicaid MO,Medicaid MO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Medica,Medica,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Tricare,Tricare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC All Payer,UHC All Payer,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Exchange,UHC Exchange,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Medicaid,UHC Medicaid,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UMR CPD,UMR CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Medicare,UHC Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144261,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Wellcare,Wellcare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Meritain Health PPO CPD,Meritain Health PPO CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna/Commercial Product,Aetna/Commercial Product,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Meritain Health CPD,Meritain Health CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Starmark CPD,Starmark CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna Medicare,Aetna Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Ambetter ,Ambetter ,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Access,Anthem Blue Access,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Access Choice,Anthem Blue Access Choice,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Preferred,Anthem Blue Preferred,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Pathway,Anthem Pathway,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Alliance,Anthem Alliance,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Medicare,Anthem Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna,Cigna,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna PPO,Cigna PPO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna Medicare Advantage,Cigna Medicare Advantage,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Essence,Essence,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthlink HMO,Healthlink HMO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthlink PPO,Healthlink PPO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,HomeState Health Plan,HomeState Health Plan,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Humana Gold,Humana Gold,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Medicaid MO,Medicaid MO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Medica,Medica,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Tricare,Tricare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC All Payer,UHC All Payer,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Exchange,UHC Exchange,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Medicaid,UHC Medicaid,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UMR CPD,UMR CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Medicare,UHC Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144262,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Wellcare,Wellcare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Meritain Health PPO CPD,Meritain Health PPO CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna/Commercial Product,Aetna/Commercial Product,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Meritain Health CPD,Meritain Health CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Starmark CPD,Starmark CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna Medicare,Aetna Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Ambetter ,Ambetter ,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Access,Anthem Blue Access,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Access Choice,Anthem Blue Access Choice,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Preferred,Anthem Blue Preferred,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Pathway,Anthem Pathway,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Alliance,Anthem Alliance,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Medicare,Anthem Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna,Cigna,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna PPO,Cigna PPO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna Medicare Advantage,Cigna Medicare Advantage,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Essence,Essence,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthlink HMO,Healthlink HMO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthlink PPO,Healthlink PPO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,HomeState Health Plan,HomeState Health Plan,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Humana Gold,Humana Gold,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Medicaid MO,Medicaid MO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Medica,Medica,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Tricare,Tricare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC All Payer,UHC All Payer,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Exchange,UHC Exchange,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Medicaid,UHC Medicaid,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UMR CPD,UMR CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Medicare,UHC Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144263,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Wellcare,Wellcare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health PPO CPD,Meritain Health PPO CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/Commercial Product,Aetna/Commercial Product,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health CPD,Meritain Health CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Starmark CPD,Starmark CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna Medicare,Aetna Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Ambetter ,Ambetter ,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access,Anthem Blue Access,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access Choice,Anthem Blue Access Choice,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Preferred,Anthem Blue Preferred,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Pathway,Anthem Pathway,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Alliance,Anthem Alliance,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Medicare,Anthem Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna,Cigna,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna PPO,Cigna PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna Medicare Advantage,Cigna Medicare Advantage,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Essence,Essence,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink HMO,Healthlink HMO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink PPO,Healthlink PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,HomeState Health Plan,HomeState Health Plan,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Humana Gold,Humana Gold,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medicaid MO,Medicaid MO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medica,Medica,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Tricare,Tricare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC All Payer,UHC All Payer,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Exchange,UHC Exchange,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicaid,UHC Medicaid,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UMR CPD,UMR CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicare,UHC Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33144264,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Wellcare,Wellcare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health PPO CPD,Meritain Health PPO CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/Commercial Product,Aetna/Commercial Product,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health CPD,Meritain Health CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Starmark CPD,Starmark CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna Medicare,Aetna Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Ambetter ,Ambetter ,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access,Anthem Blue Access,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access Choice,Anthem Blue Access Choice,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Preferred,Anthem Blue Preferred,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Pathway,Anthem Pathway,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Alliance,Anthem Alliance,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Medicare,Anthem Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna,Cigna,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna PPO,Cigna PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna Medicare Advantage,Cigna Medicare Advantage,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Essence,Essence,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink HMO,Healthlink HMO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink PPO,Healthlink PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,HomeState Health Plan,HomeState Health Plan,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Humana Gold,Humana Gold,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medicaid MO,Medicaid MO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medica,Medica,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Tricare,Tricare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC All Payer,UHC All Payer,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Exchange,UHC Exchange,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicaid,UHC Medicaid,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UMR CPD,UMR CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicare,UHC Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33144265,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Wellcare,Wellcare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Meritain Health PPO CPD,Meritain Health PPO CPD,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Aetna/Commercial Product,Aetna/Commercial Product,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Meritain Health CPD,Meritain Health CPD,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Starmark CPD,Starmark CPD,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Aetna Medicare,Aetna Medicare,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Ambetter ,Ambetter ,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Blue Access,Anthem Blue Access,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Blue Access Choice,Anthem Blue Access Choice,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Blue Preferred,Anthem Blue Preferred,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Pathway,Anthem Pathway,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Alliance,Anthem Alliance,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Anthem Medicare,Anthem Medicare,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Cigna,Cigna,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Cigna PPO,Cigna PPO,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Cigna Medicare Advantage,Cigna Medicare Advantage,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Essence,Essence,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Healthlink HMO,Healthlink HMO,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Healthlink PPO,Healthlink PPO,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,HomeState Health Plan,HomeState Health Plan,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Humana Gold,Humana Gold,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Medicaid MO,Medicaid MO,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Medica,Medica,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Tricare,Tricare,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,UHC All Payer,UHC All Payer,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,UHC Exchange,UHC Exchange,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,UHC Medicaid,UHC Medicaid,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,UMR CPD,UMR CPD,95.26,,,,,,,per diem,95.26,95.26,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,UHC Medicare,UHC Medicare,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33144266,CDM,279,RC,,,,,,Inpatient,,,95.26,95.26,Wellcare,Wellcare,95.26,,,,,,,case rate,95.26,95.26,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Meritain Health PPO CPD,Meritain Health PPO CPD,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Aetna/Commercial Product,Aetna/Commercial Product,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Meritain Health CPD,Meritain Health CPD,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Starmark CPD,Starmark CPD,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Aetna Medicare,Aetna Medicare,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Ambetter ,Ambetter ,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Blue Access,Anthem Blue Access,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Blue Access Choice,Anthem Blue Access Choice,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Blue Preferred,Anthem Blue Preferred,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Pathway,Anthem Pathway,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Alliance,Anthem Alliance,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Anthem Medicare,Anthem Medicare,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Cigna,Cigna,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Cigna PPO,Cigna PPO,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Cigna Medicare Advantage,Cigna Medicare Advantage,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Essence,Essence,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Healthlink HMO,Healthlink HMO,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Healthlink PPO,Healthlink PPO,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,HomeState Health Plan,HomeState Health Plan,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Humana Gold,Humana Gold,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Medicaid MO,Medicaid MO,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Medica,Medica,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Tricare,Tricare,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,UHC All Payer,UHC All Payer,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,UHC Exchange,UHC Exchange,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,UHC Medicaid,UHC Medicaid,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,UMR CPD,UMR CPD,65.95,,,,,,,per diem,65.95,65.95,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,UHC Medicare,UHC Medicare,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33144267,CDM,279,RC,,,,,,Inpatient,,,65.95,65.95,Wellcare,Wellcare,65.95,,,,,,,case rate,65.95,65.95,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Meritain Health PPO CPD,Meritain Health PPO CPD,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Aetna/Commercial Product,Aetna/Commercial Product,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Meritain Health CPD,Meritain Health CPD,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Starmark CPD,Starmark CPD,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Aetna Medicare,Aetna Medicare,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Ambetter ,Ambetter ,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Blue Access,Anthem Blue Access,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Blue Access Choice,Anthem Blue Access Choice,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Blue Preferred,Anthem Blue Preferred,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Pathway,Anthem Pathway,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Alliance,Anthem Alliance,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Anthem Medicare,Anthem Medicare,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Cigna,Cigna,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Cigna PPO,Cigna PPO,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Cigna Medicare Advantage,Cigna Medicare Advantage,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Essence,Essence,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Healthlink HMO,Healthlink HMO,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Healthlink PPO,Healthlink PPO,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,HomeState Health Plan,HomeState Health Plan,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Humana Gold,Humana Gold,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Medicaid MO,Medicaid MO,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Medica,Medica,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Tricare,Tricare,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,UHC All Payer,UHC All Payer,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,UHC Exchange,UHC Exchange,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,UHC Medicaid,UHC Medicaid,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,UMR CPD,UMR CPD,93.69,,,,,,,per diem,93.69,93.69,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,UHC Medicare,UHC Medicare,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33144268,CDM,279,RC,,,,,,Inpatient,,,93.69,93.69,Wellcare,Wellcare,93.69,,,,,,,case rate,93.69,93.69,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Meritain Health PPO CPD,Meritain Health PPO CPD,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Aetna/Commercial Product,Aetna/Commercial Product,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Meritain Health CPD,Meritain Health CPD,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Starmark CPD,Starmark CPD,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Aetna Medicare,Aetna Medicare,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Ambetter ,Ambetter ,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Blue Access,Anthem Blue Access,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Blue Access Choice,Anthem Blue Access Choice,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Blue Preferred,Anthem Blue Preferred,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Pathway,Anthem Pathway,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Alliance,Anthem Alliance,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Anthem Medicare,Anthem Medicare,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Cigna,Cigna,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Cigna PPO,Cigna PPO,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Cigna Medicare Advantage,Cigna Medicare Advantage,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Essence,Essence,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Healthlink HMO,Healthlink HMO,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Healthlink PPO,Healthlink PPO,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,HomeState Health Plan,HomeState Health Plan,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Humana Gold,Humana Gold,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Medicaid MO,Medicaid MO,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Medica,Medica,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Tricare,Tricare,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,UHC All Payer,UHC All Payer,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,UHC Exchange,UHC Exchange,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,UHC Medicaid,UHC Medicaid,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,UMR CPD,UMR CPD,52.87,,,,,,,per diem,52.87,52.87,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,UHC Medicare,UHC Medicare,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33144269,CDM,279,RC,,,,,,Inpatient,,,52.87,52.87,Wellcare,Wellcare,52.87,,,,,,,case rate,52.87,52.87,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Meritain Health PPO CPD,Meritain Health PPO CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna/Commercial Product,Aetna/Commercial Product,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Meritain Health CPD,Meritain Health CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Starmark CPD,Starmark CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Aetna Medicare,Aetna Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Ambetter ,Ambetter ,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Access,Anthem Blue Access,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Access Choice,Anthem Blue Access Choice,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Blue Preferred,Anthem Blue Preferred,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Pathway,Anthem Pathway,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Alliance,Anthem Alliance,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Anthem Medicare,Anthem Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna,Cigna,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna PPO,Cigna PPO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Cigna Medicare Advantage,Cigna Medicare Advantage,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Essence,Essence,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthlink HMO,Healthlink HMO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Healthlink PPO,Healthlink PPO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,HomeState Health Plan,HomeState Health Plan,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Humana Gold,Humana Gold,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Medicaid MO,Medicaid MO,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Medica,Medica,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Tricare,Tricare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC All Payer,UHC All Payer,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Exchange,UHC Exchange,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Medicaid,UHC Medicaid,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UMR CPD,UMR CPD,149.17,,,,,,,per diem,149.17,149.17,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,UHC Medicare,UHC Medicare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33144270,CDM,279,RC,,,,,,Inpatient,,,149.17,149.17,Wellcare,Wellcare,149.17,,,,,,,case rate,149.17,149.17,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Meritain Health PPO CPD,Meritain Health PPO CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna/Commercial Product,Aetna/Commercial Product,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Meritain Health CPD,Meritain Health CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Starmark CPD,Starmark CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Aetna Medicare,Aetna Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Ambetter ,Ambetter ,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Access,Anthem Blue Access,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Access Choice,Anthem Blue Access Choice,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Blue Preferred,Anthem Blue Preferred,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Pathway,Anthem Pathway,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Alliance,Anthem Alliance,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Anthem Medicare,Anthem Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna,Cigna,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna PPO,Cigna PPO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Cigna Medicare Advantage,Cigna Medicare Advantage,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Essence,Essence,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthlink HMO,Healthlink HMO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Healthlink PPO,Healthlink PPO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,HomeState Health Plan,HomeState Health Plan,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Humana Gold,Humana Gold,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Medicaid MO,Medicaid MO,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Medica,Medica,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Tricare,Tricare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC All Payer,UHC All Payer,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Exchange,UHC Exchange,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Medicaid,UHC Medicaid,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UMR CPD,UMR CPD,68.05,,,,,,,per diem,68.05,68.05,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,UHC Medicare,UHC Medicare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33144271,CDM,279,RC,,,,,,Inpatient,,,68.05,68.05,Wellcare,Wellcare,68.05,,,,,,,case rate,68.05,68.05,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Meritain Health PPO CPD,Meritain Health PPO CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna/Commercial Product,Aetna/Commercial Product,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Meritain Health CPD,Meritain Health CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Starmark CPD,Starmark CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Aetna Medicare,Aetna Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Ambetter ,Ambetter ,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Access,Anthem Blue Access,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Access Choice,Anthem Blue Access Choice,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Blue Preferred,Anthem Blue Preferred,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Pathway,Anthem Pathway,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Alliance,Anthem Alliance,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Anthem Medicare,Anthem Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna,Cigna,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna PPO,Cigna PPO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Cigna Medicare Advantage,Cigna Medicare Advantage,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Essence,Essence,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthlink HMO,Healthlink HMO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Healthlink PPO,Healthlink PPO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,HomeState Health Plan,HomeState Health Plan,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Humana Gold,Humana Gold,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Medicaid MO,Medicaid MO,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Medica,Medica,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Tricare,Tricare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC All Payer,UHC All Payer,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Exchange,UHC Exchange,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Medicaid,UHC Medicaid,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UMR CPD,UMR CPD,58.36,,,,,,,per diem,58.36,58.36,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,UHC Medicare,UHC Medicare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33144272,CDM,279,RC,,,,,,Inpatient,,,58.36,58.36,Wellcare,Wellcare,58.36,,,,,,,case rate,58.36,58.36,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Meritain Health PPO CPD,Meritain Health PPO CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna/Commercial Product,Aetna/Commercial Product,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Meritain Health CPD,Meritain Health CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Starmark CPD,Starmark CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Aetna Medicare,Aetna Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Ambetter ,Ambetter ,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Access,Anthem Blue Access,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Access Choice,Anthem Blue Access Choice,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Blue Preferred,Anthem Blue Preferred,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Pathway,Anthem Pathway,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Alliance,Anthem Alliance,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Anthem Medicare,Anthem Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna,Cigna,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna PPO,Cigna PPO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Cigna Medicare Advantage,Cigna Medicare Advantage,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Essence,Essence,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthlink HMO,Healthlink HMO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Healthlink PPO,Healthlink PPO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,HomeState Health Plan,HomeState Health Plan,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Humana Gold,Humana Gold,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Medicaid MO,Medicaid MO,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Medica,Medica,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Tricare,Tricare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC All Payer,UHC All Payer,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Exchange,UHC Exchange,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Medicaid,UHC Medicaid,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UMR CPD,UMR CPD,153.62,,,,,,,per diem,153.62,153.62,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,UHC Medicare,UHC Medicare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33144273,CDM,279,RC,,,,,,Inpatient,,,153.62,153.62,Wellcare,Wellcare,153.62,,,,,,,case rate,153.62,153.62,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health PPO CPD,Meritain Health PPO CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/Commercial Product,Aetna/Commercial Product,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health CPD,Meritain Health CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Starmark CPD,Starmark CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna Medicare,Aetna Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Ambetter ,Ambetter ,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access,Anthem Blue Access,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access Choice,Anthem Blue Access Choice,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Preferred,Anthem Blue Preferred,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Pathway,Anthem Pathway,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Alliance,Anthem Alliance,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Medicare,Anthem Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna,Cigna,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna PPO,Cigna PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna Medicare Advantage,Cigna Medicare Advantage,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Essence,Essence,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink HMO,Healthlink HMO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink PPO,Healthlink PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,HomeState Health Plan,HomeState Health Plan,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Humana Gold,Humana Gold,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medicaid MO,Medicaid MO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medica,Medica,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Tricare,Tricare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC All Payer,UHC All Payer,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Exchange,UHC Exchange,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicaid,UHC Medicaid,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UMR CPD,UMR CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicare,UHC Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33144274,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Wellcare,Wellcare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Meritain Health PPO CPD,Meritain Health PPO CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna/Commercial Product,Aetna/Commercial Product,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Meritain Health CPD,Meritain Health CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Starmark CPD,Starmark CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna Medicare,Aetna Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Ambetter ,Ambetter ,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Access,Anthem Blue Access,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Access Choice,Anthem Blue Access Choice,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Preferred,Anthem Blue Preferred,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Pathway,Anthem Pathway,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Alliance,Anthem Alliance,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Medicare,Anthem Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna,Cigna,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna PPO,Cigna PPO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna Medicare Advantage,Cigna Medicare Advantage,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Essence,Essence,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthlink HMO,Healthlink HMO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthlink PPO,Healthlink PPO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,HomeState Health Plan,HomeState Health Plan,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Humana Gold,Humana Gold,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Medicaid MO,Medicaid MO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Medica,Medica,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Tricare,Tricare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC All Payer,UHC All Payer,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Exchange,UHC Exchange,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Medicaid,UHC Medicaid,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UMR CPD,UMR CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Medicare,UHC Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33144275,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Wellcare,Wellcare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Meritain Health PPO CPD,Meritain Health PPO CPD,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Aetna/Commercial Product,Aetna/Commercial Product,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Meritain Health CPD,Meritain Health CPD,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Starmark CPD,Starmark CPD,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Aetna Medicare,Aetna Medicare,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Ambetter ,Ambetter ,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Blue Access,Anthem Blue Access,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Blue Access Choice,Anthem Blue Access Choice,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Blue Preferred,Anthem Blue Preferred,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Pathway,Anthem Pathway,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Alliance,Anthem Alliance,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Anthem Medicare,Anthem Medicare,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Cigna,Cigna,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Cigna PPO,Cigna PPO,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Cigna Medicare Advantage,Cigna Medicare Advantage,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Essence,Essence,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Healthlink HMO,Healthlink HMO,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Healthlink PPO,Healthlink PPO,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,HomeState Health Plan,HomeState Health Plan,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Humana Gold,Humana Gold,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Medicaid MO,Medicaid MO,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Medica,Medica,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Tricare,Tricare,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,UHC All Payer,UHC All Payer,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,UHC Exchange,UHC Exchange,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,UHC Medicaid,UHC Medicaid,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,UMR CPD,UMR CPD,244.43,,,,,,,per diem,244.43,244.43,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,UHC Medicare,UHC Medicare,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144277,CDM,279,RC,,,,,,Inpatient,,,244.43,244.43,Wellcare,Wellcare,244.43,,,,,,,case rate,244.43,244.43,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health PPO CPD,Meritain Health PPO CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna/Commercial Product,Aetna/Commercial Product,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Meritain Health CPD,Meritain Health CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Starmark CPD,Starmark CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Aetna Medicare,Aetna Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Ambetter ,Ambetter ,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access,Anthem Blue Access,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Access Choice,Anthem Blue Access Choice,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Blue Preferred,Anthem Blue Preferred,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Pathway,Anthem Pathway,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Alliance,Anthem Alliance,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Anthem Medicare,Anthem Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna,Cigna,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna PPO,Cigna PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Cigna Medicare Advantage,Cigna Medicare Advantage,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Essence,Essence,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink HMO,Healthlink HMO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Healthlink PPO,Healthlink PPO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,HomeState Health Plan,HomeState Health Plan,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Humana Gold,Humana Gold,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medicaid MO,Medicaid MO,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Medica,Medica,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Tricare,Tricare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC All Payer,UHC All Payer,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Exchange,UHC Exchange,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicaid,UHC Medicaid,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UMR CPD,UMR CPD,50.51,,,,,,,per diem,50.51,50.51,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,UHC Medicare,UHC Medicare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33144278,CDM,279,RC,,,,,,Inpatient,,,50.51,50.51,Wellcare,Wellcare,50.51,,,,,,,case rate,50.51,50.51,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Meritain Health PPO CPD,Meritain Health PPO CPD,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Aetna/Commercial Product,Aetna/Commercial Product,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Meritain Health CPD,Meritain Health CPD,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Starmark CPD,Starmark CPD,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Aetna Medicare,Aetna Medicare,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Ambetter ,Ambetter ,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Blue Access,Anthem Blue Access,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Blue Access Choice,Anthem Blue Access Choice,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Blue Preferred,Anthem Blue Preferred,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Pathway,Anthem Pathway,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Alliance,Anthem Alliance,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Anthem Medicare,Anthem Medicare,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Cigna,Cigna,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Cigna PPO,Cigna PPO,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Cigna Medicare Advantage,Cigna Medicare Advantage,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Essence,Essence,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Healthlink HMO,Healthlink HMO,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Healthlink PPO,Healthlink PPO,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,HomeState Health Plan,HomeState Health Plan,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Humana Gold,Humana Gold,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Medicaid MO,Medicaid MO,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Medica,Medica,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Tricare,Tricare,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,UHC All Payer,UHC All Payer,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,UHC Exchange,UHC Exchange,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,UHC Medicaid,UHC Medicaid,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,UMR CPD,UMR CPD,197.59,,,,,,,per diem,197.59,197.59,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,UHC Medicare,UHC Medicare,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33144279,CDM,279,RC,,,,,,Inpatient,,,197.59,197.59,Wellcare,Wellcare,197.59,,,,,,,case rate,197.59,197.59,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Meritain Health PPO CPD,Meritain Health PPO CPD,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Aetna/Commercial Product,Aetna/Commercial Product,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Meritain Health CPD,Meritain Health CPD,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Starmark CPD,Starmark CPD,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Aetna Medicare,Aetna Medicare,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Ambetter ,Ambetter ,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Blue Access,Anthem Blue Access,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Blue Access Choice,Anthem Blue Access Choice,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Blue Preferred,Anthem Blue Preferred,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Pathway,Anthem Pathway,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Alliance,Anthem Alliance,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Anthem Medicare,Anthem Medicare,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Cigna,Cigna,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Cigna PPO,Cigna PPO,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Cigna Medicare Advantage,Cigna Medicare Advantage,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Essence,Essence,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Healthlink HMO,Healthlink HMO,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Healthlink PPO,Healthlink PPO,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,HomeState Health Plan,HomeState Health Plan,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Humana Gold,Humana Gold,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Medicaid MO,Medicaid MO,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Medica,Medica,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Tricare,Tricare,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,UHC All Payer,UHC All Payer,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,UHC Exchange,UHC Exchange,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,UHC Medicaid,UHC Medicaid,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,UMR CPD,UMR CPD,156.24,,,,,,,per diem,156.24,156.24,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,UHC Medicare,UHC Medicare,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33144280,CDM,279,RC,,,,,,Inpatient,,,156.24,156.24,Wellcare,Wellcare,156.24,,,,,,,case rate,156.24,156.24,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Meritain Health PPO CPD,Meritain Health PPO CPD,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Aetna/Commercial Product,Aetna/Commercial Product,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Meritain Health CPD,Meritain Health CPD,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Starmark CPD,Starmark CPD,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Aetna Medicare,Aetna Medicare,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Ambetter ,Ambetter ,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Blue Access,Anthem Blue Access,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Blue Access Choice,Anthem Blue Access Choice,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Blue Preferred,Anthem Blue Preferred,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Pathway,Anthem Pathway,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Alliance,Anthem Alliance,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Anthem Medicare,Anthem Medicare,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Cigna,Cigna,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Cigna PPO,Cigna PPO,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Cigna Medicare Advantage,Cigna Medicare Advantage,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Essence,Essence,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Healthlink HMO,Healthlink HMO,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Healthlink PPO,Healthlink PPO,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,HomeState Health Plan,HomeState Health Plan,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Humana Gold,Humana Gold,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Medicaid MO,Medicaid MO,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Medica,Medica,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Tricare,Tricare,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,UHC All Payer,UHC All Payer,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,UHC Exchange,UHC Exchange,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,UHC Medicaid,UHC Medicaid,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,UMR CPD,UMR CPD,85.32,,,,,,,per diem,85.32,85.32,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,UHC Medicare,UHC Medicare,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33144281,CDM,279,RC,,,,,,Inpatient,,,85.32,85.32,Wellcare,Wellcare,85.32,,,,,,,case rate,85.32,85.32,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health PPO CPD,Meritain Health PPO CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna/Commercial Product,Aetna/Commercial Product,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Meritain Health CPD,Meritain Health CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Starmark CPD,Starmark CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Aetna Medicare,Aetna Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Ambetter ,Ambetter ,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access,Anthem Blue Access,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Access Choice,Anthem Blue Access Choice,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Blue Preferred,Anthem Blue Preferred,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Pathway,Anthem Pathway,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Alliance,Anthem Alliance,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Anthem Medicare,Anthem Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna,Cigna,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna PPO,Cigna PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Cigna Medicare Advantage,Cigna Medicare Advantage,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Essence,Essence,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink HMO,Healthlink HMO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Healthlink PPO,Healthlink PPO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,HomeState Health Plan,HomeState Health Plan,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Humana Gold,Humana Gold,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medicaid MO,Medicaid MO,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Medica,Medica,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Tricare,Tricare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC All Payer,UHC All Payer,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Exchange,UHC Exchange,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicaid,UHC Medicaid,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UMR CPD,UMR CPD,87.68,,,,,,,per diem,87.68,87.68,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,UHC Medicare,UHC Medicare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33144282,CDM,279,RC,,,,,,Inpatient,,,87.68,87.68,Wellcare,Wellcare,87.68,,,,,,,case rate,87.68,87.68,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Meritain Health PPO CPD,Meritain Health PPO CPD,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Aetna/Commercial Product,Aetna/Commercial Product,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Meritain Health CPD,Meritain Health CPD,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Starmark CPD,Starmark CPD,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Aetna Medicare,Aetna Medicare,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Ambetter ,Ambetter ,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Blue Access,Anthem Blue Access,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Blue Access Choice,Anthem Blue Access Choice,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Blue Preferred,Anthem Blue Preferred,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Pathway,Anthem Pathway,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Alliance,Anthem Alliance,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Anthem Medicare,Anthem Medicare,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Cigna,Cigna,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Cigna PPO,Cigna PPO,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Cigna Medicare Advantage,Cigna Medicare Advantage,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Essence,Essence,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Healthlink HMO,Healthlink HMO,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Healthlink PPO,Healthlink PPO,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,HomeState Health Plan,HomeState Health Plan,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Humana Gold,Humana Gold,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Medicaid MO,Medicaid MO,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Medica,Medica,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Tricare,Tricare,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,UHC All Payer,UHC All Payer,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,UHC Exchange,UHC Exchange,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,UHC Medicaid,UHC Medicaid,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,UMR CPD,UMR CPD,89.76,,,,,,,per diem,89.76,89.76,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,UHC Medicare,UHC Medicare,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33144283,CDM,279,RC,,,,,,Inpatient,,,89.76,89.76,Wellcare,Wellcare,89.76,,,,,,,case rate,89.76,89.76,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health PPO CPD,Meritain Health PPO CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna/Commercial Product,Aetna/Commercial Product,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Meritain Health CPD,Meritain Health CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Starmark CPD,Starmark CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Aetna Medicare,Aetna Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Ambetter ,Ambetter ,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access,Anthem Blue Access,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Access Choice,Anthem Blue Access Choice,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Blue Preferred,Anthem Blue Preferred,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Pathway,Anthem Pathway,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Alliance,Anthem Alliance,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Anthem Medicare,Anthem Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna,Cigna,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna PPO,Cigna PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Cigna Medicare Advantage,Cigna Medicare Advantage,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Essence,Essence,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink HMO,Healthlink HMO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Healthlink PPO,Healthlink PPO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,HomeState Health Plan,HomeState Health Plan,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Humana Gold,Humana Gold,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medicaid MO,Medicaid MO,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Medica,Medica,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Tricare,Tricare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC All Payer,UHC All Payer,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Exchange,UHC Exchange,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicaid,UHC Medicaid,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UMR CPD,UMR CPD,164.35,,,,,,,per diem,164.35,164.35,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,UHC Medicare,UHC Medicare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33144284,CDM,279,RC,,,,,,Inpatient,,,164.35,164.35,Wellcare,Wellcare,164.35,,,,,,,case rate,164.35,164.35,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Meritain Health PPO CPD,Meritain Health PPO CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna/Commercial Product,Aetna/Commercial Product,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Meritain Health CPD,Meritain Health CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Starmark CPD,Starmark CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna Medicare,Aetna Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Ambetter ,Ambetter ,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Access,Anthem Blue Access,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Access Choice,Anthem Blue Access Choice,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Preferred,Anthem Blue Preferred,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Pathway,Anthem Pathway,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Alliance,Anthem Alliance,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Medicare,Anthem Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna,Cigna,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna PPO,Cigna PPO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna Medicare Advantage,Cigna Medicare Advantage,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Essence,Essence,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthlink HMO,Healthlink HMO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthlink PPO,Healthlink PPO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,HomeState Health Plan,HomeState Health Plan,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Humana Gold,Humana Gold,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Medicaid MO,Medicaid MO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Medica,Medica,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Tricare,Tricare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC All Payer,UHC All Payer,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Exchange,UHC Exchange,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Medicaid,UHC Medicaid,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UMR CPD,UMR CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Medicare,UHC Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33144285,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Wellcare,Wellcare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Meritain Health PPO CPD,Meritain Health PPO CPD,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Aetna/Commercial Product,Aetna/Commercial Product,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Meritain Health CPD,Meritain Health CPD,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Starmark CPD,Starmark CPD,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Aetna Medicare,Aetna Medicare,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Ambetter ,Ambetter ,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Blue Access,Anthem Blue Access,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Blue Access Choice,Anthem Blue Access Choice,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Blue Preferred,Anthem Blue Preferred,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Pathway,Anthem Pathway,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Alliance,Anthem Alliance,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Anthem Medicare,Anthem Medicare,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Cigna,Cigna,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Cigna PPO,Cigna PPO,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Cigna Medicare Advantage,Cigna Medicare Advantage,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Essence,Essence,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Healthlink HMO,Healthlink HMO,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Healthlink PPO,Healthlink PPO,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,HomeState Health Plan,HomeState Health Plan,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Humana Gold,Humana Gold,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Medicaid MO,Medicaid MO,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Medica,Medica,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Tricare,Tricare,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,UHC All Payer,UHC All Payer,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,UHC Exchange,UHC Exchange,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,UHC Medicaid,UHC Medicaid,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,UMR CPD,UMR CPD,77.99,,,,,,,per diem,77.99,77.99,"Per diem rate, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,UHC Medicare,UHC Medicare,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SMARTVEST AIRWAY (MEDPULSE)   ,33144287,CDM,279,RC,,,,,,Inpatient,,,77.99,77.99,Wellcare,Wellcare,77.99,,,,,,,case rate,77.99,77.99,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health PPO CPD,Meritain Health PPO CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna/Commercial Product,Aetna/Commercial Product,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Meritain Health CPD,Meritain Health CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Starmark CPD,Starmark CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Aetna Medicare,Aetna Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Ambetter ,Ambetter ,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access,Anthem Blue Access,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Access Choice,Anthem Blue Access Choice,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Blue Preferred,Anthem Blue Preferred,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Pathway,Anthem Pathway,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Alliance,Anthem Alliance,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Anthem Medicare,Anthem Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna,Cigna,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna PPO,Cigna PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Cigna Medicare Advantage,Cigna Medicare Advantage,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Essence,Essence,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink HMO,Healthlink HMO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Healthlink PPO,Healthlink PPO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,HomeState Health Plan,HomeState Health Plan,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Humana Gold,Humana Gold,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medicaid MO,Medicaid MO,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Medica,Medica,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Tricare,Tricare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC All Payer,UHC All Payer,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Exchange,UHC Exchange,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicaid,UHC Medicaid,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UMR CPD,UMR CPD,30.36,,,,,,,per diem,30.36,30.36,"Per diem rate, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,UHC Medicare,UHC Medicare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
SCD- SEQUENTIAL COMPRESSION   ,33144288,CDM,279,RC,,,,,,Inpatient,,,30.36,30.36,Wellcare,Wellcare,30.36,,,,,,,case rate,30.36,30.36,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Meritain Health PPO CPD,Meritain Health PPO CPD,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Aetna/Commercial Product,Aetna/Commercial Product,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Meritain Health CPD,Meritain Health CPD,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Starmark CPD,Starmark CPD,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Aetna Medicare,Aetna Medicare,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Ambetter ,Ambetter ,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Blue Access,Anthem Blue Access,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Blue Access Choice,Anthem Blue Access Choice,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Blue Preferred,Anthem Blue Preferred,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Pathway,Anthem Pathway,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Alliance,Anthem Alliance,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Anthem Medicare,Anthem Medicare,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Cigna,Cigna,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Cigna PPO,Cigna PPO,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Cigna Medicare Advantage,Cigna Medicare Advantage,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Essence,Essence,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Healthlink HMO,Healthlink HMO,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Healthlink PPO,Healthlink PPO,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,HomeState Health Plan,HomeState Health Plan,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Humana Gold,Humana Gold,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Medicaid MO,Medicaid MO,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Medica,Medica,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Tricare,Tricare,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,UHC All Payer,UHC All Payer,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,UHC Exchange,UHC Exchange,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,UHC Medicaid,UHC Medicaid,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,UMR CPD,UMR CPD,761.55,,,,,,,per diem,761.55,761.55,"Per diem rate, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,UHC Medicare,UHC Medicare,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
ECU MONTHLY RENTAL            ,33144289,CDM,279,RC,,,,,,Inpatient,,,761.55,761.55,Wellcare,Wellcare,761.55,,,,,,,case rate,761.55,761.55,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Meritain Health PPO CPD,Meritain Health PPO CPD,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Aetna/Commercial Product,Aetna/Commercial Product,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Meritain Health CPD,Meritain Health CPD,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Starmark CPD,Starmark CPD,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Aetna Medicare,Aetna Medicare,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Ambetter ,Ambetter ,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Blue Access,Anthem Blue Access,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Blue Access Choice,Anthem Blue Access Choice,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Blue Preferred,Anthem Blue Preferred,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Pathway,Anthem Pathway,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Alliance,Anthem Alliance,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Anthem Medicare,Anthem Medicare,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Cigna,Cigna,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Cigna PPO,Cigna PPO,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Cigna Medicare Advantage,Cigna Medicare Advantage,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Essence,Essence,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Healthlink HMO,Healthlink HMO,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Healthlink PPO,Healthlink PPO,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,HomeState Health Plan,HomeState Health Plan,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Humana Gold,Humana Gold,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Medicaid MO,Medicaid MO,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Medica,Medica,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Tricare,Tricare,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,UHC All Payer,UHC All Payer,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,UHC Exchange,UHC Exchange,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,UHC Medicaid,UHC Medicaid,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,UMR CPD,UMR CPD,12.57,,,,,,,per diem,12.57,12.57,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,UHC Medicare,UHC Medicare,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT   ,33144290,CDM,279,RC,,,,,,Inpatient,,,12.57,12.57,Wellcare,Wellcare,12.57,,,,,,,case rate,12.57,12.57,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Meritain Health PPO CPD,Meritain Health PPO CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna/Commercial Product,Aetna/Commercial Product,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Meritain Health CPD,Meritain Health CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Starmark CPD,Starmark CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Aetna Medicare,Aetna Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Ambetter ,Ambetter ,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Access,Anthem Blue Access,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Access Choice,Anthem Blue Access Choice,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Blue Preferred,Anthem Blue Preferred,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Pathway,Anthem Pathway,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Alliance,Anthem Alliance,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Anthem Medicare,Anthem Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna,Cigna,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna PPO,Cigna PPO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Cigna Medicare Advantage,Cigna Medicare Advantage,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Essence,Essence,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthlink HMO,Healthlink HMO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Healthlink PPO,Healthlink PPO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,HomeState Health Plan,HomeState Health Plan,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Humana Gold,Humana Gold,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Medicaid MO,Medicaid MO,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Medica,Medica,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Tricare,Tricare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC All Payer,UHC All Payer,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Exchange,UHC Exchange,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Medicaid,UHC Medicaid,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UMR CPD,UMR CPD,3.67,,,,,,,per diem,3.67,3.67,"Per diem rate, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,UHC Medicare,UHC Medicare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
CPAP HUMIDIFIER W/HEATER DAILY,33144291,CDM,279,RC,,,,,,Inpatient,,,3.67,3.67,Wellcare,Wellcare,3.67,,,,,,,case rate,3.67,3.67,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Meritain Health PPO CPD,Meritain Health PPO CPD,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Aetna/Commercial Product,Aetna/Commercial Product,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Meritain Health CPD,Meritain Health CPD,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Starmark CPD,Starmark CPD,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Aetna Medicare,Aetna Medicare,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Ambetter ,Ambetter ,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Blue Access,Anthem Blue Access,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Blue Access Choice,Anthem Blue Access Choice,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Blue Preferred,Anthem Blue Preferred,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Pathway,Anthem Pathway,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Alliance,Anthem Alliance,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Anthem Medicare,Anthem Medicare,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Cigna,Cigna,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Cigna PPO,Cigna PPO,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Cigna Medicare Advantage,Cigna Medicare Advantage,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Essence,Essence,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Healthlink HMO,Healthlink HMO,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Healthlink PPO,Healthlink PPO,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,HomeState Health Plan,HomeState Health Plan,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Humana Gold,Humana Gold,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Medicaid MO,Medicaid MO,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Medica,Medica,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Tricare,Tricare,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,UHC All Payer,UHC All Payer,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,UHC Exchange,UHC Exchange,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,UHC Medicaid,UHC Medicaid,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,UMR CPD,UMR CPD,177.44,,,,,,,per diem,177.44,177.44,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,UHC Medicare,UHC Medicare,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33144292,CDM,279,RC,,,,,,Inpatient,,,177.44,177.44,Wellcare,Wellcare,177.44,,,,,,,case rate,177.44,177.44,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health PPO CPD,Meritain Health PPO CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/Commercial Product,Aetna/Commercial Product,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health CPD,Meritain Health CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Starmark CPD,Starmark CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna Medicare,Aetna Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Ambetter ,Ambetter ,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access,Anthem Blue Access,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access Choice,Anthem Blue Access Choice,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Preferred,Anthem Blue Preferred,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Pathway,Anthem Pathway,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Alliance,Anthem Alliance,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Medicare,Anthem Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna,Cigna,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna PPO,Cigna PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna Medicare Advantage,Cigna Medicare Advantage,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Essence,Essence,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink HMO,Healthlink HMO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink PPO,Healthlink PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,HomeState Health Plan,HomeState Health Plan,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Humana Gold,Humana Gold,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medicaid MO,Medicaid MO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medica,Medica,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Tricare,Tricare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC All Payer,UHC All Payer,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Exchange,UHC Exchange,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicaid,UHC Medicaid,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UMR CPD,UMR CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicare,UHC Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33144293,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Wellcare,Wellcare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Meritain Health PPO CPD,Meritain Health PPO CPD,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Aetna/Commercial Product,Aetna/Commercial Product,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Meritain Health CPD,Meritain Health CPD,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Starmark CPD,Starmark CPD,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Aetna Medicare,Aetna Medicare,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Ambetter ,Ambetter ,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Blue Access,Anthem Blue Access,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Blue Access Choice,Anthem Blue Access Choice,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Blue Preferred,Anthem Blue Preferred,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Pathway,Anthem Pathway,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Alliance,Anthem Alliance,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Anthem Medicare,Anthem Medicare,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Cigna,Cigna,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Cigna PPO,Cigna PPO,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Cigna Medicare Advantage,Cigna Medicare Advantage,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Essence,Essence,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Healthlink HMO,Healthlink HMO,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Healthlink PPO,Healthlink PPO,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,HomeState Health Plan,HomeState Health Plan,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Humana Gold,Humana Gold,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Medicaid MO,Medicaid MO,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Medica,Medica,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Tricare,Tricare,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,UHC All Payer,UHC All Payer,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,UHC Exchange,UHC Exchange,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,UHC Medicaid,UHC Medicaid,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,UMR CPD,UMR CPD,49.46,,,,,,,per diem,49.46,49.46,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,UHC Medicare,UHC Medicare,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33144294,CDM,279,RC,,,,,,Inpatient,,,49.46,49.46,Wellcare,Wellcare,49.46,,,,,,,case rate,49.46,49.46,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Meritain Health PPO CPD,Meritain Health PPO CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna/Commercial Product,Aetna/Commercial Product,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Meritain Health CPD,Meritain Health CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Starmark CPD,Starmark CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Aetna Medicare,Aetna Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Ambetter ,Ambetter ,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Access,Anthem Blue Access,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Access Choice,Anthem Blue Access Choice,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Blue Preferred,Anthem Blue Preferred,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Pathway,Anthem Pathway,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Alliance,Anthem Alliance,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Anthem Medicare,Anthem Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna,Cigna,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna PPO,Cigna PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Cigna Medicare Advantage,Cigna Medicare Advantage,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Essence,Essence,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthlink HMO,Healthlink HMO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Healthlink PPO,Healthlink PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,HomeState Health Plan,HomeState Health Plan,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Humana Gold,Humana Gold,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Medicaid MO,Medicaid MO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Medica,Medica,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Tricare,Tricare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC All Payer,UHC All Payer,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Exchange,UHC Exchange,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Medicaid,UHC Medicaid,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UMR CPD,UMR CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,UHC Medicare,UHC Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33144295,CDM,279,RC,,,,,,Inpatient,,,26.7,26.7,Wellcare,Wellcare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Meritain Health PPO CPD,Meritain Health PPO CPD,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Aetna/Commercial Product,Aetna/Commercial Product,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Meritain Health CPD,Meritain Health CPD,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Starmark CPD,Starmark CPD,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Aetna Medicare,Aetna Medicare,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Ambetter ,Ambetter ,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Blue Access,Anthem Blue Access,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Blue Access Choice,Anthem Blue Access Choice,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Blue Preferred,Anthem Blue Preferred,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Pathway,Anthem Pathway,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Alliance,Anthem Alliance,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Anthem Medicare,Anthem Medicare,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Cigna,Cigna,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Cigna PPO,Cigna PPO,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Cigna Medicare Advantage,Cigna Medicare Advantage,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Essence,Essence,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Healthlink HMO,Healthlink HMO,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Healthlink PPO,Healthlink PPO,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,HomeState Health Plan,HomeState Health Plan,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Humana Gold,Humana Gold,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Medicaid MO,Medicaid MO,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Medica,Medica,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Tricare,Tricare,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,UHC All Payer,UHC All Payer,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,UHC Exchange,UHC Exchange,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,UHC Medicaid,UHC Medicaid,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,UMR CPD,UMR CPD,132.95,,,,,,,per diem,132.95,132.95,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,UHC Medicare,UHC Medicare,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC  ,33144296,CDM,279,RC,,,,,,Inpatient,,,132.95,132.95,Wellcare,Wellcare,132.95,,,,,,,case rate,132.95,132.95,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Meritain Health PPO CPD,Meritain Health PPO CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna/Commercial Product,Aetna/Commercial Product,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Meritain Health CPD,Meritain Health CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Starmark CPD,Starmark CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna Medicare,Aetna Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Ambetter ,Ambetter ,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Access,Anthem Blue Access,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Access Choice,Anthem Blue Access Choice,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Preferred,Anthem Blue Preferred,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Pathway,Anthem Pathway,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Alliance,Anthem Alliance,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Medicare,Anthem Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna,Cigna,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna PPO,Cigna PPO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna Medicare Advantage,Cigna Medicare Advantage,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Essence,Essence,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthlink HMO,Healthlink HMO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthlink PPO,Healthlink PPO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,HomeState Health Plan,HomeState Health Plan,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Humana Gold,Humana Gold,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Medicaid MO,Medicaid MO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Medica,Medica,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Tricare,Tricare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC All Payer,UHC All Payer,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Exchange,UHC Exchange,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Medicaid,UHC Medicaid,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UMR CPD,UMR CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Medicare,UHC Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33144297,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Wellcare,Wellcare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health PPO CPD,Meritain Health PPO CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna/Commercial Product,Aetna/Commercial Product,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Meritain Health CPD,Meritain Health CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Starmark CPD,Starmark CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Aetna Medicare,Aetna Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Ambetter ,Ambetter ,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access,Anthem Blue Access,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Access Choice,Anthem Blue Access Choice,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Blue Preferred,Anthem Blue Preferred,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Pathway,Anthem Pathway,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Alliance,Anthem Alliance,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Anthem Medicare,Anthem Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna,Cigna,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna PPO,Cigna PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Cigna Medicare Advantage,Cigna Medicare Advantage,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Essence,Essence,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink HMO,Healthlink HMO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Healthlink PPO,Healthlink PPO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,HomeState Health Plan,HomeState Health Plan,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Humana Gold,Humana Gold,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medicaid MO,Medicaid MO,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Medica,Medica,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Tricare,Tricare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC All Payer,UHC All Payer,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Exchange,UHC Exchange,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicaid,UHC Medicaid,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UMR CPD,UMR CPD,37.69,,,,,,,per diem,37.69,37.69,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,UHC Medicare,UHC Medicare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33144298,CDM,279,RC,,,,,,Inpatient,,,37.69,37.69,Wellcare,Wellcare,37.69,,,,,,,case rate,37.69,37.69,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Meritain Health PPO CPD,Meritain Health PPO CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna/Commercial Product,Aetna/Commercial Product,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Meritain Health CPD,Meritain Health CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Starmark CPD,Starmark CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Aetna Medicare,Aetna Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Ambetter ,Ambetter ,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Access,Anthem Blue Access,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Access Choice,Anthem Blue Access Choice,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Blue Preferred,Anthem Blue Preferred,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Pathway,Anthem Pathway,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Alliance,Anthem Alliance,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Anthem Medicare,Anthem Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna,Cigna,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna PPO,Cigna PPO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Cigna Medicare Advantage,Cigna Medicare Advantage,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Essence,Essence,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthlink HMO,Healthlink HMO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Healthlink PPO,Healthlink PPO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,HomeState Health Plan,HomeState Health Plan,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Humana Gold,Humana Gold,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Medicaid MO,Medicaid MO,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Medica,Medica,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Tricare,Tricare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC All Payer,UHC All Payer,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Exchange,UHC Exchange,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Medicaid,UHC Medicaid,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UMR CPD,UMR CPD,34.29,,,,,,,per diem,34.29,34.29,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,UHC Medicare,UHC Medicare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33144299,CDM,279,RC,,,,,,Inpatient,,,34.29,34.29,Wellcare,Wellcare,34.29,,,,,,,case rate,34.29,34.29,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Meritain Health PPO CPD,Meritain Health PPO CPD,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Aetna/Commercial Product,Aetna/Commercial Product,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Meritain Health CPD,Meritain Health CPD,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Starmark CPD,Starmark CPD,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Aetna Medicare,Aetna Medicare,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Ambetter ,Ambetter ,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Blue Access,Anthem Blue Access,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Blue Access Choice,Anthem Blue Access Choice,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Blue Preferred,Anthem Blue Preferred,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Pathway,Anthem Pathway,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Alliance,Anthem Alliance,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Anthem Medicare,Anthem Medicare,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Cigna,Cigna,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Cigna PPO,Cigna PPO,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Cigna Medicare Advantage,Cigna Medicare Advantage,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Essence,Essence,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Healthlink HMO,Healthlink HMO,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Healthlink PPO,Healthlink PPO,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,HomeState Health Plan,HomeState Health Plan,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Humana Gold,Humana Gold,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Medicaid MO,Medicaid MO,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Medica,Medica,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Tricare,Tricare,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,UHC All Payer,UHC All Payer,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,UHC Exchange,UHC Exchange,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,UHC Medicaid,UHC Medicaid,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,UMR CPD,UMR CPD,159.64,,,,,,,per diem,159.64,159.64,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,UHC Medicare,UHC Medicare,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR   ,33144300,CDM,279,RC,,,,,,Inpatient,,,159.64,159.64,Wellcare,Wellcare,159.64,,,,,,,case rate,159.64,159.64,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Meritain Health PPO CPD,Meritain Health PPO CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna/Commercial Product,Aetna/Commercial Product,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Meritain Health CPD,Meritain Health CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Starmark CPD,Starmark CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Aetna Medicare,Aetna Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Ambetter ,Ambetter ,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Access,Anthem Blue Access,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Access Choice,Anthem Blue Access Choice,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Blue Preferred,Anthem Blue Preferred,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Pathway,Anthem Pathway,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Alliance,Anthem Alliance,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Anthem Medicare,Anthem Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna,Cigna,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna PPO,Cigna PPO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Cigna Medicare Advantage,Cigna Medicare Advantage,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Essence,Essence,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthlink HMO,Healthlink HMO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Healthlink PPO,Healthlink PPO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,HomeState Health Plan,HomeState Health Plan,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Humana Gold,Humana Gold,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Medicaid MO,Medicaid MO,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Medica,Medica,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Tricare,Tricare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC All Payer,UHC All Payer,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Exchange,UHC Exchange,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Medicaid,UHC Medicaid,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,UMR CPD,UMR CPD,190,,,,,,,per diem,190,190,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,UHC Medicare,UHC Medicare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33144301,CDM,279,RC,,,,,,Inpatient,,,190,190,Wellcare,Wellcare,190,,,,,,,case rate,190,190,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health PPO CPD,Meritain Health PPO CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna/Commercial Product,Aetna/Commercial Product,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Meritain Health CPD,Meritain Health CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Starmark CPD,Starmark CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Aetna Medicare,Aetna Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Ambetter ,Ambetter ,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access,Anthem Blue Access,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Access Choice,Anthem Blue Access Choice,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Blue Preferred,Anthem Blue Preferred,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Pathway,Anthem Pathway,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Alliance,Anthem Alliance,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Anthem Medicare,Anthem Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna,Cigna,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna PPO,Cigna PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Cigna Medicare Advantage,Cigna Medicare Advantage,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Essence,Essence,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink HMO,Healthlink HMO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Healthlink PPO,Healthlink PPO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,HomeState Health Plan,HomeState Health Plan,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Humana Gold,Humana Gold,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medicaid MO,Medicaid MO,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Medica,Medica,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Tricare,Tricare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC All Payer,UHC All Payer,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Exchange,UHC Exchange,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicaid,UHC Medicaid,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UMR CPD,UMR CPD,45.8,,,,,,,per diem,45.8,45.8,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,UHC Medicare,UHC Medicare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33144302,CDM,279,RC,,,,,,Inpatient,,,45.8,45.8,Wellcare,Wellcare,45.8,,,,,,,case rate,45.8,45.8,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Meritain Health PPO CPD,Meritain Health PPO CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna/Commercial Product,Aetna/Commercial Product,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Meritain Health CPD,Meritain Health CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Starmark CPD,Starmark CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Aetna Medicare,Aetna Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Ambetter ,Ambetter ,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Access,Anthem Blue Access,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Access Choice,Anthem Blue Access Choice,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Blue Preferred,Anthem Blue Preferred,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Pathway,Anthem Pathway,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Alliance,Anthem Alliance,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Anthem Medicare,Anthem Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna,Cigna,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna PPO,Cigna PPO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Cigna Medicare Advantage,Cigna Medicare Advantage,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Essence,Essence,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthlink HMO,Healthlink HMO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Healthlink PPO,Healthlink PPO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,HomeState Health Plan,HomeState Health Plan,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Humana Gold,Humana Gold,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Medicaid MO,Medicaid MO,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Medica,Medica,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Tricare,Tricare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC All Payer,UHC All Payer,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Exchange,UHC Exchange,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Medicaid,UHC Medicaid,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UMR CPD,UMR CPD,22.51,,,,,,,per diem,22.51,22.51,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,UHC Medicare,UHC Medicare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33144303,CDM,279,RC,,,,,,Inpatient,,,22.51,22.51,Wellcare,Wellcare,22.51,,,,,,,case rate,22.51,22.51,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health PPO CPD,Meritain Health PPO CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna/Commercial Product,Aetna/Commercial Product,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Meritain Health CPD,Meritain Health CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Starmark CPD,Starmark CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Aetna Medicare,Aetna Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Ambetter ,Ambetter ,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access,Anthem Blue Access,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Access Choice,Anthem Blue Access Choice,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Blue Preferred,Anthem Blue Preferred,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Pathway,Anthem Pathway,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Alliance,Anthem Alliance,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Anthem Medicare,Anthem Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna,Cigna,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna PPO,Cigna PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Cigna Medicare Advantage,Cigna Medicare Advantage,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Essence,Essence,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink HMO,Healthlink HMO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Healthlink PPO,Healthlink PPO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,HomeState Health Plan,HomeState Health Plan,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Humana Gold,Humana Gold,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medicaid MO,Medicaid MO,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Medica,Medica,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Tricare,Tricare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC All Payer,UHC All Payer,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Exchange,UHC Exchange,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicaid,UHC Medicaid,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UMR CPD,UMR CPD,4.98,,,,,,,per diem,4.98,4.98,"Per diem rate, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,UHC Medicare,UHC Medicare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
MEDLEY PUMP MODULE LVP DAILY  ,33144305,CDM,279,RC,,,,,,Inpatient,,,4.98,4.98,Wellcare,Wellcare,4.98,,,,,,,case rate,4.98,4.98,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Meritain Health PPO CPD,Meritain Health PPO CPD,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Aetna/Commercial Product,Aetna/Commercial Product,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Meritain Health CPD,Meritain Health CPD,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Starmark CPD,Starmark CPD,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Aetna Medicare,Aetna Medicare,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Ambetter ,Ambetter ,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Blue Access,Anthem Blue Access,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Blue Access Choice,Anthem Blue Access Choice,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Blue Preferred,Anthem Blue Preferred,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Pathway,Anthem Pathway,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Alliance,Anthem Alliance,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Anthem Medicare,Anthem Medicare,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Cigna,Cigna,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Cigna PPO,Cigna PPO,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Cigna Medicare Advantage,Cigna Medicare Advantage,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Essence,Essence,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Healthlink HMO,Healthlink HMO,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Healthlink PPO,Healthlink PPO,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,HomeState Health Plan,HomeState Health Plan,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Humana Gold,Humana Gold,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Medicaid MO,Medicaid MO,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Medica,Medica,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Tricare,Tricare,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,UHC All Payer,UHC All Payer,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,UHC Exchange,UHC Exchange,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,UHC Medicaid,UHC Medicaid,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,UMR CPD,UMR CPD,8.12,,,,,,,per diem,8.12,8.12,"Per diem rate, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,UHC Medicare,UHC Medicare,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
KANGAROO PUMP ENTERAL DAILY   ,33144307,CDM,279,RC,,,,,,Inpatient,,,8.12,8.12,Wellcare,Wellcare,8.12,,,,,,,case rate,8.12,8.12,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Meritain Health PPO CPD,Meritain Health PPO CPD,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Aetna/Commercial Product,Aetna/Commercial Product,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Meritain Health CPD,Meritain Health CPD,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Starmark CPD,Starmark CPD,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Aetna Medicare,Aetna Medicare,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Ambetter ,Ambetter ,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Blue Access,Anthem Blue Access,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Blue Access Choice,Anthem Blue Access Choice,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Blue Preferred,Anthem Blue Preferred,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Pathway,Anthem Pathway,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Alliance,Anthem Alliance,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Anthem Medicare,Anthem Medicare,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Cigna,Cigna,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Cigna PPO,Cigna PPO,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Cigna Medicare Advantage,Cigna Medicare Advantage,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Essence,Essence,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Healthlink HMO,Healthlink HMO,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Healthlink PPO,Healthlink PPO,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,HomeState Health Plan,HomeState Health Plan,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Humana Gold,Humana Gold,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Medicaid MO,Medicaid MO,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Medica,Medica,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Tricare,Tricare,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,UHC All Payer,UHC All Payer,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,UHC Exchange,UHC Exchange,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,UHC Medicaid,UHC Medicaid,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,UMR CPD,UMR CPD,62.03,,,,,,,per diem,62.03,62.03,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,UHC Medicare,UHC Medicare,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 RECL/         ,33144309,CDM,279,RC,,,,,,Inpatient,,,62.03,62.03,Wellcare,Wellcare,62.03,,,,,,,case rate,62.03,62.03,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Meritain Health PPO CPD,Meritain Health PPO CPD,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Aetna/Commercial Product,Aetna/Commercial Product,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Meritain Health CPD,Meritain Health CPD,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Starmark CPD,Starmark CPD,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Aetna Medicare,Aetna Medicare,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Ambetter ,Ambetter ,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Blue Access,Anthem Blue Access,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Blue Access Choice,Anthem Blue Access Choice,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Blue Preferred,Anthem Blue Preferred,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Pathway,Anthem Pathway,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Alliance,Anthem Alliance,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Anthem Medicare,Anthem Medicare,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Cigna,Cigna,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Cigna PPO,Cigna PPO,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Cigna Medicare Advantage,Cigna Medicare Advantage,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Essence,Essence,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Healthlink HMO,Healthlink HMO,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Healthlink PPO,Healthlink PPO,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,HomeState Health Plan,HomeState Health Plan,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Humana Gold,Humana Gold,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Medicaid MO,Medicaid MO,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Medica,Medica,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Tricare,Tricare,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,UHC All Payer,UHC All Payer,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,UHC Exchange,UHC Exchange,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,UHC Medicaid,UHC Medicaid,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,UMR CPD,UMR CPD,39.02,,,,,,,per diem,39.02,39.02,"Per diem rate, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,UHC Medicare,UHC Medicare,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
SHOWER COMMODE CHAIR 750LB    ,33144310,CDM,279,RC,,,,,,Inpatient,,,39.02,39.02,Wellcare,Wellcare,39.02,,,,,,,case rate,39.02,39.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Meritain Health PPO CPD,Meritain Health PPO CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna/Commercial Product,Aetna/Commercial Product,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Meritain Health CPD,Meritain Health CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Starmark CPD,Starmark CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna Medicare,Aetna Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Ambetter ,Ambetter ,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Access,Anthem Blue Access,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Access Choice,Anthem Blue Access Choice,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Preferred,Anthem Blue Preferred,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Pathway,Anthem Pathway,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Alliance,Anthem Alliance,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Medicare,Anthem Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna,Cigna,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna PPO,Cigna PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna Medicare Advantage,Cigna Medicare Advantage,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Essence,Essence,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthlink HMO,Healthlink HMO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthlink PPO,Healthlink PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,HomeState Health Plan,HomeState Health Plan,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Humana Gold,Humana Gold,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Medicaid MO,Medicaid MO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Medica,Medica,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Tricare,Tricare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC All Payer,UHC All Payer,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Exchange,UHC Exchange,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Medicaid,UHC Medicaid,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UMR CPD,UMR CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Medicare,UHC Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
BARIATRIC LIFT 600LB CAP      ,33144311,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Wellcare,Wellcare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Meritain Health PPO CPD,Meritain Health PPO CPD,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Aetna/Commercial Product,Aetna/Commercial Product,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Meritain Health CPD,Meritain Health CPD,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Starmark CPD,Starmark CPD,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Aetna Medicare,Aetna Medicare,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Ambetter ,Ambetter ,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Blue Access,Anthem Blue Access,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Blue Access Choice,Anthem Blue Access Choice,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Blue Preferred,Anthem Blue Preferred,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Pathway,Anthem Pathway,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Alliance,Anthem Alliance,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Anthem Medicare,Anthem Medicare,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Cigna,Cigna,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Cigna PPO,Cigna PPO,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Cigna Medicare Advantage,Cigna Medicare Advantage,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Essence,Essence,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Healthlink HMO,Healthlink HMO,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Healthlink PPO,Healthlink PPO,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,HomeState Health Plan,HomeState Health Plan,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Humana Gold,Humana Gold,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Medicaid MO,Medicaid MO,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Medica,Medica,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Tricare,Tricare,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,UHC All Payer,UHC All Payer,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,UHC Exchange,UHC Exchange,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,UHC Medicaid,UHC Medicaid,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,UMR CPD,UMR CPD,182.94,,,,,,,per diem,182.94,182.94,"Per diem rate, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,UHC Medicare,UHC Medicare,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
DOLPHIN BARIATRIC MATTRESS    ,33144312,CDM,279,RC,,,,,,Inpatient,,,182.94,182.94,Wellcare,Wellcare,182.94,,,,,,,case rate,182.94,182.94,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Meritain Health PPO CPD,Meritain Health PPO CPD,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Aetna/Commercial Product,Aetna/Commercial Product,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Meritain Health CPD,Meritain Health CPD,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Starmark CPD,Starmark CPD,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Aetna Medicare,Aetna Medicare,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Ambetter ,Ambetter ,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Blue Access,Anthem Blue Access,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Blue Access Choice,Anthem Blue Access Choice,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Blue Preferred,Anthem Blue Preferred,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Pathway,Anthem Pathway,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Alliance,Anthem Alliance,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Anthem Medicare,Anthem Medicare,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Cigna,Cigna,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Cigna PPO,Cigna PPO,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Cigna Medicare Advantage,Cigna Medicare Advantage,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Essence,Essence,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Healthlink HMO,Healthlink HMO,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Healthlink PPO,Healthlink PPO,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,HomeState Health Plan,HomeState Health Plan,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Humana Gold,Humana Gold,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Medicaid MO,Medicaid MO,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Medica,Medica,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Tricare,Tricare,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,UHC All Payer,UHC All Payer,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,UHC Exchange,UHC Exchange,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,UHC Medicaid,UHC Medicaid,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,UMR CPD,UMR CPD,21.99,,,,,,,per diem,21.99,21.99,"Per diem rate, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,UHC Medicare,UHC Medicare,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
POSEY BED BUMPER PAD 49       ,33144314,CDM,279,RC,,,,,,Inpatient,,,21.99,21.99,Wellcare,Wellcare,21.99,,,,,,,case rate,21.99,21.99,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Meritain Health PPO CPD,Meritain Health PPO CPD,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Aetna/Commercial Product,Aetna/Commercial Product,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Meritain Health CPD,Meritain Health CPD,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Starmark CPD,Starmark CPD,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Aetna Medicare,Aetna Medicare,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Ambetter ,Ambetter ,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Blue Access,Anthem Blue Access,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Blue Access Choice,Anthem Blue Access Choice,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Blue Preferred,Anthem Blue Preferred,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Pathway,Anthem Pathway,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Alliance,Anthem Alliance,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Anthem Medicare,Anthem Medicare,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Cigna,Cigna,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Cigna PPO,Cigna PPO,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Cigna Medicare Advantage,Cigna Medicare Advantage,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Essence,Essence,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Healthlink HMO,Healthlink HMO,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Healthlink PPO,Healthlink PPO,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,HomeState Health Plan,HomeState Health Plan,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Humana Gold,Humana Gold,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Medicaid MO,Medicaid MO,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Medica,Medica,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Tricare,Tricare,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,UHC All Payer,UHC All Payer,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,UHC Exchange,UHC Exchange,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,UHC Medicaid,UHC Medicaid,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,UMR CPD,UMR CPD,244.69,,,,,,,per diem,244.69,244.69,"Per diem rate, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,UHC Medicare,UHC Medicare,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
VAC ULTA THERAPY UNIT DAILY   ,33144315,CDM,279,RC,,,,,,Inpatient,,,244.69,244.69,Wellcare,Wellcare,244.69,,,,,,,case rate,244.69,244.69,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Meritain Health PPO CPD,Meritain Health PPO CPD,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Aetna/Commercial Product,Aetna/Commercial Product,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Meritain Health CPD,Meritain Health CPD,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Starmark CPD,Starmark CPD,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Aetna Medicare,Aetna Medicare,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Ambetter ,Ambetter ,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Blue Access,Anthem Blue Access,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Blue Access Choice,Anthem Blue Access Choice,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Blue Preferred,Anthem Blue Preferred,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Pathway,Anthem Pathway,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Alliance,Anthem Alliance,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Anthem Medicare,Anthem Medicare,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Cigna,Cigna,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Cigna PPO,Cigna PPO,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Cigna Medicare Advantage,Cigna Medicare Advantage,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Essence,Essence,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Healthlink HMO,Healthlink HMO,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Healthlink PPO,Healthlink PPO,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,HomeState Health Plan,HomeState Health Plan,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Humana Gold,Humana Gold,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Medicaid MO,Medicaid MO,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Medica,Medica,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Tricare,Tricare,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,UHC All Payer,UHC All Payer,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,UHC Exchange,UHC Exchange,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,UHC Medicaid,UHC Medicaid,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,UMR CPD,UMR CPD,20.42,,,,,,,per diem,20.42,20.42,"Per diem rate, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,UHC Medicare,UHC Medicare,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
SPECTRA CPM DAILY RENTAL UHC  ,33144316,CDM,279,RC,,,,,,Inpatient,,,20.42,20.42,Wellcare,Wellcare,20.42,,,,,,,case rate,20.42,20.42,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Meritain Health PPO CPD,Meritain Health PPO CPD,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Aetna/Commercial Product,Aetna/Commercial Product,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Meritain Health CPD,Meritain Health CPD,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Starmark CPD,Starmark CPD,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Aetna Medicare,Aetna Medicare,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Ambetter ,Ambetter ,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Blue Access,Anthem Blue Access,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Blue Access Choice,Anthem Blue Access Choice,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Blue Preferred,Anthem Blue Preferred,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Pathway,Anthem Pathway,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Alliance,Anthem Alliance,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Anthem Medicare,Anthem Medicare,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Cigna,Cigna,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Cigna PPO,Cigna PPO,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Cigna Medicare Advantage,Cigna Medicare Advantage,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Essence,Essence,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Healthlink HMO,Healthlink HMO,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Healthlink PPO,Healthlink PPO,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,HomeState Health Plan,HomeState Health Plan,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Humana Gold,Humana Gold,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Medicaid MO,Medicaid MO,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Medica,Medica,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Tricare,Tricare,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,UHC All Payer,UHC All Payer,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,UHC Exchange,UHC Exchange,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,UHC Medicaid,UHC Medicaid,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,UMR CPD,UMR CPD,146.29,,,,,,,per diem,146.29,146.29,"Per diem rate, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,UHC Medicare,UHC Medicare,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
"POSEY 8070 SAFE BED FRAME,    ",33144317,CDM,279,RC,,,,,,Inpatient,,,146.29,146.29,Wellcare,Wellcare,146.29,,,,,,,case rate,146.29,146.29,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Meritain Health PPO CPD,Meritain Health PPO CPD,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Aetna/Commercial Product,Aetna/Commercial Product,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Meritain Health CPD,Meritain Health CPD,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Starmark CPD,Starmark CPD,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Aetna Medicare,Aetna Medicare,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Ambetter ,Ambetter ,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Blue Access,Anthem Blue Access,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Blue Access Choice,Anthem Blue Access Choice,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Blue Preferred,Anthem Blue Preferred,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Pathway,Anthem Pathway,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Alliance,Anthem Alliance,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Anthem Medicare,Anthem Medicare,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Cigna,Cigna,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Cigna PPO,Cigna PPO,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Cigna Medicare Advantage,Cigna Medicare Advantage,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Essence,Essence,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Healthlink HMO,Healthlink HMO,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Healthlink PPO,Healthlink PPO,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,HomeState Health Plan,HomeState Health Plan,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Humana Gold,Humana Gold,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Medicaid MO,Medicaid MO,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Medica,Medica,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Tricare,Tricare,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,UHC All Payer,UHC All Payer,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,UHC Exchange,UHC Exchange,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,UHC Medicaid,UHC Medicaid,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,UMR CPD,UMR CPD,230.3,,,,,,,per diem,230.3,230.3,"Per diem rate, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,UHC Medicare,UHC Medicare,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
BARIATRIC BED 1000LB RENTAL   ,33144318,CDM,279,RC,,,,,,Inpatient,,,230.3,230.3,Wellcare,Wellcare,230.3,,,,,,,case rate,230.3,230.3,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Meritain Health PPO CPD,Meritain Health PPO CPD,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Aetna/Commercial Product,Aetna/Commercial Product,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Meritain Health CPD,Meritain Health CPD,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Starmark CPD,Starmark CPD,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Aetna Medicare,Aetna Medicare,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Ambetter ,Ambetter ,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Blue Access,Anthem Blue Access,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Blue Access Choice,Anthem Blue Access Choice,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Blue Preferred,Anthem Blue Preferred,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Pathway,Anthem Pathway,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Alliance,Anthem Alliance,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Anthem Medicare,Anthem Medicare,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Cigna,Cigna,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Cigna PPO,Cigna PPO,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Cigna Medicare Advantage,Cigna Medicare Advantage,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Essence,Essence,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Healthlink HMO,Healthlink HMO,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Healthlink PPO,Healthlink PPO,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,HomeState Health Plan,HomeState Health Plan,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Humana Gold,Humana Gold,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Medicaid MO,Medicaid MO,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Medica,Medica,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Tricare,Tricare,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,UHC All Payer,UHC All Payer,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,UHC Exchange,UHC Exchange,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,UHC Medicaid,UHC Medicaid,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,UMR CPD,UMR CPD,91.33,,,,,,,per diem,91.33,91.33,"Per diem rate, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,UHC Medicare,UHC Medicare,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
"SECURE II BED 35X84, 500LB,   ",33144319,CDM,279,RC,,,,,,Inpatient,,,91.33,91.33,Wellcare,Wellcare,91.33,,,,,,,case rate,91.33,91.33,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Meritain Health PPO CPD,Meritain Health PPO CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna/Commercial Product,Aetna/Commercial Product,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Meritain Health CPD,Meritain Health CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Starmark CPD,Starmark CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Aetna Medicare,Aetna Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Ambetter ,Ambetter ,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Access,Anthem Blue Access,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Access Choice,Anthem Blue Access Choice,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Blue Preferred,Anthem Blue Preferred,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Pathway,Anthem Pathway,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Alliance,Anthem Alliance,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Anthem Medicare,Anthem Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna,Cigna,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna PPO,Cigna PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Cigna Medicare Advantage,Cigna Medicare Advantage,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Essence,Essence,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthlink HMO,Healthlink HMO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Healthlink PPO,Healthlink PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,HomeState Health Plan,HomeState Health Plan,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Humana Gold,Humana Gold,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Medicaid MO,Medicaid MO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Medica,Medica,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Tricare,Tricare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC All Payer,UHC All Payer,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Exchange,UHC Exchange,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Medicaid,UHC Medicaid,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UMR CPD,UMR CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,UHC Medicare,UHC Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
STAGE IV 3000 AP/LAL MATTRESS ,33144322,CDM,279,RC,,,,,,Inpatient,,,73.02,73.02,Wellcare,Wellcare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Meritain Health PPO CPD,Meritain Health PPO CPD,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Aetna/Commercial Product,Aetna/Commercial Product,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Meritain Health CPD,Meritain Health CPD,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Starmark CPD,Starmark CPD,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Aetna Medicare,Aetna Medicare,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Ambetter ,Ambetter ,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Blue Access,Anthem Blue Access,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Blue Access Choice,Anthem Blue Access Choice,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Blue Preferred,Anthem Blue Preferred,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Pathway,Anthem Pathway,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Alliance,Anthem Alliance,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Anthem Medicare,Anthem Medicare,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Cigna,Cigna,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Cigna PPO,Cigna PPO,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Cigna Medicare Advantage,Cigna Medicare Advantage,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Essence,Essence,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Healthlink HMO,Healthlink HMO,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Healthlink PPO,Healthlink PPO,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,HomeState Health Plan,HomeState Health Plan,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Humana Gold,Humana Gold,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Medicaid MO,Medicaid MO,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Medica,Medica,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Tricare,Tricare,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,UHC All Payer,UHC All Payer,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,UHC Exchange,UHC Exchange,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,UHC Medicaid,UHC Medicaid,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,UMR CPD,UMR CPD,127.98,,,,,,,per diem,127.98,127.98,"Per diem rate, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,UHC Medicare,UHC Medicare,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
TRIFLEX 2 BED PLATFOMR 1000LB ,33144323,CDM,279,RC,,,,,,Inpatient,,,127.98,127.98,Wellcare,Wellcare,127.98,,,,,,,case rate,127.98,127.98,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Meritain Health PPO CPD,Meritain Health PPO CPD,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Aetna/Commercial Product,Aetna/Commercial Product,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Meritain Health CPD,Meritain Health CPD,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Starmark CPD,Starmark CPD,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Aetna Medicare,Aetna Medicare,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Ambetter ,Ambetter ,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Blue Access,Anthem Blue Access,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Blue Access Choice,Anthem Blue Access Choice,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Blue Preferred,Anthem Blue Preferred,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Pathway,Anthem Pathway,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Alliance,Anthem Alliance,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Anthem Medicare,Anthem Medicare,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Cigna,Cigna,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Cigna PPO,Cigna PPO,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Cigna Medicare Advantage,Cigna Medicare Advantage,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Essence,Essence,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Healthlink HMO,Healthlink HMO,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Healthlink PPO,Healthlink PPO,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,HomeState Health Plan,HomeState Health Plan,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Humana Gold,Humana Gold,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Medicaid MO,Medicaid MO,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Medica,Medica,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Tricare,Tricare,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,UHC All Payer,UHC All Payer,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,UHC Exchange,UHC Exchange,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,UHC Medicaid,UHC Medicaid,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,UMR CPD,UMR CPD,18.32,,,,,,,per diem,18.32,18.32,"Per diem rate, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,UHC Medicare,UHC Medicare,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
REM MATTRESS-STRYKER BED FRAME,33144324,CDM,279,RC,,,,,,Inpatient,,,18.32,18.32,Wellcare,Wellcare,18.32,,,,,,,case rate,18.32,18.32,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Meritain Health PPO CPD,Meritain Health PPO CPD,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Aetna/Commercial Product,Aetna/Commercial Product,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Meritain Health CPD,Meritain Health CPD,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Starmark CPD,Starmark CPD,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Aetna Medicare,Aetna Medicare,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Ambetter ,Ambetter ,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Blue Access,Anthem Blue Access,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Blue Access Choice,Anthem Blue Access Choice,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Blue Preferred,Anthem Blue Preferred,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Pathway,Anthem Pathway,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Alliance,Anthem Alliance,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Anthem Medicare,Anthem Medicare,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Cigna,Cigna,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Cigna PPO,Cigna PPO,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Cigna Medicare Advantage,Cigna Medicare Advantage,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Essence,Essence,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Healthlink HMO,Healthlink HMO,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Healthlink PPO,Healthlink PPO,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,HomeState Health Plan,HomeState Health Plan,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Humana Gold,Humana Gold,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Medicaid MO,Medicaid MO,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Medica,Medica,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Tricare,Tricare,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,UHC All Payer,UHC All Payer,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,UHC Exchange,UHC Exchange,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,UHC Medicaid,UHC Medicaid,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,UMR CPD,UMR CPD,35.81,,,,,,,per diem,35.81,35.81,"Per diem rate, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,UHC Medicare,UHC Medicare,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
CERVICAL COLLAR OPEN TRACHEA  ,33144363,CDM,270,RC,,,,,,Inpatient,,,35.81,35.81,Wellcare,Wellcare,35.81,,,,,,,case rate,35.81,35.81,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Meritain Health PPO CPD,Meritain Health PPO CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna/Commercial Product,Aetna/Commercial Product,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Meritain Health CPD,Meritain Health CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Starmark CPD,Starmark CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna Medicare,Aetna Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Ambetter ,Ambetter ,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Access,Anthem Blue Access,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Access Choice,Anthem Blue Access Choice,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Preferred,Anthem Blue Preferred,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Pathway,Anthem Pathway,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Alliance,Anthem Alliance,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Medicare,Anthem Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna,Cigna,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna PPO,Cigna PPO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna Medicare Advantage,Cigna Medicare Advantage,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Essence,Essence,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthlink HMO,Healthlink HMO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthlink PPO,Healthlink PPO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,HomeState Health Plan,HomeState Health Plan,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Humana Gold,Humana Gold,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Medicaid MO,Medicaid MO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Medica,Medica,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Tricare,Tricare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC All Payer,UHC All Payer,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Exchange,UHC Exchange,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Medicaid,UHC Medicaid,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UMR CPD,UMR CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Medicare,UHC Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
ALARIS PUMP RENTAL            ,33144364,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Wellcare,Wellcare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Meritain Health PPO CPD,Meritain Health PPO CPD,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Aetna/Commercial Product,Aetna/Commercial Product,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Meritain Health CPD,Meritain Health CPD,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Starmark CPD,Starmark CPD,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Aetna Medicare,Aetna Medicare,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Ambetter ,Ambetter ,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Blue Access,Anthem Blue Access,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Blue Access Choice,Anthem Blue Access Choice,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Blue Preferred,Anthem Blue Preferred,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Pathway,Anthem Pathway,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Alliance,Anthem Alliance,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Anthem Medicare,Anthem Medicare,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Cigna,Cigna,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Cigna PPO,Cigna PPO,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Cigna Medicare Advantage,Cigna Medicare Advantage,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Essence,Essence,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Healthlink HMO,Healthlink HMO,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Healthlink PPO,Healthlink PPO,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,HomeState Health Plan,HomeState Health Plan,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Humana Gold,Humana Gold,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Medicaid MO,Medicaid MO,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Medica,Medica,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Tricare,Tricare,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,UHC All Payer,UHC All Payer,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,UHC Exchange,UHC Exchange,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,UHC Medicaid,UHC Medicaid,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,UMR CPD,UMR CPD,41.56,,,,,,,per diem,41.56,41.56,"Per diem rate, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,UHC Medicare,UHC Medicare,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
DOLPHIN MATTRESS              ,33144365,CDM,279,RC,,,,,,Inpatient,,,41.56,41.56,Wellcare,Wellcare,41.56,,,,,,,case rate,41.56,41.56,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Meritain Health PPO CPD,Meritain Health PPO CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna/Commercial Product,Aetna/Commercial Product,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Meritain Health CPD,Meritain Health CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Starmark CPD,Starmark CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Aetna Medicare,Aetna Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Ambetter ,Ambetter ,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Access,Anthem Blue Access,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Access Choice,Anthem Blue Access Choice,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Blue Preferred,Anthem Blue Preferred,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Pathway,Anthem Pathway,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Alliance,Anthem Alliance,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Anthem Medicare,Anthem Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna,Cigna,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna PPO,Cigna PPO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Cigna Medicare Advantage,Cigna Medicare Advantage,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Essence,Essence,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthlink HMO,Healthlink HMO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Healthlink PPO,Healthlink PPO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,HomeState Health Plan,HomeState Health Plan,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Humana Gold,Humana Gold,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Medicaid MO,Medicaid MO,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Medica,Medica,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Tricare,Tricare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC All Payer,UHC All Payer,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Exchange,UHC Exchange,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Medicaid,UHC Medicaid,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UMR CPD,UMR CPD,6.89,,,,,,,per diem,6.89,6.89,"Per diem rate, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,UHC Medicare,UHC Medicare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
KANGAROO PUMP RENTAL          ,33144366,CDM,279,RC,,,,,,Inpatient,,,6.89,6.89,Wellcare,Wellcare,6.89,,,,,,,case rate,6.89,6.89,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Meritain Health PPO CPD,Meritain Health PPO CPD,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Aetna/Commercial Product,Aetna/Commercial Product,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Meritain Health CPD,Meritain Health CPD,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Starmark CPD,Starmark CPD,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Aetna Medicare,Aetna Medicare,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Ambetter ,Ambetter ,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Blue Access,Anthem Blue Access,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Blue Access Choice,Anthem Blue Access Choice,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Blue Preferred,Anthem Blue Preferred,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Pathway,Anthem Pathway,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Alliance,Anthem Alliance,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Anthem Medicare,Anthem Medicare,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Cigna,Cigna,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Cigna PPO,Cigna PPO,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Cigna Medicare Advantage,Cigna Medicare Advantage,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Essence,Essence,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Healthlink HMO,Healthlink HMO,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Healthlink PPO,Healthlink PPO,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,HomeState Health Plan,HomeState Health Plan,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Humana Gold,Humana Gold,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Medicaid MO,Medicaid MO,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Medica,Medica,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Tricare,Tricare,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,UHC All Payer,UHC All Payer,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,UHC Exchange,UHC Exchange,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,UHC Medicaid,UHC Medicaid,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,UMR CPD,UMR CPD,121.62,,,,,,,per diem,121.62,121.62,"Per diem rate, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,UHC Medicare,UHC Medicare,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
SHRINKER                      ,33144367,CDM,270,RC,L8440,HCPCS,,,,Inpatient,,,121.62,121.62,Wellcare,Wellcare,121.62,,,,,,,case rate,121.62,121.62,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
"ABD 9""                        ",33146444,CDM,270,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Meritain Health PPO CPD,Meritain Health PPO CPD,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Aetna/Commercial Product,Aetna/Commercial Product,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Meritain Health CPD,Meritain Health CPD,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Starmark CPD,Starmark CPD,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Aetna Medicare,Aetna Medicare,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Ambetter ,Ambetter ,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Blue Access,Anthem Blue Access,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Blue Access Choice,Anthem Blue Access Choice,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Blue Preferred,Anthem Blue Preferred,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Pathway,Anthem Pathway,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Alliance,Anthem Alliance,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Anthem Medicare,Anthem Medicare,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Cigna,Cigna,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Cigna PPO,Cigna PPO,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Cigna Medicare Advantage,Cigna Medicare Advantage,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Essence,Essence,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Healthlink HMO,Healthlink HMO,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Healthlink PPO,Healthlink PPO,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,HomeState Health Plan,HomeState Health Plan,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Humana Gold,Humana Gold,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Medicaid MO,Medicaid MO,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Medica,Medica,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Tricare,Tricare,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,UHC All Payer,UHC All Payer,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,UHC Exchange,UHC Exchange,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,UHC Medicaid,UHC Medicaid,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,UMR CPD,UMR CPD,9.3,,,,,,,per diem,9.3,9.3,"Per diem rate, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,UHC Medicare,UHC Medicare,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
SLINGS ARM                    ,33146450,CDM,270,RC,,,,,,Inpatient,,,9.3,9.3,Wellcare,Wellcare,9.3,,,,,,,case rate,9.3,9.3,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Meritain Health PPO CPD,Meritain Health PPO CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna/Commercial Product,Aetna/Commercial Product,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Meritain Health CPD,Meritain Health CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Starmark CPD,Starmark CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Aetna Medicare,Aetna Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Ambetter ,Ambetter ,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Access,Anthem Blue Access,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Access Choice,Anthem Blue Access Choice,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Blue Preferred,Anthem Blue Preferred,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Pathway,Anthem Pathway,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Alliance,Anthem Alliance,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Anthem Medicare,Anthem Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna,Cigna,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna PPO,Cigna PPO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Cigna Medicare Advantage,Cigna Medicare Advantage,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Essence,Essence,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthlink HMO,Healthlink HMO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Healthlink PPO,Healthlink PPO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,HomeState Health Plan,HomeState Health Plan,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Humana Gold,Humana Gold,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Medicaid MO,Medicaid MO,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Medica,Medica,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Tricare,Tricare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC All Payer,UHC All Payer,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Exchange,UHC Exchange,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Medicaid,UHC Medicaid,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UMR CPD,UMR CPD,17.54,,,,,,,per diem,17.54,17.54,"Per diem rate, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,UHC Medicare,UHC Medicare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
POST OP SHOES                 ,33146451,CDM,270,RC,,,,,,Inpatient,,,17.54,17.54,Wellcare,Wellcare,17.54,,,,,,,case rate,17.54,17.54,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33146639,CDM,279,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Meritain Health PPO CPD,Meritain Health PPO CPD,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Aetna/Commercial Product,Aetna/Commercial Product,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Meritain Health CPD,Meritain Health CPD,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Starmark CPD,Starmark CPD,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Aetna Medicare,Aetna Medicare,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Ambetter ,Ambetter ,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Blue Access,Anthem Blue Access,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Blue Access Choice,Anthem Blue Access Choice,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Blue Preferred,Anthem Blue Preferred,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Pathway,Anthem Pathway,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Alliance,Anthem Alliance,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Anthem Medicare,Anthem Medicare,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Cigna,Cigna,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Cigna PPO,Cigna PPO,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Cigna Medicare Advantage,Cigna Medicare Advantage,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Essence,Essence,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Healthlink HMO,Healthlink HMO,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Healthlink PPO,Healthlink PPO,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,HomeState Health Plan,HomeState Health Plan,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Humana Gold,Humana Gold,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Medicaid MO,Medicaid MO,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Medica,Medica,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Tricare,Tricare,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,UHC All Payer,UHC All Payer,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,UHC Exchange,UHC Exchange,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,UHC Medicaid,UHC Medicaid,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,UMR CPD,UMR CPD,59.74,,,,,,,per diem,59.74,59.74,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,UHC Medicare,UHC Medicare,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33146676,CDM,279,RC,,,,,,Inpatient,,,59.74,59.74,Wellcare,Wellcare,59.74,,,,,,,case rate,59.74,59.74,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Meritain Health PPO CPD,Meritain Health PPO CPD,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Aetna/Commercial Product,Aetna/Commercial Product,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Meritain Health CPD,Meritain Health CPD,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Starmark CPD,Starmark CPD,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Aetna Medicare,Aetna Medicare,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Ambetter ,Ambetter ,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Blue Access,Anthem Blue Access,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Blue Access Choice,Anthem Blue Access Choice,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Blue Preferred,Anthem Blue Preferred,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Pathway,Anthem Pathway,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Alliance,Anthem Alliance,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Anthem Medicare,Anthem Medicare,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Cigna,Cigna,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Cigna PPO,Cigna PPO,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Cigna Medicare Advantage,Cigna Medicare Advantage,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Essence,Essence,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Healthlink HMO,Healthlink HMO,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Healthlink PPO,Healthlink PPO,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,HomeState Health Plan,HomeState Health Plan,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Humana Gold,Humana Gold,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Medicaid MO,Medicaid MO,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Medica,Medica,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Tricare,Tricare,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,UHC All Payer,UHC All Payer,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,UHC Exchange,UHC Exchange,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,UHC Medicaid,UHC Medicaid,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,UMR CPD,UMR CPD,49.81,,,,,,,per diem,49.81,49.81,"Per diem rate, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,UHC Medicare,UHC Medicare,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
BI-PAP RENTAL (FREEDOM)       ,33146678,CDM,279,RC,,,,,,Inpatient,,,49.81,49.81,Wellcare,Wellcare,49.81,,,,,,,case rate,49.81,49.81,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Meritain Health PPO CPD,Meritain Health PPO CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna/Commercial Product,Aetna/Commercial Product,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Meritain Health CPD,Meritain Health CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Starmark CPD,Starmark CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna Medicare,Aetna Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Ambetter ,Ambetter ,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Access,Anthem Blue Access,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Access Choice,Anthem Blue Access Choice,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Preferred,Anthem Blue Preferred,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Pathway,Anthem Pathway,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Alliance,Anthem Alliance,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Medicare,Anthem Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna,Cigna,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna PPO,Cigna PPO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna Medicare Advantage,Cigna Medicare Advantage,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Essence,Essence,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthlink HMO,Healthlink HMO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthlink PPO,Healthlink PPO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,HomeState Health Plan,HomeState Health Plan,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Humana Gold,Humana Gold,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Medicaid MO,Medicaid MO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Medica,Medica,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Tricare,Tricare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC All Payer,UHC All Payer,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Exchange,UHC Exchange,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Medicaid,UHC Medicaid,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UMR CPD,UMR CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Medicare,UHC Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33146705,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Wellcare,Wellcare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health PPO CPD,Meritain Health PPO CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/Commercial Product,Aetna/Commercial Product,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health CPD,Meritain Health CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Starmark CPD,Starmark CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna Medicare,Aetna Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Ambetter ,Ambetter ,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access,Anthem Blue Access,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access Choice,Anthem Blue Access Choice,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Preferred,Anthem Blue Preferred,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Pathway,Anthem Pathway,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Alliance,Anthem Alliance,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Medicare,Anthem Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna,Cigna,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna PPO,Cigna PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna Medicare Advantage,Cigna Medicare Advantage,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Essence,Essence,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink HMO,Healthlink HMO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink PPO,Healthlink PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,HomeState Health Plan,HomeState Health Plan,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Humana Gold,Humana Gold,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Medicaid MO,Medicaid MO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Medica,Medica,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Tricare,Tricare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC All Payer,UHC All Payer,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Exchange,UHC Exchange,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicaid,UHC Medicaid,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,UMR CPD,UMR CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicare,UHC Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
BARIATRIC RECLINING CHAIR     ,33146715,CDM,279,RC,,,,,,Inpatient,,,75,75,Wellcare,Wellcare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SPECIAL ORDER     ",33146717,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
CPM HAND DAILY RENTAL         ,33146721,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Meritain Health PPO CPD,Meritain Health PPO CPD,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Aetna/Commercial Product,Aetna/Commercial Product,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Meritain Health CPD,Meritain Health CPD,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Starmark CPD,Starmark CPD,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Aetna Medicare,Aetna Medicare,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Ambetter ,Ambetter ,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Blue Access,Anthem Blue Access,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Blue Access Choice,Anthem Blue Access Choice,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Blue Preferred,Anthem Blue Preferred,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Pathway,Anthem Pathway,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Alliance,Anthem Alliance,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Anthem Medicare,Anthem Medicare,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Cigna,Cigna,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Cigna PPO,Cigna PPO,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Cigna Medicare Advantage,Cigna Medicare Advantage,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Essence,Essence,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Healthlink HMO,Healthlink HMO,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Healthlink PPO,Healthlink PPO,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,HomeState Health Plan,HomeState Health Plan,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Humana Gold,Humana Gold,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Medicaid MO,Medicaid MO,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Medica,Medica,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Tricare,Tricare,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,UHC All Payer,UHC All Payer,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,UHC Exchange,UHC Exchange,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,UHC Medicaid,UHC Medicaid,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,UMR CPD,UMR CPD,6.13,,,,,,,per diem,6.13,6.13,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,UHC Medicare,UHC Medicare,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY DAILY RENTAL   ,33146724,CDM,279,RC,,,,,,Inpatient,,,6.13,6.13,Wellcare,Wellcare,6.13,,,,,,,case rate,6.13,6.13,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARI RECLINER RENT            ,33146732,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health PPO CPD,Meritain Health PPO CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/Commercial Product,Aetna/Commercial Product,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health CPD,Meritain Health CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Starmark CPD,Starmark CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna Medicare,Aetna Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Ambetter ,Ambetter ,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access,Anthem Blue Access,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access Choice,Anthem Blue Access Choice,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Preferred,Anthem Blue Preferred,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Pathway,Anthem Pathway,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Alliance,Anthem Alliance,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Medicare,Anthem Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna,Cigna,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna PPO,Cigna PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna Medicare Advantage,Cigna Medicare Advantage,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Essence,Essence,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink HMO,Healthlink HMO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink PPO,Healthlink PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,HomeState Health Plan,HomeState Health Plan,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Humana Gold,Humana Gold,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medicaid MO,Medicaid MO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medica,Medica,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Tricare,Tricare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC All Payer,UHC All Payer,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Exchange,UHC Exchange,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicaid,UHC Medicaid,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UMR CPD,UMR CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicare,UHC Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC LW BED FIXED WI     ,33146733,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Wellcare,Wellcare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Meritain Health PPO CPD,Meritain Health PPO CPD,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Aetna/Commercial Product,Aetna/Commercial Product,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Meritain Health CPD,Meritain Health CPD,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Starmark CPD,Starmark CPD,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Aetna Medicare,Aetna Medicare,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Ambetter ,Ambetter ,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Blue Access,Anthem Blue Access,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Blue Access Choice,Anthem Blue Access Choice,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Blue Preferred,Anthem Blue Preferred,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Pathway,Anthem Pathway,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Alliance,Anthem Alliance,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Anthem Medicare,Anthem Medicare,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Cigna,Cigna,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Cigna PPO,Cigna PPO,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Cigna Medicare Advantage,Cigna Medicare Advantage,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Essence,Essence,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Healthlink HMO,Healthlink HMO,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Healthlink PPO,Healthlink PPO,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,HomeState Health Plan,HomeState Health Plan,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Humana Gold,Humana Gold,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Medicaid MO,Medicaid MO,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Medica,Medica,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Tricare,Tricare,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,UHC All Payer,UHC All Payer,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,UHC Exchange,UHC Exchange,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,UHC Medicaid,UHC Medicaid,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,UMR CPD,UMR CPD,47.64,,,,,,,per diem,47.64,47.64,"Per diem rate, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,UHC Medicare,UHC Medicare,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
BARIATRIC W/C 24/36 WIDTH     ,33146734,CDM,279,RC,,,,,,Inpatient,,,47.64,47.64,Wellcare,Wellcare,47.64,,,,,,,case rate,47.64,47.64,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health PPO CPD,Meritain Health PPO CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/Commercial Product,Aetna/Commercial Product,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health CPD,Meritain Health CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Starmark CPD,Starmark CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna Medicare,Aetna Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Ambetter ,Ambetter ,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access,Anthem Blue Access,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access Choice,Anthem Blue Access Choice,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Preferred,Anthem Blue Preferred,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Pathway,Anthem Pathway,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Alliance,Anthem Alliance,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Medicare,Anthem Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna,Cigna,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna PPO,Cigna PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna Medicare Advantage,Cigna Medicare Advantage,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Essence,Essence,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink HMO,Healthlink HMO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink PPO,Healthlink PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,HomeState Health Plan,HomeState Health Plan,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Humana Gold,Humana Gold,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Medicaid MO,Medicaid MO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Medica,Medica,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Tricare,Tricare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC All Payer,UHC All Payer,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Exchange,UHC Exchange,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicaid,UHC Medicaid,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,UMR CPD,UMR CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicare,UHC Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CHG LOW BED RENTAL            ,33146738,CDM,279,RC,,,,,,Inpatient,,,60,60,Wellcare,Wellcare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Meritain Health PPO CPD,Meritain Health PPO CPD,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Aetna/Commercial Product,Aetna/Commercial Product,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Meritain Health CPD,Meritain Health CPD,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Starmark CPD,Starmark CPD,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Aetna Medicare,Aetna Medicare,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Ambetter ,Ambetter ,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Blue Access,Anthem Blue Access,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Blue Access Choice,Anthem Blue Access Choice,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Blue Preferred,Anthem Blue Preferred,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Pathway,Anthem Pathway,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Alliance,Anthem Alliance,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Anthem Medicare,Anthem Medicare,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Cigna,Cigna,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Cigna PPO,Cigna PPO,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Cigna Medicare Advantage,Cigna Medicare Advantage,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Essence,Essence,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Healthlink HMO,Healthlink HMO,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Healthlink PPO,Healthlink PPO,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,HomeState Health Plan,HomeState Health Plan,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Humana Gold,Humana Gold,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Medicaid MO,Medicaid MO,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Medica,Medica,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Tricare,Tricare,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,UHC All Payer,UHC All Payer,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,UHC Exchange,UHC Exchange,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,UHC Medicaid,UHC Medicaid,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,UMR CPD,UMR CPD,554.4,,,,,,,per diem,554.4,554.4,"Per diem rate, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,UHC Medicare,UHC Medicare,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO M SERIES            ,33146741,CDM,279,RC,,,,,,Inpatient,,,554.4,554.4,Wellcare,Wellcare,554.4,,,,,,,case rate,554.4,554.4,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
CPAP AUTO RESRONIC RENTAL     ,33146742,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Meritain Health PPO CPD,Meritain Health PPO CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna/Commercial Product,Aetna/Commercial Product,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Meritain Health CPD,Meritain Health CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Starmark CPD,Starmark CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Aetna Medicare,Aetna Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Ambetter ,Ambetter ,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Access,Anthem Blue Access,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Access Choice,Anthem Blue Access Choice,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Blue Preferred,Anthem Blue Preferred,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Pathway,Anthem Pathway,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Alliance,Anthem Alliance,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Anthem Medicare,Anthem Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna,Cigna,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna PPO,Cigna PPO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Cigna Medicare Advantage,Cigna Medicare Advantage,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Essence,Essence,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthlink HMO,Healthlink HMO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Healthlink PPO,Healthlink PPO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,HomeState Health Plan,HomeState Health Plan,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Humana Gold,Humana Gold,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Medicaid MO,Medicaid MO,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Medica,Medica,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Tricare,Tricare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC All Payer,UHC All Payer,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Exchange,UHC Exchange,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Medicaid,UHC Medicaid,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UMR CPD,UMR CPD,170.72,,,,,,,per diem,170.72,170.72,"Per diem rate, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,UHC Medicare,UHC Medicare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
FREEDOM VAC RENTAL            ,33146747,CDM,279,RC,,,,,,Inpatient,,,170.72,170.72,Wellcare,Wellcare,170.72,,,,,,,case rate,170.72,170.72,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
KNEE CPM RENTAL               ,33146782,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health PPO CPD,Meritain Health PPO CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/Commercial Product,Aetna/Commercial Product,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health CPD,Meritain Health CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Starmark CPD,Starmark CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna Medicare,Aetna Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Ambetter ,Ambetter ,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access,Anthem Blue Access,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access Choice,Anthem Blue Access Choice,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Preferred,Anthem Blue Preferred,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Pathway,Anthem Pathway,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Alliance,Anthem Alliance,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Medicare,Anthem Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna,Cigna,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna PPO,Cigna PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna Medicare Advantage,Cigna Medicare Advantage,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Essence,Essence,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink HMO,Healthlink HMO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink PPO,Healthlink PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,HomeState Health Plan,HomeState Health Plan,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Humana Gold,Humana Gold,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Medicaid MO,Medicaid MO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Medica,Medica,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Tricare,Tricare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC All Payer,UHC All Payer,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Exchange,UHC Exchange,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicaid,UHC Medicaid,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,UMR CPD,UMR CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicare,UHC Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS RENTAL           ,33146783,CDM,279,RC,,,,,,Inpatient,,,24,24,Wellcare,Wellcare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health PPO CPD,Meritain Health PPO CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/Commercial Product,Aetna/Commercial Product,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health CPD,Meritain Health CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Starmark CPD,Starmark CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna Medicare,Aetna Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Ambetter ,Ambetter ,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access,Anthem Blue Access,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access Choice,Anthem Blue Access Choice,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Preferred,Anthem Blue Preferred,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Pathway,Anthem Pathway,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Alliance,Anthem Alliance,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Medicare,Anthem Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna,Cigna,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna PPO,Cigna PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna Medicare Advantage,Cigna Medicare Advantage,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Essence,Essence,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink HMO,Healthlink HMO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink PPO,Healthlink PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,HomeState Health Plan,HomeState Health Plan,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Humana Gold,Humana Gold,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Medicaid MO,Medicaid MO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Medica,Medica,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Tricare,Tricare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC All Payer,UHC All Payer,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Exchange,UHC Exchange,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicaid,UHC Medicaid,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,UMR CPD,UMR CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicare,UHC Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
LAL MATTRESS SYSTEM RENT      ,33146784,CDM,279,RC,,,,,,Inpatient,,,60,60,Wellcare,Wellcare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Meritain Health PPO CPD,Meritain Health PPO CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna/Commercial Product,Aetna/Commercial Product,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Meritain Health CPD,Meritain Health CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Starmark CPD,Starmark CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Aetna Medicare,Aetna Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Ambetter ,Ambetter ,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Access,Anthem Blue Access,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Access Choice,Anthem Blue Access Choice,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Blue Preferred,Anthem Blue Preferred,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Pathway,Anthem Pathway,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Alliance,Anthem Alliance,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Anthem Medicare,Anthem Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna,Cigna,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna PPO,Cigna PPO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Cigna Medicare Advantage,Cigna Medicare Advantage,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Essence,Essence,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthlink HMO,Healthlink HMO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Healthlink PPO,Healthlink PPO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,HomeState Health Plan,HomeState Health Plan,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Humana Gold,Humana Gold,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Medicaid MO,Medicaid MO,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Medica,Medica,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Tricare,Tricare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC All Payer,UHC All Payer,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Exchange,UHC Exchange,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Medicaid,UHC Medicaid,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UMR CPD,UMR CPD,6.18,,,,,,,per diem,6.18,6.18,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,UHC Medicare,UHC Medicare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY 1 SECT       ,33146786,CDM,279,RC,,,,,,Inpatient,,,6.18,6.18,Wellcare,Wellcare,6.18,,,,,,,case rate,6.18,6.18,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health PPO CPD,Meritain Health PPO CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/Commercial Product,Aetna/Commercial Product,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health CPD,Meritain Health CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Starmark CPD,Starmark CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna Medicare,Aetna Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Ambetter ,Ambetter ,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access,Anthem Blue Access,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access Choice,Anthem Blue Access Choice,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Preferred,Anthem Blue Preferred,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Pathway,Anthem Pathway,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Alliance,Anthem Alliance,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Medicare,Anthem Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna,Cigna,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna PPO,Cigna PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna Medicare Advantage,Cigna Medicare Advantage,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Essence,Essence,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink HMO,Healthlink HMO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink PPO,Healthlink PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,HomeState Health Plan,HomeState Health Plan,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Humana Gold,Humana Gold,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medicaid MO,Medicaid MO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medica,Medica,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Tricare,Tricare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC All Payer,UHC All Payer,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Exchange,UHC Exchange,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicaid,UHC Medicaid,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UMR CPD,UMR CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicare,UHC Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
MATTRESS OVERLAY W/CVR        ,33146787,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Wellcare,Wellcare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Meritain Health PPO CPD,Meritain Health PPO CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna/Commercial Product,Aetna/Commercial Product,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Meritain Health CPD,Meritain Health CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Starmark CPD,Starmark CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Aetna Medicare,Aetna Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Ambetter ,Ambetter ,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Access,Anthem Blue Access,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Access Choice,Anthem Blue Access Choice,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Blue Preferred,Anthem Blue Preferred,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Pathway,Anthem Pathway,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Alliance,Anthem Alliance,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Anthem Medicare,Anthem Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna,Cigna,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna PPO,Cigna PPO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Cigna Medicare Advantage,Cigna Medicare Advantage,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Essence,Essence,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthlink HMO,Healthlink HMO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Healthlink PPO,Healthlink PPO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,HomeState Health Plan,HomeState Health Plan,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Humana Gold,Humana Gold,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Medicaid MO,Medicaid MO,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Medica,Medica,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Tricare,Tricare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC All Payer,UHC All Payer,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Exchange,UHC Exchange,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Medicaid,UHC Medicaid,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UMR CPD,UMR CPD,187.25,,,,,,,per diem,187.25,187.25,"Per diem rate, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,UHC Medicare,UHC Medicare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
REST HAND ORHTO LG RIGHT      ,33146789,CDM,270,RC,,,,,,Inpatient,,,187.25,187.25,Wellcare,Wellcare,187.25,,,,,,,case rate,187.25,187.25,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health PPO CPD,Meritain Health PPO CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/Commercial Product,Aetna/Commercial Product,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health CPD,Meritain Health CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Starmark CPD,Starmark CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna Medicare,Aetna Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Ambetter ,Ambetter ,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access,Anthem Blue Access,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access Choice,Anthem Blue Access Choice,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Preferred,Anthem Blue Preferred,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Pathway,Anthem Pathway,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Alliance,Anthem Alliance,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Medicare,Anthem Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna,Cigna,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna PPO,Cigna PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna Medicare Advantage,Cigna Medicare Advantage,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Essence,Essence,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink HMO,Healthlink HMO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink PPO,Healthlink PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,HomeState Health Plan,HomeState Health Plan,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Humana Gold,Humana Gold,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medicaid MO,Medicaid MO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medica,Medica,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Tricare,Tricare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC All Payer,UHC All Payer,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Exchange,UHC Exchange,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicaid,UHC Medicaid,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UMR CPD,UMR CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicare,UHC Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO CUSHION RECLINER RNT     ,33146791,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Wellcare,Wellcare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health PPO CPD,Meritain Health PPO CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna/Commercial Product,Aetna/Commercial Product,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Meritain Health CPD,Meritain Health CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Starmark CPD,Starmark CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Aetna Medicare,Aetna Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Ambetter ,Ambetter ,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access,Anthem Blue Access,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access Choice,Anthem Blue Access Choice,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Blue Preferred,Anthem Blue Preferred,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Pathway,Anthem Pathway,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Alliance,Anthem Alliance,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Anthem Medicare,Anthem Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna,Cigna,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna PPO,Cigna PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Cigna Medicare Advantage,Cigna Medicare Advantage,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Essence,Essence,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink HMO,Healthlink HMO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Healthlink PPO,Healthlink PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,HomeState Health Plan,HomeState Health Plan,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Humana Gold,Humana Gold,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Medicaid MO,Medicaid MO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Medica,Medica,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Tricare,Tricare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC All Payer,UHC All Payer,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Exchange,UHC Exchange,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicaid,UHC Medicaid,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,UMR CPD,UMR CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,UHC Medicare,UHC Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
ROHO W/C CUSHION RENTAL       ,33146792,CDM,279,RC,,,,,,Inpatient,,,12,12,Wellcare,Wellcare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health PPO CPD,Meritain Health PPO CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/Commercial Product,Aetna/Commercial Product,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health CPD,Meritain Health CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Starmark CPD,Starmark CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna Medicare,Aetna Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Ambetter ,Ambetter ,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access,Anthem Blue Access,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access Choice,Anthem Blue Access Choice,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Preferred,Anthem Blue Preferred,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Pathway,Anthem Pathway,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Alliance,Anthem Alliance,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Medicare,Anthem Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna,Cigna,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna PPO,Cigna PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna Medicare Advantage,Cigna Medicare Advantage,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Essence,Essence,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink HMO,Healthlink HMO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink PPO,Healthlink PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,HomeState Health Plan,HomeState Health Plan,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Humana Gold,Humana Gold,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medicaid MO,Medicaid MO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medica,Medica,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Tricare,Tricare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC All Payer,UHC All Payer,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Exchange,UHC Exchange,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicaid,UHC Medicaid,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UMR CPD,UMR CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicare,UHC Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 16IN DRIVE LW      ,33146796,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Wellcare,Wellcare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health PPO CPD,Meritain Health PPO CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/Commercial Product,Aetna/Commercial Product,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health CPD,Meritain Health CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Starmark CPD,Starmark CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna Medicare,Aetna Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Ambetter ,Ambetter ,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access,Anthem Blue Access,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access Choice,Anthem Blue Access Choice,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Preferred,Anthem Blue Preferred,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Pathway,Anthem Pathway,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Alliance,Anthem Alliance,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Medicare,Anthem Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna,Cigna,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna PPO,Cigna PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna Medicare Advantage,Cigna Medicare Advantage,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Essence,Essence,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink HMO,Healthlink HMO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink PPO,Healthlink PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,HomeState Health Plan,HomeState Health Plan,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Humana Gold,Humana Gold,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medicaid MO,Medicaid MO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medica,Medica,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Tricare,Tricare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC All Payer,UHC All Payer,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Exchange,UHC Exchange,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicaid,UHC Medicaid,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UMR CPD,UMR CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicare,UHC Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE LW      ,33146797,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Wellcare,Wellcare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN DRIVE STND    ,33146798,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health PPO CPD,Meritain Health PPO CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/Commercial Product,Aetna/Commercial Product,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health CPD,Meritain Health CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Starmark CPD,Starmark CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna Medicare,Aetna Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Ambetter ,Ambetter ,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access,Anthem Blue Access,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access Choice,Anthem Blue Access Choice,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Preferred,Anthem Blue Preferred,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Pathway,Anthem Pathway,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Alliance,Anthem Alliance,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Medicare,Anthem Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna,Cigna,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna PPO,Cigna PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna Medicare Advantage,Cigna Medicare Advantage,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Essence,Essence,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink HMO,Healthlink HMO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink PPO,Healthlink PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,HomeState Health Plan,HomeState Health Plan,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Humana Gold,Humana Gold,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medicaid MO,Medicaid MO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medica,Medica,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Tricare,Tricare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC All Payer,UHC All Payer,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Exchange,UHC Exchange,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicaid,UHC Medicaid,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UMR CPD,UMR CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicare,UHC Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 18IN RECLINE       ,33146799,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Wellcare,Wellcare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health PPO CPD,Meritain Health PPO CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/Commercial Product,Aetna/Commercial Product,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health CPD,Meritain Health CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Starmark CPD,Starmark CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna Medicare,Aetna Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Ambetter ,Ambetter ,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access,Anthem Blue Access,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access Choice,Anthem Blue Access Choice,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Preferred,Anthem Blue Preferred,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Pathway,Anthem Pathway,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Alliance,Anthem Alliance,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Medicare,Anthem Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna,Cigna,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna PPO,Cigna PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna Medicare Advantage,Cigna Medicare Advantage,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Essence,Essence,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink HMO,Healthlink HMO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink PPO,Healthlink PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,HomeState Health Plan,HomeState Health Plan,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Humana Gold,Humana Gold,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medicaid MO,Medicaid MO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medica,Medica,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Tricare,Tricare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC All Payer,UHC All Payer,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Exchange,UHC Exchange,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicaid,UHC Medicaid,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UMR CPD,UMR CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicare,UHC Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 20IN DRIVE LW      ,33146800,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Wellcare,Wellcare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health PPO CPD,Meritain Health PPO CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna/Commercial Product,Aetna/Commercial Product,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Meritain Health CPD,Meritain Health CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Starmark CPD,Starmark CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Aetna Medicare,Aetna Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Ambetter ,Ambetter ,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access,Anthem Blue Access,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Access Choice,Anthem Blue Access Choice,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Blue Preferred,Anthem Blue Preferred,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Pathway,Anthem Pathway,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Alliance,Anthem Alliance,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Anthem Medicare,Anthem Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna,Cigna,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna PPO,Cigna PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Cigna Medicare Advantage,Cigna Medicare Advantage,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Essence,Essence,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink HMO,Healthlink HMO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Healthlink PPO,Healthlink PPO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,HomeState Health Plan,HomeState Health Plan,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Humana Gold,Humana Gold,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medicaid MO,Medicaid MO,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Medica,Medica,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Tricare,Tricare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC All Payer,UHC All Payer,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Exchange,UHC Exchange,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicaid,UHC Medicaid,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UMR CPD,UMR CPD,95.02,,,,,,,per diem,95.02,95.02,"Per diem rate, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,UHC Medicare,UHC Medicare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHEELCHAIR 24IN WIDE          ,33146801,CDM,279,RC,,,,,,Inpatient,,,95.02,95.02,Wellcare,Wellcare,95.02,,,,,,,case rate,95.02,95.02,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Meritain Health PPO CPD,Meritain Health PPO CPD,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Aetna/Commercial Product,Aetna/Commercial Product,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Meritain Health CPD,Meritain Health CPD,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Starmark CPD,Starmark CPD,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Aetna Medicare,Aetna Medicare,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Ambetter ,Ambetter ,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Blue Access,Anthem Blue Access,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Blue Access Choice,Anthem Blue Access Choice,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Blue Preferred,Anthem Blue Preferred,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Pathway,Anthem Pathway,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Alliance,Anthem Alliance,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Anthem Medicare,Anthem Medicare,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Cigna,Cigna,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Cigna PPO,Cigna PPO,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Cigna Medicare Advantage,Cigna Medicare Advantage,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Essence,Essence,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Healthlink HMO,Healthlink HMO,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Healthlink PPO,Healthlink PPO,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,HomeState Health Plan,HomeState Health Plan,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Humana Gold,Humana Gold,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Medicaid MO,Medicaid MO,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Medica,Medica,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Tricare,Tricare,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,UHC All Payer,UHC All Payer,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,UHC Exchange,UHC Exchange,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,UHC Medicaid,UHC Medicaid,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,UMR CPD,UMR CPD,142.66,,,,,,,per diem,142.66,142.66,"Per diem rate, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,UHC Medicare,UHC Medicare,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR REC 20X16 SIL RENT     ,33146802,CDM,279,RC,,,,,,Inpatient,,,142.66,142.66,Wellcare,Wellcare,142.66,,,,,,,case rate,142.66,142.66,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Meritain Health PPO CPD,Meritain Health PPO CPD,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Aetna/Commercial Product,Aetna/Commercial Product,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Meritain Health CPD,Meritain Health CPD,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Starmark CPD,Starmark CPD,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Aetna Medicare,Aetna Medicare,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Ambetter ,Ambetter ,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Blue Access,Anthem Blue Access,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Blue Access Choice,Anthem Blue Access Choice,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Blue Preferred,Anthem Blue Preferred,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Pathway,Anthem Pathway,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Alliance,Anthem Alliance,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Anthem Medicare,Anthem Medicare,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Cigna,Cigna,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Cigna PPO,Cigna PPO,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Cigna Medicare Advantage,Cigna Medicare Advantage,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Essence,Essence,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Healthlink HMO,Healthlink HMO,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Healthlink PPO,Healthlink PPO,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,HomeState Health Plan,HomeState Health Plan,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Humana Gold,Humana Gold,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Medicaid MO,Medicaid MO,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Medica,Medica,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Tricare,Tricare,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,UHC All Payer,UHC All Payer,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,UHC Exchange,UHC Exchange,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,UHC Medicaid,UHC Medicaid,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,UMR CPD,UMR CPD,126.69,,,,,,,per diem,126.69,126.69,"Per diem rate, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,UHC Medicare,UHC Medicare,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
WHLCHR TRACER 20IN DE RENT    ,33146803,CDM,279,RC,,,,,,Inpatient,,,126.69,126.69,Wellcare,Wellcare,126.69,,,,,,,case rate,126.69,126.69,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Meritain Health PPO CPD,Meritain Health PPO CPD,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Aetna/Commercial Product,Aetna/Commercial Product,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Meritain Health CPD,Meritain Health CPD,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Starmark CPD,Starmark CPD,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Aetna Medicare,Aetna Medicare,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Ambetter ,Ambetter ,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Blue Access,Anthem Blue Access,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Blue Access Choice,Anthem Blue Access Choice,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Blue Preferred,Anthem Blue Preferred,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Pathway,Anthem Pathway,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Alliance,Anthem Alliance,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Anthem Medicare,Anthem Medicare,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Cigna,Cigna,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Cigna PPO,Cigna PPO,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Cigna Medicare Advantage,Cigna Medicare Advantage,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Essence,Essence,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Healthlink HMO,Healthlink HMO,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Healthlink PPO,Healthlink PPO,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,HomeState Health Plan,HomeState Health Plan,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Humana Gold,Humana Gold,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Medicaid MO,Medicaid MO,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Medica,Medica,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Tricare,Tricare,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,UHC All Payer,UHC All Payer,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,UHC Exchange,UHC Exchange,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,UHC Medicaid,UHC Medicaid,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,UMR CPD,UMR CPD,1108.54,,,,,,,per diem,1108.54,1108.54,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,UHC Medicare,UHC Medicare,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN            ,33146804,CDM,279,RC,,,,,,Inpatient,,,1108.54,1108.54,Wellcare,Wellcare,1108.54,,,,,,,case rate,1108.54,1108.54,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Meritain Health PPO CPD,Meritain Health PPO CPD,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Aetna/Commercial Product,Aetna/Commercial Product,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Meritain Health CPD,Meritain Health CPD,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Starmark CPD,Starmark CPD,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Aetna Medicare,Aetna Medicare,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Ambetter ,Ambetter ,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Blue Access,Anthem Blue Access,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Blue Access Choice,Anthem Blue Access Choice,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Blue Preferred,Anthem Blue Preferred,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Pathway,Anthem Pathway,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Alliance,Anthem Alliance,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Anthem Medicare,Anthem Medicare,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Cigna,Cigna,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Cigna PPO,Cigna PPO,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Cigna Medicare Advantage,Cigna Medicare Advantage,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Essence,Essence,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Healthlink HMO,Healthlink HMO,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Healthlink PPO,Healthlink PPO,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,HomeState Health Plan,HomeState Health Plan,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Humana Gold,Humana Gold,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Medicaid MO,Medicaid MO,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Medica,Medica,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Tricare,Tricare,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,UHC All Payer,UHC All Payer,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,UHC Exchange,UHC Exchange,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,UHC Medicaid,UHC Medicaid,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,UMR CPD,UMR CPD,45.58,,,,,,,per diem,45.58,45.58,"Per diem rate, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,UHC Medicare,UHC Medicare,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO ARM SLING W/STRAP       ,33146805,CDM,270,RC,,,,,,Inpatient,,,45.58,45.58,Wellcare,Wellcare,45.58,,,,,,,case rate,45.58,45.58,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Meritain Health PPO CPD,Meritain Health PPO CPD,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Aetna/Commercial Product,Aetna/Commercial Product,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Meritain Health CPD,Meritain Health CPD,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Starmark CPD,Starmark CPD,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Aetna Medicare,Aetna Medicare,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Ambetter ,Ambetter ,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Blue Access,Anthem Blue Access,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Blue Access Choice,Anthem Blue Access Choice,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Blue Preferred,Anthem Blue Preferred,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Pathway,Anthem Pathway,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Alliance,Anthem Alliance,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Anthem Medicare,Anthem Medicare,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Cigna,Cigna,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Cigna PPO,Cigna PPO,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Cigna Medicare Advantage,Cigna Medicare Advantage,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Essence,Essence,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Healthlink HMO,Healthlink HMO,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Healthlink PPO,Healthlink PPO,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,HomeState Health Plan,HomeState Health Plan,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Humana Gold,Humana Gold,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Medicaid MO,Medicaid MO,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Medica,Medica,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Tricare,Tricare,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,UHC All Payer,UHC All Payer,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,UHC Exchange,UHC Exchange,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,UHC Medicaid,UHC Medicaid,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,UMR CPD,UMR CPD,97.59,,,,,,,per diem,97.59,97.59,"Per diem rate, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,UHC Medicare,UHC Medicare,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
ORTHO WALKING CAST SHOE       ,33146819,CDM,270,RC,,,,,,Inpatient,,,97.59,97.59,Wellcare,Wellcare,97.59,,,,,,,case rate,97.59,97.59,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Meritain Health PPO CPD,Meritain Health PPO CPD,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Aetna/Commercial Product,Aetna/Commercial Product,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Meritain Health CPD,Meritain Health CPD,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Starmark CPD,Starmark CPD,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Aetna Medicare,Aetna Medicare,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Ambetter ,Ambetter ,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Blue Access,Anthem Blue Access,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Blue Access Choice,Anthem Blue Access Choice,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Blue Preferred,Anthem Blue Preferred,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Pathway,Anthem Pathway,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Alliance,Anthem Alliance,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Anthem Medicare,Anthem Medicare,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Cigna,Cigna,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Cigna PPO,Cigna PPO,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Cigna Medicare Advantage,Cigna Medicare Advantage,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Essence,Essence,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Healthlink HMO,Healthlink HMO,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Healthlink PPO,Healthlink PPO,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,HomeState Health Plan,HomeState Health Plan,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Humana Gold,Humana Gold,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Medicaid MO,Medicaid MO,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Medica,Medica,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Tricare,Tricare,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,UHC All Payer,UHC All Payer,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,UHC Exchange,UHC Exchange,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,UHC Medicaid,UHC Medicaid,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,UMR CPD,UMR CPD,2.83,,,,,,,per diem,2.83,2.83,"Per diem rate, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,UHC Medicare,UHC Medicare,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
"ORTHO, PLASTER ROLL 2IN       ",33146820,CDM,272,RC,,,,,,Inpatient,,,2.83,2.83,Wellcare,Wellcare,2.83,,,,,,,case rate,2.83,2.83,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Meritain Health PPO CPD,Meritain Health PPO CPD,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Aetna/Commercial Product,Aetna/Commercial Product,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Meritain Health CPD,Meritain Health CPD,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Starmark CPD,Starmark CPD,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Aetna Medicare,Aetna Medicare,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Ambetter ,Ambetter ,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Blue Access,Anthem Blue Access,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Blue Access Choice,Anthem Blue Access Choice,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Blue Preferred,Anthem Blue Preferred,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Pathway,Anthem Pathway,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Alliance,Anthem Alliance,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Anthem Medicare,Anthem Medicare,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Cigna,Cigna,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Cigna PPO,Cigna PPO,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Cigna Medicare Advantage,Cigna Medicare Advantage,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Essence,Essence,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Healthlink HMO,Healthlink HMO,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Healthlink PPO,Healthlink PPO,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,HomeState Health Plan,HomeState Health Plan,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Humana Gold,Humana Gold,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Medicaid MO,Medicaid MO,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Medica,Medica,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Tricare,Tricare,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,UHC All Payer,UHC All Payer,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,UHC Exchange,UHC Exchange,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,UHC Medicaid,UHC Medicaid,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,UMR CPD,UMR CPD,175.36,,,,,,,per diem,175.36,175.36,"Per diem rate, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,UHC Medicare,UHC Medicare,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
SPLINT POSTERIOR FOOT MED     ,33146864,CDM,272,RC,,,,,,Inpatient,,,175.36,175.36,Wellcare,Wellcare,175.36,,,,,,,case rate,175.36,175.36,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Meritain Health PPO CPD,Meritain Health PPO CPD,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Aetna/Commercial Product,Aetna/Commercial Product,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Meritain Health CPD,Meritain Health CPD,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Starmark CPD,Starmark CPD,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Aetna Medicare,Aetna Medicare,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Ambetter ,Ambetter ,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Blue Access,Anthem Blue Access,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Blue Access Choice,Anthem Blue Access Choice,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Blue Preferred,Anthem Blue Preferred,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Pathway,Anthem Pathway,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Alliance,Anthem Alliance,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Anthem Medicare,Anthem Medicare,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Cigna,Cigna,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Cigna PPO,Cigna PPO,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Cigna Medicare Advantage,Cigna Medicare Advantage,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Essence,Essence,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Healthlink HMO,Healthlink HMO,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Healthlink PPO,Healthlink PPO,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,HomeState Health Plan,HomeState Health Plan,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Humana Gold,Humana Gold,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Medicaid MO,Medicaid MO,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Medica,Medica,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Tricare,Tricare,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,UHC All Payer,UHC All Payer,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,UHC Exchange,UHC Exchange,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,UHC Medicaid,UHC Medicaid,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,UMR CPD,UMR CPD,28.3,,,,,,,per diem,28.3,28.3,"Per diem rate, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,UHC Medicare,UHC Medicare,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PHILADELPHIA COLLAR           ,33147383,CDM,274,RC,,,,,,Inpatient,,,28.3,28.3,Wellcare,Wellcare,28.3,,,,,,,case rate,28.3,28.3,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Meritain Health PPO CPD,Meritain Health PPO CPD,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Aetna/Commercial Product,Aetna/Commercial Product,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Meritain Health CPD,Meritain Health CPD,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Starmark CPD,Starmark CPD,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Aetna Medicare,Aetna Medicare,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Ambetter ,Ambetter ,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Blue Access,Anthem Blue Access,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Blue Access Choice,Anthem Blue Access Choice,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Blue Preferred,Anthem Blue Preferred,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Pathway,Anthem Pathway,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Alliance,Anthem Alliance,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Anthem Medicare,Anthem Medicare,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Cigna,Cigna,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Cigna PPO,Cigna PPO,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Cigna Medicare Advantage,Cigna Medicare Advantage,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Essence,Essence,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Healthlink HMO,Healthlink HMO,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Healthlink PPO,Healthlink PPO,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,HomeState Health Plan,HomeState Health Plan,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Humana Gold,Humana Gold,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Medicaid MO,Medicaid MO,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Medica,Medica,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Tricare,Tricare,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,UHC All Payer,UHC All Payer,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,UHC Exchange,UHC Exchange,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,UHC Medicaid,UHC Medicaid,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,UMR CPD,UMR CPD,89.95,,,,,,,per diem,89.95,89.95,"Per diem rate, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,UHC Medicare,UHC Medicare,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
PREFAB WHFO W/O JOINTS        ,33147384,CDM,274,RC,,,,,,Inpatient,,,89.95,89.95,Wellcare,Wellcare,89.95,,,,,,,case rate,89.95,89.95,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health PPO CPD,Meritain Health PPO CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/Commercial Product,Aetna/Commercial Product,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health CPD,Meritain Health CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Starmark CPD,Starmark CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna Medicare,Aetna Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Ambetter ,Ambetter ,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access,Anthem Blue Access,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access Choice,Anthem Blue Access Choice,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Preferred,Anthem Blue Preferred,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Pathway,Anthem Pathway,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Alliance,Anthem Alliance,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Medicare,Anthem Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna,Cigna,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna PPO,Cigna PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna Medicare Advantage,Cigna Medicare Advantage,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Essence,Essence,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink HMO,Healthlink HMO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink PPO,Healthlink PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,HomeState Health Plan,HomeState Health Plan,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Humana Gold,Humana Gold,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medicaid MO,Medicaid MO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medica,Medica,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Tricare,Tricare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC All Payer,UHC All Payer,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Exchange,UHC Exchange,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicaid,UHC Medicaid,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UMR CPD,UMR CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicare,UHC Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
FALL PADS (PAIR) DAILY RENTAL ,33147464,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Wellcare,Wellcare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Meritain Health PPO CPD,Meritain Health PPO CPD,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Aetna/Commercial Product,Aetna/Commercial Product,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Meritain Health CPD,Meritain Health CPD,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Starmark CPD,Starmark CPD,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Aetna Medicare,Aetna Medicare,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Ambetter ,Ambetter ,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Blue Access,Anthem Blue Access,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Blue Access Choice,Anthem Blue Access Choice,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Blue Preferred,Anthem Blue Preferred,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Pathway,Anthem Pathway,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Alliance,Anthem Alliance,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Anthem Medicare,Anthem Medicare,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Cigna,Cigna,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Cigna PPO,Cigna PPO,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Cigna Medicare Advantage,Cigna Medicare Advantage,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Essence,Essence,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Healthlink HMO,Healthlink HMO,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Healthlink PPO,Healthlink PPO,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,HomeState Health Plan,HomeState Health Plan,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Humana Gold,Humana Gold,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Medicaid MO,Medicaid MO,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Medica,Medica,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Tricare,Tricare,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,UHC All Payer,UHC All Payer,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,UHC Exchange,UHC Exchange,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,UHC Medicaid,UHC Medicaid,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,UMR CPD,UMR CPD,1081.5,,,,,,,per diem,1081.5,1081.5,"Per diem rate, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,UHC Medicare,UHC Medicare,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
TILT IN SPACE 24IN MEDXCHANGE ,33147529,CDM,279,RC,,,,,,Inpatient,,,1081.5,1081.5,Wellcare,Wellcare,1081.5,,,,,,,case rate,1081.5,1081.5,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
HAND CPM LANTZ MEDICAL        ,33147530,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health PPO CPD,Meritain Health PPO CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna/Commercial Product,Aetna/Commercial Product,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Meritain Health CPD,Meritain Health CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Starmark CPD,Starmark CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Aetna Medicare,Aetna Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Ambetter ,Ambetter ,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access,Anthem Blue Access,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Access Choice,Anthem Blue Access Choice,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Blue Preferred,Anthem Blue Preferred,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Pathway,Anthem Pathway,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Alliance,Anthem Alliance,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Anthem Medicare,Anthem Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna,Cigna,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna PPO,Cigna PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Cigna Medicare Advantage,Cigna Medicare Advantage,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Essence,Essence,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink HMO,Healthlink HMO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Healthlink PPO,Healthlink PPO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,HomeState Health Plan,HomeState Health Plan,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Humana Gold,Humana Gold,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medicaid MO,Medicaid MO,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Medica,Medica,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Tricare,Tricare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC All Payer,UHC All Payer,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Exchange,UHC Exchange,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicaid,UHC Medicaid,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UMR CPD,UMR CPD,24.72,,,,,,,per diem,24.72,24.72,"Per diem rate, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,UHC Medicare,UHC Medicare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
ROHO Mattress Overlay Section ,33147534,CDM,279,RC,,,,,,Inpatient,,,24.72,24.72,Wellcare,Wellcare,24.72,,,,,,,case rate,24.72,24.72,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Meritain Health PPO CPD,Meritain Health PPO CPD,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Aetna/Commercial Product,Aetna/Commercial Product,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Meritain Health CPD,Meritain Health CPD,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Starmark CPD,Starmark CPD,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Aetna Medicare,Aetna Medicare,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Ambetter ,Ambetter ,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Blue Access,Anthem Blue Access,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Blue Access Choice,Anthem Blue Access Choice,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Blue Preferred,Anthem Blue Preferred,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Pathway,Anthem Pathway,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Alliance,Anthem Alliance,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Anthem Medicare,Anthem Medicare,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Cigna,Cigna,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Cigna PPO,Cigna PPO,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Cigna Medicare Advantage,Cigna Medicare Advantage,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Essence,Essence,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Healthlink HMO,Healthlink HMO,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Healthlink PPO,Healthlink PPO,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,HomeState Health Plan,HomeState Health Plan,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Humana Gold,Humana Gold,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Medicaid MO,Medicaid MO,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Medica,Medica,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Tricare,Tricare,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,UHC All Payer,UHC All Payer,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,UHC Exchange,UHC Exchange,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,UHC Medicaid,UHC Medicaid,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,UMR CPD,UMR CPD,33.99,,,,,,,per diem,33.99,33.99,"Per diem rate, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,UHC Medicare,UHC Medicare,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
NOA Low Bed                   ,33147535,CDM,279,RC,,,,,,Inpatient,,,33.99,33.99,Wellcare,Wellcare,33.99,,,,,,,case rate,33.99,33.99,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Meritain Health PPO CPD,Meritain Health PPO CPD,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Aetna/Commercial Product,Aetna/Commercial Product,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Meritain Health CPD,Meritain Health CPD,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Starmark CPD,Starmark CPD,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Aetna Medicare,Aetna Medicare,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Ambetter ,Ambetter ,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Blue Access,Anthem Blue Access,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Blue Access Choice,Anthem Blue Access Choice,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Blue Preferred,Anthem Blue Preferred,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Pathway,Anthem Pathway,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Alliance,Anthem Alliance,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Anthem Medicare,Anthem Medicare,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Cigna,Cigna,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Cigna PPO,Cigna PPO,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Cigna Medicare Advantage,Cigna Medicare Advantage,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Essence,Essence,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Healthlink HMO,Healthlink HMO,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Healthlink PPO,Healthlink PPO,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,HomeState Health Plan,HomeState Health Plan,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Humana Gold,Humana Gold,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Medicaid MO,Medicaid MO,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Medica,Medica,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Tricare,Tricare,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,UHC All Payer,UHC All Payer,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,UHC Exchange,UHC Exchange,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,UHC Medicaid,UHC Medicaid,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,UMR CPD,UMR CPD,90,,,,,,,per diem,90,90,"Per diem rate, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,UHC Medicare,UHC Medicare,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed - 42 IN     ,33147536,CDM,279,RC,,,,,,Inpatient,,,90,90,Wellcare,Wellcare,90,,,,,,,case rate,90,90,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health PPO CPD,Meritain Health PPO CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/Commercial Product,Aetna/Commercial Product,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health CPD,Meritain Health CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Starmark CPD,Starmark CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna Medicare,Aetna Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Ambetter ,Ambetter ,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access,Anthem Blue Access,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access Choice,Anthem Blue Access Choice,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Preferred,Anthem Blue Preferred,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Pathway,Anthem Pathway,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Alliance,Anthem Alliance,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Medicare,Anthem Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna,Cigna,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna PPO,Cigna PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna Medicare Advantage,Cigna Medicare Advantage,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Essence,Essence,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink HMO,Healthlink HMO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink PPO,Healthlink PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,HomeState Health Plan,HomeState Health Plan,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Humana Gold,Humana Gold,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Medicaid MO,Medicaid MO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Medica,Medica,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Tricare,Tricare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC All Payer,UHC All Payer,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Exchange,UHC Exchange,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicaid,UHC Medicaid,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,UMR CPD,UMR CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicare,UHC Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Low Bed with scales ,33147537,CDM,279,RC,,,,,,Inpatient,,,180,180,Wellcare,Wellcare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Posey Bed Canopy Enclosure    ,33147538,CDM,279,RC,,,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health PPO CPD,Meritain Health PPO CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna/Commercial Product,Aetna/Commercial Product,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Meritain Health CPD,Meritain Health CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Starmark CPD,Starmark CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Aetna Medicare,Aetna Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Ambetter ,Ambetter ,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access,Anthem Blue Access,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Access Choice,Anthem Blue Access Choice,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Blue Preferred,Anthem Blue Preferred,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Pathway,Anthem Pathway,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Alliance,Anthem Alliance,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Anthem Medicare,Anthem Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna,Cigna,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna PPO,Cigna PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Cigna Medicare Advantage,Cigna Medicare Advantage,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Essence,Essence,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink HMO,Healthlink HMO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Healthlink PPO,Healthlink PPO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,HomeState Health Plan,HomeState Health Plan,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Humana Gold,Humana Gold,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Medicaid MO,Medicaid MO,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Medica,Medica,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Tricare,Tricare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC All Payer,UHC All Payer,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Exchange,UHC Exchange,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicaid,UHC Medicaid,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,UMR CPD,UMR CPD,180,,,,,,,per diem,180,180,"Per diem rate, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,UHC Medicare,UHC Medicare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Bed with Scales     ,33147539,CDM,279,RC,,,,,,Inpatient,,,180,180,Wellcare,Wellcare,180,,,,,,,case rate,180,180,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health PPO CPD,Meritain Health PPO CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/Commercial Product,Aetna/Commercial Product,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health CPD,Meritain Health CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Starmark CPD,Starmark CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna Medicare,Aetna Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Ambetter ,Ambetter ,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access,Anthem Blue Access,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access Choice,Anthem Blue Access Choice,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Preferred,Anthem Blue Preferred,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Pathway,Anthem Pathway,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Alliance,Anthem Alliance,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Medicare,Anthem Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna,Cigna,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna PPO,Cigna PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna Medicare Advantage,Cigna Medicare Advantage,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Essence,Essence,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink HMO,Healthlink HMO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink PPO,Healthlink PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,HomeState Health Plan,HomeState Health Plan,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Humana Gold,Humana Gold,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Medicaid MO,Medicaid MO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Medica,Medica,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Tricare,Tricare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC All Payer,UHC All Payer,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Exchange,UHC Exchange,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicaid,UHC Medicaid,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,UMR CPD,UMR CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicare,UHC Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Foam Mattress       ,33147540,CDM,279,RC,,,,,,Inpatient,,,30,30,Wellcare,Wellcare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Free Standing Trapez,33147541,CDM,279,RC,,,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Meritain Health PPO CPD,Meritain Health PPO CPD,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Aetna/Commercial Product,Aetna/Commercial Product,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Meritain Health CPD,Meritain Health CPD,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Starmark CPD,Starmark CPD,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Aetna Medicare,Aetna Medicare,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Ambetter ,Ambetter ,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Blue Access,Anthem Blue Access,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Blue Access Choice,Anthem Blue Access Choice,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Blue Preferred,Anthem Blue Preferred,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Pathway,Anthem Pathway,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Alliance,Anthem Alliance,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Anthem Medicare,Anthem Medicare,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Cigna,Cigna,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Cigna PPO,Cigna PPO,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Cigna Medicare Advantage,Cigna Medicare Advantage,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Essence,Essence,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Healthlink HMO,Healthlink HMO,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Healthlink PPO,Healthlink PPO,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,HomeState Health Plan,HomeState Health Plan,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Humana Gold,Humana Gold,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Medicaid MO,Medicaid MO,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Medica,Medica,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Tricare,Tricare,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,UHC All Payer,UHC All Payer,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,UHC Exchange,UHC Exchange,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,UHC Medicaid,UHC Medicaid,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,UMR CPD,UMR CPD,309,,,,,,,per diem,309,309,"Per diem rate, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,UHC Medicare,UHC Medicare,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
Bariatric Room Package        ,33147542,CDM,279,RC,,,,,,Inpatient,,,309,309,Wellcare,Wellcare,309,,,,,,,case rate,309,309,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SARA Lift (Stand Up Lift)     ,33147543,CDM,279,RC,,,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health PPO CPD,Meritain Health PPO CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna/Commercial Product,Aetna/Commercial Product,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Meritain Health CPD,Meritain Health CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Starmark CPD,Starmark CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Aetna Medicare,Aetna Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Ambetter ,Ambetter ,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access,Anthem Blue Access,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Access Choice,Anthem Blue Access Choice,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Blue Preferred,Anthem Blue Preferred,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Pathway,Anthem Pathway,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Alliance,Anthem Alliance,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Anthem Medicare,Anthem Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna,Cigna,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna PPO,Cigna PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Cigna Medicare Advantage,Cigna Medicare Advantage,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Essence,Essence,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink HMO,Healthlink HMO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Healthlink PPO,Healthlink PPO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,HomeState Health Plan,HomeState Health Plan,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Humana Gold,Humana Gold,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Medicaid MO,Medicaid MO,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Medica,Medica,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Tricare,Tricare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC All Payer,UHC All Payer,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Exchange,UHC Exchange,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicaid,UHC Medicaid,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,UMR CPD,UMR CPD,75,,,,,,,per diem,75,75,"Per diem rate, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,UHC Medicare,UHC Medicare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Lazy Boy Recliner             ,33147544,CDM,279,RC,,,,,,Inpatient,,,75,75,Wellcare,Wellcare,75,,,,,,,case rate,75,75,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Meritain Health PPO CPD,Meritain Health PPO CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Aetna/Commercial Product,Aetna/Commercial Product,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Meritain Health CPD,Meritain Health CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Starmark CPD,Starmark CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Aetna Medicare,Aetna Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Ambetter ,Ambetter ,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Blue Access,Anthem Blue Access,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Blue Access Choice,Anthem Blue Access Choice,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Blue Preferred,Anthem Blue Preferred,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Pathway,Anthem Pathway,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Alliance,Anthem Alliance,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Anthem Medicare,Anthem Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Cigna,Cigna,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Cigna PPO,Cigna PPO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Cigna Medicare Advantage,Cigna Medicare Advantage,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Essence,Essence,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Healthlink HMO,Healthlink HMO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Healthlink PPO,Healthlink PPO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,HomeState Health Plan,HomeState Health Plan,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Humana Gold,Humana Gold,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Medicaid MO,Medicaid MO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Medica,Medica,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Tricare,Tricare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,UHC All Payer,UHC All Payer,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,UHC Exchange,UHC Exchange,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,UHC Medicaid,UHC Medicaid,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,UMR CPD,UMR CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,UHC Medicare,UHC Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Safe-T Ambassador Bed         ,33147545,CDM,279,RC,,,,,,Inpatient,,,185.4,185.4,Wellcare,Wellcare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Pro          ,33147546,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health PPO CPD,Meritain Health PPO CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna/Commercial Product,Aetna/Commercial Product,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Meritain Health CPD,Meritain Health CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Starmark CPD,Starmark CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Aetna Medicare,Aetna Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Ambetter ,Ambetter ,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access,Anthem Blue Access,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Access Choice,Anthem Blue Access Choice,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Blue Preferred,Anthem Blue Preferred,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Pathway,Anthem Pathway,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Alliance,Anthem Alliance,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Anthem Medicare,Anthem Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna,Cigna,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna PPO,Cigna PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Cigna Medicare Advantage,Cigna Medicare Advantage,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Essence,Essence,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink HMO,Healthlink HMO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Healthlink PPO,Healthlink PPO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,HomeState Health Plan,HomeState Health Plan,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Humana Gold,Humana Gold,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Medicaid MO,Medicaid MO,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Medica,Medica,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Tricare,Tricare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC All Payer,UHC All Payer,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Exchange,UHC Exchange,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicaid,UHC Medicaid,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,UMR CPD,UMR CPD,8,,,,,,,per diem,8,8,"Per diem rate, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,UHC Medicare,UHC Medicare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Resironics Auto CPAP          ,33147547,CDM,279,RC,,,,,,Inpatient,,,8,8,Wellcare,Wellcare,8,,,,,,,case rate,8,8,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Meritain Health PPO CPD,Meritain Health PPO CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna/Commercial Product,Aetna/Commercial Product,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Meritain Health CPD,Meritain Health CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Starmark CPD,Starmark CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna Medicare,Aetna Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Ambetter ,Ambetter ,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Access,Anthem Blue Access,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Access Choice,Anthem Blue Access Choice,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Preferred,Anthem Blue Preferred,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Pathway,Anthem Pathway,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Alliance,Anthem Alliance,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Medicare,Anthem Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna,Cigna,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna PPO,Cigna PPO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna Medicare Advantage,Cigna Medicare Advantage,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Essence,Essence,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthlink HMO,Healthlink HMO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthlink PPO,Healthlink PPO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,HomeState Health Plan,HomeState Health Plan,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Humana Gold,Humana Gold,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Medicaid MO,Medicaid MO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Medica,Medica,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Tricare,Tricare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC All Payer,UHC All Payer,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Exchange,UHC Exchange,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Medicaid,UHC Medicaid,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UMR CPD,UMR CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Medicare,UHC Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro 2       ,33147548,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Wellcare,Wellcare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Meritain Health PPO CPD,Meritain Health PPO CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna/Commercial Product,Aetna/Commercial Product,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Meritain Health CPD,Meritain Health CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Starmark CPD,Starmark CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna Medicare,Aetna Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Ambetter ,Ambetter ,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Access,Anthem Blue Access,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Access Choice,Anthem Blue Access Choice,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Preferred,Anthem Blue Preferred,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Pathway,Anthem Pathway,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Alliance,Anthem Alliance,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Medicare,Anthem Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna,Cigna,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna PPO,Cigna PPO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna Medicare Advantage,Cigna Medicare Advantage,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Essence,Essence,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthlink HMO,Healthlink HMO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthlink PPO,Healthlink PPO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,HomeState Health Plan,HomeState Health Plan,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Humana Gold,Humana Gold,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Medicaid MO,Medicaid MO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Medica,Medica,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Tricare,Tricare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC All Payer,UHC All Payer,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Exchange,UHC Exchange,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Medicaid,UHC Medicaid,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UMR CPD,UMR CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Medicare,UHC Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Bipap ST          ,33147549,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Wellcare,Wellcare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Meritain Health PPO CPD,Meritain Health PPO CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna/Commercial Product,Aetna/Commercial Product,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Meritain Health CPD,Meritain Health CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Starmark CPD,Starmark CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Aetna Medicare,Aetna Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Ambetter ,Ambetter ,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Access,Anthem Blue Access,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Access Choice,Anthem Blue Access Choice,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Blue Preferred,Anthem Blue Preferred,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Pathway,Anthem Pathway,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Alliance,Anthem Alliance,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Anthem Medicare,Anthem Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna,Cigna,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna PPO,Cigna PPO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Cigna Medicare Advantage,Cigna Medicare Advantage,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Essence,Essence,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthlink HMO,Healthlink HMO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Healthlink PPO,Healthlink PPO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,HomeState Health Plan,HomeState Health Plan,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Humana Gold,Humana Gold,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Medicaid MO,Medicaid MO,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Medica,Medica,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Tricare,Tricare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC All Payer,UHC All Payer,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Exchange,UHC Exchange,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Medicaid,UHC Medicaid,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UMR CPD,UMR CPD,9.27,,,,,,,per diem,9.27,9.27,"Per diem rate, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,UHC Medicare,UHC Medicare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Pro-Auto          ,33147550,CDM,279,RC,,,,,,Inpatient,,,9.27,9.27,Wellcare,Wellcare,9.27,,,,,,,case rate,9.27,9.27,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Meritain Health PPO CPD,Meritain Health PPO CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna/Commercial Product,Aetna/Commercial Product,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Meritain Health CPD,Meritain Health CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Starmark CPD,Starmark CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Aetna Medicare,Aetna Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Ambetter ,Ambetter ,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Access,Anthem Blue Access,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Access Choice,Anthem Blue Access Choice,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Blue Preferred,Anthem Blue Preferred,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Pathway,Anthem Pathway,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Alliance,Anthem Alliance,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Anthem Medicare,Anthem Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna,Cigna,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna PPO,Cigna PPO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Cigna Medicare Advantage,Cigna Medicare Advantage,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Essence,Essence,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthlink HMO,Healthlink HMO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Healthlink PPO,Healthlink PPO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,HomeState Health Plan,HomeState Health Plan,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Humana Gold,Humana Gold,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Medicaid MO,Medicaid MO,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Medica,Medica,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Tricare,Tricare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC All Payer,UHC All Payer,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Exchange,UHC Exchange,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Medicaid,UHC Medicaid,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UMR CPD,UMR CPD,20.6,,,,,,,per diem,20.6,20.6,"Per diem rate, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,UHC Medicare,UHC Medicare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Auto SV           ,33147551,CDM,279,RC,,,,,,Inpatient,,,20.6,20.6,Wellcare,Wellcare,20.6,,,,,,,case rate,20.6,20.6,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Meritain Health PPO CPD,Meritain Health PPO CPD,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Aetna/Commercial Product,Aetna/Commercial Product,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Meritain Health CPD,Meritain Health CPD,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Starmark CPD,Starmark CPD,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Aetna Medicare,Aetna Medicare,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Ambetter ,Ambetter ,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Blue Access,Anthem Blue Access,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Blue Access Choice,Anthem Blue Access Choice,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Blue Preferred,Anthem Blue Preferred,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Pathway,Anthem Pathway,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Alliance,Anthem Alliance,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Anthem Medicare,Anthem Medicare,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Cigna,Cigna,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Cigna PPO,Cigna PPO,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Cigna Medicare Advantage,Cigna Medicare Advantage,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Essence,Essence,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Healthlink HMO,Healthlink HMO,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Healthlink PPO,Healthlink PPO,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,HomeState Health Plan,HomeState Health Plan,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Humana Gold,Humana Gold,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Medicaid MO,Medicaid MO,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Medica,Medica,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Tricare,Tricare,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,UHC All Payer,UHC All Payer,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,UHC Exchange,UHC Exchange,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,UHC Medicaid,UHC Medicaid,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,UMR CPD,UMR CPD,87.55,,,,,,,per diem,87.55,87.55,"Per diem rate, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,UHC Medicare,UHC Medicare,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics Trilogy Vent      ,33147552,CDM,279,RC,,,,,,Inpatient,,,87.55,87.55,Wellcare,Wellcare,87.55,,,,,,,case rate,87.55,87.55,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health PPO CPD,Meritain Health PPO CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/Commercial Product,Aetna/Commercial Product,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health CPD,Meritain Health CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Starmark CPD,Starmark CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna Medicare,Aetna Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Ambetter ,Ambetter ,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access,Anthem Blue Access,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access Choice,Anthem Blue Access Choice,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Preferred,Anthem Blue Preferred,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Pathway,Anthem Pathway,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Alliance,Anthem Alliance,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Medicare,Anthem Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna,Cigna,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna PPO,Cigna PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna Medicare Advantage,Cigna Medicare Advantage,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Essence,Essence,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink HMO,Healthlink HMO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink PPO,Healthlink PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,HomeState Health Plan,HomeState Health Plan,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Humana Gold,Humana Gold,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medicaid MO,Medicaid MO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medica,Medica,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Tricare,Tricare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC All Payer,UHC All Payer,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Exchange,UHC Exchange,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicaid,UHC Medicaid,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UMR CPD,UMR CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicare,UHC Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147553,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Wellcare,Wellcare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health PPO CPD,Meritain Health PPO CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna/Commercial Product,Aetna/Commercial Product,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Meritain Health CPD,Meritain Health CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Starmark CPD,Starmark CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Aetna Medicare,Aetna Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Ambetter ,Ambetter ,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access,Anthem Blue Access,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Access Choice,Anthem Blue Access Choice,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Blue Preferred,Anthem Blue Preferred,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Pathway,Anthem Pathway,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Alliance,Anthem Alliance,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Anthem Medicare,Anthem Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna,Cigna,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna PPO,Cigna PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Cigna Medicare Advantage,Cigna Medicare Advantage,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Essence,Essence,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink HMO,Healthlink HMO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Healthlink PPO,Healthlink PPO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,HomeState Health Plan,HomeState Health Plan,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Humana Gold,Humana Gold,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medicaid MO,Medicaid MO,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Medica,Medica,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Tricare,Tricare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC All Payer,UHC All Payer,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Exchange,UHC Exchange,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicaid,UHC Medicaid,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UMR CPD,UMR CPD,4.64,,,,,,,per diem,4.64,4.64,"Per diem rate, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,UHC Medicare,UHC Medicare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Remstar      ,33147554,CDM,279,RC,,,,,,Inpatient,,,4.64,4.64,Wellcare,Wellcare,4.64,,,,,,,case rate,4.64,4.64,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147555,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics CPAP Auto M Series,33147556,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health PPO CPD,Meritain Health PPO CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/Commercial Product,Aetna/Commercial Product,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health CPD,Meritain Health CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Starmark CPD,Starmark CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna Medicare,Aetna Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Ambetter ,Ambetter ,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access,Anthem Blue Access,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access Choice,Anthem Blue Access Choice,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Preferred,Anthem Blue Preferred,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Pathway,Anthem Pathway,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Alliance,Anthem Alliance,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Medicare,Anthem Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna,Cigna,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna PPO,Cigna PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna Medicare Advantage,Cigna Medicare Advantage,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Essence,Essence,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink HMO,Healthlink HMO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink PPO,Healthlink PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,HomeState Health Plan,HomeState Health Plan,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Humana Gold,Humana Gold,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medicaid MO,Medicaid MO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medica,Medica,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Tricare,Tricare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC All Payer,UHC All Payer,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Exchange,UHC Exchange,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicaid,UHC Medicaid,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UMR CPD,UMR CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicare,UHC Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Pro System  ,33147557,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Wellcare,Wellcare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health PPO CPD,Meritain Health PPO CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/Commercial Product,Aetna/Commercial Product,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health CPD,Meritain Health CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Starmark CPD,Starmark CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna Medicare,Aetna Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Ambetter ,Ambetter ,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access,Anthem Blue Access,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access Choice,Anthem Blue Access Choice,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Preferred,Anthem Blue Preferred,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Pathway,Anthem Pathway,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Alliance,Anthem Alliance,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Medicare,Anthem Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna,Cigna,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna PPO,Cigna PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna Medicare Advantage,Cigna Medicare Advantage,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Essence,Essence,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink HMO,Healthlink HMO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink PPO,Healthlink PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,HomeState Health Plan,HomeState Health Plan,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Humana Gold,Humana Gold,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medicaid MO,Medicaid MO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medica,Medica,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Tricare,Tricare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC All Payer,UHC All Payer,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Exchange,UHC Exchange,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicaid,UHC Medicaid,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UMR CPD,UMR CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicare,UHC Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Respironics Bipap Auto        ,33147558,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Wellcare,Wellcare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health PPO CPD,Meritain Health PPO CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna/Commercial Product,Aetna/Commercial Product,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Meritain Health CPD,Meritain Health CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Starmark CPD,Starmark CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Aetna Medicare,Aetna Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Ambetter ,Ambetter ,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access,Anthem Blue Access,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Access Choice,Anthem Blue Access Choice,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Blue Preferred,Anthem Blue Preferred,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Pathway,Anthem Pathway,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Alliance,Anthem Alliance,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Anthem Medicare,Anthem Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna,Cigna,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna PPO,Cigna PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Cigna Medicare Advantage,Cigna Medicare Advantage,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Essence,Essence,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink HMO,Healthlink HMO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Healthlink PPO,Healthlink PPO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,HomeState Health Plan,HomeState Health Plan,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Humana Gold,Humana Gold,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medicaid MO,Medicaid MO,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Medica,Medica,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Tricare,Tricare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC All Payer,UHC All Payer,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Exchange,UHC Exchange,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicaid,UHC Medicaid,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UMR CPD,UMR CPD,5.72,,,,,,,per diem,5.72,5.72,"Per diem rate, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,UHC Medicare,UHC Medicare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Cpap Icon Nova w/ Heater      ,33147561,CDM,279,RC,,,,,,Inpatient,,,5.72,5.72,Wellcare,Wellcare,5.72,,,,,,,case rate,5.72,5.72,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Meritain Health PPO CPD,Meritain Health PPO CPD,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Aetna/Commercial Product,Aetna/Commercial Product,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Meritain Health CPD,Meritain Health CPD,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Starmark CPD,Starmark CPD,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Aetna Medicare,Aetna Medicare,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Ambetter ,Ambetter ,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Blue Access,Anthem Blue Access,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Blue Access Choice,Anthem Blue Access Choice,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Blue Preferred,Anthem Blue Preferred,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Pathway,Anthem Pathway,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Alliance,Anthem Alliance,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Anthem Medicare,Anthem Medicare,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Cigna,Cigna,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Cigna PPO,Cigna PPO,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Cigna Medicare Advantage,Cigna Medicare Advantage,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Essence,Essence,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Healthlink HMO,Healthlink HMO,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Healthlink PPO,Healthlink PPO,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,HomeState Health Plan,HomeState Health Plan,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Humana Gold,Humana Gold,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Medicaid MO,Medicaid MO,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Medica,Medica,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Tricare,Tricare,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,UHC All Payer,UHC All Payer,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,UHC Exchange,UHC Exchange,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,UHC Medicaid,UHC Medicaid,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,UMR CPD,UMR CPD,772.5,,,,,,,per diem,772.5,772.5,"Per diem rate, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,UHC Medicare,UHC Medicare,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Quickie Iris Wheelchair       ,33147564,CDM,279,RC,,,,,,Inpatient,,,772.5,772.5,Wellcare,Wellcare,772.5,,,,,,,case rate,772.5,772.5,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 LW Wheelchair      ,33147565,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 LW Wheelchair      ,33147566,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 LW Wheelchair      ,33147567,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in16 Standard Wheelchair,33147568,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in18 Standard Wheelchair,33147569,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in20 Standard Wheelchair,33147570,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Drive in22 Sentra Wheelchair  ,33147571,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Meritain Health PPO CPD,Meritain Health PPO CPD,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Aetna/Commercial Product,Aetna/Commercial Product,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Meritain Health CPD,Meritain Health CPD,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Starmark CPD,Starmark CPD,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Aetna Medicare,Aetna Medicare,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Ambetter ,Ambetter ,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Blue Access,Anthem Blue Access,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Blue Access Choice,Anthem Blue Access Choice,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Blue Preferred,Anthem Blue Preferred,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Pathway,Anthem Pathway,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Alliance,Anthem Alliance,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Anthem Medicare,Anthem Medicare,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Cigna,Cigna,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Cigna PPO,Cigna PPO,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Cigna Medicare Advantage,Cigna Medicare Advantage,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Essence,Essence,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Healthlink HMO,Healthlink HMO,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Healthlink PPO,Healthlink PPO,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,HomeState Health Plan,HomeState Health Plan,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Humana Gold,Humana Gold,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Medicaid MO,Medicaid MO,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Medica,Medica,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Tricare,Tricare,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,UHC All Payer,UHC All Payer,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,UHC Exchange,UHC Exchange,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,UHC Medicaid,UHC Medicaid,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,UMR CPD,UMR CPD,10.82,,,,,,,per diem,10.82,10.82,"Per diem rate, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,UHC Medicare,UHC Medicare,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Articulating Leg Rest         ,33147572,CDM,279,RC,,,,,,Inpatient,,,10.82,10.82,Wellcare,Wellcare,10.82,,,,,,,case rate,10.82,10.82,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health PPO CPD,Meritain Health PPO CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/Commercial Product,Aetna/Commercial Product,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health CPD,Meritain Health CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Starmark CPD,Starmark CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna Medicare,Aetna Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Ambetter ,Ambetter ,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access,Anthem Blue Access,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access Choice,Anthem Blue Access Choice,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Preferred,Anthem Blue Preferred,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Pathway,Anthem Pathway,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Alliance,Anthem Alliance,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Medicare,Anthem Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna,Cigna,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna PPO,Cigna PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna Medicare Advantage,Cigna Medicare Advantage,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Essence,Essence,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink HMO,Healthlink HMO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink PPO,Healthlink PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,HomeState Health Plan,HomeState Health Plan,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Humana Gold,Humana Gold,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medicaid MO,Medicaid MO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medica,Medica,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Tricare,Tricare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC All Payer,UHC All Payer,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Exchange,UHC Exchange,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicaid,UHC Medicaid,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UMR CPD,UMR CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicare,UHC Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive in22 Reclining Wheelchai,33147573,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Wellcare,Wellcare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health PPO CPD,Meritain Health PPO CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna/Commercial Product,Aetna/Commercial Product,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Meritain Health CPD,Meritain Health CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Starmark CPD,Starmark CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Aetna Medicare,Aetna Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Ambetter ,Ambetter ,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access,Anthem Blue Access,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Access Choice,Anthem Blue Access Choice,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Blue Preferred,Anthem Blue Preferred,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Pathway,Anthem Pathway,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Alliance,Anthem Alliance,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Anthem Medicare,Anthem Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna,Cigna,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna PPO,Cigna PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Cigna Medicare Advantage,Cigna Medicare Advantage,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Essence,Essence,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink HMO,Healthlink HMO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Healthlink PPO,Healthlink PPO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,HomeState Health Plan,HomeState Health Plan,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Humana Gold,Humana Gold,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medicaid MO,Medicaid MO,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Medica,Medica,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Tricare,Tricare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC All Payer,UHC All Payer,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Exchange,UHC Exchange,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicaid,UHC Medicaid,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UMR CPD,UMR CPD,15.45,,,,,,,per diem,15.45,15.45,"Per diem rate, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,UHC Medicare,UHC Medicare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Drive Anti Tippers            ,33147574,CDM,279,RC,,,,,,Inpatient,,,15.45,15.45,Wellcare,Wellcare,15.45,,,,,,,case rate,15.45,15.45,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Meritain Health PPO CPD,Meritain Health PPO CPD,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Aetna/Commercial Product,Aetna/Commercial Product,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Meritain Health CPD,Meritain Health CPD,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Starmark CPD,Starmark CPD,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Aetna Medicare,Aetna Medicare,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Ambetter ,Ambetter ,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Blue Access,Anthem Blue Access,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Blue Access Choice,Anthem Blue Access Choice,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Blue Preferred,Anthem Blue Preferred,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Pathway,Anthem Pathway,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Alliance,Anthem Alliance,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Anthem Medicare,Anthem Medicare,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Cigna,Cigna,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Cigna PPO,Cigna PPO,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Cigna Medicare Advantage,Cigna Medicare Advantage,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Essence,Essence,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Healthlink HMO,Healthlink HMO,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Healthlink PPO,Healthlink PPO,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,HomeState Health Plan,HomeState Health Plan,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Humana Gold,Humana Gold,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Medicaid MO,Medicaid MO,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Medica,Medica,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Tricare,Tricare,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,UHC All Payer,UHC All Payer,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,UHC Exchange,UHC Exchange,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,UHC Medicaid,UHC Medicaid,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,UMR CPD,UMR CPD,236.39,,,,,,,per diem,236.39,236.39,"Per diem rate, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,UHC Medicare,UHC Medicare,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Stand Up Lift (SARA Lift)     ,33147575,CDM,279,RC,,,,,,Inpatient,,,236.39,236.39,Wellcare,Wellcare,236.39,,,,,,,case rate,236.39,236.39,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Meritain Health PPO CPD,Meritain Health PPO CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna/Commercial Product,Aetna/Commercial Product,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Meritain Health CPD,Meritain Health CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Starmark CPD,Starmark CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna Medicare,Aetna Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Ambetter ,Ambetter ,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Access,Anthem Blue Access,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Access Choice,Anthem Blue Access Choice,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Preferred,Anthem Blue Preferred,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Pathway,Anthem Pathway,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Alliance,Anthem Alliance,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Medicare,Anthem Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna,Cigna,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna PPO,Cigna PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna Medicare Advantage,Cigna Medicare Advantage,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Essence,Essence,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthlink HMO,Healthlink HMO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthlink PPO,Healthlink PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,HomeState Health Plan,HomeState Health Plan,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Humana Gold,Humana Gold,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Medicaid MO,Medicaid MO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Medica,Medica,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Tricare,Tricare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC All Payer,UHC All Payer,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Exchange,UHC Exchange,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Medicaid,UHC Medicaid,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UMR CPD,UMR CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Medicare,UHC Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair LW 16X             ,33147576,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Wellcare,Wellcare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health PPO CPD,Meritain Health PPO CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna/Commercial Product,Aetna/Commercial Product,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Meritain Health CPD,Meritain Health CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Starmark CPD,Starmark CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Aetna Medicare,Aetna Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Ambetter ,Ambetter ,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access,Anthem Blue Access,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Access Choice,Anthem Blue Access Choice,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Blue Preferred,Anthem Blue Preferred,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Pathway,Anthem Pathway,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Alliance,Anthem Alliance,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Anthem Medicare,Anthem Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna,Cigna,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna PPO,Cigna PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Cigna Medicare Advantage,Cigna Medicare Advantage,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Essence,Essence,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink HMO,Healthlink HMO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Healthlink PPO,Healthlink PPO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,HomeState Health Plan,HomeState Health Plan,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Humana Gold,Humana Gold,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medicaid MO,Medicaid MO,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Medica,Medica,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Tricare,Tricare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC All Payer,UHC All Payer,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Exchange,UHC Exchange,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicaid,UHC Medicaid,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UMR CPD,UMR CPD,139.05,,,,,,,per diem,139.05,139.05,"Per diem rate, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,UHC Medicare,UHC Medicare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair SX                 ,33147577,CDM,279,RC,,,,,,Inpatient,,,139.05,139.05,Wellcare,Wellcare,139.05,,,,,,,case rate,139.05,139.05,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147578,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 20in DE     ,33147580,CDM,279,RC,,,,,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair             ,33147581,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair LT WT              ,33147582,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Tracer Wheelchair 24 inch     ,33147583,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Meritain Health PPO CPD,Meritain Health PPO CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Aetna/Commercial Product,Aetna/Commercial Product,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Meritain Health CPD,Meritain Health CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Starmark CPD,Starmark CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Aetna Medicare,Aetna Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Ambetter ,Ambetter ,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Blue Access,Anthem Blue Access,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Blue Access Choice,Anthem Blue Access Choice,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Blue Preferred,Anthem Blue Preferred,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Pathway,Anthem Pathway,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Alliance,Anthem Alliance,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Anthem Medicare,Anthem Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Cigna,Cigna,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Cigna PPO,Cigna PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Cigna Medicare Advantage,Cigna Medicare Advantage,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Essence,Essence,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Healthlink HMO,Healthlink HMO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Healthlink PPO,Healthlink PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,HomeState Health Plan,HomeState Health Plan,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Humana Gold,Humana Gold,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Medicaid MO,Medicaid MO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Medica,Medica,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Tricare,Tricare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,UHC All Payer,UHC All Payer,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,UHC Exchange,UHC Exchange,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,UHC Medicaid,UHC Medicaid,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,UMR CPD,UMR CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,UHC Medicare,UHC Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20in Recliner      ,33147584,CDM,279,RC,,,,,,Inpatient,,,231.75,231.75,Wellcare,Wellcare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 20X16              ,33147585,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
Wheelchair 24 Inch Wide       ,33147586,CDM,279,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES - LANTZ MEDICAL        ,33147613,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
GLOVES LARGE RIGHT - LANTZ MED,33147614,CDM,270,RC,,,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health PPO CPD,Meritain Health PPO CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna/Commercial Product,Aetna/Commercial Product,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Meritain Health CPD,Meritain Health CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Starmark CPD,Starmark CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Aetna Medicare,Aetna Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Ambetter ,Ambetter ,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access,Anthem Blue Access,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Access Choice,Anthem Blue Access Choice,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Blue Preferred,Anthem Blue Preferred,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Pathway,Anthem Pathway,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Alliance,Anthem Alliance,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Anthem Medicare,Anthem Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna,Cigna,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna PPO,Cigna PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Cigna Medicare Advantage,Cigna Medicare Advantage,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Essence,Essence,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink HMO,Healthlink HMO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Healthlink PPO,Healthlink PPO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,HomeState Health Plan,HomeState Health Plan,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Humana Gold,Humana Gold,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Medicaid MO,Medicaid MO,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Medica,Medica,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Tricare,Tricare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC All Payer,UHC All Payer,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Exchange,UHC Exchange,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicaid,UHC Medicaid,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,UMR CPD,UMR CPD,45,,,,,,,per diem,45,45,"Per diem rate, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,UHC Medicare,UHC Medicare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
WHEELCHAIR RECLINING 18X16    ,33147616,CDM,279,RC,,,,,,Inpatient,,,45,45,Wellcare,Wellcare,45,,,,,,,case rate,45,45,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Meritain Health PPO CPD,Meritain Health PPO CPD,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Aetna/Commercial Product,Aetna/Commercial Product,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Meritain Health CPD,Meritain Health CPD,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Starmark CPD,Starmark CPD,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Aetna Medicare,Aetna Medicare,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Ambetter ,Ambetter ,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Blue Access,Anthem Blue Access,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Blue Access Choice,Anthem Blue Access Choice,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Blue Preferred,Anthem Blue Preferred,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Pathway,Anthem Pathway,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Alliance,Anthem Alliance,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Anthem Medicare,Anthem Medicare,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Cigna,Cigna,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Cigna PPO,Cigna PPO,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Cigna Medicare Advantage,Cigna Medicare Advantage,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Essence,Essence,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Healthlink HMO,Healthlink HMO,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Healthlink PPO,Healthlink PPO,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,HomeState Health Plan,HomeState Health Plan,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Humana Gold,Humana Gold,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Medicaid MO,Medicaid MO,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Medica,Medica,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Tricare,Tricare,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,UHC All Payer,UHC All Payer,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,UHC Exchange,UHC Exchange,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,UHC Medicaid,UHC Medicaid,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,UMR CPD,UMR CPD,20.61,,,,,,,per diem,20.61,20.61,"Per diem rate, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,UHC Medicare,UHC Medicare,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
BIPAP AUTO SV ADV             ,33147619,CDM,279,RC,,,,,,Inpatient,,,20.61,20.61,Wellcare,Wellcare,20.61,,,,,,,case rate,20.61,20.61,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health PPO CPD,Meritain Health PPO CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna/Commercial Product,Aetna/Commercial Product,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Meritain Health CPD,Meritain Health CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Starmark CPD,Starmark CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Aetna Medicare,Aetna Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Ambetter ,Ambetter ,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access,Anthem Blue Access,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Access Choice,Anthem Blue Access Choice,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Blue Preferred,Anthem Blue Preferred,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Pathway,Anthem Pathway,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Alliance,Anthem Alliance,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Anthem Medicare,Anthem Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna,Cigna,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna PPO,Cigna PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Cigna Medicare Advantage,Cigna Medicare Advantage,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Essence,Essence,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink HMO,Healthlink HMO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Healthlink PPO,Healthlink PPO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,HomeState Health Plan,HomeState Health Plan,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Humana Gold,Humana Gold,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Medicaid MO,Medicaid MO,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Medica,Medica,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Tricare,Tricare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC All Payer,UHC All Payer,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Exchange,UHC Exchange,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicaid,UHC Medicaid,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,UMR CPD,UMR CPD,24,,,,,,,per diem,24,24,"Per diem rate, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,UHC Medicare,UHC Medicare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
ROHO MATTRESS OVERLAY 4 SECT  ,33147623,CDM,279,RC,,,,,,Inpatient,,,24,24,Wellcare,Wellcare,24,,,,,,,case rate,24,24,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Meritain Health PPO CPD,Meritain Health PPO CPD,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Aetna/Commercial Product,Aetna/Commercial Product,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Meritain Health CPD,Meritain Health CPD,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Starmark CPD,Starmark CPD,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Aetna Medicare,Aetna Medicare,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Ambetter ,Ambetter ,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Blue Access,Anthem Blue Access,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Blue Access Choice,Anthem Blue Access Choice,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Blue Preferred,Anthem Blue Preferred,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Pathway,Anthem Pathway,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Alliance,Anthem Alliance,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Anthem Medicare,Anthem Medicare,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Cigna,Cigna,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Cigna PPO,Cigna PPO,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Cigna Medicare Advantage,Cigna Medicare Advantage,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Essence,Essence,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Healthlink HMO,Healthlink HMO,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Healthlink PPO,Healthlink PPO,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,HomeState Health Plan,HomeState Health Plan,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Humana Gold,Humana Gold,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Medicaid MO,Medicaid MO,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Medica,Medica,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Tricare,Tricare,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,UHC All Payer,UHC All Payer,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,UHC Exchange,UHC Exchange,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,UHC Medicaid,UHC Medicaid,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,UMR CPD,UMR CPD,386.25,,,,,,,per diem,386.25,386.25,"Per diem rate, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,UHC Medicare,UHC Medicare,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIFE VEST-ZOLL                ,33147626,CDM,279,RC,,,,,,Inpatient,,,386.25,386.25,Wellcare,Wellcare,386.25,,,,,,,case rate,386.25,386.25,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Meritain Health PPO CPD,Meritain Health PPO CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Aetna/Commercial Product,Aetna/Commercial Product,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Meritain Health CPD,Meritain Health CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Starmark CPD,Starmark CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Aetna Medicare,Aetna Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Ambetter ,Ambetter ,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Blue Access,Anthem Blue Access,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Blue Access Choice,Anthem Blue Access Choice,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Blue Preferred,Anthem Blue Preferred,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Pathway,Anthem Pathway,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Alliance,Anthem Alliance,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Anthem Medicare,Anthem Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Cigna,Cigna,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Cigna PPO,Cigna PPO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Cigna Medicare Advantage,Cigna Medicare Advantage,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Essence,Essence,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Healthlink HMO,Healthlink HMO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Healthlink PPO,Healthlink PPO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,HomeState Health Plan,HomeState Health Plan,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Humana Gold,Humana Gold,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Medicaid MO,Medicaid MO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Medica,Medica,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Tricare,Tricare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,UHC All Payer,UHC All Payer,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,UHC Exchange,UHC Exchange,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,UHC Medicaid,UHC Medicaid,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,UMR CPD,UMR CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,UHC Medicare,UHC Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
LIGHTWT WHEELCHAIR-MED SPEC   ,33147627,CDM,279,RC,,,,,,Inpatient,,,169.95,169.95,Wellcare,Wellcare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Meritain Health PPO CPD,Meritain Health PPO CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna/Commercial Product,Aetna/Commercial Product,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Meritain Health CPD,Meritain Health CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Starmark CPD,Starmark CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Aetna Medicare,Aetna Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Ambetter ,Ambetter ,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Access,Anthem Blue Access,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Access Choice,Anthem Blue Access Choice,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Blue Preferred,Anthem Blue Preferred,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Pathway,Anthem Pathway,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Alliance,Anthem Alliance,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Anthem Medicare,Anthem Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna,Cigna,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna PPO,Cigna PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Cigna Medicare Advantage,Cigna Medicare Advantage,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Essence,Essence,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthlink HMO,Healthlink HMO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Healthlink PPO,Healthlink PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,HomeState Health Plan,HomeState Health Plan,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Humana Gold,Humana Gold,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Medicaid MO,Medicaid MO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Medica,Medica,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Tricare,Tricare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC All Payer,UHC All Payer,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Exchange,UHC Exchange,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Medicaid,UHC Medicaid,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UMR CPD,UMR CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,UHC Medicare,UHC Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
VIPER WHEELCHAIR              ,33147629,CDM,279,RC,,,,,,Inpatient,,,154.5,154.5,Wellcare,Wellcare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
ONE ARM DRIVE                 ,33147634,CDM,279,RC,,,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health PPO CPD,Meritain Health PPO CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna/Commercial Product,Aetna/Commercial Product,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Meritain Health CPD,Meritain Health CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Starmark CPD,Starmark CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Aetna Medicare,Aetna Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Ambetter ,Ambetter ,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access,Anthem Blue Access,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Access Choice,Anthem Blue Access Choice,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Blue Preferred,Anthem Blue Preferred,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Pathway,Anthem Pathway,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Alliance,Anthem Alliance,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Anthem Medicare,Anthem Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna,Cigna,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna PPO,Cigna PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Cigna Medicare Advantage,Cigna Medicare Advantage,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Essence,Essence,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink HMO,Healthlink HMO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Healthlink PPO,Healthlink PPO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,HomeState Health Plan,HomeState Health Plan,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Humana Gold,Humana Gold,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medicaid MO,Medicaid MO,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Medica,Medica,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Tricare,Tricare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC All Payer,UHC All Payer,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Exchange,UHC Exchange,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicaid,UHC Medicaid,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UMR CPD,UMR CPD,10.04,,,,,,,per diem,10.04,10.04,"Per diem rate, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,UHC Medicare,UHC Medicare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
AIRCURUVE 10 V AUTO BIPAP KIT ,33147636,CDM,279,RC,,,,,,Inpatient,,,10.04,10.04,Wellcare,Wellcare,10.04,,,,,,,case rate,10.04,10.04,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Meritain Health PPO CPD,Meritain Health PPO CPD,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Aetna/Commercial Product,Aetna/Commercial Product,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Meritain Health CPD,Meritain Health CPD,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Starmark CPD,Starmark CPD,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Aetna Medicare,Aetna Medicare,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Ambetter ,Ambetter ,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Blue Access,Anthem Blue Access,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Blue Access Choice,Anthem Blue Access Choice,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Blue Preferred,Anthem Blue Preferred,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Pathway,Anthem Pathway,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Alliance,Anthem Alliance,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Anthem Medicare,Anthem Medicare,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Cigna,Cigna,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Cigna PPO,Cigna PPO,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Cigna Medicare Advantage,Cigna Medicare Advantage,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Essence,Essence,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Healthlink HMO,Healthlink HMO,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Healthlink PPO,Healthlink PPO,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,HomeState Health Plan,HomeState Health Plan,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Humana Gold,Humana Gold,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Medicaid MO,Medicaid MO,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Medica,Medica,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Tricare,Tricare,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,UHC All Payer,UHC All Payer,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,UHC Exchange,UHC Exchange,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,UHC Medicaid,UHC Medicaid,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,UMR CPD,UMR CPD,3090,,,,,,,per diem,3090,3090,"Per diem rate, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,UHC Medicare,UHC Medicare,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
TRILOGY VENT RENTAL           ,33147646,CDM,279,RC,,,,,,Inpatient,,,3090,3090,Wellcare,Wellcare,3090,,,,,,,case rate,3090,3090,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL L,33148001,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP SMALL R,33148002,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148003,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP MEDIUM ,33148004,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE L,33148005,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health PPO CPD,Meritain Health PPO CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna/Commercial Product,Aetna/Commercial Product,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Meritain Health CPD,Meritain Health CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Starmark CPD,Starmark CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Aetna Medicare,Aetna Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Ambetter ,Ambetter ,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access,Anthem Blue Access,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Access Choice,Anthem Blue Access Choice,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Blue Preferred,Anthem Blue Preferred,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Pathway,Anthem Pathway,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Alliance,Anthem Alliance,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Anthem Medicare,Anthem Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna,Cigna,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna PPO,Cigna PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Cigna Medicare Advantage,Cigna Medicare Advantage,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Essence,Essence,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink HMO,Healthlink HMO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Healthlink PPO,Healthlink PPO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,HomeState Health Plan,HomeState Health Plan,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Humana Gold,Humana Gold,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medicaid MO,Medicaid MO,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Medica,Medica,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Tricare,Tricare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC All Payer,UHC All Payer,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Exchange,UHC Exchange,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicaid,UHC Medicaid,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UMR CPD,UMR CPD,65.43,,,,,,,per diem,65.43,65.43,"Per diem rate, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,UHC Medicare,UHC Medicare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
SPLINT AIRCAST STIRRUP LARGE R,33148006,CDM,270,RC,,,,,,Inpatient,,,65.43,65.43,Wellcare,Wellcare,65.43,,,,,,,case rate,65.43,65.43,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Meritain Health PPO CPD,Meritain Health PPO CPD,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Aetna/Commercial Product,Aetna/Commercial Product,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Meritain Health CPD,Meritain Health CPD,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Starmark CPD,Starmark CPD,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Aetna Medicare,Aetna Medicare,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Ambetter ,Ambetter ,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Blue Access,Anthem Blue Access,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Blue Access Choice,Anthem Blue Access Choice,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Blue Preferred,Anthem Blue Preferred,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Pathway,Anthem Pathway,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Alliance,Anthem Alliance,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Anthem Medicare,Anthem Medicare,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Cigna,Cigna,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Cigna PPO,Cigna PPO,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Cigna Medicare Advantage,Cigna Medicare Advantage,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Essence,Essence,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Healthlink HMO,Healthlink HMO,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Healthlink PPO,Healthlink PPO,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,HomeState Health Plan,HomeState Health Plan,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Humana Gold,Humana Gold,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Medicaid MO,Medicaid MO,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Medica,Medica,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Tricare,Tricare,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,UHC All Payer,UHC All Payer,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,UHC Exchange,UHC Exchange,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,UHC Medicaid,UHC Medicaid,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,UMR CPD,UMR CPD,75.9,,,,,,,per diem,75.9,75.9,"Per diem rate, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,UHC Medicare,UHC Medicare,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CAST SLIMLINE PED SM     ,33148019,CDM,270,RC,,,,,,Inpatient,,,75.9,75.9,Wellcare,Wellcare,75.9,,,,,,,case rate,75.9,75.9,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Meritain Health PPO CPD,Meritain Health PPO CPD,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Aetna/Commercial Product,Aetna/Commercial Product,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Meritain Health CPD,Meritain Health CPD,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Starmark CPD,Starmark CPD,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Aetna Medicare,Aetna Medicare,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Ambetter ,Ambetter ,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Blue Access,Anthem Blue Access,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Blue Access Choice,Anthem Blue Access Choice,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Blue Preferred,Anthem Blue Preferred,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Pathway,Anthem Pathway,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Alliance,Anthem Alliance,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Anthem Medicare,Anthem Medicare,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Cigna,Cigna,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Cigna PPO,Cigna PPO,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Cigna Medicare Advantage,Cigna Medicare Advantage,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Essence,Essence,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Healthlink HMO,Healthlink HMO,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Healthlink PPO,Healthlink PPO,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,HomeState Health Plan,HomeState Health Plan,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Humana Gold,Humana Gold,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Medicaid MO,Medicaid MO,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Medica,Medica,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Tricare,Tricare,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,UHC All Payer,UHC All Payer,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,UHC Exchange,UHC Exchange,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,UHC Medicaid,UHC Medicaid,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,UMR CPD,UMR CPD,140.8,,,,,,,per diem,140.8,140.8,"Per diem rate, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,UHC Medicare,UHC Medicare,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE                   ,33148020,CDM,270,RC,,,,,,Inpatient,,,140.8,140.8,Wellcare,Wellcare,140.8,,,,,,,case rate,140.8,140.8,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Meritain Health PPO CPD,Meritain Health PPO CPD,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Aetna/Commercial Product,Aetna/Commercial Product,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Meritain Health CPD,Meritain Health CPD,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Starmark CPD,Starmark CPD,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Aetna Medicare,Aetna Medicare,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Ambetter ,Ambetter ,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Blue Access,Anthem Blue Access,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Blue Access Choice,Anthem Blue Access Choice,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Blue Preferred,Anthem Blue Preferred,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Pathway,Anthem Pathway,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Alliance,Anthem Alliance,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Anthem Medicare,Anthem Medicare,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Cigna,Cigna,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Cigna PPO,Cigna PPO,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Cigna Medicare Advantage,Cigna Medicare Advantage,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Essence,Essence,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Healthlink HMO,Healthlink HMO,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Healthlink PPO,Healthlink PPO,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,HomeState Health Plan,HomeState Health Plan,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Humana Gold,Humana Gold,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Medicaid MO,Medicaid MO,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Medica,Medica,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Tricare,Tricare,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,UHC All Payer,UHC All Payer,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,UHC Exchange,UHC Exchange,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,UHC Medicaid,UHC Medicaid,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,UMR CPD,UMR CPD,342.1,,,,,,,per diem,342.1,342.1,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,UHC Medicare,UHC Medicare,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR LNG 13IN,33148021,CDM,270,RC,,,,,,Inpatient,,,342.1,342.1,Wellcare,Wellcare,342.1,,,,,,,case rate,342.1,342.1,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Meritain Health PPO CPD,Meritain Health PPO CPD,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Aetna/Commercial Product,Aetna/Commercial Product,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Meritain Health CPD,Meritain Health CPD,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Starmark CPD,Starmark CPD,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Aetna Medicare,Aetna Medicare,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Ambetter ,Ambetter ,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Blue Access,Anthem Blue Access,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Blue Access Choice,Anthem Blue Access Choice,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Blue Preferred,Anthem Blue Preferred,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Pathway,Anthem Pathway,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Alliance,Anthem Alliance,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Anthem Medicare,Anthem Medicare,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Cigna,Cigna,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Cigna PPO,Cigna PPO,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Cigna Medicare Advantage,Cigna Medicare Advantage,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Essence,Essence,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Healthlink HMO,Healthlink HMO,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Healthlink PPO,Healthlink PPO,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,HomeState Health Plan,HomeState Health Plan,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Humana Gold,Humana Gold,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Medicaid MO,Medicaid MO,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Medica,Medica,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Tricare,Tricare,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,UHC All Payer,UHC All Payer,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,UHC Exchange,UHC Exchange,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,UHC Medicaid,UHC Medicaid,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,UMR CPD,UMR CPD,133.98,,,,,,,per diem,133.98,133.98,"Per diem rate, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,UHC Medicare,UHC Medicare,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT CRADLE PRUVENTOR SHT 9IN ,33148022,CDM,270,RC,,,,,,Inpatient,,,133.98,133.98,Wellcare,Wellcare,133.98,,,,,,,case rate,133.98,133.98,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Meritain Health PPO CPD,Meritain Health PPO CPD,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Aetna/Commercial Product,Aetna/Commercial Product,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Meritain Health CPD,Meritain Health CPD,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Starmark CPD,Starmark CPD,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Aetna Medicare,Aetna Medicare,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Ambetter ,Ambetter ,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Blue Access,Anthem Blue Access,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Blue Access Choice,Anthem Blue Access Choice,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Blue Preferred,Anthem Blue Preferred,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Pathway,Anthem Pathway,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Alliance,Anthem Alliance,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Anthem Medicare,Anthem Medicare,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Cigna,Cigna,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Cigna PPO,Cigna PPO,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Cigna Medicare Advantage,Cigna Medicare Advantage,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Essence,Essence,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Healthlink HMO,Healthlink HMO,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Healthlink PPO,Healthlink PPO,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,HomeState Health Plan,HomeState Health Plan,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Humana Gold,Humana Gold,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Medicaid MO,Medicaid MO,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Medica,Medica,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Tricare,Tricare,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,UHC All Payer,UHC All Payer,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,UHC Exchange,UHC Exchange,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,UHC Medicaid,UHC Medicaid,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,UMR CPD,UMR CPD,300,,,,,,,per diem,300,300,"Per diem rate, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,UHC Medicare,UHC Medicare,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT PRAFO LINER BARIATRIC    ,33148023,CDM,270,RC,,,,,,Inpatient,,,300,300,Wellcare,Wellcare,300,,,,,,,case rate,300,300,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Meritain Health PPO CPD,Meritain Health PPO CPD,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Aetna/Commercial Product,Aetna/Commercial Product,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Meritain Health CPD,Meritain Health CPD,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Starmark CPD,Starmark CPD,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Aetna Medicare,Aetna Medicare,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Ambetter ,Ambetter ,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Blue Access,Anthem Blue Access,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Blue Access Choice,Anthem Blue Access Choice,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Blue Preferred,Anthem Blue Preferred,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Pathway,Anthem Pathway,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Alliance,Anthem Alliance,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Anthem Medicare,Anthem Medicare,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Cigna,Cigna,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Cigna PPO,Cigna PPO,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Cigna Medicare Advantage,Cigna Medicare Advantage,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Essence,Essence,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Healthlink HMO,Healthlink HMO,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Healthlink PPO,Healthlink PPO,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,HomeState Health Plan,HomeState Health Plan,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Humana Gold,Humana Gold,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Medicaid MO,Medicaid MO,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Medica,Medica,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Tricare,Tricare,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,UHC All Payer,UHC All Payer,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,UHC Exchange,UHC Exchange,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,UHC Medicaid,UHC Medicaid,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,UMR CPD,UMR CPD,63.8,,,,,,,per diem,63.8,63.8,"Per diem rate, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,UHC Medicare,UHC Medicare,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT TRACTION UNIV            ,33148024,CDM,270,RC,,,,,,Inpatient,,,63.8,63.8,Wellcare,Wellcare,63.8,,,,,,,case rate,63.8,63.8,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Meritain Health PPO CPD,Meritain Health PPO CPD,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Aetna/Commercial Product,Aetna/Commercial Product,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Meritain Health CPD,Meritain Health CPD,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Starmark CPD,Starmark CPD,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Aetna Medicare,Aetna Medicare,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Ambetter ,Ambetter ,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Blue Access,Anthem Blue Access,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Blue Access Choice,Anthem Blue Access Choice,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Blue Preferred,Anthem Blue Preferred,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Pathway,Anthem Pathway,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Alliance,Anthem Alliance,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Anthem Medicare,Anthem Medicare,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Cigna,Cigna,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Cigna PPO,Cigna PPO,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Cigna Medicare Advantage,Cigna Medicare Advantage,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Essence,Essence,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Healthlink HMO,Healthlink HMO,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Healthlink PPO,Healthlink PPO,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,HomeState Health Plan,HomeState Health Plan,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Humana Gold,Humana Gold,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Medicaid MO,Medicaid MO,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Medica,Medica,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Tricare,Tricare,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,UHC All Payer,UHC All Payer,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,UHC Exchange,UHC Exchange,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,UHC Medicaid,UHC Medicaid,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,UMR CPD,UMR CPD,655.6,,,,,,,per diem,655.6,655.6,"Per diem rate, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,UHC Medicare,UHC Medicare,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BOOT VASC ROOKE MED           ,33148025,CDM,270,RC,,,,,,Inpatient,,,655.6,655.6,Wellcare,Wellcare,655.6,,,,,,,case rate,655.6,655.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Meritain Health PPO CPD,Meritain Health PPO CPD,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Aetna/Commercial Product,Aetna/Commercial Product,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Meritain Health CPD,Meritain Health CPD,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Starmark CPD,Starmark CPD,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Aetna Medicare,Aetna Medicare,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Ambetter ,Ambetter ,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Blue Access,Anthem Blue Access,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Blue Access Choice,Anthem Blue Access Choice,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Blue Preferred,Anthem Blue Preferred,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Pathway,Anthem Pathway,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Alliance,Anthem Alliance,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Anthem Medicare,Anthem Medicare,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Cigna,Cigna,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Cigna PPO,Cigna PPO,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Cigna Medicare Advantage,Cigna Medicare Advantage,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Essence,Essence,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Healthlink HMO,Healthlink HMO,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Healthlink PPO,Healthlink PPO,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,HomeState Health Plan,HomeState Health Plan,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Humana Gold,Humana Gold,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Medicaid MO,Medicaid MO,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Medica,Medica,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Tricare,Tricare,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,UHC All Payer,UHC All Payer,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,UHC Exchange,UHC Exchange,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,UHC Medicaid,UHC Medicaid,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,UMR CPD,UMR CPD,687.5,,,,,,,per diem,687.5,687.5,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,UHC Medicare,UHC Medicare,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION      ,33148026,CDM,270,RC,,,,,,Inpatient,,,687.5,687.5,Wellcare,Wellcare,687.5,,,,,,,case rate,687.5,687.5,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Meritain Health PPO CPD,Meritain Health PPO CPD,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Aetna/Commercial Product,Aetna/Commercial Product,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Meritain Health CPD,Meritain Health CPD,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Starmark CPD,Starmark CPD,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Aetna Medicare,Aetna Medicare,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Ambetter ,Ambetter ,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Blue Access,Anthem Blue Access,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Blue Access Choice,Anthem Blue Access Choice,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Blue Preferred,Anthem Blue Preferred,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Pathway,Anthem Pathway,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Alliance,Anthem Alliance,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Anthem Medicare,Anthem Medicare,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Cigna,Cigna,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Cigna PPO,Cigna PPO,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Cigna Medicare Advantage,Cigna Medicare Advantage,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Essence,Essence,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Healthlink HMO,Healthlink HMO,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Healthlink PPO,Healthlink PPO,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,HomeState Health Plan,HomeState Health Plan,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Humana Gold,Humana Gold,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Medicaid MO,Medicaid MO,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Medica,Medica,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Tricare,Tricare,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,UHC All Payer,UHC All Payer,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,UHC Exchange,UHC Exchange,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,UHC Medicaid,UHC Medicaid,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,UMR CPD,UMR CPD,721.6,,,,,,,per diem,721.6,721.6,"Per diem rate, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,UHC Medicare,UHC Medicare,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE ACE HYPEREXTENTION LNG  ,33148027,CDM,270,RC,,,,,,Inpatient,,,721.6,721.6,Wellcare,Wellcare,721.6,,,,,,,case rate,721.6,721.6,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Meritain Health PPO CPD,Meritain Health PPO CPD,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Aetna/Commercial Product,Aetna/Commercial Product,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Meritain Health CPD,Meritain Health CPD,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Starmark CPD,Starmark CPD,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Aetna Medicare,Aetna Medicare,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Ambetter ,Ambetter ,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Blue Access,Anthem Blue Access,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Blue Access Choice,Anthem Blue Access Choice,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Blue Preferred,Anthem Blue Preferred,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Pathway,Anthem Pathway,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Alliance,Anthem Alliance,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Anthem Medicare,Anthem Medicare,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Cigna,Cigna,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Cigna PPO,Cigna PPO,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Cigna Medicare Advantage,Cigna Medicare Advantage,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Essence,Essence,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Healthlink HMO,Healthlink HMO,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Healthlink PPO,Healthlink PPO,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,HomeState Health Plan,HomeState Health Plan,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Humana Gold,Humana Gold,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Medicaid MO,Medicaid MO,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Medica,Medica,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Tricare,Tricare,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,UHC All Payer,UHC All Payer,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,UHC Exchange,UHC Exchange,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,UHC Medicaid,UHC Medicaid,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,UMR CPD,UMR CPD,943.8,,,,,,,per diem,943.8,943.8,"Per diem rate, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,UHC Medicare,UHC Medicare,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
BRACE CHAIR BACK LG           ,33148028,CDM,270,RC,,,,,,Inpatient,,,943.8,943.8,Wellcare,Wellcare,943.8,,,,,,,case rate,943.8,943.8,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health PPO CPD,Meritain Health PPO CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/Commercial Product,Aetna/Commercial Product,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health CPD,Meritain Health CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Starmark CPD,Starmark CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna Medicare,Aetna Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Ambetter ,Ambetter ,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access,Anthem Blue Access,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access Choice,Anthem Blue Access Choice,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Preferred,Anthem Blue Preferred,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Pathway,Anthem Pathway,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Alliance,Anthem Alliance,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Medicare,Anthem Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna,Cigna,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna PPO,Cigna PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna Medicare Advantage,Cigna Medicare Advantage,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Essence,Essence,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink HMO,Healthlink HMO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink PPO,Healthlink PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,HomeState Health Plan,HomeState Health Plan,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Humana Gold,Humana Gold,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Medicaid MO,Medicaid MO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Medica,Medica,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Tricare,Tricare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC All Payer,UHC All Payer,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Exchange,UHC Exchange,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicaid,UHC Medicaid,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UMR CPD,UMR CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicare,UHC Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG MENS LG         ,33148029,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Wellcare,Wellcare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health PPO CPD,Meritain Health PPO CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna/Commercial Product,Aetna/Commercial Product,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Meritain Health CPD,Meritain Health CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Starmark CPD,Starmark CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Aetna Medicare,Aetna Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Ambetter ,Ambetter ,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access,Anthem Blue Access,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Access Choice,Anthem Blue Access Choice,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Blue Preferred,Anthem Blue Preferred,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Pathway,Anthem Pathway,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Alliance,Anthem Alliance,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Anthem Medicare,Anthem Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna,Cigna,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna PPO,Cigna PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Cigna Medicare Advantage,Cigna Medicare Advantage,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Essence,Essence,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink HMO,Healthlink HMO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Healthlink PPO,Healthlink PPO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,HomeState Health Plan,HomeState Health Plan,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Humana Gold,Humana Gold,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Medicaid MO,Medicaid MO,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Medica,Medica,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Tricare,Tricare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC All Payer,UHC All Payer,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Exchange,UHC Exchange,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicaid,UHC Medicaid,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UMR CPD,UMR CPD,27.5,,,,,,,per diem,27.5,27.5,"Per diem rate, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,UHC Medicare,UHC Medicare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE MED SURG WOMENS MED      ,33148030,CDM,270,RC,,,,,,Inpatient,,,27.5,27.5,Wellcare,Wellcare,27.5,,,,,,,case rate,27.5,27.5,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO LG      ,33148031,CDM,270,RC,,,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO MED     ,33148032,CDM,270,RC,,,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SHOE ORTHOWEDGE DARCO SM      ,33148033,CDM,270,RC,,,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health PPO CPD,Meritain Health PPO CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/Commercial Product,Aetna/Commercial Product,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health CPD,Meritain Health CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Starmark CPD,Starmark CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna Medicare,Aetna Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Ambetter ,Ambetter ,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access,Anthem Blue Access,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access Choice,Anthem Blue Access Choice,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Preferred,Anthem Blue Preferred,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Pathway,Anthem Pathway,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Alliance,Anthem Alliance,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Medicare,Anthem Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna,Cigna,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna PPO,Cigna PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna Medicare Advantage,Cigna Medicare Advantage,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Essence,Essence,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink HMO,Healthlink HMO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink PPO,Healthlink PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,HomeState Health Plan,HomeState Health Plan,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Humana Gold,Humana Gold,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medicaid MO,Medicaid MO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medica,Medica,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Tricare,Tricare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC All Payer,UHC All Payer,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Exchange,UHC Exchange,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicaid,UHC Medicaid,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UMR CPD,UMR CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicare,UHC Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33148034,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Wellcare,Wellcare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health PPO CPD,Meritain Health PPO CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/Commercial Product,Aetna/Commercial Product,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health CPD,Meritain Health CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Starmark CPD,Starmark CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna Medicare,Aetna Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Ambetter ,Ambetter ,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access,Anthem Blue Access,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access Choice,Anthem Blue Access Choice,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Preferred,Anthem Blue Preferred,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Pathway,Anthem Pathway,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Alliance,Anthem Alliance,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Medicare,Anthem Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna,Cigna,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna PPO,Cigna PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna Medicare Advantage,Cigna Medicare Advantage,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Essence,Essence,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink HMO,Healthlink HMO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink PPO,Healthlink PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,HomeState Health Plan,HomeState Health Plan,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Humana Gold,Humana Gold,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medicaid MO,Medicaid MO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medica,Medica,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Tricare,Tricare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC All Payer,UHC All Payer,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Exchange,UHC Exchange,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicaid,UHC Medicaid,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UMR CPD,UMR CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicare,UHC Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM MED                 ,33148035,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Wellcare,Wellcare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Meritain Health PPO CPD,Meritain Health PPO CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna/Commercial Product,Aetna/Commercial Product,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Meritain Health CPD,Meritain Health CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Starmark CPD,Starmark CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna Medicare,Aetna Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Ambetter ,Ambetter ,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Access,Anthem Blue Access,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Access Choice,Anthem Blue Access Choice,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Preferred,Anthem Blue Preferred,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Pathway,Anthem Pathway,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Alliance,Anthem Alliance,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Medicare,Anthem Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna,Cigna,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna PPO,Cigna PPO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna Medicare Advantage,Cigna Medicare Advantage,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Essence,Essence,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthlink HMO,Healthlink HMO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthlink PPO,Healthlink PPO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,HomeState Health Plan,HomeState Health Plan,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Humana Gold,Humana Gold,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Medicaid MO,Medicaid MO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Medica,Medica,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Tricare,Tricare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC All Payer,UHC All Payer,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Exchange,UHC Exchange,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Medicaid,UHC Medicaid,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UMR CPD,UMR CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Medicare,UHC Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU LG  ,33148036,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Wellcare,Wellcare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Meritain Health PPO CPD,Meritain Health PPO CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna/Commercial Product,Aetna/Commercial Product,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Meritain Health CPD,Meritain Health CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Starmark CPD,Starmark CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Aetna Medicare,Aetna Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Ambetter ,Ambetter ,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Access,Anthem Blue Access,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Access Choice,Anthem Blue Access Choice,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Blue Preferred,Anthem Blue Preferred,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Pathway,Anthem Pathway,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Alliance,Anthem Alliance,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Anthem Medicare,Anthem Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna,Cigna,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna PPO,Cigna PPO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Cigna Medicare Advantage,Cigna Medicare Advantage,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Essence,Essence,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthlink HMO,Healthlink HMO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Healthlink PPO,Healthlink PPO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,HomeState Health Plan,HomeState Health Plan,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Humana Gold,Humana Gold,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Medicaid MO,Medicaid MO,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Medica,Medica,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Tricare,Tricare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC All Payer,UHC All Payer,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Exchange,UHC Exchange,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Medicaid,UHC Medicaid,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UMR CPD,UMR CPD,18.7,,,,,,,per diem,18.7,18.7,"Per diem rate, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,UHC Medicare,UHC Medicare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SLING ARM W/PAD STRAP BLU MED ,33148037,CDM,270,RC,,,,,,Inpatient,,,18.7,18.7,Wellcare,Wellcare,18.7,,,,,,,case rate,18.7,18.7,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health PPO CPD,Meritain Health PPO CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna/Commercial Product,Aetna/Commercial Product,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Meritain Health CPD,Meritain Health CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Starmark CPD,Starmark CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Aetna Medicare,Aetna Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Ambetter ,Ambetter ,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access,Anthem Blue Access,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Access Choice,Anthem Blue Access Choice,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Blue Preferred,Anthem Blue Preferred,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Pathway,Anthem Pathway,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Alliance,Anthem Alliance,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Anthem Medicare,Anthem Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna,Cigna,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna PPO,Cigna PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Cigna Medicare Advantage,Cigna Medicare Advantage,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Essence,Essence,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink HMO,Healthlink HMO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Healthlink PPO,Healthlink PPO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,HomeState Health Plan,HomeState Health Plan,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Humana Gold,Humana Gold,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Medicaid MO,Medicaid MO,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Medica,Medica,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Tricare,Tricare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC All Payer,UHC All Payer,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Exchange,UHC Exchange,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicaid,UHC Medicaid,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UMR CPD,UMR CPD,277.2,,,,,,,per diem,277.2,277.2,"Per diem rate, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,UHC Medicare,UHC Medicare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
SUPPORT BARI FULL BDY LAT ROTA,33148043,CDM,270,RC,,,,,,Inpatient,,,277.2,277.2,Wellcare,Wellcare,277.2,,,,,,,case rate,277.2,277.2,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Meritain Health PPO CPD,Meritain Health PPO CPD,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Aetna/Commercial Product,Aetna/Commercial Product,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Meritain Health CPD,Meritain Health CPD,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Starmark CPD,Starmark CPD,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Aetna Medicare,Aetna Medicare,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Ambetter ,Ambetter ,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Blue Access,Anthem Blue Access,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Blue Access Choice,Anthem Blue Access Choice,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Blue Preferred,Anthem Blue Preferred,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Pathway,Anthem Pathway,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Alliance,Anthem Alliance,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Anthem Medicare,Anthem Medicare,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Cigna,Cigna,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Cigna PPO,Cigna PPO,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Cigna Medicare Advantage,Cigna Medicare Advantage,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Essence,Essence,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Healthlink HMO,Healthlink HMO,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Healthlink PPO,Healthlink PPO,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,HomeState Health Plan,HomeState Health Plan,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Humana Gold,Humana Gold,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Medicaid MO,Medicaid MO,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Medica,Medica,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Tricare,Tricare,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,UHC All Payer,UHC All Payer,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,UHC Exchange,UHC Exchange,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,UHC Medicaid,UHC Medicaid,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,UMR CPD,UMR CPD,53.31,,,,,,,per diem,53.31,53.31,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,UHC Medicare,UHC Medicare,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL ADJUS,33148047,CDM,272,RC,,,,,,Inpatient,,,53.31,53.31,Wellcare,Wellcare,53.31,,,,,,,case rate,53.31,53.31,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Meritain Health PPO CPD,Meritain Health PPO CPD,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Aetna/Commercial Product,Aetna/Commercial Product,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Meritain Health CPD,Meritain Health CPD,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Starmark CPD,Starmark CPD,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Aetna Medicare,Aetna Medicare,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Ambetter ,Ambetter ,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Blue Access,Anthem Blue Access,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Blue Access Choice,Anthem Blue Access Choice,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Blue Preferred,Anthem Blue Preferred,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Pathway,Anthem Pathway,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Alliance,Anthem Alliance,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Anthem Medicare,Anthem Medicare,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Cigna,Cigna,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Cigna PPO,Cigna PPO,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Cigna Medicare Advantage,Cigna Medicare Advantage,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Essence,Essence,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Healthlink HMO,Healthlink HMO,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Healthlink PPO,Healthlink PPO,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,HomeState Health Plan,HomeState Health Plan,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Humana Gold,Humana Gold,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Medicaid MO,Medicaid MO,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Medica,Medica,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Tricare,Tricare,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,UHC All Payer,UHC All Payer,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,UHC Exchange,UHC Exchange,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,UHC Medicaid,UHC Medicaid,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,UMR CPD,UMR CPD,60.3,,,,,,,per diem,60.3,60.3,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,UHC Medicare,UHC Medicare,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE 3 PANEL CANVA,33148048,CDM,272,RC,,,,,,Inpatient,,,60.3,60.3,Wellcare,Wellcare,60.3,,,,,,,case rate,60.3,60.3,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Meritain Health PPO CPD,Meritain Health PPO CPD,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Aetna/Commercial Product,Aetna/Commercial Product,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Meritain Health CPD,Meritain Health CPD,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Starmark CPD,Starmark CPD,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Aetna Medicare,Aetna Medicare,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Ambetter ,Ambetter ,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Blue Access,Anthem Blue Access,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Blue Access Choice,Anthem Blue Access Choice,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Blue Preferred,Anthem Blue Preferred,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Pathway,Anthem Pathway,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Alliance,Anthem Alliance,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Anthem Medicare,Anthem Medicare,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Cigna,Cigna,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Cigna PPO,Cigna PPO,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Cigna Medicare Advantage,Cigna Medicare Advantage,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Essence,Essence,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Healthlink HMO,Healthlink HMO,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Healthlink PPO,Healthlink PPO,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,HomeState Health Plan,HomeState Health Plan,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Humana Gold,Humana Gold,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Medicaid MO,Medicaid MO,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Medica,Medica,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Tricare,Tricare,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,UHC All Payer,UHC All Payer,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,UHC Exchange,UHC Exchange,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,UHC Medicaid,UHC Medicaid,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,UMR CPD,UMR CPD,15.4,,,,,,,per diem,15.4,15.4,"Per diem rate, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,UHC Medicare,UHC Medicare,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
SET EPUMP KNGRO ANTI FREE FLOW,33148085,CDM,279,RC,,,,,,Inpatient,,,15.4,15.4,Wellcare,Wellcare,15.4,,,,,,,case rate,15.4,15.4,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Meritain Health PPO CPD,Meritain Health PPO CPD,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Aetna/Commercial Product,Aetna/Commercial Product,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Meritain Health CPD,Meritain Health CPD,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Starmark CPD,Starmark CPD,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Aetna Medicare,Aetna Medicare,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Ambetter ,Ambetter ,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Blue Access,Anthem Blue Access,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Blue Access Choice,Anthem Blue Access Choice,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Blue Preferred,Anthem Blue Preferred,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Pathway,Anthem Pathway,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Alliance,Anthem Alliance,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Anthem Medicare,Anthem Medicare,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Cigna,Cigna,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Cigna PPO,Cigna PPO,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Cigna Medicare Advantage,Cigna Medicare Advantage,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Essence,Essence,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Healthlink HMO,Healthlink HMO,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Healthlink PPO,Healthlink PPO,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,HomeState Health Plan,HomeState Health Plan,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Humana Gold,Humana Gold,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Medicaid MO,Medicaid MO,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Medica,Medica,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Tricare,Tricare,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,UHC All Payer,UHC All Payer,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,UHC Exchange,UHC Exchange,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,UHC Medicaid,UHC Medicaid,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,UMR CPD,UMR CPD,285.69,,,,,,,per diem,285.69,285.69,"Per diem rate, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,UHC Medicare,UHC Medicare,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Bariartic Overlay Mattr,33148137,CDM,279,RC,,,,,,Inpatient,,,285.69,285.69,Wellcare,Wellcare,285.69,,,,,,,case rate,285.69,285.69,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Meritain Health PPO CPD,Meritain Health PPO CPD,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Aetna/Commercial Product,Aetna/Commercial Product,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Meritain Health CPD,Meritain Health CPD,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Starmark CPD,Starmark CPD,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Aetna Medicare,Aetna Medicare,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Ambetter ,Ambetter ,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Blue Access,Anthem Blue Access,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Blue Access Choice,Anthem Blue Access Choice,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Blue Preferred,Anthem Blue Preferred,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Pathway,Anthem Pathway,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Alliance,Anthem Alliance,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Anthem Medicare,Anthem Medicare,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Cigna,Cigna,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Cigna PPO,Cigna PPO,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Cigna Medicare Advantage,Cigna Medicare Advantage,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Essence,Essence,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Healthlink HMO,Healthlink HMO,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Healthlink PPO,Healthlink PPO,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,HomeState Health Plan,HomeState Health Plan,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Humana Gold,Humana Gold,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Medicaid MO,Medicaid MO,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Medica,Medica,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Tricare,Tricare,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,UHC All Payer,UHC All Payer,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,UHC Exchange,UHC Exchange,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,UHC Medicaid,UHC Medicaid,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,UMR CPD,UMR CPD,85.53,,,,,,,per diem,85.53,85.53,"Per diem rate, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,UHC Medicare,UHC Medicare,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
Waffle Overlay Mattress 1025EC,33148138,CDM,279,RC,,,,,,Inpatient,,,85.53,85.53,Wellcare,Wellcare,85.53,,,,,,,case rate,85.53,85.53,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Meritain Health PPO CPD,Meritain Health PPO CPD,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Aetna/Commercial Product,Aetna/Commercial Product,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Meritain Health CPD,Meritain Health CPD,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Starmark CPD,Starmark CPD,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Aetna Medicare,Aetna Medicare,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Ambetter ,Ambetter ,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Blue Access,Anthem Blue Access,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Blue Access Choice,Anthem Blue Access Choice,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Blue Preferred,Anthem Blue Preferred,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Pathway,Anthem Pathway,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Alliance,Anthem Alliance,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Anthem Medicare,Anthem Medicare,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Cigna,Cigna,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Cigna PPO,Cigna PPO,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Cigna Medicare Advantage,Cigna Medicare Advantage,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Essence,Essence,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Healthlink HMO,Healthlink HMO,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Healthlink PPO,Healthlink PPO,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,HomeState Health Plan,HomeState Health Plan,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Humana Gold,Humana Gold,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Medicaid MO,Medicaid MO,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Medica,Medica,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Tricare,Tricare,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,UHC All Payer,UHC All Payer,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,UHC Exchange,UHC Exchange,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,UHC Medicaid,UHC Medicaid,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,UMR CPD,UMR CPD,38.07,,,,,,,per diem,38.07,38.07,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,UHC Medicare,UHC Medicare,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL SM,33148168,CDM,270,RC,,,,,,Inpatient,,,38.07,38.07,Wellcare,Wellcare,38.07,,,,,,,case rate,38.07,38.07,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Meritain Health PPO CPD,Meritain Health PPO CPD,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Aetna/Commercial Product,Aetna/Commercial Product,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Meritain Health CPD,Meritain Health CPD,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Starmark CPD,Starmark CPD,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Aetna Medicare,Aetna Medicare,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Ambetter ,Ambetter ,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Blue Access,Anthem Blue Access,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Blue Access Choice,Anthem Blue Access Choice,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Blue Preferred,Anthem Blue Preferred,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Pathway,Anthem Pathway,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Alliance,Anthem Alliance,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Anthem Medicare,Anthem Medicare,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Cigna,Cigna,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Cigna PPO,Cigna PPO,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Cigna Medicare Advantage,Cigna Medicare Advantage,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Essence,Essence,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Healthlink HMO,Healthlink HMO,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Healthlink PPO,Healthlink PPO,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,HomeState Health Plan,HomeState Health Plan,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Humana Gold,Humana Gold,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Medicaid MO,Medicaid MO,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Medica,Medica,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Tricare,Tricare,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,UHC All Payer,UHC All Payer,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,UHC Exchange,UHC Exchange,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,UHC Medicaid,UHC Medicaid,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,UMR CPD,UMR CPD,38.37,,,,,,,per diem,38.37,38.37,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,UHC Medicare,UHC Medicare,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL ME,33148169,CDM,270,RC,,,,,,Inpatient,,,38.37,38.37,Wellcare,Wellcare,38.37,,,,,,,case rate,38.37,38.37,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Meritain Health PPO CPD,Meritain Health PPO CPD,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Aetna/Commercial Product,Aetna/Commercial Product,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Meritain Health CPD,Meritain Health CPD,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Starmark CPD,Starmark CPD,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Aetna Medicare,Aetna Medicare,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Ambetter ,Ambetter ,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Blue Access,Anthem Blue Access,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Blue Access Choice,Anthem Blue Access Choice,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Blue Preferred,Anthem Blue Preferred,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Pathway,Anthem Pathway,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Alliance,Anthem Alliance,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Anthem Medicare,Anthem Medicare,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Cigna,Cigna,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Cigna PPO,Cigna PPO,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Cigna Medicare Advantage,Cigna Medicare Advantage,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Essence,Essence,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Healthlink HMO,Healthlink HMO,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Healthlink PPO,Healthlink PPO,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,HomeState Health Plan,HomeState Health Plan,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Humana Gold,Humana Gold,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Medicaid MO,Medicaid MO,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Medica,Medica,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Tricare,Tricare,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,UHC All Payer,UHC All Payer,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,UHC Exchange,UHC Exchange,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,UHC Medicaid,UHC Medicaid,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,UMR CPD,UMR CPD,39.09,,,,,,,per diem,39.09,39.09,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,UHC Medicare,UHC Medicare,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL LR,33148170,CDM,270,RC,,,,,,Inpatient,,,39.09,39.09,Wellcare,Wellcare,39.09,,,,,,,case rate,39.09,39.09,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Meritain Health PPO CPD,Meritain Health PPO CPD,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Aetna/Commercial Product,Aetna/Commercial Product,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Meritain Health CPD,Meritain Health CPD,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Starmark CPD,Starmark CPD,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Aetna Medicare,Aetna Medicare,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Ambetter ,Ambetter ,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Blue Access,Anthem Blue Access,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Blue Access Choice,Anthem Blue Access Choice,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Blue Preferred,Anthem Blue Preferred,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Pathway,Anthem Pathway,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Alliance,Anthem Alliance,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Anthem Medicare,Anthem Medicare,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Cigna,Cigna,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Cigna PPO,Cigna PPO,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Cigna Medicare Advantage,Cigna Medicare Advantage,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Essence,Essence,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Healthlink HMO,Healthlink HMO,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Healthlink PPO,Healthlink PPO,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,HomeState Health Plan,HomeState Health Plan,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Humana Gold,Humana Gold,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Medicaid MO,Medicaid MO,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Medica,Medica,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Tricare,Tricare,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,UHC All Payer,UHC All Payer,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,UHC Exchange,UHC Exchange,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,UHC Medicaid,UHC Medicaid,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,UMR CPD,UMR CPD,39.99,,,,,,,per diem,39.99,39.99,"Per diem rate, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,UHC Medicare,UHC Medicare,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
BELT 9-PANEL 12IN ABDOMINAL XL,33148171,CDM,270,RC,,,,,,Inpatient,,,39.99,39.99,Wellcare,Wellcare,39.99,,,,,,,case rate,39.99,39.99,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Meritain Health PPO CPD,Meritain Health PPO CPD,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Aetna/Commercial Product,Aetna/Commercial Product,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Meritain Health CPD,Meritain Health CPD,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Starmark CPD,Starmark CPD,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Aetna Medicare,Aetna Medicare,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Ambetter ,Ambetter ,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Blue Access,Anthem Blue Access,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Blue Access Choice,Anthem Blue Access Choice,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Blue Preferred,Anthem Blue Preferred,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Pathway,Anthem Pathway,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Alliance,Anthem Alliance,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Anthem Medicare,Anthem Medicare,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Cigna,Cigna,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Cigna PPO,Cigna PPO,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Cigna Medicare Advantage,Cigna Medicare Advantage,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Essence,Essence,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Healthlink HMO,Healthlink HMO,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Healthlink PPO,Healthlink PPO,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,HomeState Health Plan,HomeState Health Plan,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Humana Gold,Humana Gold,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Medicaid MO,Medicaid MO,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Medica,Medica,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Tricare,Tricare,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,UHC All Payer,UHC All Payer,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,UHC Exchange,UHC Exchange,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,UHC Medicaid,UHC Medicaid,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,UMR CPD,UMR CPD,135.24,,,,,,,per diem,135.24,135.24,"Per diem rate, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,UHC Medicare,UHC Medicare,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
VISTA COLLAR SET- ADULT # 7983,33148177,CDM,270,RC,,,,,,Inpatient,,,135.24,135.24,Wellcare,Wellcare,135.24,,,,,,,case rate,135.24,135.24,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Meritain Health PPO CPD,Meritain Health PPO CPD,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Aetna/Commercial Product,Aetna/Commercial Product,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Meritain Health CPD,Meritain Health CPD,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Starmark CPD,Starmark CPD,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Aetna Medicare,Aetna Medicare,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Ambetter ,Ambetter ,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Blue Access,Anthem Blue Access,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Blue Access Choice,Anthem Blue Access Choice,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Blue Preferred,Anthem Blue Preferred,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Pathway,Anthem Pathway,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Alliance,Anthem Alliance,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Anthem Medicare,Anthem Medicare,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Cigna,Cigna,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Cigna PPO,Cigna PPO,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Cigna Medicare Advantage,Cigna Medicare Advantage,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Essence,Essence,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Healthlink HMO,Healthlink HMO,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Healthlink PPO,Healthlink PPO,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,HomeState Health Plan,HomeState Health Plan,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Humana Gold,Humana Gold,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Medicaid MO,Medicaid MO,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Medica,Medica,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Tricare,Tricare,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,UHC All Payer,UHC All Payer,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,UHC Exchange,UHC Exchange,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,UHC Medicaid,UHC Medicaid,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,UMR CPD,UMR CPD,346.5,,,,,,,per diem,346.5,346.5,"Per diem rate, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,UHC Medicare,UHC Medicare,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
OVERLAY MATTRESS SOFCARE W/PUM,33148275,CDM,279,RC,,,,,,Inpatient,,,346.5,346.5,Wellcare,Wellcare,346.5,,,,,,,case rate,346.5,346.5,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Meritain Health PPO CPD,Meritain Health PPO CPD,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Aetna/Commercial Product,Aetna/Commercial Product,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Meritain Health CPD,Meritain Health CPD,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Starmark CPD,Starmark CPD,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Aetna Medicare,Aetna Medicare,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Ambetter ,Ambetter ,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Blue Access,Anthem Blue Access,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Blue Access Choice,Anthem Blue Access Choice,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Blue Preferred,Anthem Blue Preferred,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Pathway,Anthem Pathway,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Alliance,Anthem Alliance,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Anthem Medicare,Anthem Medicare,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Cigna,Cigna,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Cigna PPO,Cigna PPO,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Cigna Medicare Advantage,Cigna Medicare Advantage,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Essence,Essence,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Healthlink HMO,Healthlink HMO,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Healthlink PPO,Healthlink PPO,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,HomeState Health Plan,HomeState Health Plan,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Humana Gold,Humana Gold,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Medicaid MO,Medicaid MO,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Medica,Medica,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Tricare,Tricare,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,UHC All Payer,UHC All Payer,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,UHC Exchange,UHC Exchange,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,UHC Medicaid,UHC Medicaid,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,UMR CPD,UMR CPD,98.85,,,,,,,per diem,98.85,98.85,"Per diem rate, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,UHC Medicare,UHC Medicare,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
TLSO REPLACEMENT PAD # 993642 ,33148281,CDM,270,RC,,,,,,Inpatient,,,98.85,98.85,Wellcare,Wellcare,98.85,,,,,,,case rate,98.85,98.85,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Meritain Health PPO CPD,Meritain Health PPO CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna/Commercial Product,Aetna/Commercial Product,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Meritain Health CPD,Meritain Health CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Starmark CPD,Starmark CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna Medicare,Aetna Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Ambetter ,Ambetter ,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Access,Anthem Blue Access,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Access Choice,Anthem Blue Access Choice,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Preferred,Anthem Blue Preferred,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Pathway,Anthem Pathway,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Alliance,Anthem Alliance,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Medicare,Anthem Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna,Cigna,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna PPO,Cigna PPO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna Medicare Advantage,Cigna Medicare Advantage,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Essence,Essence,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthlink HMO,Healthlink HMO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthlink PPO,Healthlink PPO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,HomeState Health Plan,HomeState Health Plan,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Humana Gold,Humana Gold,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Medicaid MO,Medicaid MO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Medica,Medica,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Tricare,Tricare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC All Payer,UHC All Payer,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Exchange,UHC Exchange,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Medicaid,UHC Medicaid,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UMR CPD,UMR CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Medicare,UHC Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW/HEEL FOAM SM  ,33148289,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Wellcare,Wellcare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Meritain Health PPO CPD,Meritain Health PPO CPD,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Aetna/Commercial Product,Aetna/Commercial Product,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Meritain Health CPD,Meritain Health CPD,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Starmark CPD,Starmark CPD,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Aetna Medicare,Aetna Medicare,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Ambetter ,Ambetter ,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Blue Access,Anthem Blue Access,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Blue Access Choice,Anthem Blue Access Choice,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Blue Preferred,Anthem Blue Preferred,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Pathway,Anthem Pathway,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Alliance,Anthem Alliance,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Anthem Medicare,Anthem Medicare,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Cigna,Cigna,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Cigna PPO,Cigna PPO,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Cigna Medicare Advantage,Cigna Medicare Advantage,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Essence,Essence,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Healthlink HMO,Healthlink HMO,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Healthlink PPO,Healthlink PPO,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,HomeState Health Plan,HomeState Health Plan,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Humana Gold,Humana Gold,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Medicaid MO,Medicaid MO,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Medica,Medica,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Tricare,Tricare,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,UHC All Payer,UHC All Payer,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,UHC Exchange,UHC Exchange,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,UHC Medicaid,UHC Medicaid,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,UMR CPD,UMR CPD,34.1,,,,,,,per diem,34.1,34.1,"Per diem rate, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,UHC Medicare,UHC Medicare,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR EYE I-GUARD         ,33148290,CDM,272,RC,,,,,,Inpatient,,,34.1,34.1,Wellcare,Wellcare,34.1,,,,,,,case rate,34.1,34.1,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Meritain Health PPO CPD,Meritain Health PPO CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna/Commercial Product,Aetna/Commercial Product,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Meritain Health CPD,Meritain Health CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Starmark CPD,Starmark CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Aetna Medicare,Aetna Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Ambetter ,Ambetter ,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Access,Anthem Blue Access,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Access Choice,Anthem Blue Access Choice,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Blue Preferred,Anthem Blue Preferred,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Pathway,Anthem Pathway,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Alliance,Anthem Alliance,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Anthem Medicare,Anthem Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna,Cigna,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna PPO,Cigna PPO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Cigna Medicare Advantage,Cigna Medicare Advantage,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Essence,Essence,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthlink HMO,Healthlink HMO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Healthlink PPO,Healthlink PPO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,HomeState Health Plan,HomeState Health Plan,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Humana Gold,Humana Gold,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Medicaid MO,Medicaid MO,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Medica,Medica,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Tricare,Tricare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC All Payer,UHC All Payer,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Exchange,UHC Exchange,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Medicaid,UHC Medicaid,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UMR CPD,UMR CPD,85.8,,,,,,,per diem,85.8,85.8,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,UHC Medicare,UHC Medicare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL ELBOW MED      ,33148291,CDM,270,RC,,,,,,Inpatient,,,85.8,85.8,Wellcare,Wellcare,85.8,,,,,,,case rate,85.8,85.8,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Meritain Health PPO CPD,Meritain Health PPO CPD,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Aetna/Commercial Product,Aetna/Commercial Product,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Meritain Health CPD,Meritain Health CPD,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Starmark CPD,Starmark CPD,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Aetna Medicare,Aetna Medicare,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Ambetter ,Ambetter ,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Blue Access,Anthem Blue Access,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Blue Access Choice,Anthem Blue Access Choice,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Blue Preferred,Anthem Blue Preferred,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Pathway,Anthem Pathway,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Alliance,Anthem Alliance,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Anthem Medicare,Anthem Medicare,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Cigna,Cigna,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Cigna PPO,Cigna PPO,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Cigna Medicare Advantage,Cigna Medicare Advantage,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Essence,Essence,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Healthlink HMO,Healthlink HMO,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Healthlink PPO,Healthlink PPO,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,HomeState Health Plan,HomeState Health Plan,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Humana Gold,Humana Gold,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Medicaid MO,Medicaid MO,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Medica,Medica,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Tricare,Tricare,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,UHC All Payer,UHC All Payer,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,UHC Exchange,UHC Exchange,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,UHC Medicaid,UHC Medicaid,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,UMR CPD,UMR CPD,31.9,,,,,,,per diem,31.9,31.9,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,UHC Medicare,UHC Medicare,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL SHEEPSKIN MED  ,33148292,CDM,270,RC,,,,,,Inpatient,,,31.9,31.9,Wellcare,Wellcare,31.9,,,,,,,case rate,31.9,31.9,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Meritain Health PPO CPD,Meritain Health PPO CPD,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Aetna/Commercial Product,Aetna/Commercial Product,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Meritain Health CPD,Meritain Health CPD,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Starmark CPD,Starmark CPD,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Aetna Medicare,Aetna Medicare,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Ambetter ,Ambetter ,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Blue Access,Anthem Blue Access,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Blue Access Choice,Anthem Blue Access Choice,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Blue Preferred,Anthem Blue Preferred,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Pathway,Anthem Pathway,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Alliance,Anthem Alliance,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Anthem Medicare,Anthem Medicare,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Cigna,Cigna,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Cigna PPO,Cigna PPO,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Cigna Medicare Advantage,Cigna Medicare Advantage,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Essence,Essence,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Healthlink HMO,Healthlink HMO,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Healthlink PPO,Healthlink PPO,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,HomeState Health Plan,HomeState Health Plan,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Humana Gold,Humana Gold,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Medicaid MO,Medicaid MO,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Medica,Medica,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Tricare,Tricare,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,UHC All Payer,UHC All Payer,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,UHC Exchange,UHC Exchange,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,UHC Medicaid,UHC Medicaid,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,UMR CPD,UMR CPD,50.6,,,,,,,per diem,50.6,50.6,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,UHC Medicare,UHC Medicare,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW STD      ,33148293,CDM,270,RC,,,,,,Inpatient,,,50.6,50.6,Wellcare,Wellcare,50.6,,,,,,,case rate,50.6,50.6,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Meritain Health PPO CPD,Meritain Health PPO CPD,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Aetna/Commercial Product,Aetna/Commercial Product,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Meritain Health CPD,Meritain Health CPD,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Starmark CPD,Starmark CPD,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Aetna Medicare,Aetna Medicare,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Ambetter ,Ambetter ,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Blue Access,Anthem Blue Access,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Blue Access Choice,Anthem Blue Access Choice,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Blue Preferred,Anthem Blue Preferred,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Pathway,Anthem Pathway,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Alliance,Anthem Alliance,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Anthem Medicare,Anthem Medicare,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Cigna,Cigna,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Cigna PPO,Cigna PPO,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Cigna Medicare Advantage,Cigna Medicare Advantage,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Essence,Essence,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Healthlink HMO,Healthlink HMO,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Healthlink PPO,Healthlink PPO,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,HomeState Health Plan,HomeState Health Plan,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Humana Gold,Humana Gold,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Medicaid MO,Medicaid MO,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Medica,Medica,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Tricare,Tricare,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,UHC All Payer,UHC All Payer,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,UHC Exchange,UHC Exchange,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,UHC Medicaid,UHC Medicaid,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,UMR CPD,UMR CPD,16.59,,,,,,,per diem,16.59,16.59,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,UHC Medicare,UHC Medicare,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL/ELBOW LG # 6224,33148298,CDM,270,RC,,,,,,Inpatient,,,16.59,16.59,Wellcare,Wellcare,16.59,,,,,,,case rate,16.59,16.59,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Meritain Health PPO CPD,Meritain Health PPO CPD,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Aetna/Commercial Product,Aetna/Commercial Product,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Meritain Health CPD,Meritain Health CPD,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Starmark CPD,Starmark CPD,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Aetna Medicare,Aetna Medicare,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Ambetter ,Ambetter ,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Blue Access,Anthem Blue Access,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Blue Access Choice,Anthem Blue Access Choice,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Blue Preferred,Anthem Blue Preferred,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Pathway,Anthem Pathway,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Alliance,Anthem Alliance,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Anthem Medicare,Anthem Medicare,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Cigna,Cigna,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Cigna PPO,Cigna PPO,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Cigna Medicare Advantage,Cigna Medicare Advantage,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Essence,Essence,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Healthlink HMO,Healthlink HMO,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Healthlink PPO,Healthlink PPO,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,HomeState Health Plan,HomeState Health Plan,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Humana Gold,Humana Gold,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Medicaid MO,Medicaid MO,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Medica,Medica,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Tricare,Tricare,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,UHC All Payer,UHC All Payer,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,UHC Exchange,UHC Exchange,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,UHC Medicaid,UHC Medicaid,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,UMR CPD,UMR CPD,39.1,,,,,,,per diem,39.1,39.1,"Per diem rate, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,UHC Medicare,UHC Medicare,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
BELT 9 PANEL ABDOM XXL 79-8932,33148358,CDM,270,RC,,,,,,Inpatient,,,39.1,39.1,Wellcare,Wellcare,39.1,,,,,,,case rate,39.1,39.1,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Meritain Health PPO CPD,Meritain Health PPO CPD,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Aetna/Commercial Product,Aetna/Commercial Product,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Meritain Health CPD,Meritain Health CPD,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Starmark CPD,Starmark CPD,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Aetna Medicare,Aetna Medicare,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Ambetter ,Ambetter ,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Blue Access,Anthem Blue Access,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Blue Access Choice,Anthem Blue Access Choice,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Blue Preferred,Anthem Blue Preferred,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Pathway,Anthem Pathway,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Alliance,Anthem Alliance,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Anthem Medicare,Anthem Medicare,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Cigna,Cigna,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Cigna PPO,Cigna PPO,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Cigna Medicare Advantage,Cigna Medicare Advantage,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Essence,Essence,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Healthlink HMO,Healthlink HMO,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Healthlink PPO,Healthlink PPO,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,HomeState Health Plan,HomeState Health Plan,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Humana Gold,Humana Gold,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Medicaid MO,Medicaid MO,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Medica,Medica,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Tricare,Tricare,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,UHC All Payer,UHC All Payer,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,UHC Exchange,UHC Exchange,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,UHC Medicaid,UHC Medicaid,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,UMR CPD,UMR CPD,5.75,,,,,,,per diem,5.75,5.75,"Per diem rate, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,UHC Medicare,UHC Medicare,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
COLLAR TRACH ADULT 204B       ,33148364,CDM,272,RC,,,,,,Inpatient,,,5.75,5.75,Wellcare,Wellcare,5.75,,,,,,,case rate,5.75,5.75,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Meritain Health PPO CPD,Meritain Health PPO CPD,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Aetna/Commercial Product,Aetna/Commercial Product,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Meritain Health CPD,Meritain Health CPD,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Starmark CPD,Starmark CPD,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Aetna Medicare,Aetna Medicare,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Ambetter ,Ambetter ,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Blue Access,Anthem Blue Access,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Blue Access Choice,Anthem Blue Access Choice,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Blue Preferred,Anthem Blue Preferred,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Pathway,Anthem Pathway,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Alliance,Anthem Alliance,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Anthem Medicare,Anthem Medicare,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Cigna,Cigna,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Cigna PPO,Cigna PPO,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Cigna Medicare Advantage,Cigna Medicare Advantage,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Essence,Essence,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Healthlink HMO,Healthlink HMO,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Healthlink PPO,Healthlink PPO,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,HomeState Health Plan,HomeState Health Plan,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Humana Gold,Humana Gold,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Medicaid MO,Medicaid MO,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Medica,Medica,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Tricare,Tricare,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,UHC All Payer,UHC All Payer,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,UHC Exchange,UHC Exchange,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,UHC Medicaid,UHC Medicaid,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,UMR CPD,UMR CPD,795,,,,,,,per diem,795,795,"Per diem rate, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,UHC Medicare,UHC Medicare,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
LSO BACK BRACE #993540        ,33148615,CDM,274,RC,,,,,,Inpatient,,,795,795,Wellcare,Wellcare,795,,,,,,,case rate,795,795,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Meritain Health PPO CPD,Meritain Health PPO CPD,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Aetna/Commercial Product,Aetna/Commercial Product,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Meritain Health CPD,Meritain Health CPD,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Starmark CPD,Starmark CPD,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Aetna Medicare,Aetna Medicare,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Ambetter ,Ambetter ,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Blue Access,Anthem Blue Access,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Blue Access Choice,Anthem Blue Access Choice,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Blue Preferred,Anthem Blue Preferred,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Pathway,Anthem Pathway,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Alliance,Anthem Alliance,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Anthem Medicare,Anthem Medicare,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Cigna,Cigna,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Cigna PPO,Cigna PPO,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Cigna Medicare Advantage,Cigna Medicare Advantage,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Essence,Essence,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Healthlink HMO,Healthlink HMO,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Healthlink PPO,Healthlink PPO,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,HomeState Health Plan,HomeState Health Plan,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Humana Gold,Humana Gold,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Medicaid MO,Medicaid MO,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Medica,Medica,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Tricare,Tricare,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,UHC All Payer,UHC All Payer,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,UHC Exchange,UHC Exchange,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,UHC Medicaid,UHC Medicaid,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,UMR CPD,UMR CPD,1005,,,,,,,per diem,1005,1005,"Per diem rate, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,UHC Medicare,UHC Medicare,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
TLSO BACK BRACE #993640       ,33148616,CDM,274,RC,,,,,,Inpatient,,,1005,1005,Wellcare,Wellcare,1005,,,,,,,case rate,1005,1005,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Meritain Health PPO CPD,Meritain Health PPO CPD,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Aetna/Commercial Product,Aetna/Commercial Product,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Meritain Health CPD,Meritain Health CPD,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Starmark CPD,Starmark CPD,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Aetna Medicare,Aetna Medicare,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Ambetter ,Ambetter ,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Blue Access,Anthem Blue Access,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Blue Access Choice,Anthem Blue Access Choice,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Blue Preferred,Anthem Blue Preferred,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Pathway,Anthem Pathway,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Alliance,Anthem Alliance,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Anthem Medicare,Anthem Medicare,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Cigna,Cigna,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Cigna PPO,Cigna PPO,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Cigna Medicare Advantage,Cigna Medicare Advantage,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Essence,Essence,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Healthlink HMO,Healthlink HMO,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Healthlink PPO,Healthlink PPO,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,HomeState Health Plan,HomeState Health Plan,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Humana Gold,Humana Gold,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Medicaid MO,Medicaid MO,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Medica,Medica,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Tricare,Tricare,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,UHC All Payer,UHC All Payer,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,UHC Exchange,UHC Exchange,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,UHC Medicaid,UHC Medicaid,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,UMR CPD,UMR CPD,499.13,,,,,,,per diem,499.13,499.13,"Per diem rate, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,UHC Medicare,UHC Medicare,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
MACHINE ICEMAN COLD THERAPY   ,33148631,CDM,279,RC,,,,,,Inpatient,,,499.13,499.13,Wellcare,Wellcare,499.13,,,,,,,case rate,499.13,499.13,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health PPO CPD,Meritain Health PPO CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/Commercial Product,Aetna/Commercial Product,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health CPD,Meritain Health CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Starmark CPD,Starmark CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna Medicare,Aetna Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Ambetter ,Ambetter ,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access,Anthem Blue Access,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access Choice,Anthem Blue Access Choice,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Preferred,Anthem Blue Preferred,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Pathway,Anthem Pathway,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Alliance,Anthem Alliance,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Medicare,Anthem Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna,Cigna,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna PPO,Cigna PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna Medicare Advantage,Cigna Medicare Advantage,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Essence,Essence,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink HMO,Healthlink HMO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink PPO,Healthlink PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,HomeState Health Plan,HomeState Health Plan,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Humana Gold,Humana Gold,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medicaid MO,Medicaid MO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medica,Medica,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Tricare,Tricare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC All Payer,UHC All Payer,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Exchange,UHC Exchange,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicaid,UHC Medicaid,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UMR CPD,UMR CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicare,UHC Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP OPEN PAT MED ,33148670,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Wellcare,Wellcare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health PPO CPD,Meritain Health PPO CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/Commercial Product,Aetna/Commercial Product,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health CPD,Meritain Health CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Starmark CPD,Starmark CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna Medicare,Aetna Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Ambetter ,Ambetter ,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access,Anthem Blue Access,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access Choice,Anthem Blue Access Choice,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Preferred,Anthem Blue Preferred,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Pathway,Anthem Pathway,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Alliance,Anthem Alliance,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Medicare,Anthem Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna,Cigna,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna PPO,Cigna PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna Medicare Advantage,Cigna Medicare Advantage,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Essence,Essence,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink HMO,Healthlink HMO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink PPO,Healthlink PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,HomeState Health Plan,HomeState Health Plan,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Humana Gold,Humana Gold,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medicaid MO,Medicaid MO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medica,Medica,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Tricare,Tricare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC All Payer,UHC All Payer,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Exchange,UHC Exchange,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicaid,UHC Medicaid,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UMR CPD,UMR CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicare,UHC Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT LG       ,33148671,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Wellcare,Wellcare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health PPO CPD,Meritain Health PPO CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna/Commercial Product,Aetna/Commercial Product,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Meritain Health CPD,Meritain Health CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Starmark CPD,Starmark CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Aetna Medicare,Aetna Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Ambetter ,Ambetter ,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access,Anthem Blue Access,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Access Choice,Anthem Blue Access Choice,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Blue Preferred,Anthem Blue Preferred,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Pathway,Anthem Pathway,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Alliance,Anthem Alliance,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Anthem Medicare,Anthem Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna,Cigna,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna PPO,Cigna PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Cigna Medicare Advantage,Cigna Medicare Advantage,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Essence,Essence,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink HMO,Healthlink HMO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Healthlink PPO,Healthlink PPO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,HomeState Health Plan,HomeState Health Plan,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Humana Gold,Humana Gold,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medicaid MO,Medicaid MO,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Medica,Medica,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Tricare,Tricare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC All Payer,UHC All Payer,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Exchange,UHC Exchange,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicaid,UHC Medicaid,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UMR CPD,UMR CPD,19.77,,,,,,,per diem,19.77,19.77,"Per diem rate, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,UHC Medicare,UHC Medicare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
SLEEVE KNEE SUPP PAT XL       ,33148672,CDM,270,RC,,,,,,Inpatient,,,19.77,19.77,Wellcare,Wellcare,19.77,,,,,,,case rate,19.77,19.77,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health PPO CPD,Meritain Health PPO CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/Commercial Product,Aetna/Commercial Product,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health CPD,Meritain Health CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Starmark CPD,Starmark CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna Medicare,Aetna Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Ambetter ,Ambetter ,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access,Anthem Blue Access,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access Choice,Anthem Blue Access Choice,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Preferred,Anthem Blue Preferred,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Pathway,Anthem Pathway,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Alliance,Anthem Alliance,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Medicare,Anthem Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna,Cigna,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna PPO,Cigna PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna Medicare Advantage,Cigna Medicare Advantage,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Essence,Essence,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink HMO,Healthlink HMO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink PPO,Healthlink PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,HomeState Health Plan,HomeState Health Plan,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Humana Gold,Humana Gold,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medicaid MO,Medicaid MO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medica,Medica,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Tricare,Tricare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC All Payer,UHC All Payer,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Exchange,UHC Exchange,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicaid,UHC Medicaid,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UMR CPD,UMR CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicare,UHC Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL SM 11-16IN    ,33148679,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Wellcare,Wellcare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health PPO CPD,Meritain Health PPO CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/Commercial Product,Aetna/Commercial Product,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health CPD,Meritain Health CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Starmark CPD,Starmark CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna Medicare,Aetna Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Ambetter ,Ambetter ,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access,Anthem Blue Access,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access Choice,Anthem Blue Access Choice,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Preferred,Anthem Blue Preferred,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Pathway,Anthem Pathway,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Alliance,Anthem Alliance,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Medicare,Anthem Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna,Cigna,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna PPO,Cigna PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna Medicare Advantage,Cigna Medicare Advantage,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Essence,Essence,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink HMO,Healthlink HMO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink PPO,Healthlink PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,HomeState Health Plan,HomeState Health Plan,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Humana Gold,Humana Gold,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medicaid MO,Medicaid MO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medica,Medica,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Tricare,Tricare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC All Payer,UHC All Payer,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Exchange,UHC Exchange,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicaid,UHC Medicaid,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UMR CPD,UMR CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicare,UHC Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MED 13-18IN   ,33148680,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Wellcare,Wellcare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health PPO CPD,Meritain Health PPO CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna/Commercial Product,Aetna/Commercial Product,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Meritain Health CPD,Meritain Health CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Starmark CPD,Starmark CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Aetna Medicare,Aetna Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Ambetter ,Ambetter ,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access,Anthem Blue Access,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Access Choice,Anthem Blue Access Choice,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Blue Preferred,Anthem Blue Preferred,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Pathway,Anthem Pathway,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Alliance,Anthem Alliance,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Anthem Medicare,Anthem Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna,Cigna,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna PPO,Cigna PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Cigna Medicare Advantage,Cigna Medicare Advantage,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Essence,Essence,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink HMO,Healthlink HMO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Healthlink PPO,Healthlink PPO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,HomeState Health Plan,HomeState Health Plan,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Humana Gold,Humana Gold,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medicaid MO,Medicaid MO,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Medica,Medica,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Tricare,Tricare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC All Payer,UHC All Payer,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Exchange,UHC Exchange,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicaid,UHC Medicaid,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UMR CPD,UMR CPD,9.21,,,,,,,per diem,9.21,9.21,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,UHC Medicare,UHC Medicare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL LG 15-20IN    ,33148681,CDM,270,RC,,,,,,Inpatient,,,9.21,9.21,Wellcare,Wellcare,9.21,,,,,,,case rate,9.21,9.21,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Meritain Health PPO CPD,Meritain Health PPO CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Aetna/Commercial Product,Aetna/Commercial Product,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Meritain Health CPD,Meritain Health CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Starmark CPD,Starmark CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Aetna Medicare,Aetna Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Ambetter ,Ambetter ,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Blue Access,Anthem Blue Access,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Blue Access Choice,Anthem Blue Access Choice,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Blue Preferred,Anthem Blue Preferred,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Pathway,Anthem Pathway,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Alliance,Anthem Alliance,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Anthem Medicare,Anthem Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Cigna,Cigna,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Cigna PPO,Cigna PPO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Cigna Medicare Advantage,Cigna Medicare Advantage,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Essence,Essence,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Healthlink HMO,Healthlink HMO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Healthlink PPO,Healthlink PPO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,HomeState Health Plan,HomeState Health Plan,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Humana Gold,Humana Gold,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Medicaid MO,Medicaid MO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Medica,Medica,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Tricare,Tricare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,UHC All Payer,UHC All Payer,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,UHC Exchange,UHC Exchange,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,UHC Medicaid,UHC Medicaid,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,UMR CPD,UMR CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,UHC Medicare,UHC Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 9in 3-PANEL ELASTIC    ,33150013,CDM,270,RC,,,,,,Inpatient,,,44,44,Wellcare,Wellcare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Meritain Health PPO CPD,Meritain Health PPO CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna/Commercial Product,Aetna/Commercial Product,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Meritain Health CPD,Meritain Health CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Starmark CPD,Starmark CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna Medicare,Aetna Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Ambetter ,Ambetter ,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Access,Anthem Blue Access,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Access Choice,Anthem Blue Access Choice,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Preferred,Anthem Blue Preferred,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Pathway,Anthem Pathway,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Alliance,Anthem Alliance,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Medicare,Anthem Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna,Cigna,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna PPO,Cigna PPO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna Medicare Advantage,Cigna Medicare Advantage,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Essence,Essence,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthlink HMO,Healthlink HMO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthlink PPO,Healthlink PPO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,HomeState Health Plan,HomeState Health Plan,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Humana Gold,Humana Gold,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Medicaid MO,Medicaid MO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Medica,Medica,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Tricare,Tricare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC All Payer,UHC All Payer,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Exchange,UHC Exchange,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Medicaid,UHC Medicaid,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,UMR CPD,UMR CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Medicare,UHC Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL LG             ,33150014,CDM,270,RC,,,,,,Inpatient,,,51,51,Wellcare,Wellcare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health PPO CPD,Meritain Health PPO CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna/Commercial Product,Aetna/Commercial Product,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Meritain Health CPD,Meritain Health CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Starmark CPD,Starmark CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Aetna Medicare,Aetna Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Ambetter ,Ambetter ,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access,Anthem Blue Access,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Access Choice,Anthem Blue Access Choice,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Blue Preferred,Anthem Blue Preferred,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Pathway,Anthem Pathway,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Alliance,Anthem Alliance,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Anthem Medicare,Anthem Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna,Cigna,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna PPO,Cigna PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Cigna Medicare Advantage,Cigna Medicare Advantage,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Essence,Essence,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink HMO,Healthlink HMO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Healthlink PPO,Healthlink PPO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,HomeState Health Plan,HomeState Health Plan,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Humana Gold,Humana Gold,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Medicaid MO,Medicaid MO,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Medica,Medica,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Tricare,Tricare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC All Payer,UHC All Payer,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Exchange,UHC Exchange,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicaid,UHC Medicaid,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,UMR CPD,UMR CPD,59,,,,,,,per diem,59,59,"Per diem rate, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,UHC Medicare,UHC Medicare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
BINDER 4 PANEL SM             ,33150015,CDM,270,RC,,,,,,Inpatient,,,59,59,Wellcare,Wellcare,59,,,,,,,case rate,59,59,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health PPO CPD,Meritain Health PPO CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/Commercial Product,Aetna/Commercial Product,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health CPD,Meritain Health CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Starmark CPD,Starmark CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna Medicare,Aetna Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Ambetter ,Ambetter ,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access,Anthem Blue Access,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access Choice,Anthem Blue Access Choice,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Preferred,Anthem Blue Preferred,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Pathway,Anthem Pathway,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Alliance,Anthem Alliance,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Medicare,Anthem Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna,Cigna,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna PPO,Cigna PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna Medicare Advantage,Cigna Medicare Advantage,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Essence,Essence,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink HMO,Healthlink HMO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink PPO,Healthlink PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,HomeState Health Plan,HomeState Health Plan,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Humana Gold,Humana Gold,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Medicaid MO,Medicaid MO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Medica,Medica,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Tricare,Tricare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC All Payer,UHC All Payer,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Exchange,UHC Exchange,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicaid,UHC Medicaid,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,UMR CPD,UMR CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicare,UHC Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ABDOMINAL BINDER 10in         ,33150017,CDM,270,RC,,,,,,Inpatient,,,38,38,Wellcare,Wellcare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Meritain Health PPO CPD,Meritain Health PPO CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna/Commercial Product,Aetna/Commercial Product,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Meritain Health CPD,Meritain Health CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Starmark CPD,Starmark CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Aetna Medicare,Aetna Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Ambetter ,Ambetter ,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Access,Anthem Blue Access,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Access Choice,Anthem Blue Access Choice,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Blue Preferred,Anthem Blue Preferred,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Pathway,Anthem Pathway,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Alliance,Anthem Alliance,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Anthem Medicare,Anthem Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna,Cigna,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna PPO,Cigna PPO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Cigna Medicare Advantage,Cigna Medicare Advantage,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Essence,Essence,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthlink HMO,Healthlink HMO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Healthlink PPO,Healthlink PPO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,HomeState Health Plan,HomeState Health Plan,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Humana Gold,Humana Gold,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Medicaid MO,Medicaid MO,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Medica,Medica,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Tricare,Tricare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC All Payer,UHC All Payer,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Exchange,UHC Exchange,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Medicaid,UHC Medicaid,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,UMR CPD,UMR CPD,51,,,,,,,per diem,51,51,"Per diem rate, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,UHC Medicare,UHC Medicare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
ARM ELEVATOR                  ,33150033,CDM,270,RC,,,,,,Inpatient,,,51,51,Wellcare,Wellcare,51,,,,,,,case rate,51,51,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Meritain Health PPO CPD,Meritain Health PPO CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Aetna/Commercial Product,Aetna/Commercial Product,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Meritain Health CPD,Meritain Health CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Starmark CPD,Starmark CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Aetna Medicare,Aetna Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Ambetter ,Ambetter ,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Blue Access,Anthem Blue Access,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Blue Access Choice,Anthem Blue Access Choice,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Blue Preferred,Anthem Blue Preferred,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Pathway,Anthem Pathway,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Alliance,Anthem Alliance,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Anthem Medicare,Anthem Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Cigna,Cigna,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Cigna PPO,Cigna PPO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Cigna Medicare Advantage,Cigna Medicare Advantage,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Essence,Essence,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Healthlink HMO,Healthlink HMO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Healthlink PPO,Healthlink PPO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,HomeState Health Plan,HomeState Health Plan,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Humana Gold,Humana Gold,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Medicaid MO,Medicaid MO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Medica,Medica,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Tricare,Tricare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,UHC All Payer,UHC All Payer,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,UHC Exchange,UHC Exchange,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,UHC Medicaid,UHC Medicaid,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,UMR CPD,UMR CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,UHC Medicare,UHC Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
BOOT BUCK                     ,33150057,CDM,270,RC,,,,,,Inpatient,,,74,74,Wellcare,Wellcare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Meritain Health PPO CPD,Meritain Health PPO CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna/Commercial Product,Aetna/Commercial Product,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Meritain Health CPD,Meritain Health CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Starmark CPD,Starmark CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna Medicare,Aetna Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Ambetter ,Ambetter ,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Access,Anthem Blue Access,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Access Choice,Anthem Blue Access Choice,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Preferred,Anthem Blue Preferred,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Pathway,Anthem Pathway,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Alliance,Anthem Alliance,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Medicare,Anthem Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna,Cigna,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna PPO,Cigna PPO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna Medicare Advantage,Cigna Medicare Advantage,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Essence,Essence,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthlink HMO,Healthlink HMO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthlink PPO,Healthlink PPO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,HomeState Health Plan,HomeState Health Plan,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Humana Gold,Humana Gold,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Medicaid MO,Medicaid MO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Medica,Medica,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Tricare,Tricare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC All Payer,UHC All Payer,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Exchange,UHC Exchange,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Medicaid,UHC Medicaid,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,UMR CPD,UMR CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Medicare,UHC Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX LARGE            ,33150076,CDM,270,RC,,,,,,Inpatient,,,40,40,Wellcare,Wellcare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Meritain Health PPO CPD,Meritain Health PPO CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna/Commercial Product,Aetna/Commercial Product,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Meritain Health CPD,Meritain Health CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Starmark CPD,Starmark CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Aetna Medicare,Aetna Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Ambetter ,Ambetter ,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Access,Anthem Blue Access,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Access Choice,Anthem Blue Access Choice,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Blue Preferred,Anthem Blue Preferred,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Pathway,Anthem Pathway,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Alliance,Anthem Alliance,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Anthem Medicare,Anthem Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna,Cigna,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna PPO,Cigna PPO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Cigna Medicare Advantage,Cigna Medicare Advantage,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Essence,Essence,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthlink HMO,Healthlink HMO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Healthlink PPO,Healthlink PPO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,HomeState Health Plan,HomeState Health Plan,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Humana Gold,Humana Gold,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Medicaid MO,Medicaid MO,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Medica,Medica,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Tricare,Tricare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC All Payer,UHC All Payer,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Exchange,UHC Exchange,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Medicaid,UHC Medicaid,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,UMR CPD,UMR CPD,40,,,,,,,per diem,40,40,"Per diem rate, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,UHC Medicare,UHC Medicare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE EX SMALL            ,33150077,CDM,270,RC,,,,,,Inpatient,,,40,40,Wellcare,Wellcare,40,,,,,,,case rate,40,40,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Meritain Health PPO CPD,Meritain Health PPO CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna/Commercial Product,Aetna/Commercial Product,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Meritain Health CPD,Meritain Health CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Starmark CPD,Starmark CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna Medicare,Aetna Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Ambetter ,Ambetter ,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Access,Anthem Blue Access,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Access Choice,Anthem Blue Access Choice,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Preferred,Anthem Blue Preferred,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Pathway,Anthem Pathway,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Alliance,Anthem Alliance,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Medicare,Anthem Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna,Cigna,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna PPO,Cigna PPO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna Medicare Advantage,Cigna Medicare Advantage,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Essence,Essence,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthlink HMO,Healthlink HMO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthlink PPO,Healthlink PPO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,HomeState Health Plan,HomeState Health Plan,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Humana Gold,Humana Gold,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Medicaid MO,Medicaid MO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Medica,Medica,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Tricare,Tricare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC All Payer,UHC All Payer,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Exchange,UHC Exchange,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Medicaid,UHC Medicaid,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,UMR CPD,UMR CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Medicare,UHC Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST SHOE SMALL               ,33150078,CDM,270,RC,,,,,,Inpatient,,,43,43,Wellcare,Wellcare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Meritain Health PPO CPD,Meritain Health PPO CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Aetna/Commercial Product,Aetna/Commercial Product,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Meritain Health CPD,Meritain Health CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Starmark CPD,Starmark CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Aetna Medicare,Aetna Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Ambetter ,Ambetter ,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access,Anthem Blue Access,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access Choice,Anthem Blue Access Choice,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Blue Preferred,Anthem Blue Preferred,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Pathway,Anthem Pathway,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Alliance,Anthem Alliance,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Anthem Medicare,Anthem Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Cigna,Cigna,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Cigna PPO,Cigna PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Cigna Medicare Advantage,Cigna Medicare Advantage,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Essence,Essence,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Healthlink HMO,Healthlink HMO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Healthlink PPO,Healthlink PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,HomeState Health Plan,HomeState Health Plan,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Humana Gold,Humana Gold,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Medicaid MO,Medicaid MO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Medica,Medica,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Tricare,Tricare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,UHC All Payer,UHC All Payer,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,UHC Exchange,UHC Exchange,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,UHC Medicaid,UHC Medicaid,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,UMR CPD,UMR CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,UHC Medicare,UHC Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 3inin    ,33150079,CDM,270,RC,,,,,,Inpatient,,,21,21,Wellcare,Wellcare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 4inin    ,33150080,CDM,270,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
CAST TAPE FIBERGLASS 5inin    ,33150081,CDM,270,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Meritain Health PPO CPD,Meritain Health PPO CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna/Commercial Product,Aetna/Commercial Product,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Meritain Health CPD,Meritain Health CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Starmark CPD,Starmark CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna Medicare,Aetna Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Ambetter ,Ambetter ,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Access,Anthem Blue Access,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Access Choice,Anthem Blue Access Choice,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Preferred,Anthem Blue Preferred,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Pathway,Anthem Pathway,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Alliance,Anthem Alliance,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Medicare,Anthem Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna,Cigna,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna PPO,Cigna PPO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna Medicare Advantage,Cigna Medicare Advantage,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Essence,Essence,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthlink HMO,Healthlink HMO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthlink PPO,Healthlink PPO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,HomeState Health Plan,HomeState Health Plan,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Humana Gold,Humana Gold,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Medicaid MO,Medicaid MO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Medica,Medica,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Tricare,Tricare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC All Payer,UHC All Payer,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Exchange,UHC Exchange,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Medicaid,UHC Medicaid,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,UMR CPD,UMR CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Medicare,UHC Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
"COLLAR, STIFF NECK (ALL)      ",33150097,CDM,270,RC,,,,,,Inpatient,,,65,65,Wellcare,Wellcare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Meritain Health PPO CPD,Meritain Health PPO CPD,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Aetna/Commercial Product,Aetna/Commercial Product,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Meritain Health CPD,Meritain Health CPD,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Starmark CPD,Starmark CPD,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Aetna Medicare,Aetna Medicare,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Ambetter ,Ambetter ,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Blue Access,Anthem Blue Access,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Blue Access Choice,Anthem Blue Access Choice,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Blue Preferred,Anthem Blue Preferred,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Pathway,Anthem Pathway,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Alliance,Anthem Alliance,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Anthem Medicare,Anthem Medicare,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Cigna,Cigna,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Cigna PPO,Cigna PPO,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Cigna Medicare Advantage,Cigna Medicare Advantage,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Essence,Essence,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Healthlink HMO,Healthlink HMO,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Healthlink PPO,Healthlink PPO,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,HomeState Health Plan,HomeState Health Plan,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Humana Gold,Humana Gold,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Medicaid MO,Medicaid MO,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Medica,Medica,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Tricare,Tricare,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,UHC All Payer,UHC All Payer,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,UHC Exchange,UHC Exchange,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,UHC Medicaid,UHC Medicaid,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,UMR CPD,UMR CPD,68,,,,,,,per diem,68,68,"Per diem rate, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,UHC Medicare,UHC Medicare,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
CRUTCHES PAIR                 ,33150113,CDM,270,RC,,,,,,Inpatient,,,68,68,Wellcare,Wellcare,68,,,,,,,case rate,68,68,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Meritain Health PPO CPD,Meritain Health PPO CPD,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Aetna/Commercial Product,Aetna/Commercial Product,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Meritain Health CPD,Meritain Health CPD,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Starmark CPD,Starmark CPD,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Aetna Medicare,Aetna Medicare,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Ambetter ,Ambetter ,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Blue Access,Anthem Blue Access,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Blue Access Choice,Anthem Blue Access Choice,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Blue Preferred,Anthem Blue Preferred,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Pathway,Anthem Pathway,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Alliance,Anthem Alliance,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Anthem Medicare,Anthem Medicare,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Cigna,Cigna,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Cigna PPO,Cigna PPO,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Cigna Medicare Advantage,Cigna Medicare Advantage,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Essence,Essence,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Healthlink HMO,Healthlink HMO,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Healthlink PPO,Healthlink PPO,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,HomeState Health Plan,HomeState Health Plan,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Humana Gold,Humana Gold,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Medicaid MO,Medicaid MO,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Medica,Medica,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Tricare,Tricare,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,UHC All Payer,UHC All Payer,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,UHC Exchange,UHC Exchange,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,UHC Medicaid,UHC Medicaid,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,UMR CPD,UMR CPD,155,,,,,,,per diem,155,155,"Per diem rate, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,UHC Medicare,UHC Medicare,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
ELECTRIC-COOL MACHINE         ,33150153,CDM,279,RC,,,,,,Inpatient,,,155,155,Wellcare,Wellcare,155,,,,,,,case rate,155,155,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Meritain Health PPO CPD,Meritain Health PPO CPD,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Aetna/Commercial Product,Aetna/Commercial Product,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Meritain Health CPD,Meritain Health CPD,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Starmark CPD,Starmark CPD,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Aetna Medicare,Aetna Medicare,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Ambetter ,Ambetter ,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Blue Access,Anthem Blue Access,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Blue Access Choice,Anthem Blue Access Choice,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Blue Preferred,Anthem Blue Preferred,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Pathway,Anthem Pathway,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Alliance,Anthem Alliance,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Anthem Medicare,Anthem Medicare,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Cigna,Cigna,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Cigna PPO,Cigna PPO,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Cigna Medicare Advantage,Cigna Medicare Advantage,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Essence,Essence,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Healthlink HMO,Healthlink HMO,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Healthlink PPO,Healthlink PPO,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,HomeState Health Plan,HomeState Health Plan,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Humana Gold,Humana Gold,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Medicaid MO,Medicaid MO,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Medica,Medica,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Tricare,Tricare,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,UHC All Payer,UHC All Payer,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,UHC Exchange,UHC Exchange,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,UHC Medicaid,UHC Medicaid,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,UMR CPD,UMR CPD,5.5,,,,,,,per diem,5.5,5.5,"Per diem rate, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,UHC Medicare,UHC Medicare,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
FOOTWEAR PATIENT DOUBLE       ,33150166,CDM,270,RC,,,,,,Inpatient,,,5.5,5.5,Wellcare,Wellcare,5.5,,,,,,,case rate,5.5,5.5,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Meritain Health PPO CPD,Meritain Health PPO CPD,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Aetna/Commercial Product,Aetna/Commercial Product,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Meritain Health CPD,Meritain Health CPD,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Starmark CPD,Starmark CPD,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Aetna Medicare,Aetna Medicare,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Ambetter ,Ambetter ,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Blue Access,Anthem Blue Access,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Blue Access Choice,Anthem Blue Access Choice,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Blue Preferred,Anthem Blue Preferred,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Pathway,Anthem Pathway,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Alliance,Anthem Alliance,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Anthem Medicare,Anthem Medicare,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Cigna,Cigna,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Cigna PPO,Cigna PPO,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Cigna Medicare Advantage,Cigna Medicare Advantage,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Essence,Essence,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Healthlink HMO,Healthlink HMO,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Healthlink PPO,Healthlink PPO,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,HomeState Health Plan,HomeState Health Plan,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Humana Gold,Humana Gold,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Medicaid MO,Medicaid MO,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Medica,Medica,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Tricare,Tricare,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,UHC All Payer,UHC All Payer,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,UHC Exchange,UHC Exchange,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,UHC Medicaid,UHC Medicaid,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,UMR CPD,UMR CPD,214,,,,,,,per diem,214,214,"Per diem rate, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,UHC Medicare,UHC Medicare,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L1                       ,33150179,CDM,270,RC,,,,,,Inpatient,,,214,214,Wellcare,Wellcare,214,,,,,,,case rate,214,214,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Meritain Health PPO CPD,Meritain Health PPO CPD,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Aetna/Commercial Product,Aetna/Commercial Product,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Meritain Health CPD,Meritain Health CPD,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Starmark CPD,Starmark CPD,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Aetna Medicare,Aetna Medicare,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Ambetter ,Ambetter ,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Blue Access,Anthem Blue Access,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Blue Access Choice,Anthem Blue Access Choice,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Blue Preferred,Anthem Blue Preferred,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Pathway,Anthem Pathway,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Alliance,Anthem Alliance,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Anthem Medicare,Anthem Medicare,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Cigna,Cigna,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Cigna PPO,Cigna PPO,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Cigna Medicare Advantage,Cigna Medicare Advantage,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Essence,Essence,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Healthlink HMO,Healthlink HMO,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Healthlink PPO,Healthlink PPO,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,HomeState Health Plan,HomeState Health Plan,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Humana Gold,Humana Gold,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Medicaid MO,Medicaid MO,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Medica,Medica,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Tricare,Tricare,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,UHC All Payer,UHC All Payer,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,UHC Exchange,UHC Exchange,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,UHC Medicaid,UHC Medicaid,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,UMR CPD,UMR CPD,398,,,,,,,per diem,398,398,"Per diem rate, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,UHC Medicare,UHC Medicare,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L2                       ,33150180,CDM,270,RC,,,,,,Inpatient,,,398,398,Wellcare,Wellcare,398,,,,,,,case rate,398,398,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Meritain Health PPO CPD,Meritain Health PPO CPD,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Aetna/Commercial Product,Aetna/Commercial Product,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Meritain Health CPD,Meritain Health CPD,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Starmark CPD,Starmark CPD,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Aetna Medicare,Aetna Medicare,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Ambetter ,Ambetter ,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Blue Access,Anthem Blue Access,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Blue Access Choice,Anthem Blue Access Choice,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Blue Preferred,Anthem Blue Preferred,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Pathway,Anthem Pathway,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Alliance,Anthem Alliance,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Anthem Medicare,Anthem Medicare,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Cigna,Cigna,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Cigna PPO,Cigna PPO,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Cigna Medicare Advantage,Cigna Medicare Advantage,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Essence,Essence,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Healthlink HMO,Healthlink HMO,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Healthlink PPO,Healthlink PPO,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,HomeState Health Plan,HomeState Health Plan,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Humana Gold,Humana Gold,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Medicaid MO,Medicaid MO,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Medica,Medica,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Tricare,Tricare,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,UHC All Payer,UHC All Payer,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,UHC Exchange,UHC Exchange,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,UHC Medicaid,UHC Medicaid,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,UMR CPD,UMR CPD,612,,,,,,,per diem,612,612,"Per diem rate, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,UHC Medicare,UHC Medicare,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L3                       ,33150181,CDM,270,RC,,,,,,Inpatient,,,612,612,Wellcare,Wellcare,612,,,,,,,case rate,612,612,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Meritain Health PPO CPD,Meritain Health PPO CPD,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Aetna/Commercial Product,Aetna/Commercial Product,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Meritain Health CPD,Meritain Health CPD,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Starmark CPD,Starmark CPD,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Aetna Medicare,Aetna Medicare,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Ambetter ,Ambetter ,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Blue Access,Anthem Blue Access,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Blue Access Choice,Anthem Blue Access Choice,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Blue Preferred,Anthem Blue Preferred,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Pathway,Anthem Pathway,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Alliance,Anthem Alliance,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Anthem Medicare,Anthem Medicare,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Cigna,Cigna,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Cigna PPO,Cigna PPO,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Cigna Medicare Advantage,Cigna Medicare Advantage,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Essence,Essence,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Healthlink HMO,Healthlink HMO,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Healthlink PPO,Healthlink PPO,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,HomeState Health Plan,HomeState Health Plan,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Humana Gold,Humana Gold,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Medicaid MO,Medicaid MO,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Medica,Medica,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Tricare,Tricare,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,UHC All Payer,UHC All Payer,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,UHC Exchange,UHC Exchange,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,UHC Medicaid,UHC Medicaid,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,UMR CPD,UMR CPD,657,,,,,,,per diem,657,657,"Per diem rate, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,UHC Medicare,UHC Medicare,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L4                       ,33150182,CDM,270,RC,,,,,,Inpatient,,,657,657,Wellcare,Wellcare,657,,,,,,,case rate,657,657,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Meritain Health PPO CPD,Meritain Health PPO CPD,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Aetna/Commercial Product,Aetna/Commercial Product,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Meritain Health CPD,Meritain Health CPD,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Starmark CPD,Starmark CPD,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Aetna Medicare,Aetna Medicare,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Ambetter ,Ambetter ,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Blue Access,Anthem Blue Access,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Blue Access Choice,Anthem Blue Access Choice,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Blue Preferred,Anthem Blue Preferred,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Pathway,Anthem Pathway,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Alliance,Anthem Alliance,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Anthem Medicare,Anthem Medicare,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Cigna,Cigna,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Cigna PPO,Cigna PPO,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Cigna Medicare Advantage,Cigna Medicare Advantage,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Essence,Essence,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Healthlink HMO,Healthlink HMO,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Healthlink PPO,Healthlink PPO,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,HomeState Health Plan,HomeState Health Plan,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Humana Gold,Humana Gold,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Medicaid MO,Medicaid MO,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Medica,Medica,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Tricare,Tricare,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,UHC All Payer,UHC All Payer,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,UHC Exchange,UHC Exchange,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,UHC Medicaid,UHC Medicaid,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,UMR CPD,UMR CPD,878,,,,,,,per diem,878,878,"Per diem rate, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,UHC Medicare,UHC Medicare,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L5                       ,33150183,CDM,270,RC,,,,,,Inpatient,,,878,878,Wellcare,Wellcare,878,,,,,,,case rate,878,878,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Meritain Health PPO CPD,Meritain Health PPO CPD,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Aetna/Commercial Product,Aetna/Commercial Product,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Meritain Health CPD,Meritain Health CPD,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Starmark CPD,Starmark CPD,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Aetna Medicare,Aetna Medicare,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Ambetter ,Ambetter ,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Blue Access,Anthem Blue Access,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Blue Access Choice,Anthem Blue Access Choice,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Blue Preferred,Anthem Blue Preferred,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Pathway,Anthem Pathway,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Alliance,Anthem Alliance,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Anthem Medicare,Anthem Medicare,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Cigna,Cigna,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Cigna PPO,Cigna PPO,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Cigna Medicare Advantage,Cigna Medicare Advantage,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Essence,Essence,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Healthlink HMO,Healthlink HMO,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Healthlink PPO,Healthlink PPO,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,HomeState Health Plan,HomeState Health Plan,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Humana Gold,Humana Gold,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Medicaid MO,Medicaid MO,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Medica,Medica,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Tricare,Tricare,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,UHC All Payer,UHC All Payer,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,UHC Exchange,UHC Exchange,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,UHC Medicaid,UHC Medicaid,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,UMR CPD,UMR CPD,1098,,,,,,,per diem,1098,1098,"Per diem rate, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,UHC Medicare,UHC Medicare,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L6                       ,33150184,CDM,270,RC,,,,,,Inpatient,,,1098,1098,Wellcare,Wellcare,1098,,,,,,,case rate,1098,1098,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Meritain Health PPO CPD,Meritain Health PPO CPD,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Aetna/Commercial Product,Aetna/Commercial Product,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Meritain Health CPD,Meritain Health CPD,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Starmark CPD,Starmark CPD,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Aetna Medicare,Aetna Medicare,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Ambetter ,Ambetter ,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Blue Access,Anthem Blue Access,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Blue Access Choice,Anthem Blue Access Choice,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Blue Preferred,Anthem Blue Preferred,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Pathway,Anthem Pathway,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Alliance,Anthem Alliance,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Anthem Medicare,Anthem Medicare,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Cigna,Cigna,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Cigna PPO,Cigna PPO,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Cigna Medicare Advantage,Cigna Medicare Advantage,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Essence,Essence,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Healthlink HMO,Healthlink HMO,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Healthlink PPO,Healthlink PPO,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,HomeState Health Plan,HomeState Health Plan,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Humana Gold,Humana Gold,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Medicaid MO,Medicaid MO,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Medica,Medica,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Tricare,Tricare,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,UHC All Payer,UHC All Payer,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,UHC Exchange,UHC Exchange,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,UHC Medicaid,UHC Medicaid,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,UMR CPD,UMR CPD,1822,,,,,,,per diem,1822,1822,"Per diem rate, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,UHC Medicare,UHC Medicare,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L7                       ,33150185,CDM,270,RC,,,,,,Inpatient,,,1822,1822,Wellcare,Wellcare,1822,,,,,,,case rate,1822,1822,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Meritain Health PPO CPD,Meritain Health PPO CPD,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Aetna/Commercial Product,Aetna/Commercial Product,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Meritain Health CPD,Meritain Health CPD,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Starmark CPD,Starmark CPD,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Aetna Medicare,Aetna Medicare,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Ambetter ,Ambetter ,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Blue Access,Anthem Blue Access,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Blue Access Choice,Anthem Blue Access Choice,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Blue Preferred,Anthem Blue Preferred,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Pathway,Anthem Pathway,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Alliance,Anthem Alliance,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Anthem Medicare,Anthem Medicare,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Cigna,Cigna,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Cigna PPO,Cigna PPO,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Cigna Medicare Advantage,Cigna Medicare Advantage,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Essence,Essence,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Healthlink HMO,Healthlink HMO,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Healthlink PPO,Healthlink PPO,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,HomeState Health Plan,HomeState Health Plan,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Humana Gold,Humana Gold,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Medicaid MO,Medicaid MO,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Medica,Medica,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Tricare,Tricare,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,UHC All Payer,UHC All Payer,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,UHC Exchange,UHC Exchange,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,UHC Medicaid,UHC Medicaid,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,UMR CPD,UMR CPD,2735,,,,,,,per diem,2735,2735,"Per diem rate, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,UHC Medicare,UHC Medicare,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L8                       ,33150186,CDM,270,RC,,,,,,Inpatient,,,2735,2735,Wellcare,Wellcare,2735,,,,,,,case rate,2735,2735,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Meritain Health PPO CPD,Meritain Health PPO CPD,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Aetna/Commercial Product,Aetna/Commercial Product,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Meritain Health CPD,Meritain Health CPD,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Starmark CPD,Starmark CPD,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Aetna Medicare,Aetna Medicare,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Ambetter ,Ambetter ,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Blue Access,Anthem Blue Access,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Blue Access Choice,Anthem Blue Access Choice,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Blue Preferred,Anthem Blue Preferred,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Pathway,Anthem Pathway,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Alliance,Anthem Alliance,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Anthem Medicare,Anthem Medicare,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Cigna,Cigna,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Cigna PPO,Cigna PPO,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Cigna Medicare Advantage,Cigna Medicare Advantage,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Essence,Essence,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Healthlink HMO,Healthlink HMO,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Healthlink PPO,Healthlink PPO,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,HomeState Health Plan,HomeState Health Plan,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Humana Gold,Humana Gold,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Medicaid MO,Medicaid MO,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Medica,Medica,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Tricare,Tricare,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,UHC All Payer,UHC All Payer,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,UHC Exchange,UHC Exchange,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,UHC Medicaid,UHC Medicaid,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,UMR CPD,UMR CPD,3650,,,,,,,per diem,3650,3650,"Per diem rate, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,UHC Medicare,UHC Medicare,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HALO L9                       ,33150187,CDM,270,RC,,,,,,Inpatient,,,3650,3650,Wellcare,Wellcare,3650,,,,,,,case rate,3650,3650,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Meritain Health PPO CPD,Meritain Health PPO CPD,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Aetna/Commercial Product,Aetna/Commercial Product,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Meritain Health CPD,Meritain Health CPD,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Starmark CPD,Starmark CPD,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Aetna Medicare,Aetna Medicare,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Ambetter ,Ambetter ,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Blue Access,Anthem Blue Access,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Blue Access Choice,Anthem Blue Access Choice,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Blue Preferred,Anthem Blue Preferred,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Pathway,Anthem Pathway,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Alliance,Anthem Alliance,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Anthem Medicare,Anthem Medicare,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Cigna,Cigna,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Cigna PPO,Cigna PPO,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Cigna Medicare Advantage,Cigna Medicare Advantage,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Essence,Essence,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Healthlink HMO,Healthlink HMO,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Healthlink PPO,Healthlink PPO,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,HomeState Health Plan,HomeState Health Plan,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Humana Gold,Humana Gold,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Medicaid MO,Medicaid MO,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Medica,Medica,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Tricare,Tricare,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,UHC All Payer,UHC All Payer,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,UHC Exchange,UHC Exchange,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,UHC Medicaid,UHC Medicaid,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,UMR CPD,UMR CPD,3568,,,,,,,per diem,3568,3568,"Per diem rate, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,UHC Medicare,UHC Medicare,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HARDWARE VEST HALO            ,33150188,CDM,270,RC,,,,,,Inpatient,,,3568,3568,Wellcare,Wellcare,3568,,,,,,,case rate,3568,3568,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Meritain Health PPO CPD,Meritain Health PPO CPD,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Aetna/Commercial Product,Aetna/Commercial Product,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Meritain Health CPD,Meritain Health CPD,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Starmark CPD,Starmark CPD,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Aetna Medicare,Aetna Medicare,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Ambetter ,Ambetter ,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Blue Access,Anthem Blue Access,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Blue Access Choice,Anthem Blue Access Choice,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Blue Preferred,Anthem Blue Preferred,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Pathway,Anthem Pathway,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Alliance,Anthem Alliance,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Anthem Medicare,Anthem Medicare,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Cigna,Cigna,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Cigna PPO,Cigna PPO,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Cigna Medicare Advantage,Cigna Medicare Advantage,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Essence,Essence,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Healthlink HMO,Healthlink HMO,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Healthlink PPO,Healthlink PPO,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,HomeState Health Plan,HomeState Health Plan,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Humana Gold,Humana Gold,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Medicaid MO,Medicaid MO,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Medica,Medica,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Tricare,Tricare,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,UHC All Payer,UHC All Payer,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,UHC Exchange,UHC Exchange,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,UHC Medicaid,UHC Medicaid,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,UMR CPD,UMR CPD,403,,,,,,,per diem,403,403,"Per diem rate, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,UHC Medicare,UHC Medicare,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
HEEL PRESSURE DVC - SAGE      ,33150192,CDM,270,RC,,,,,,Inpatient,,,403,403,Wellcare,Wellcare,403,,,,,,,case rate,403,403,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Meritain Health PPO CPD,Meritain Health PPO CPD,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Aetna/Commercial Product,Aetna/Commercial Product,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Meritain Health CPD,Meritain Health CPD,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Starmark CPD,Starmark CPD,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Aetna Medicare,Aetna Medicare,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Ambetter ,Ambetter ,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Blue Access,Anthem Blue Access,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Blue Access Choice,Anthem Blue Access Choice,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Blue Preferred,Anthem Blue Preferred,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Pathway,Anthem Pathway,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Alliance,Anthem Alliance,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Anthem Medicare,Anthem Medicare,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Cigna,Cigna,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Cigna PPO,Cigna PPO,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Cigna Medicare Advantage,Cigna Medicare Advantage,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Essence,Essence,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Healthlink HMO,Healthlink HMO,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Healthlink PPO,Healthlink PPO,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,HomeState Health Plan,HomeState Health Plan,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Humana Gold,Humana Gold,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Medicaid MO,Medicaid MO,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Medica,Medica,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Tricare,Tricare,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,UHC All Payer,UHC All Payer,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,UHC Exchange,UHC Exchange,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,UHC Medicaid,UHC Medicaid,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,UMR CPD,UMR CPD,97,,,,,,,per diem,97,97,"Per diem rate, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,UHC Medicare,UHC Medicare,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
LOW LEVEL AIR THERAPY BED     ,33150194,CDM,279,RC,,,,,,Inpatient,,,97,97,Wellcare,Wellcare,97,,,,,,,case rate,97,97,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Meritain Health PPO CPD,Meritain Health PPO CPD,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Aetna/Commercial Product,Aetna/Commercial Product,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Meritain Health CPD,Meritain Health CPD,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Starmark CPD,Starmark CPD,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Aetna Medicare,Aetna Medicare,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Ambetter ,Ambetter ,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Blue Access,Anthem Blue Access,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Blue Access Choice,Anthem Blue Access Choice,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Blue Preferred,Anthem Blue Preferred,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Pathway,Anthem Pathway,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Alliance,Anthem Alliance,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Anthem Medicare,Anthem Medicare,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Cigna,Cigna,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Cigna PPO,Cigna PPO,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Cigna Medicare Advantage,Cigna Medicare Advantage,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Essence,Essence,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Healthlink HMO,Healthlink HMO,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Healthlink PPO,Healthlink PPO,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,HomeState Health Plan,HomeState Health Plan,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Humana Gold,Humana Gold,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Medicaid MO,Medicaid MO,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Medica,Medica,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Tricare,Tricare,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,UHC All Payer,UHC All Payer,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,UHC Exchange,UHC Exchange,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,UHC Medicaid,UHC Medicaid,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,UMR CPD,UMR CPD,295,,,,,,,per diem,295,295,"Per diem rate, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,UHC Medicare,UHC Medicare,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
MEDIUM LEVEL AIR THERAPY BED  ,33150195,CDM,279,RC,,,,,,Inpatient,,,295,295,Wellcare,Wellcare,295,,,,,,,case rate,295,295,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Meritain Health PPO CPD,Meritain Health PPO CPD,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Aetna/Commercial Product,Aetna/Commercial Product,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Meritain Health CPD,Meritain Health CPD,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Starmark CPD,Starmark CPD,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Aetna Medicare,Aetna Medicare,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Ambetter ,Ambetter ,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Blue Access,Anthem Blue Access,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Blue Access Choice,Anthem Blue Access Choice,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Blue Preferred,Anthem Blue Preferred,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Pathway,Anthem Pathway,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Alliance,Anthem Alliance,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Anthem Medicare,Anthem Medicare,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Cigna,Cigna,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Cigna PPO,Cigna PPO,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Cigna Medicare Advantage,Cigna Medicare Advantage,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Essence,Essence,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Healthlink HMO,Healthlink HMO,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Healthlink PPO,Healthlink PPO,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,HomeState Health Plan,HomeState Health Plan,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Humana Gold,Humana Gold,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Medicaid MO,Medicaid MO,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Medica,Medica,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Tricare,Tricare,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,UHC All Payer,UHC All Payer,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,UHC Exchange,UHC Exchange,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,UHC Medicaid,UHC Medicaid,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,UMR CPD,UMR CPD,353,,,,,,,per diem,353,353,"Per diem rate, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,UHC Medicare,UHC Medicare,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI ABDOMEN VAC RENTAL        ,33150210,CDM,279,RC,,,,,,Inpatient,,,353,353,Wellcare,Wellcare,353,,,,,,,case rate,353,353,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Meritain Health PPO CPD,Meritain Health PPO CPD,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Aetna/Commercial Product,Aetna/Commercial Product,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Meritain Health CPD,Meritain Health CPD,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Starmark CPD,Starmark CPD,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Aetna Medicare,Aetna Medicare,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Ambetter ,Ambetter ,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Blue Access,Anthem Blue Access,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Blue Access Choice,Anthem Blue Access Choice,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Blue Preferred,Anthem Blue Preferred,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Pathway,Anthem Pathway,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Alliance,Anthem Alliance,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Anthem Medicare,Anthem Medicare,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Cigna,Cigna,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Cigna PPO,Cigna PPO,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Cigna Medicare Advantage,Cigna Medicare Advantage,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Essence,Essence,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Healthlink HMO,Healthlink HMO,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Healthlink PPO,Healthlink PPO,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,HomeState Health Plan,HomeState Health Plan,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Humana Gold,Humana Gold,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Medicaid MO,Medicaid MO,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Medica,Medica,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Tricare,Tricare,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,UHC All Payer,UHC All Payer,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,UHC Exchange,UHC Exchange,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,UHC Medicaid,UHC Medicaid,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,UMR CPD,UMR CPD,486,,,,,,,per diem,486,486,"Per diem rate, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,UHC Medicare,UHC Medicare,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
KCI VAC SYSTEM                ,33150211,CDM,279,RC,,,,,,Inpatient,,,486,486,Wellcare,Wellcare,486,,,,,,,case rate,486,486,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Meritain Health PPO CPD,Meritain Health PPO CPD,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Aetna/Commercial Product,Aetna/Commercial Product,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Meritain Health CPD,Meritain Health CPD,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Starmark CPD,Starmark CPD,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Aetna Medicare,Aetna Medicare,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Ambetter ,Ambetter ,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Blue Access,Anthem Blue Access,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Blue Access Choice,Anthem Blue Access Choice,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Blue Preferred,Anthem Blue Preferred,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Pathway,Anthem Pathway,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Alliance,Anthem Alliance,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Anthem Medicare,Anthem Medicare,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Cigna,Cigna,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Cigna PPO,Cigna PPO,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Cigna Medicare Advantage,Cigna Medicare Advantage,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Essence,Essence,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Healthlink HMO,Healthlink HMO,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Healthlink PPO,Healthlink PPO,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,HomeState Health Plan,HomeState Health Plan,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Humana Gold,Humana Gold,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Medicaid MO,Medicaid MO,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Medica,Medica,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Tricare,Tricare,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,UHC All Payer,UHC All Payer,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,UHC Exchange,UHC Exchange,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,UHC Medicaid,UHC Medicaid,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,UMR CPD,UMR CPD,171,,,,,,,per diem,171,171,"Per diem rate, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,UHC Medicare,UHC Medicare,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MATTRESS WAFFLE               ,33150224,CDM,279,RC,,,,,,Inpatient,,,171,171,Wellcare,Wellcare,171,,,,,,,case rate,171,171,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Meritain Health PPO CPD,Meritain Health PPO CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna/Commercial Product,Aetna/Commercial Product,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Meritain Health CPD,Meritain Health CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Starmark CPD,Starmark CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Aetna Medicare,Aetna Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Ambetter ,Ambetter ,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Access,Anthem Blue Access,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Access Choice,Anthem Blue Access Choice,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Blue Preferred,Anthem Blue Preferred,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Pathway,Anthem Pathway,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Alliance,Anthem Alliance,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Anthem Medicare,Anthem Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna,Cigna,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna PPO,Cigna PPO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Cigna Medicare Advantage,Cigna Medicare Advantage,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Essence,Essence,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthlink HMO,Healthlink HMO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Healthlink PPO,Healthlink PPO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,HomeState Health Plan,HomeState Health Plan,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Humana Gold,Humana Gold,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Medicaid MO,Medicaid MO,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Medica,Medica,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Tricare,Tricare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC All Payer,UHC All Payer,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Exchange,UHC Exchange,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Medicaid,UHC Medicaid,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UMR CPD,UMR CPD,19.5,,,,,,,per diem,19.5,19.5,"Per diem rate, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,UHC Medicare,UHC Medicare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MED/SURG SHOE                 ,33150225,CDM,270,RC,,,,,,Inpatient,,,19.5,19.5,Wellcare,Wellcare,19.5,,,,,,,case rate,19.5,19.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Meritain Health PPO CPD,Meritain Health PPO CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna/Commercial Product,Aetna/Commercial Product,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Meritain Health CPD,Meritain Health CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Starmark CPD,Starmark CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Aetna Medicare,Aetna Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Ambetter ,Ambetter ,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Access,Anthem Blue Access,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Access Choice,Anthem Blue Access Choice,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Blue Preferred,Anthem Blue Preferred,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Pathway,Anthem Pathway,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Alliance,Anthem Alliance,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Anthem Medicare,Anthem Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna,Cigna,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna PPO,Cigna PPO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Cigna Medicare Advantage,Cigna Medicare Advantage,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Essence,Essence,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthlink HMO,Healthlink HMO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Healthlink PPO,Healthlink PPO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,HomeState Health Plan,HomeState Health Plan,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Humana Gold,Humana Gold,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Medicaid MO,Medicaid MO,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Medica,Medica,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Tricare,Tricare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC All Payer,UHC All Payer,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Exchange,UHC Exchange,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Medicaid,UHC Medicaid,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UMR CPD,UMR CPD,149.5,,,,,,,per diem,149.5,149.5,"Per diem rate, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,UHC Medicare,UHC Medicare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MUELLER WRAPAROUND KNEE BRACE ,33150238,CDM,270,RC,,,,,,Inpatient,,,149.5,149.5,Wellcare,Wellcare,149.5,,,,,,,case rate,149.5,149.5,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Meritain Health PPO CPD,Meritain Health PPO CPD,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Aetna/Commercial Product,Aetna/Commercial Product,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Meritain Health CPD,Meritain Health CPD,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Starmark CPD,Starmark CPD,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Aetna Medicare,Aetna Medicare,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Ambetter ,Ambetter ,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Blue Access,Anthem Blue Access,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Blue Access Choice,Anthem Blue Access Choice,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Blue Preferred,Anthem Blue Preferred,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Pathway,Anthem Pathway,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Alliance,Anthem Alliance,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Anthem Medicare,Anthem Medicare,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Cigna,Cigna,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Cigna PPO,Cigna PPO,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Cigna Medicare Advantage,Cigna Medicare Advantage,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Essence,Essence,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Healthlink HMO,Healthlink HMO,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Healthlink PPO,Healthlink PPO,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,HomeState Health Plan,HomeState Health Plan,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Humana Gold,Humana Gold,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Medicaid MO,Medicaid MO,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Medica,Medica,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Tricare,Tricare,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,UHC All Payer,UHC All Payer,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,UHC Exchange,UHC Exchange,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,UHC Medicaid,UHC Medicaid,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,UMR CPD,UMR CPD,170,,,,,,,per diem,170,170,"Per diem rate, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,UHC Medicare,UHC Medicare,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
MULTI-PODUS BOOT              ,33150240,CDM,270,RC,,,,,,Inpatient,,,170,170,Wellcare,Wellcare,170,,,,,,,case rate,170,170,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Meritain Health PPO CPD,Meritain Health PPO CPD,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Aetna/Commercial Product,Aetna/Commercial Product,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Meritain Health CPD,Meritain Health CPD,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Starmark CPD,Starmark CPD,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Aetna Medicare,Aetna Medicare,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Ambetter ,Ambetter ,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Blue Access,Anthem Blue Access,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Blue Access Choice,Anthem Blue Access Choice,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Blue Preferred,Anthem Blue Preferred,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Pathway,Anthem Pathway,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Alliance,Anthem Alliance,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Anthem Medicare,Anthem Medicare,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Cigna,Cigna,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Cigna PPO,Cigna PPO,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Cigna Medicare Advantage,Cigna Medicare Advantage,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Essence,Essence,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Healthlink HMO,Healthlink HMO,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Healthlink PPO,Healthlink PPO,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,HomeState Health Plan,HomeState Health Plan,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Humana Gold,Humana Gold,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Medicaid MO,Medicaid MO,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Medica,Medica,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Tricare,Tricare,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,UHC All Payer,UHC All Payer,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,UHC Exchange,UHC Exchange,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,UHC Medicaid,UHC Medicaid,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,UMR CPD,UMR CPD,112.75,,,,,,,per diem,112.75,112.75,"Per diem rate, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,UHC Medicare,UHC Medicare,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
OVERHEAD TRAPEZE              ,33150300,CDM,279,RC,,,,,,Inpatient,,,112.75,112.75,Wellcare,Wellcare,112.75,,,,,,,case rate,112.75,112.75,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Meritain Health PPO CPD,Meritain Health PPO CPD,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Aetna/Commercial Product,Aetna/Commercial Product,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Meritain Health CPD,Meritain Health CPD,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Starmark CPD,Starmark CPD,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Aetna Medicare,Aetna Medicare,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Ambetter ,Ambetter ,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Blue Access,Anthem Blue Access,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Blue Access Choice,Anthem Blue Access Choice,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Blue Preferred,Anthem Blue Preferred,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Pathway,Anthem Pathway,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Alliance,Anthem Alliance,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Anthem Medicare,Anthem Medicare,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Cigna,Cigna,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Cigna PPO,Cigna PPO,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Cigna Medicare Advantage,Cigna Medicare Advantage,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Essence,Essence,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Healthlink HMO,Healthlink HMO,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Healthlink PPO,Healthlink PPO,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,HomeState Health Plan,HomeState Health Plan,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Humana Gold,Humana Gold,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Medicaid MO,Medicaid MO,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Medica,Medica,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Tricare,Tricare,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,UHC All Payer,UHC All Payer,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,UHC Exchange,UHC Exchange,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,UHC Medicaid,UHC Medicaid,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,UMR CPD,UMR CPD,142,,,,,,,per diem,142,142,"Per diem rate, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,UHC Medicare,UHC Medicare,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW GRAV LINEAR            ,33150329,CDM,270,RC,,,,,,Inpatient,,,142,142,Wellcare,Wellcare,142,,,,,,,case rate,142,142,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Meritain Health PPO CPD,Meritain Health PPO CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna/Commercial Product,Aetna/Commercial Product,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Meritain Health CPD,Meritain Health CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Starmark CPD,Starmark CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Aetna Medicare,Aetna Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Ambetter ,Ambetter ,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Access,Anthem Blue Access,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Access Choice,Anthem Blue Access Choice,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Blue Preferred,Anthem Blue Preferred,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Pathway,Anthem Pathway,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Alliance,Anthem Alliance,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Anthem Medicare,Anthem Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna,Cigna,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna PPO,Cigna PPO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Cigna Medicare Advantage,Cigna Medicare Advantage,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Essence,Essence,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthlink HMO,Healthlink HMO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Healthlink PPO,Healthlink PPO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,HomeState Health Plan,HomeState Health Plan,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Humana Gold,Humana Gold,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Medicaid MO,Medicaid MO,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Medica,Medica,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Tricare,Tricare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC All Payer,UHC All Payer,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Exchange,UHC Exchange,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Medicaid,UHC Medicaid,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,UMR CPD,UMR CPD,65,,,,,,,per diem,65,65,"Per diem rate, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,UHC Medicare,UHC Medicare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PILLOW PRONE 5in OSI          ,33150330,CDM,270,RC,,,,,,Inpatient,,,65,65,Wellcare,Wellcare,65,,,,,,,case rate,65,65,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Meritain Health PPO CPD,Meritain Health PPO CPD,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Aetna/Commercial Product,Aetna/Commercial Product,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Meritain Health CPD,Meritain Health CPD,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Starmark CPD,Starmark CPD,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Aetna Medicare,Aetna Medicare,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Ambetter ,Ambetter ,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Blue Access,Anthem Blue Access,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Blue Access Choice,Anthem Blue Access Choice,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Blue Preferred,Anthem Blue Preferred,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Pathway,Anthem Pathway,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Alliance,Anthem Alliance,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Anthem Medicare,Anthem Medicare,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Cigna,Cigna,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Cigna PPO,Cigna PPO,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Cigna Medicare Advantage,Cigna Medicare Advantage,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Essence,Essence,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Healthlink HMO,Healthlink HMO,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Healthlink PPO,Healthlink PPO,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,HomeState Health Plan,HomeState Health Plan,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Humana Gold,Humana Gold,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Medicaid MO,Medicaid MO,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Medica,Medica,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Tricare,Tricare,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,UHC All Payer,UHC All Payer,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,UHC Exchange,UHC Exchange,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,UHC Medicaid,UHC Medicaid,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,UMR CPD,UMR CPD,6.5,,,,,,,per diem,6.5,6.5,"Per diem rate, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,UHC Medicare,UHC Medicare,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
PROTECTOR ELBOW STANDARD      ,33150340,CDM,270,RC,,,,,,Inpatient,,,6.5,6.5,Wellcare,Wellcare,6.5,,,,,,,case rate,6.5,6.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Meritain Health PPO CPD,Meritain Health PPO CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna/Commercial Product,Aetna/Commercial Product,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Meritain Health CPD,Meritain Health CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Starmark CPD,Starmark CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Aetna Medicare,Aetna Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Ambetter ,Ambetter ,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Access,Anthem Blue Access,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Access Choice,Anthem Blue Access Choice,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Blue Preferred,Anthem Blue Preferred,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Pathway,Anthem Pathway,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Alliance,Anthem Alliance,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Anthem Medicare,Anthem Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna,Cigna,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna PPO,Cigna PPO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Cigna Medicare Advantage,Cigna Medicare Advantage,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Essence,Essence,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthlink HMO,Healthlink HMO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Healthlink PPO,Healthlink PPO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,HomeState Health Plan,HomeState Health Plan,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Humana Gold,Humana Gold,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Medicaid MO,Medicaid MO,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Medica,Medica,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Tricare,Tricare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC All Payer,UHC All Payer,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Exchange,UHC Exchange,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Medicaid,UHC Medicaid,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UMR CPD,UMR CPD,991.5,,,,,,,per diem,991.5,991.5,"Per diem rate, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,UHC Medicare,UHC Medicare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
RAIL PADDED SIDE for SEIZURE  ,33150342,CDM,279,RC,,,,,,Inpatient,,,991.5,991.5,Wellcare,Wellcare,991.5,,,,,,,case rate,991.5,991.5,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health PPO CPD,Meritain Health PPO CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/Commercial Product,Aetna/Commercial Product,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health CPD,Meritain Health CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Starmark CPD,Starmark CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna Medicare,Aetna Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Ambetter ,Ambetter ,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access,Anthem Blue Access,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access Choice,Anthem Blue Access Choice,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Preferred,Anthem Blue Preferred,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Pathway,Anthem Pathway,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Alliance,Anthem Alliance,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Medicare,Anthem Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna,Cigna,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna PPO,Cigna PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna Medicare Advantage,Cigna Medicare Advantage,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Essence,Essence,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink HMO,Healthlink HMO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink PPO,Healthlink PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,HomeState Health Plan,HomeState Health Plan,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Humana Gold,Humana Gold,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Medicaid MO,Medicaid MO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Medica,Medica,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Tricare,Tricare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC All Payer,UHC All Payer,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Exchange,UHC Exchange,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicaid,UHC Medicaid,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,UMR CPD,UMR CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicare,UHC Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
"SHOE, POST OP (ALL)           ",33150356,CDM,270,RC,,,,,,Inpatient,,,38,38,Wellcare,Wellcare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Meritain Health PPO CPD,Meritain Health PPO CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna/Commercial Product,Aetna/Commercial Product,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Meritain Health CPD,Meritain Health CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Starmark CPD,Starmark CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Aetna Medicare,Aetna Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Ambetter ,Ambetter ,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Access,Anthem Blue Access,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Access Choice,Anthem Blue Access Choice,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Blue Preferred,Anthem Blue Preferred,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Pathway,Anthem Pathway,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Alliance,Anthem Alliance,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Anthem Medicare,Anthem Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna,Cigna,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna PPO,Cigna PPO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Cigna Medicare Advantage,Cigna Medicare Advantage,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Essence,Essence,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthlink HMO,Healthlink HMO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Healthlink PPO,Healthlink PPO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,HomeState Health Plan,HomeState Health Plan,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Humana Gold,Humana Gold,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Medicaid MO,Medicaid MO,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Medica,Medica,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Tricare,Tricare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC All Payer,UHC All Payer,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Exchange,UHC Exchange,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Medicaid,UHC Medicaid,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,UMR CPD,UMR CPD,43,,,,,,,per diem,43,43,"Per diem rate, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,UHC Medicare,UHC Medicare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SLING KNEE                    ,33150363,CDM,270,RC,,,,,,Inpatient,,,43,43,Wellcare,Wellcare,43,,,,,,,case rate,43,43,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health PPO CPD,Meritain Health PPO CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna/Commercial Product,Aetna/Commercial Product,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Meritain Health CPD,Meritain Health CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Starmark CPD,Starmark CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Aetna Medicare,Aetna Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Ambetter ,Ambetter ,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access,Anthem Blue Access,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Access Choice,Anthem Blue Access Choice,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Blue Preferred,Anthem Blue Preferred,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Pathway,Anthem Pathway,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Alliance,Anthem Alliance,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Anthem Medicare,Anthem Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna,Cigna,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna PPO,Cigna PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Cigna Medicare Advantage,Cigna Medicare Advantage,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Essence,Essence,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink HMO,Healthlink HMO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Healthlink PPO,Healthlink PPO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,HomeState Health Plan,HomeState Health Plan,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Humana Gold,Humana Gold,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Medicaid MO,Medicaid MO,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Medica,Medica,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Tricare,Tricare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC All Payer,UHC All Payer,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Exchange,UHC Exchange,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicaid,UHC Medicaid,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,UMR CPD,UMR CPD,38,,,,,,,per diem,38,38,"Per diem rate, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,UHC Medicare,UHC Medicare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 2in-4in           ,33150371,CDM,270,RC,,,,,,Inpatient,,,38,38,Wellcare,Wellcare,38,,,,,,,case rate,38,38,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
SPLINT ROLL 5in x 30in        ,33150372,CDM,270,RC,,,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALPHA EXCELL OVLY MATT - RENTA,33150487,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATE LOW-AIR LOSS MATTRES,33150488,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Meritain Health PPO CPD,Meritain Health PPO CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna/Commercial Product,Aetna/Commercial Product,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Meritain Health CPD,Meritain Health CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Starmark CPD,Starmark CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Aetna Medicare,Aetna Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Ambetter ,Ambetter ,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Access,Anthem Blue Access,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Access Choice,Anthem Blue Access Choice,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Blue Preferred,Anthem Blue Preferred,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Pathway,Anthem Pathway,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Alliance,Anthem Alliance,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Anthem Medicare,Anthem Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna,Cigna,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna PPO,Cigna PPO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Cigna Medicare Advantage,Cigna Medicare Advantage,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Essence,Essence,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthlink HMO,Healthlink HMO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Healthlink PPO,Healthlink PPO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,HomeState Health Plan,HomeState Health Plan,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Humana Gold,Humana Gold,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Medicaid MO,Medicaid MO,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Medica,Medica,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Tricare,Tricare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC All Payer,UHC All Payer,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Exchange,UHC Exchange,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Medicaid,UHC Medicaid,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UMR CPD,UMR CPD,16.5,,,,,,,per diem,16.5,16.5,"Per diem rate, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,UHC Medicare,UHC Medicare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
ALTERNATING PRESSURE MATTRESS ,33150489,CDM,279,RC,,,,,,Inpatient,,,16.5,16.5,Wellcare,Wellcare,16.5,,,,,,,case rate,16.5,16.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health PPO CPD,Meritain Health PPO CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/Commercial Product,Aetna/Commercial Product,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health CPD,Meritain Health CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Starmark CPD,Starmark CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna Medicare,Aetna Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Ambetter ,Ambetter ,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access,Anthem Blue Access,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access Choice,Anthem Blue Access Choice,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Preferred,Anthem Blue Preferred,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Pathway,Anthem Pathway,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Alliance,Anthem Alliance,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Medicare,Anthem Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna,Cigna,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna PPO,Cigna PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna Medicare Advantage,Cigna Medicare Advantage,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Essence,Essence,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink HMO,Healthlink HMO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink PPO,Healthlink PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,HomeState Health Plan,HomeState Health Plan,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Humana Gold,Humana Gold,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medicaid MO,Medicaid MO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medica,Medica,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Tricare,Tricare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC All Payer,UHC All Payer,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Exchange,UHC Exchange,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicaid,UHC Medicaid,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UMR CPD,UMR CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicare,UHC Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
AUTO EXCELL MATTRESS DAILY REN,33150490,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Wellcare,Wellcare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARI WCHAIR W/ELECT REC RENT  ,33150491,CDM,279,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Meritain Health PPO CPD,Meritain Health PPO CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna/Commercial Product,Aetna/Commercial Product,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Meritain Health CPD,Meritain Health CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Starmark CPD,Starmark CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Aetna Medicare,Aetna Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Ambetter ,Ambetter ,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Access,Anthem Blue Access,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Access Choice,Anthem Blue Access Choice,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Blue Preferred,Anthem Blue Preferred,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Pathway,Anthem Pathway,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Alliance,Anthem Alliance,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Anthem Medicare,Anthem Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna,Cigna,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna PPO,Cigna PPO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Cigna Medicare Advantage,Cigna Medicare Advantage,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Essence,Essence,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthlink HMO,Healthlink HMO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Healthlink PPO,Healthlink PPO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,HomeState Health Plan,HomeState Health Plan,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Humana Gold,Humana Gold,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Medicaid MO,Medicaid MO,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Medica,Medica,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Tricare,Tricare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC All Payer,UHC All Payer,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Exchange,UHC Exchange,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Medicaid,UHC Medicaid,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UMR CPD,UMR CPD,166.5,,,,,,,per diem,166.5,166.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,UHC Medicare,UHC Medicare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED - REHAB - RENTAL,33150492,CDM,279,RC,,,,,,Inpatient,,,166.5,166.5,Wellcare,Wellcare,166.5,,,,,,,case rate,166.5,166.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED (CONTOURA 880) R,33150493,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Meritain Health PPO CPD,Meritain Health PPO CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna/Commercial Product,Aetna/Commercial Product,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Meritain Health CPD,Meritain Health CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Starmark CPD,Starmark CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Aetna Medicare,Aetna Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Ambetter ,Ambetter ,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Access,Anthem Blue Access,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Access Choice,Anthem Blue Access Choice,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Blue Preferred,Anthem Blue Preferred,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Pathway,Anthem Pathway,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Alliance,Anthem Alliance,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Anthem Medicare,Anthem Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna,Cigna,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna PPO,Cigna PPO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Cigna Medicare Advantage,Cigna Medicare Advantage,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Essence,Essence,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthlink HMO,Healthlink HMO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Healthlink PPO,Healthlink PPO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,HomeState Health Plan,HomeState Health Plan,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Humana Gold,Humana Gold,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Medicaid MO,Medicaid MO,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Medica,Medica,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Tricare,Tricare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC All Payer,UHC All Payer,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Exchange,UHC Exchange,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Medicaid,UHC Medicaid,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,UMR CPD,UMR CPD,73,,,,,,,per diem,73,73,"Per diem rate, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,UHC Medicare,UHC Medicare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED TRIFLEX BLOWER A,33150494,CDM,279,RC,,,,,,Inpatient,,,73,73,Wellcare,Wellcare,73,,,,,,,case rate,73,73,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health PPO CPD,Meritain Health PPO CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/Commercial Product,Aetna/Commercial Product,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health CPD,Meritain Health CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Starmark CPD,Starmark CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna Medicare,Aetna Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Ambetter ,Ambetter ,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access,Anthem Blue Access,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access Choice,Anthem Blue Access Choice,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Preferred,Anthem Blue Preferred,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Pathway,Anthem Pathway,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Alliance,Anthem Alliance,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Medicare,Anthem Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna,Cigna,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna PPO,Cigna PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna Medicare Advantage,Cigna Medicare Advantage,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Essence,Essence,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink HMO,Healthlink HMO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink PPO,Healthlink PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,HomeState Health Plan,HomeState Health Plan,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Humana Gold,Humana Gold,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medicaid MO,Medicaid MO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medica,Medica,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Tricare,Tricare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC All Payer,UHC All Payer,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Exchange,UHC Exchange,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicaid,UHC Medicaid,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UMR CPD,UMR CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicare,UHC Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC BED-REHAB PLTFRM W/M,33150495,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Wellcare,Wellcare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Meritain Health PPO CPD,Meritain Health PPO CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna/Commercial Product,Aetna/Commercial Product,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Meritain Health CPD,Meritain Health CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Starmark CPD,Starmark CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Aetna Medicare,Aetna Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Ambetter ,Ambetter ,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Access,Anthem Blue Access,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Access Choice,Anthem Blue Access Choice,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Blue Preferred,Anthem Blue Preferred,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Pathway,Anthem Pathway,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Alliance,Anthem Alliance,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Anthem Medicare,Anthem Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna,Cigna,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna PPO,Cigna PPO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Cigna Medicare Advantage,Cigna Medicare Advantage,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Essence,Essence,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthlink HMO,Healthlink HMO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Healthlink PPO,Healthlink PPO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,HomeState Health Plan,HomeState Health Plan,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Humana Gold,Humana Gold,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Medicaid MO,Medicaid MO,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Medica,Medica,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Tricare,Tricare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC All Payer,UHC All Payer,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Exchange,UHC Exchange,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Medicaid,UHC Medicaid,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UMR CPD,UMR CPD,20.5,,,,,,,per diem,20.5,20.5,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,UHC Medicare,UHC Medicare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE RENTAL (700l,33150496,CDM,279,RC,,,,,,Inpatient,,,20.5,20.5,Wellcare,Wellcare,20.5,,,,,,,case rate,20.5,20.5,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health PPO CPD,Meritain Health PPO CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/Commercial Product,Aetna/Commercial Product,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health CPD,Meritain Health CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Starmark CPD,Starmark CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna Medicare,Aetna Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Ambetter ,Ambetter ,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access,Anthem Blue Access,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access Choice,Anthem Blue Access Choice,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Preferred,Anthem Blue Preferred,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Pathway,Anthem Pathway,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Alliance,Anthem Alliance,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Medicare,Anthem Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna,Cigna,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna PPO,Cigna PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna Medicare Advantage,Cigna Medicare Advantage,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Essence,Essence,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink HMO,Healthlink HMO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink PPO,Healthlink PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,HomeState Health Plan,HomeState Health Plan,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Humana Gold,Humana Gold,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Medicaid MO,Medicaid MO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Medica,Medica,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Tricare,Tricare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC All Payer,UHC All Payer,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Exchange,UHC Exchange,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicaid,UHC Medicaid,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,UMR CPD,UMR CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicare,UHC Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC COMMODE/SHOWER CHAIR,33150497,CDM,279,RC,,,,,,Inpatient,,,50,50,Wellcare,Wellcare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health PPO CPD,Meritain Health PPO CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/Commercial Product,Aetna/Commercial Product,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health CPD,Meritain Health CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Starmark CPD,Starmark CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna Medicare,Aetna Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Ambetter ,Ambetter ,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access,Anthem Blue Access,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access Choice,Anthem Blue Access Choice,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Preferred,Anthem Blue Preferred,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Pathway,Anthem Pathway,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Alliance,Anthem Alliance,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Medicare,Anthem Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna,Cigna,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna PPO,Cigna PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna Medicare Advantage,Cigna Medicare Advantage,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Essence,Essence,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink HMO,Healthlink HMO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink PPO,Healthlink PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,HomeState Health Plan,HomeState Health Plan,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Humana Gold,Humana Gold,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Medicaid MO,Medicaid MO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Medica,Medica,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Tricare,Tricare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC All Payer,UHC All Payer,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Exchange,UHC Exchange,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicaid,UHC Medicaid,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,UMR CPD,UMR CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicare,UHC Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WALKER DAILY RENTAL ,33150498,CDM,279,RC,,,,,,Inpatient,,,4,4,Wellcare,Wellcare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health PPO CPD,Meritain Health PPO CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna/Commercial Product,Aetna/Commercial Product,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Meritain Health CPD,Meritain Health CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Starmark CPD,Starmark CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Aetna Medicare,Aetna Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Ambetter ,Ambetter ,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access,Anthem Blue Access,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Access Choice,Anthem Blue Access Choice,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Blue Preferred,Anthem Blue Preferred,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Pathway,Anthem Pathway,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Alliance,Anthem Alliance,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Anthem Medicare,Anthem Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna,Cigna,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna PPO,Cigna PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Cigna Medicare Advantage,Cigna Medicare Advantage,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Essence,Essence,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink HMO,Healthlink HMO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Healthlink PPO,Healthlink PPO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,HomeState Health Plan,HomeState Health Plan,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Humana Gold,Humana Gold,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Medicaid MO,Medicaid MO,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Medica,Medica,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Tricare,Tricare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC All Payer,UHC All Payer,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Exchange,UHC Exchange,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicaid,UHC Medicaid,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,UMR CPD,UMR CPD,50,,,,,,,per diem,50,50,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,UHC Medicare,UHC Medicare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR 750lb CAP,33150499,CDM,279,RC,,,,,,Inpatient,,,50,50,Wellcare,Wellcare,50,,,,,,,case rate,50,50,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BARIATRIC WHEELCHAIR RENTAL   ,33150500,CDM,279,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health PPO CPD,Meritain Health PPO CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna/Commercial Product,Aetna/Commercial Product,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Meritain Health CPD,Meritain Health CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Starmark CPD,Starmark CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Aetna Medicare,Aetna Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Ambetter ,Ambetter ,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access,Anthem Blue Access,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Access Choice,Anthem Blue Access Choice,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Blue Preferred,Anthem Blue Preferred,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Pathway,Anthem Pathway,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Alliance,Anthem Alliance,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Anthem Medicare,Anthem Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna,Cigna,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna PPO,Cigna PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Cigna Medicare Advantage,Cigna Medicare Advantage,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Essence,Essence,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink HMO,Healthlink HMO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Healthlink PPO,Healthlink PPO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,HomeState Health Plan,HomeState Health Plan,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Humana Gold,Humana Gold,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Medicaid MO,Medicaid MO,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Medica,Medica,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Tricare,Tricare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC All Payer,UHC All Payer,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Exchange,UHC Exchange,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicaid,UHC Medicaid,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,UMR CPD,UMR CPD,4,,,,,,,per diem,4,4,"Per diem rate, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,UHC Medicare,UHC Medicare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BED FLOOR MAT DAILY RENTAL    ,33150502,CDM,279,RC,,,,,,Inpatient,,,4,4,Wellcare,Wellcare,4,,,,,,,case rate,4,4,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health PPO CPD,Meritain Health PPO CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/Commercial Product,Aetna/Commercial Product,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health CPD,Meritain Health CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Starmark CPD,Starmark CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna Medicare,Aetna Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Ambetter ,Ambetter ,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access,Anthem Blue Access,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access Choice,Anthem Blue Access Choice,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Preferred,Anthem Blue Preferred,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Pathway,Anthem Pathway,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Alliance,Anthem Alliance,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Medicare,Anthem Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna,Cigna,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna PPO,Cigna PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna Medicare Advantage,Cigna Medicare Advantage,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Essence,Essence,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink HMO,Healthlink HMO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink PPO,Healthlink PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,HomeState Health Plan,HomeState Health Plan,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Humana Gold,Humana Gold,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Medicaid MO,Medicaid MO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Medica,Medica,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Tricare,Tricare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC All Payer,UHC All Payer,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Exchange,UHC Exchange,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicaid,UHC Medicaid,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,UMR CPD,UMR CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicare,UHC Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BI-PAP DAILY RENTAL (FREEDOM) ,33150503,CDM,279,RC,,,,,,Inpatient,,,30,30,Wellcare,Wellcare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BREEZE AIR MATTRESS DAILY RENT,33150504,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Meritain Health PPO CPD,Meritain Health PPO CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Aetna/Commercial Product,Aetna/Commercial Product,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Meritain Health CPD,Meritain Health CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Starmark CPD,Starmark CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Aetna Medicare,Aetna Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Ambetter ,Ambetter ,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Blue Access,Anthem Blue Access,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Blue Access Choice,Anthem Blue Access Choice,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Blue Preferred,Anthem Blue Preferred,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Pathway,Anthem Pathway,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Alliance,Anthem Alliance,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Anthem Medicare,Anthem Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Cigna,Cigna,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Cigna PPO,Cigna PPO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Cigna Medicare Advantage,Cigna Medicare Advantage,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Essence,Essence,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Healthlink HMO,Healthlink HMO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Healthlink PPO,Healthlink PPO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,HomeState Health Plan,HomeState Health Plan,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Humana Gold,Humana Gold,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Medicaid MO,Medicaid MO,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Medica,Medica,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Tricare,Tricare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,UHC All Payer,UHC All Payer,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,UHC Exchange,UHC Exchange,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,UHC Medicaid,UHC Medicaid,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,UMR CPD,UMR CPD,44,,,,,,,per diem,44,44,"Per diem rate, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,UHC Medicare,UHC Medicare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BUMPER GUARD-RENT             ,33150505,CDM,279,RC,,,,,,Inpatient,,,44,44,Wellcare,Wellcare,44,,,,,,,case rate,44,44,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Meritain Health PPO CPD,Meritain Health PPO CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna/Commercial Product,Aetna/Commercial Product,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Meritain Health CPD,Meritain Health CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Starmark CPD,Starmark CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Aetna Medicare,Aetna Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Ambetter ,Ambetter ,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Access,Anthem Blue Access,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Access Choice,Anthem Blue Access Choice,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Blue Preferred,Anthem Blue Preferred,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Pathway,Anthem Pathway,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Alliance,Anthem Alliance,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Anthem Medicare,Anthem Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna,Cigna,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna PPO,Cigna PPO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Cigna Medicare Advantage,Cigna Medicare Advantage,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Essence,Essence,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthlink HMO,Healthlink HMO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Healthlink PPO,Healthlink PPO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,HomeState Health Plan,HomeState Health Plan,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Humana Gold,Humana Gold,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Medicaid MO,Medicaid MO,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Medica,Medica,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Tricare,Tricare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC All Payer,UHC All Payer,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Exchange,UHC Exchange,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Medicaid,UHC Medicaid,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,UMR CPD,UMR CPD,125,,,,,,,per diem,125,125,"Per diem rate, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,UHC Medicare,UHC Medicare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
BURKE TRIFLEX BARIATRIC BED RE,33150506,CDM,279,RC,,,,,,Inpatient,,,125,125,Wellcare,Wellcare,125,,,,,,,case rate,125,125,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CAMTEK RECLINING WHEELCHAIR RE,33150507,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health PPO CPD,Meritain Health PPO CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/Commercial Product,Aetna/Commercial Product,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health CPD,Meritain Health CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Starmark CPD,Starmark CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna Medicare,Aetna Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Ambetter ,Ambetter ,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access,Anthem Blue Access,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access Choice,Anthem Blue Access Choice,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Preferred,Anthem Blue Preferred,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Pathway,Anthem Pathway,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Alliance,Anthem Alliance,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Medicare,Anthem Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna,Cigna,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna PPO,Cigna PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna Medicare Advantage,Cigna Medicare Advantage,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Essence,Essence,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink HMO,Healthlink HMO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink PPO,Healthlink PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,HomeState Health Plan,HomeState Health Plan,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Humana Gold,Humana Gold,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Medicaid MO,Medicaid MO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Medica,Medica,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Tricare,Tricare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC All Payer,UHC All Payer,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Exchange,UHC Exchange,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicaid,UHC Medicaid,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,UMR CPD,UMR CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicare,UHC Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 1080- BARIATRIC BED D,33150508,CDM,279,RC,,,,,,Inpatient,,,156,156,Wellcare,Wellcare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health PPO CPD,Meritain Health PPO CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/Commercial Product,Aetna/Commercial Product,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health CPD,Meritain Health CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Starmark CPD,Starmark CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna Medicare,Aetna Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Ambetter ,Ambetter ,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access,Anthem Blue Access,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access Choice,Anthem Blue Access Choice,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Preferred,Anthem Blue Preferred,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Pathway,Anthem Pathway,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Alliance,Anthem Alliance,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Medicare,Anthem Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna,Cigna,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna PPO,Cigna PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna Medicare Advantage,Cigna Medicare Advantage,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Essence,Essence,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink HMO,Healthlink HMO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink PPO,Healthlink PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,HomeState Health Plan,HomeState Health Plan,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Humana Gold,Humana Gold,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Medicaid MO,Medicaid MO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Medica,Medica,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Tricare,Tricare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC All Payer,UHC All Payer,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Exchange,UHC Exchange,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicaid,UHC Medicaid,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,UMR CPD,UMR CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicare,UHC Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CONTOURA 980 - BARIATRIC BED D,33150509,CDM,279,RC,,,,,,Inpatient,,,135,135,Wellcare,Wellcare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Meritain Health PPO CPD,Meritain Health PPO CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna/Commercial Product,Aetna/Commercial Product,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Meritain Health CPD,Meritain Health CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Starmark CPD,Starmark CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Aetna Medicare,Aetna Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Ambetter ,Ambetter ,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Access,Anthem Blue Access,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Access Choice,Anthem Blue Access Choice,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Blue Preferred,Anthem Blue Preferred,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Pathway,Anthem Pathway,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Alliance,Anthem Alliance,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Anthem Medicare,Anthem Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna,Cigna,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna PPO,Cigna PPO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Cigna Medicare Advantage,Cigna Medicare Advantage,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Essence,Essence,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthlink HMO,Healthlink HMO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Healthlink PPO,Healthlink PPO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,HomeState Health Plan,HomeState Health Plan,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Humana Gold,Humana Gold,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Medicaid MO,Medicaid MO,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Medica,Medica,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Tricare,Tricare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC All Payer,UHC All Payer,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Exchange,UHC Exchange,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Medicaid,UHC Medicaid,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UMR CPD,UMR CPD,10.5,,,,,,,per diem,10.5,10.5,"Per diem rate, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,UHC Medicare,UHC Medicare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPAP UNIT DAILY RENTAL CONT PO,33150511,CDM,279,RC,,,,,,Inpatient,,,10.5,10.5,Wellcare,Wellcare,10.5,,,,,,,case rate,10.5,10.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health PPO CPD,Meritain Health PPO CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/Commercial Product,Aetna/Commercial Product,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health CPD,Meritain Health CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Starmark CPD,Starmark CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna Medicare,Aetna Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Ambetter ,Ambetter ,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access,Anthem Blue Access,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access Choice,Anthem Blue Access Choice,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Preferred,Anthem Blue Preferred,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Pathway,Anthem Pathway,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Alliance,Anthem Alliance,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Medicare,Anthem Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna,Cigna,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna PPO,Cigna PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna Medicare Advantage,Cigna Medicare Advantage,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Essence,Essence,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink HMO,Healthlink HMO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink PPO,Healthlink PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,HomeState Health Plan,HomeState Health Plan,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Humana Gold,Humana Gold,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medicaid MO,Medicaid MO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medica,Medica,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Tricare,Tricare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC All Payer,UHC All Payer,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Exchange,UHC Exchange,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicaid,UHC Medicaid,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UMR CPD,UMR CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicare,UHC Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM KNEE DAILY RENTAL         ,33150512,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Wellcare,Wellcare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Meritain Health PPO CPD,Meritain Health PPO CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna/Commercial Product,Aetna/Commercial Product,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Meritain Health CPD,Meritain Health CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Starmark CPD,Starmark CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Aetna Medicare,Aetna Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Ambetter ,Ambetter ,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Access,Anthem Blue Access,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Access Choice,Anthem Blue Access Choice,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Blue Preferred,Anthem Blue Preferred,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Pathway,Anthem Pathway,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Alliance,Anthem Alliance,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Anthem Medicare,Anthem Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna,Cigna,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna PPO,Cigna PPO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Cigna Medicare Advantage,Cigna Medicare Advantage,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Essence,Essence,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthlink HMO,Healthlink HMO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Healthlink PPO,Healthlink PPO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,HomeState Health Plan,HomeState Health Plan,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Humana Gold,Humana Gold,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Medicaid MO,Medicaid MO,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Medica,Medica,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Tricare,Tricare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC All Payer,UHC All Payer,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Exchange,UHC Exchange,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Medicaid,UHC Medicaid,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,UMR CPD,UMR CPD,53,,,,,,,per diem,53,53,"Per diem rate, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,UHC Medicare,UHC Medicare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CPM MACHINE DAILY RENTAL      ,33150513,CDM,279,RC,,,,,,Inpatient,,,53,53,Wellcare,Wellcare,53,,,,,,,case rate,53,53,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health PPO CPD,Meritain Health PPO CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/Commercial Product,Aetna/Commercial Product,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health CPD,Meritain Health CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Starmark CPD,Starmark CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna Medicare,Aetna Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Ambetter ,Ambetter ,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access,Anthem Blue Access,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access Choice,Anthem Blue Access Choice,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Preferred,Anthem Blue Preferred,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Pathway,Anthem Pathway,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Alliance,Anthem Alliance,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Medicare,Anthem Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna,Cigna,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna PPO,Cigna PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna Medicare Advantage,Cigna Medicare Advantage,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Essence,Essence,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink HMO,Healthlink HMO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink PPO,Healthlink PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,HomeState Health Plan,HomeState Health Plan,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Humana Gold,Humana Gold,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Medicaid MO,Medicaid MO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Medica,Medica,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Tricare,Tricare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC All Payer,UHC All Payer,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Exchange,UHC Exchange,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicaid,UHC Medicaid,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,UMR CPD,UMR CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicare,UHC Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
CRADLE FOOT ND-RENT           ,33150515,CDM,279,RC,,,,,,Inpatient,,,30,30,Wellcare,Wellcare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP HEAT LAMP               ,33150517,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health PPO CPD,Meritain Health PPO CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna/Commercial Product,Aetna/Commercial Product,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Meritain Health CPD,Meritain Health CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Starmark CPD,Starmark CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Aetna Medicare,Aetna Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Ambetter ,Ambetter ,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access,Anthem Blue Access,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Access Choice,Anthem Blue Access Choice,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Blue Preferred,Anthem Blue Preferred,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Pathway,Anthem Pathway,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Alliance,Anthem Alliance,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Anthem Medicare,Anthem Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna,Cigna,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna PPO,Cigna PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Cigna Medicare Advantage,Cigna Medicare Advantage,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Essence,Essence,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink HMO,Healthlink HMO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Healthlink PPO,Healthlink PPO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,HomeState Health Plan,HomeState Health Plan,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Humana Gold,Humana Gold,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Medicaid MO,Medicaid MO,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Medica,Medica,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Tricare,Tricare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC All Payer,UHC All Payer,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Exchange,UHC Exchange,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicaid,UHC Medicaid,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,UMR CPD,UMR CPD,25,,,,,,,per diem,25,25,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,UHC Medicare,UHC Medicare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-EMERSON PUMP    ,33150518,CDM,279,RC,,,,,,Inpatient,,,25,25,Wellcare,Wellcare,25,,,,,,,case rate,25,25,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Meritain Health PPO CPD,Meritain Health PPO CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna/Commercial Product,Aetna/Commercial Product,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Meritain Health CPD,Meritain Health CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Starmark CPD,Starmark CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Aetna Medicare,Aetna Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Ambetter ,Ambetter ,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Access,Anthem Blue Access,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Access Choice,Anthem Blue Access Choice,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Blue Preferred,Anthem Blue Preferred,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Pathway,Anthem Pathway,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Alliance,Anthem Alliance,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Anthem Medicare,Anthem Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna,Cigna,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna PPO,Cigna PPO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Cigna Medicare Advantage,Cigna Medicare Advantage,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Essence,Essence,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthlink HMO,Healthlink HMO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Healthlink PPO,Healthlink PPO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,HomeState Health Plan,HomeState Health Plan,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Humana Gold,Humana Gold,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Medicaid MO,Medicaid MO,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Medica,Medica,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Tricare,Tricare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC All Payer,UHC All Payer,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Exchange,UHC Exchange,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Medicaid,UHC Medicaid,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,UMR CPD,UMR CPD,78,,,,,,,per diem,78,78,"Per diem rate, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,UHC Medicare,UHC Medicare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP PERDIEM-KNEE EXERCISER  ,33150519,CDM,279,RC,,,,,,Inpatient,,,78,78,Wellcare,Wellcare,78,,,,,,,case rate,78,78,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Meritain Health PPO CPD,Meritain Health PPO CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna/Commercial Product,Aetna/Commercial Product,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Meritain Health CPD,Meritain Health CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Starmark CPD,Starmark CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Aetna Medicare,Aetna Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Ambetter ,Ambetter ,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Access,Anthem Blue Access,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Access Choice,Anthem Blue Access Choice,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Blue Preferred,Anthem Blue Preferred,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Pathway,Anthem Pathway,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Alliance,Anthem Alliance,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Anthem Medicare,Anthem Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna,Cigna,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna PPO,Cigna PPO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Cigna Medicare Advantage,Cigna Medicare Advantage,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Essence,Essence,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthlink HMO,Healthlink HMO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Healthlink PPO,Healthlink PPO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,HomeState Health Plan,HomeState Health Plan,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Humana Gold,Humana Gold,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Medicaid MO,Medicaid MO,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Medica,Medica,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Tricare,Tricare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC All Payer,UHC All Payer,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Exchange,UHC Exchange,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Medicaid,UHC Medicaid,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UMR CPD,UMR CPD,200.5,,,,,,,per diem,200.5,200.5,"Per diem rate, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,UHC Medicare,UHC Medicare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP T-WALKER                ,33150520,CDM,279,RC,,,,,,Inpatient,,,200.5,200.5,Wellcare,Wellcare,200.5,,,,,,,case rate,200.5,200.5,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health PPO CPD,Meritain Health PPO CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna/Commercial Product,Aetna/Commercial Product,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Meritain Health CPD,Meritain Health CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Starmark CPD,Starmark CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Aetna Medicare,Aetna Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Ambetter ,Ambetter ,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access,Anthem Blue Access,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Access Choice,Anthem Blue Access Choice,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Blue Preferred,Anthem Blue Preferred,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Pathway,Anthem Pathway,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Alliance,Anthem Alliance,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Anthem Medicare,Anthem Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna,Cigna,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna PPO,Cigna PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Cigna Medicare Advantage,Cigna Medicare Advantage,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Essence,Essence,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink HMO,Healthlink HMO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Healthlink PPO,Healthlink PPO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,HomeState Health Plan,HomeState Health Plan,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Humana Gold,Humana Gold,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Medicaid MO,Medicaid MO,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Medica,Medica,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Tricare,Tricare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC All Payer,UHC All Payer,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Exchange,UHC Exchange,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicaid,UHC Medicaid,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,UMR CPD,UMR CPD,54,,,,,,,per diem,54,54,"Per diem rate, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,UHC Medicare,UHC Medicare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP WALKER                  ,33150521,CDM,279,RC,,,,,,Inpatient,,,54,54,Wellcare,Wellcare,54,,,,,,,case rate,54,54,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE PADS    ,33150522,CDM,279,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Meritain Health PPO CPD,Meritain Health PPO CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna/Commercial Product,Aetna/Commercial Product,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Meritain Health CPD,Meritain Health CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Starmark CPD,Starmark CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Aetna Medicare,Aetna Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Ambetter ,Ambetter ,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Access,Anthem Blue Access,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Access Choice,Anthem Blue Access Choice,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Blue Preferred,Anthem Blue Preferred,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Pathway,Anthem Pathway,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Alliance,Anthem Alliance,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Anthem Medicare,Anthem Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna,Cigna,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna PPO,Cigna PPO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Cigna Medicare Advantage,Cigna Medicare Advantage,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Essence,Essence,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthlink HMO,Healthlink HMO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Healthlink PPO,Healthlink PPO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,HomeState Health Plan,HomeState Health Plan,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Humana Gold,Humana Gold,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Medicaid MO,Medicaid MO,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Medica,Medica,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Tricare,Tricare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC All Payer,UHC All Payer,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Exchange,UHC Exchange,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Medicaid,UHC Medicaid,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UMR CPD,UMR CPD,43.5,,,,,,,per diem,43.5,43.5,"Per diem rate, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,UHC Medicare,UHC Medicare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP.HOT/ICE MACHINE-PERDIEM ,33150523,CDM,279,RC,,,,,,Inpatient,,,43.5,43.5,Wellcare,Wellcare,43.5,,,,,,,case rate,43.5,43.5,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-AQUA K PAD              ,33150524,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health PPO CPD,Meritain Health PPO CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/Commercial Product,Aetna/Commercial Product,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health CPD,Meritain Health CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Starmark CPD,Starmark CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna Medicare,Aetna Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Ambetter ,Ambetter ,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access,Anthem Blue Access,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access Choice,Anthem Blue Access Choice,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Preferred,Anthem Blue Preferred,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Pathway,Anthem Pathway,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Alliance,Anthem Alliance,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Medicare,Anthem Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna,Cigna,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna PPO,Cigna PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna Medicare Advantage,Cigna Medicare Advantage,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Essence,Essence,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink HMO,Healthlink HMO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink PPO,Healthlink PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,HomeState Health Plan,HomeState Health Plan,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Humana Gold,Humana Gold,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medicaid MO,Medicaid MO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medica,Medica,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Tricare,Tricare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC All Payer,UHC All Payer,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Exchange,UHC Exchange,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicaid,UHC Medicaid,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UMR CPD,UMR CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicare,UHC Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150525,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Wellcare,Wellcare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health PPO CPD,Meritain Health PPO CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna/Commercial Product,Aetna/Commercial Product,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Meritain Health CPD,Meritain Health CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Starmark CPD,Starmark CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Aetna Medicare,Aetna Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Ambetter ,Ambetter ,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access,Anthem Blue Access,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Access Choice,Anthem Blue Access Choice,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Blue Preferred,Anthem Blue Preferred,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Pathway,Anthem Pathway,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Alliance,Anthem Alliance,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Anthem Medicare,Anthem Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna,Cigna,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna PPO,Cigna PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Cigna Medicare Advantage,Cigna Medicare Advantage,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Essence,Essence,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink HMO,Healthlink HMO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Healthlink PPO,Healthlink PPO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,HomeState Health Plan,HomeState Health Plan,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Humana Gold,Humana Gold,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medicaid MO,Medicaid MO,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Medica,Medica,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Tricare,Tricare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC All Payer,UHC All Payer,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Exchange,UHC Exchange,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicaid,UHC Medicaid,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UMR CPD,UMR CPD,122.5,,,,,,,per diem,122.5,122.5,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,UHC Medicare,UHC Medicare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP PADS  ,33150526,CDM,279,RC,,,,,,Inpatient,,,122.5,122.5,Wellcare,Wellcare,122.5,,,,,,,case rate,122.5,122.5,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health PPO CPD,Meritain Health PPO CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/Commercial Product,Aetna/Commercial Product,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health CPD,Meritain Health CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Starmark CPD,Starmark CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna Medicare,Aetna Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Ambetter ,Ambetter ,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access,Anthem Blue Access,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access Choice,Anthem Blue Access Choice,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Preferred,Anthem Blue Preferred,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Pathway,Anthem Pathway,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Alliance,Anthem Alliance,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Medicare,Anthem Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna,Cigna,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna PPO,Cigna PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna Medicare Advantage,Cigna Medicare Advantage,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Essence,Essence,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink HMO,Healthlink HMO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink PPO,Healthlink PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,HomeState Health Plan,HomeState Health Plan,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Humana Gold,Humana Gold,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Medicaid MO,Medicaid MO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Medica,Medica,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Tricare,Tricare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC All Payer,UHC All Payer,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Exchange,UHC Exchange,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicaid,UHC Medicaid,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,UMR CPD,UMR CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicare,UHC Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150527,CDM,279,RC,,,,,,Inpatient,,,56,56,Wellcare,Wellcare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health PPO CPD,Meritain Health PPO CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna/Commercial Product,Aetna/Commercial Product,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Meritain Health CPD,Meritain Health CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Starmark CPD,Starmark CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Aetna Medicare,Aetna Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Ambetter ,Ambetter ,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access,Anthem Blue Access,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Access Choice,Anthem Blue Access Choice,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Blue Preferred,Anthem Blue Preferred,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Pathway,Anthem Pathway,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Alliance,Anthem Alliance,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Anthem Medicare,Anthem Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna,Cigna,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna PPO,Cigna PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Cigna Medicare Advantage,Cigna Medicare Advantage,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Essence,Essence,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink HMO,Healthlink HMO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Healthlink PPO,Healthlink PPO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,HomeState Health Plan,HomeState Health Plan,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Humana Gold,Humana Gold,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Medicaid MO,Medicaid MO,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Medica,Medica,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Tricare,Tricare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC All Payer,UHC All Payer,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Exchange,UHC Exchange,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicaid,UHC Medicaid,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,UMR CPD,UMR CPD,56,,,,,,,per diem,56,56,"Per diem rate, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,UHC Medicare,UHC Medicare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-FOOT IMPULSE PUMP-DAILY ,33150528,CDM,279,RC,,,,,,Inpatient,,,56,56,Wellcare,Wellcare,56,,,,,,,case rate,56,56,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150529,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health PPO CPD,Meritain Health PPO CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna/Commercial Product,Aetna/Commercial Product,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Meritain Health CPD,Meritain Health CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Starmark CPD,Starmark CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Aetna Medicare,Aetna Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Ambetter ,Ambetter ,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access,Anthem Blue Access,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Access Choice,Anthem Blue Access Choice,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Blue Preferred,Anthem Blue Preferred,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Pathway,Anthem Pathway,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Alliance,Anthem Alliance,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Anthem Medicare,Anthem Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna,Cigna,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna PPO,Cigna PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Cigna Medicare Advantage,Cigna Medicare Advantage,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Essence,Essence,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink HMO,Healthlink HMO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Healthlink PPO,Healthlink PPO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,HomeState Health Plan,HomeState Health Plan,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Humana Gold,Humana Gold,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Medicaid MO,Medicaid MO,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Medica,Medica,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Tricare,Tricare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC All Payer,UHC All Payer,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Exchange,UHC Exchange,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicaid,UHC Medicaid,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,UMR CPD,UMR CPD,48,,,,,,,per diem,48,48,"Per diem rate, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,UHC Medicare,UHC Medicare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-GOMCO                   ,33150530,CDM,279,RC,,,,,,Inpatient,,,48,48,Wellcare,Wellcare,48,,,,,,,case rate,48,48,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health PPO CPD,Meritain Health PPO CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/Commercial Product,Aetna/Commercial Product,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health CPD,Meritain Health CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Starmark CPD,Starmark CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna Medicare,Aetna Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Ambetter ,Ambetter ,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access,Anthem Blue Access,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access Choice,Anthem Blue Access Choice,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Preferred,Anthem Blue Preferred,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Pathway,Anthem Pathway,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Alliance,Anthem Alliance,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Medicare,Anthem Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna,Cigna,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna PPO,Cigna PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna Medicare Advantage,Cigna Medicare Advantage,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Essence,Essence,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink HMO,Healthlink HMO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink PPO,Healthlink PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,HomeState Health Plan,HomeState Health Plan,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Humana Gold,Humana Gold,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Medicaid MO,Medicaid MO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Medica,Medica,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Tricare,Tricare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC All Payer,UHC All Payer,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Exchange,UHC Exchange,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicaid,UHC Medicaid,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,UMR CPD,UMR CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicare,UHC Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150531,CDM,279,RC,,,,,,Inpatient,,,126,126,Wellcare,Wellcare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health PPO CPD,Meritain Health PPO CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna/Commercial Product,Aetna/Commercial Product,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Meritain Health CPD,Meritain Health CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Starmark CPD,Starmark CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Aetna Medicare,Aetna Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Ambetter ,Ambetter ,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access,Anthem Blue Access,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Access Choice,Anthem Blue Access Choice,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Blue Preferred,Anthem Blue Preferred,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Pathway,Anthem Pathway,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Alliance,Anthem Alliance,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Anthem Medicare,Anthem Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna,Cigna,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna PPO,Cigna PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Cigna Medicare Advantage,Cigna Medicare Advantage,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Essence,Essence,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink HMO,Healthlink HMO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Healthlink PPO,Healthlink PPO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,HomeState Health Plan,HomeState Health Plan,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Humana Gold,Humana Gold,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Medicaid MO,Medicaid MO,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Medica,Medica,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Tricare,Tricare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC All Payer,UHC All Payer,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Exchange,UHC Exchange,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicaid,UHC Medicaid,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,UMR CPD,UMR CPD,126,,,,,,,per diem,126,126,"Per diem rate, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,UHC Medicare,UHC Medicare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
EQUIP-TED COMPRESSION DEVICE  ,33150532,CDM,279,RC,,,,,,Inpatient,,,126,126,Wellcare,Wellcare,126,,,,,,,case rate,126,126,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Meritain Health PPO CPD,Meritain Health PPO CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna/Commercial Product,Aetna/Commercial Product,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Meritain Health CPD,Meritain Health CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Starmark CPD,Starmark CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Aetna Medicare,Aetna Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Ambetter ,Ambetter ,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Access,Anthem Blue Access,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Access Choice,Anthem Blue Access Choice,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Blue Preferred,Anthem Blue Preferred,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Pathway,Anthem Pathway,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Alliance,Anthem Alliance,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Anthem Medicare,Anthem Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna,Cigna,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna PPO,Cigna PPO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Cigna Medicare Advantage,Cigna Medicare Advantage,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Essence,Essence,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthlink HMO,Healthlink HMO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Healthlink PPO,Healthlink PPO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,HomeState Health Plan,HomeState Health Plan,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Humana Gold,Humana Gold,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Medicaid MO,Medicaid MO,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Medica,Medica,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Tricare,Tricare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC All Payer,UHC All Payer,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Exchange,UHC Exchange,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Medicaid,UHC Medicaid,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,UMR CPD,UMR CPD,499,,,,,,,per diem,499,499,"Per diem rate, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,UHC Medicare,UHC Medicare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
ERGO BARIATRIC ENVIRO WHOLE RO,33150533,CDM,279,RC,,,,,,Inpatient,,,499,499,Wellcare,Wellcare,499,,,,,,,case rate,499,499,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Meritain Health PPO CPD,Meritain Health PPO CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna/Commercial Product,Aetna/Commercial Product,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Meritain Health CPD,Meritain Health CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Starmark CPD,Starmark CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Aetna Medicare,Aetna Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Ambetter ,Ambetter ,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Access,Anthem Blue Access,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Access Choice,Anthem Blue Access Choice,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Blue Preferred,Anthem Blue Preferred,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Pathway,Anthem Pathway,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Alliance,Anthem Alliance,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Anthem Medicare,Anthem Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna,Cigna,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna PPO,Cigna PPO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Cigna Medicare Advantage,Cigna Medicare Advantage,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Essence,Essence,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthlink HMO,Healthlink HMO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Healthlink PPO,Healthlink PPO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,HomeState Health Plan,HomeState Health Plan,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Humana Gold,Humana Gold,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Medicaid MO,Medicaid MO,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Medica,Medica,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Tricare,Tricare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC All Payer,UHC All Payer,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Exchange,UHC Exchange,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Medicaid,UHC Medicaid,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UMR CPD,UMR CPD,11.5,,,,,,,per diem,11.5,11.5,"Per diem rate, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,UHC Medicare,UHC Medicare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FREEDOM MEDICAL -CPM K-4 DAILY,33150534,CDM,279,RC,,,,,,Inpatient,,,11.5,11.5,Wellcare,Wellcare,11.5,,,,,,,case rate,11.5,11.5,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Meritain Health PPO CPD,Meritain Health PPO CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna/Commercial Product,Aetna/Commercial Product,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Meritain Health CPD,Meritain Health CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Starmark CPD,Starmark CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Aetna Medicare,Aetna Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Ambetter ,Ambetter ,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access,Anthem Blue Access,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Access Choice,Anthem Blue Access Choice,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Blue Preferred,Anthem Blue Preferred,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Pathway,Anthem Pathway,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Alliance,Anthem Alliance,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Anthem Medicare,Anthem Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna,Cigna,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna PPO,Cigna PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Cigna Medicare Advantage,Cigna Medicare Advantage,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Essence,Essence,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthlink HMO,Healthlink HMO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Healthlink PPO,Healthlink PPO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,HomeState Health Plan,HomeState Health Plan,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Humana Gold,Humana Gold,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Medicaid MO,Medicaid MO,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Medica,Medica,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Tricare,Tricare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC All Payer,UHC All Payer,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Exchange,UHC Exchange,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Medicaid,UHC Medicaid,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,UMR CPD,UMR CPD,21,,,,,,,per diem,21,21,"Per diem rate, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,UHC Medicare,UHC Medicare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
FULL FRM TRAPEZE ASSEM RENT   ,33150535,CDM,279,RC,,,,,,Inpatient,,,21,21,Wellcare,Wellcare,21,,,,,,,case rate,21,21,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Meritain Health PPO CPD,Meritain Health PPO CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Aetna/Commercial Product,Aetna/Commercial Product,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Meritain Health CPD,Meritain Health CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Starmark CPD,Starmark CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Aetna Medicare,Aetna Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Ambetter ,Ambetter ,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Blue Access,Anthem Blue Access,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Blue Access Choice,Anthem Blue Access Choice,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Blue Preferred,Anthem Blue Preferred,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Pathway,Anthem Pathway,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Alliance,Anthem Alliance,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Anthem Medicare,Anthem Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Cigna,Cigna,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Cigna PPO,Cigna PPO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Cigna Medicare Advantage,Cigna Medicare Advantage,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Essence,Essence,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Healthlink HMO,Healthlink HMO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Healthlink PPO,Healthlink PPO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,HomeState Health Plan,HomeState Health Plan,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Humana Gold,Humana Gold,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Medicaid MO,Medicaid MO,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Medica,Medica,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Tricare,Tricare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,UHC All Payer,UHC All Payer,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,UHC Exchange,UHC Exchange,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,UHC Medicaid,UHC Medicaid,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,UMR CPD,UMR CPD,74,,,,,,,per diem,74,74,"Per diem rate, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,UHC Medicare,UHC Medicare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEAT MODULE H2O-RENT          ,33150536,CDM,279,RC,,,,,,Inpatient,,,74,74,Wellcare,Wellcare,74,,,,,,,case rate,74,74,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health PPO CPD,Meritain Health PPO CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/Commercial Product,Aetna/Commercial Product,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health CPD,Meritain Health CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Starmark CPD,Starmark CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna Medicare,Aetna Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Ambetter ,Ambetter ,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access,Anthem Blue Access,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access Choice,Anthem Blue Access Choice,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Preferred,Anthem Blue Preferred,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Pathway,Anthem Pathway,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Alliance,Anthem Alliance,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Medicare,Anthem Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna,Cigna,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna PPO,Cigna PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna Medicare Advantage,Cigna Medicare Advantage,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Essence,Essence,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink HMO,Healthlink HMO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink PPO,Healthlink PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,HomeState Health Plan,HomeState Health Plan,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Humana Gold,Humana Gold,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Medicaid MO,Medicaid MO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Medica,Medica,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Tricare,Tricare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC All Payer,UHC All Payer,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Exchange,UHC Exchange,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicaid,UHC Medicaid,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,UMR CPD,UMR CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicare,UHC Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HEMI WHEELCHAIR W/ANTI-TIPPER ,33150537,CDM,279,RC,,,,,,Inpatient,,,7,7,Wellcare,Wellcare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
HUNTLEIGH MINUET 2 BED DAILY R,33150538,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health PPO CPD,Meritain Health PPO CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna/Commercial Product,Aetna/Commercial Product,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Meritain Health CPD,Meritain Health CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Starmark CPD,Starmark CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Aetna Medicare,Aetna Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Ambetter ,Ambetter ,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access,Anthem Blue Access,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Access Choice,Anthem Blue Access Choice,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Blue Preferred,Anthem Blue Preferred,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Pathway,Anthem Pathway,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Alliance,Anthem Alliance,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Anthem Medicare,Anthem Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna,Cigna,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna PPO,Cigna PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Cigna Medicare Advantage,Cigna Medicare Advantage,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Essence,Essence,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink HMO,Healthlink HMO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Healthlink PPO,Healthlink PPO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,HomeState Health Plan,HomeState Health Plan,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Humana Gold,Humana Gold,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Medicaid MO,Medicaid MO,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Medica,Medica,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Tricare,Tricare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC All Payer,UHC All Payer,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Exchange,UHC Exchange,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicaid,UHC Medicaid,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UMR CPD,UMR CPD,160.5,,,,,,,per diem,160.5,160.5,"Per diem rate, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,UHC Medicare,UHC Medicare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI KINAIR MEDSURG PULSE BED D,33150540,CDM,279,RC,,,,,,Inpatient,,,160.5,160.5,Wellcare,Wellcare,160.5,,,,,,,case rate,160.5,160.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC ATS RENTAL      ,33150541,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Meritain Health PPO CPD,Meritain Health PPO CPD,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Aetna/Commercial Product,Aetna/Commercial Product,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Meritain Health CPD,Meritain Health CPD,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Starmark CPD,Starmark CPD,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Aetna Medicare,Aetna Medicare,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Ambetter ,Ambetter ,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Blue Access,Anthem Blue Access,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Blue Access Choice,Anthem Blue Access Choice,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Blue Preferred,Anthem Blue Preferred,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Pathway,Anthem Pathway,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Alliance,Anthem Alliance,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Anthem Medicare,Anthem Medicare,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Cigna,Cigna,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Cigna PPO,Cigna PPO,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Cigna Medicare Advantage,Cigna Medicare Advantage,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Essence,Essence,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Healthlink HMO,Healthlink HMO,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Healthlink PPO,Healthlink PPO,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,HomeState Health Plan,HomeState Health Plan,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Humana Gold,Humana Gold,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Medicaid MO,Medicaid MO,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Medica,Medica,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Tricare,Tricare,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,UHC All Payer,UHC All Payer,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,UHC Exchange,UHC Exchange,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,UHC Medicaid,UHC Medicaid,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,UMR CPD,UMR CPD,146.5,,,,,,,per diem,146.5,146.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,UHC Medicare,UHC Medicare,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC DAILY RENTAL    ,33150542,CDM,279,RC,,,,,,Inpatient,,,146.5,146.5,Wellcare,Wellcare,146.5,,,,,,,case rate,146.5,146.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Meritain Health PPO CPD,Meritain Health PPO CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna/Commercial Product,Aetna/Commercial Product,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Meritain Health CPD,Meritain Health CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Starmark CPD,Starmark CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Aetna Medicare,Aetna Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Ambetter ,Ambetter ,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Access,Anthem Blue Access,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Access Choice,Anthem Blue Access Choice,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Blue Preferred,Anthem Blue Preferred,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Pathway,Anthem Pathway,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Alliance,Anthem Alliance,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Anthem Medicare,Anthem Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna,Cigna,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna PPO,Cigna PPO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Cigna Medicare Advantage,Cigna Medicare Advantage,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Essence,Essence,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthlink HMO,Healthlink HMO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Healthlink PPO,Healthlink PPO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,HomeState Health Plan,HomeState Health Plan,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Humana Gold,Humana Gold,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Medicaid MO,Medicaid MO,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Medica,Medica,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Tricare,Tricare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC All Payer,UHC All Payer,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Exchange,UHC Exchange,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Medicaid,UHC Medicaid,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UMR CPD,UMR CPD,73.5,,,,,,,per diem,73.5,73.5,"Per diem rate, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,UHC Medicare,UHC Medicare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
KCI WOUND VAC FREEDOM RENTAL  ,33150543,CDM,279,RC,,,,,,Inpatient,,,73.5,73.5,Wellcare,Wellcare,73.5,,,,,,,case rate,73.5,73.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
LOW BOY BED DAILY RENTAL      ,33150544,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
MIGHTY AIR MATTRESS - LOW AIRL,33150545,CDM,279,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health PPO CPD,Meritain Health PPO CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna/Commercial Product,Aetna/Commercial Product,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Meritain Health CPD,Meritain Health CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Starmark CPD,Starmark CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Aetna Medicare,Aetna Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Ambetter ,Ambetter ,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access,Anthem Blue Access,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Access Choice,Anthem Blue Access Choice,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Blue Preferred,Anthem Blue Preferred,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Pathway,Anthem Pathway,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Alliance,Anthem Alliance,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Anthem Medicare,Anthem Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna,Cigna,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna PPO,Cigna PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Cigna Medicare Advantage,Cigna Medicare Advantage,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Essence,Essence,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink HMO,Healthlink HMO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Healthlink PPO,Healthlink PPO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,HomeState Health Plan,HomeState Health Plan,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Humana Gold,Humana Gold,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Medicaid MO,Medicaid MO,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Medica,Medica,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Tricare,Tricare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC All Payer,UHC All Payer,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Exchange,UHC Exchange,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicaid,UHC Medicaid,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,UMR CPD,UMR CPD,72,,,,,,,per diem,72,72,"Per diem rate, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,UHC Medicare,UHC Medicare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PORTA WARM MATTRESS           ,33150549,CDM,279,RC,,,,,,Inpatient,,,72,72,Wellcare,Wellcare,72,,,,,,,case rate,72,72,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
PUFF PAKS WHEELCHAIR          ,33150550,CDM,279,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI/LOW BED W/TRAPEXE       ,33150551,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC HI-LO BED DAILY RENTAL     ,33150552,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Meritain Health PPO CPD,Meritain Health PPO CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna/Commercial Product,Aetna/Commercial Product,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Meritain Health CPD,Meritain Health CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Starmark CPD,Starmark CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Aetna Medicare,Aetna Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Ambetter ,Ambetter ,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Access,Anthem Blue Access,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Access Choice,Anthem Blue Access Choice,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Blue Preferred,Anthem Blue Preferred,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Pathway,Anthem Pathway,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Alliance,Anthem Alliance,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Anthem Medicare,Anthem Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna,Cigna,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna PPO,Cigna PPO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Cigna Medicare Advantage,Cigna Medicare Advantage,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Essence,Essence,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthlink HMO,Healthlink HMO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Healthlink PPO,Healthlink PPO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,HomeState Health Plan,HomeState Health Plan,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Humana Gold,Humana Gold,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Medicaid MO,Medicaid MO,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Medica,Medica,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Tricare,Tricare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC All Payer,UHC All Payer,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Exchange,UHC Exchange,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Medicaid,UHC Medicaid,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UMR CPD,UMR CPD,145.5,,,,,,,per diem,145.5,145.5,"Per diem rate, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,UHC Medicare,UHC Medicare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC TALL BED DAILY RENTAL      ,33150553,CDM,279,RC,,,,,,Inpatient,,,145.5,145.5,Wellcare,Wellcare,145.5,,,,,,,case rate,145.5,145.5,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Meritain Health PPO CPD,Meritain Health PPO CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna/Commercial Product,Aetna/Commercial Product,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Meritain Health CPD,Meritain Health CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Starmark CPD,Starmark CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Aetna Medicare,Aetna Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Ambetter ,Ambetter ,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Access,Anthem Blue Access,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Access Choice,Anthem Blue Access Choice,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Blue Preferred,Anthem Blue Preferred,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Pathway,Anthem Pathway,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Alliance,Anthem Alliance,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Anthem Medicare,Anthem Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna,Cigna,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna PPO,Cigna PPO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Cigna Medicare Advantage,Cigna Medicare Advantage,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Essence,Essence,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthlink HMO,Healthlink HMO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Healthlink PPO,Healthlink PPO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,HomeState Health Plan,HomeState Health Plan,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Humana Gold,Humana Gold,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Medicaid MO,Medicaid MO,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Medica,Medica,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Tricare,Tricare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC All Payer,UHC All Payer,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Exchange,UHC Exchange,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Medicaid,UHC Medicaid,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,UMR CPD,UMR CPD,109,,,,,,,per diem,109,109,"Per diem rate, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,UHC Medicare,UHC Medicare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC ULTRA HI-LO BED BARIATRIC D,33150554,CDM,279,RC,,,,,,Inpatient,,,109,109,Wellcare,Wellcare,109,,,,,,,case rate,109,109,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC WHEELCHAIR BARIATRIC DAILY ,33150555,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Meritain Health PPO CPD,Meritain Health PPO CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna/Commercial Product,Aetna/Commercial Product,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Meritain Health CPD,Meritain Health CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Starmark CPD,Starmark CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Aetna Medicare,Aetna Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Ambetter ,Ambetter ,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access,Anthem Blue Access,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Access Choice,Anthem Blue Access Choice,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Blue Preferred,Anthem Blue Preferred,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Pathway,Anthem Pathway,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Alliance,Anthem Alliance,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Anthem Medicare,Anthem Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna,Cigna,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna PPO,Cigna PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Cigna Medicare Advantage,Cigna Medicare Advantage,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Essence,Essence,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthlink HMO,Healthlink HMO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Healthlink PPO,Healthlink PPO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,HomeState Health Plan,HomeState Health Plan,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Humana Gold,Humana Gold,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Medicaid MO,Medicaid MO,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Medica,Medica,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Tricare,Tricare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC All Payer,UHC All Payer,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Exchange,UHC Exchange,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Medicaid,UHC Medicaid,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,UMR CPD,UMR CPD,131,,,,,,,per diem,131,131,"Per diem rate, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,UHC Medicare,UHC Medicare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RC750 W/SCALES & RECOVERAIR 30,33150556,CDM,279,RC,,,,,,Inpatient,,,131,131,Wellcare,Wellcare,131,,,,,,,case rate,131,131,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health PPO CPD,Meritain Health PPO CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna/Commercial Product,Aetna/Commercial Product,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Meritain Health CPD,Meritain Health CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Starmark CPD,Starmark CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Aetna Medicare,Aetna Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Ambetter ,Ambetter ,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access,Anthem Blue Access,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Access Choice,Anthem Blue Access Choice,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Blue Preferred,Anthem Blue Preferred,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Pathway,Anthem Pathway,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Alliance,Anthem Alliance,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Anthem Medicare,Anthem Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna,Cigna,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna PPO,Cigna PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Cigna Medicare Advantage,Cigna Medicare Advantage,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Essence,Essence,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink HMO,Healthlink HMO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Healthlink PPO,Healthlink PPO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,HomeState Health Plan,HomeState Health Plan,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Humana Gold,Humana Gold,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medicaid MO,Medicaid MO,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Medica,Medica,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Tricare,Tricare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC All Payer,UHC All Payer,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Exchange,UHC Exchange,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicaid,UHC Medicaid,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UMR CPD,UMR CPD,18.5,,,,,,,per diem,18.5,18.5,"Per diem rate, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,UHC Medicare,UHC Medicare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER AIR 100 AIR MATTRESS  ,33150557,CDM,279,RC,,,,,,Inpatient,,,18.5,18.5,Wellcare,Wellcare,18.5,,,,,,,case rate,18.5,18.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health PPO CPD,Meritain Health PPO CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna/Commercial Product,Aetna/Commercial Product,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Meritain Health CPD,Meritain Health CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Starmark CPD,Starmark CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Aetna Medicare,Aetna Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Ambetter ,Ambetter ,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access,Anthem Blue Access,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Access Choice,Anthem Blue Access Choice,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Blue Preferred,Anthem Blue Preferred,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Pathway,Anthem Pathway,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Alliance,Anthem Alliance,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Anthem Medicare,Anthem Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna,Cigna,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna PPO,Cigna PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Cigna Medicare Advantage,Cigna Medicare Advantage,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Essence,Essence,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink HMO,Healthlink HMO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Healthlink PPO,Healthlink PPO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,HomeState Health Plan,HomeState Health Plan,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Humana Gold,Humana Gold,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medicaid MO,Medicaid MO,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Medica,Medica,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Tricare,Tricare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC All Payer,UHC All Payer,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Exchange,UHC Exchange,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicaid,UHC Medicaid,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UMR CPD,UMR CPD,33.5,,,,,,,per diem,33.5,33.5,"Per diem rate, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,UHC Medicare,UHC Medicare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE RS LOWAIR MATTRES,33150558,CDM,279,RC,,,,,,Inpatient,,,33.5,33.5,Wellcare,Wellcare,33.5,,,,,,,case rate,33.5,33.5,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health PPO CPD,Meritain Health PPO CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna/Commercial Product,Aetna/Commercial Product,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Meritain Health CPD,Meritain Health CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Starmark CPD,Starmark CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Aetna Medicare,Aetna Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Ambetter ,Ambetter ,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access,Anthem Blue Access,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Access Choice,Anthem Blue Access Choice,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Blue Preferred,Anthem Blue Preferred,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Pathway,Anthem Pathway,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Alliance,Anthem Alliance,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Anthem Medicare,Anthem Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna,Cigna,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna PPO,Cigna PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Cigna Medicare Advantage,Cigna Medicare Advantage,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Essence,Essence,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink HMO,Healthlink HMO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Healthlink PPO,Healthlink PPO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,HomeState Health Plan,HomeState Health Plan,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Humana Gold,Humana Gold,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Medicaid MO,Medicaid MO,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Medica,Medica,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Tricare,Tricare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC All Payer,UHC All Payer,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Exchange,UHC Exchange,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicaid,UHC Medicaid,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,UMR CPD,UMR CPD,31,,,,,,,per diem,31,31,"Per diem rate, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,UHC Medicare,UHC Medicare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE STIM JR OVERLAY M,33150559,CDM,279,RC,,,,,,Inpatient,,,31,31,Wellcare,Wellcare,31,,,,,,,case rate,31,31,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVER CARE TRU-TURN MATTRESS,33150560,CDM,279,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 2000 MATTRESS DAILY,33150561,CDM,279,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Meritain Health PPO CPD,Meritain Health PPO CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna/Commercial Product,Aetna/Commercial Product,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Meritain Health CPD,Meritain Health CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Starmark CPD,Starmark CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Aetna Medicare,Aetna Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Ambetter ,Ambetter ,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access,Anthem Blue Access,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Access Choice,Anthem Blue Access Choice,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Blue Preferred,Anthem Blue Preferred,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Pathway,Anthem Pathway,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Alliance,Anthem Alliance,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Anthem Medicare,Anthem Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna,Cigna,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna PPO,Cigna PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Cigna Medicare Advantage,Cigna Medicare Advantage,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Essence,Essence,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthlink HMO,Healthlink HMO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Healthlink PPO,Healthlink PPO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,HomeState Health Plan,HomeState Health Plan,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Humana Gold,Humana Gold,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Medicaid MO,Medicaid MO,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Medica,Medica,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Tricare,Tricare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC All Payer,UHC All Payer,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Exchange,UHC Exchange,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Medicaid,UHC Medicaid,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,UMR CPD,UMR CPD,22,,,,,,,per diem,22,22,"Per diem rate, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,UHC Medicare,UHC Medicare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 250 MATTRESS DAILY ,33150562,CDM,279,RC,,,,,,Inpatient,,,22,22,Wellcare,Wellcare,22,,,,,,,case rate,22,22,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Meritain Health PPO CPD,Meritain Health PPO CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna/Commercial Product,Aetna/Commercial Product,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Meritain Health CPD,Meritain Health CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Starmark CPD,Starmark CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Aetna Medicare,Aetna Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Ambetter ,Ambetter ,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Access,Anthem Blue Access,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Access Choice,Anthem Blue Access Choice,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Blue Preferred,Anthem Blue Preferred,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Pathway,Anthem Pathway,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Alliance,Anthem Alliance,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Anthem Medicare,Anthem Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna,Cigna,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna PPO,Cigna PPO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Cigna Medicare Advantage,Cigna Medicare Advantage,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Essence,Essence,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthlink HMO,Healthlink HMO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Healthlink PPO,Healthlink PPO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,HomeState Health Plan,HomeState Health Plan,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Humana Gold,Humana Gold,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Medicaid MO,Medicaid MO,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Medica,Medica,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Tricare,Tricare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC All Payer,UHC All Payer,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Exchange,UHC Exchange,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Medicaid,UHC Medicaid,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UMR CPD,UMR CPD,40.5,,,,,,,per diem,40.5,40.5,"Per diem rate, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,UHC Medicare,UHC Medicare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
RECOVERAIR 3000 MATTRESS DAILY,33150563,CDM,279,RC,,,,,,Inpatient,,,40.5,40.5,Wellcare,Wellcare,40.5,,,,,,,case rate,40.5,40.5,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Meritain Health PPO CPD,Meritain Health PPO CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna/Commercial Product,Aetna/Commercial Product,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Meritain Health CPD,Meritain Health CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Starmark CPD,Starmark CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Aetna Medicare,Aetna Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Ambetter ,Ambetter ,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Access,Anthem Blue Access,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Access Choice,Anthem Blue Access Choice,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Blue Preferred,Anthem Blue Preferred,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Pathway,Anthem Pathway,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Alliance,Anthem Alliance,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Anthem Medicare,Anthem Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna,Cigna,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna PPO,Cigna PPO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Cigna Medicare Advantage,Cigna Medicare Advantage,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Essence,Essence,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthlink HMO,Healthlink HMO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Healthlink PPO,Healthlink PPO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,HomeState Health Plan,HomeState Health Plan,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Humana Gold,Humana Gold,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Medicaid MO,Medicaid MO,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Medica,Medica,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Tricare,Tricare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC All Payer,UHC All Payer,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Exchange,UHC Exchange,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Medicaid,UHC Medicaid,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,UMR CPD,UMR CPD,128,,,,,,,per diem,128,128,"Per diem rate, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,UHC Medicare,UHC Medicare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
SAFE-T-CARE LTC RENTAL        ,33150565,CDM,279,RC,,,,,,Inpatient,,,128,128,Wellcare,Wellcare,128,,,,,,,case rate,128,128,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Meritain Health PPO CPD,Meritain Health PPO CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna/Commercial Product,Aetna/Commercial Product,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Meritain Health CPD,Meritain Health CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Starmark CPD,Starmark CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Aetna Medicare,Aetna Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Ambetter ,Ambetter ,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Access,Anthem Blue Access,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Access Choice,Anthem Blue Access Choice,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Blue Preferred,Anthem Blue Preferred,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Pathway,Anthem Pathway,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Alliance,Anthem Alliance,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Anthem Medicare,Anthem Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna,Cigna,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna PPO,Cigna PPO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Cigna Medicare Advantage,Cigna Medicare Advantage,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Essence,Essence,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthlink HMO,Healthlink HMO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Healthlink PPO,Healthlink PPO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,HomeState Health Plan,HomeState Health Plan,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Humana Gold,Humana Gold,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Medicaid MO,Medicaid MO,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Medica,Medica,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Tricare,Tricare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC All Payer,UHC All Payer,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Exchange,UHC Exchange,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Medicaid,UHC Medicaid,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,UMR CPD,UMR CPD,70,,,,,,,per diem,70,70,"Per diem rate, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,UHC Medicare,UHC Medicare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
"SAFETY BED, DAILY RENTAL      ",33150566,CDM,279,RC,,,,,,Inpatient,,,70,70,Wellcare,Wellcare,70,,,,,,,case rate,70,70,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health PPO CPD,Meritain Health PPO CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna/Commercial Product,Aetna/Commercial Product,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Meritain Health CPD,Meritain Health CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Starmark CPD,Starmark CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Aetna Medicare,Aetna Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Ambetter ,Ambetter ,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access,Anthem Blue Access,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Access Choice,Anthem Blue Access Choice,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Blue Preferred,Anthem Blue Preferred,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Pathway,Anthem Pathway,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Alliance,Anthem Alliance,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Anthem Medicare,Anthem Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna,Cigna,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna PPO,Cigna PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Cigna Medicare Advantage,Cigna Medicare Advantage,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Essence,Essence,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink HMO,Healthlink HMO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Healthlink PPO,Healthlink PPO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,HomeState Health Plan,HomeState Health Plan,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Humana Gold,Humana Gold,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medicaid MO,Medicaid MO,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Medica,Medica,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Tricare,Tricare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC All Payer,UHC All Payer,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Exchange,UHC Exchange,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicaid,UHC Medicaid,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UMR CPD,UMR CPD,249.5,,,,,,,per diem,249.5,249.5,"Per diem rate, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,UHC Medicare,UHC Medicare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SHUTTLE CHAIR DAILY RENTAL    ,33150567,CDM,279,RC,,,,,,Inpatient,,,249.5,249.5,Wellcare,Wellcare,249.5,,,,,,,case rate,249.5,249.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health PPO CPD,Meritain Health PPO CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna/Commercial Product,Aetna/Commercial Product,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Meritain Health CPD,Meritain Health CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Starmark CPD,Starmark CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Aetna Medicare,Aetna Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Ambetter ,Ambetter ,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access,Anthem Blue Access,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Access Choice,Anthem Blue Access Choice,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Blue Preferred,Anthem Blue Preferred,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Pathway,Anthem Pathway,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Alliance,Anthem Alliance,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Anthem Medicare,Anthem Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna,Cigna,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna PPO,Cigna PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Cigna Medicare Advantage,Cigna Medicare Advantage,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Essence,Essence,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink HMO,Healthlink HMO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Healthlink PPO,Healthlink PPO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,HomeState Health Plan,HomeState Health Plan,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Humana Gold,Humana Gold,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medicaid MO,Medicaid MO,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Medica,Medica,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Tricare,Tricare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC All Payer,UHC All Payer,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Exchange,UHC Exchange,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicaid,UHC Medicaid,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UMR CPD,UMR CPD,37.5,,,,,,,per diem,37.5,37.5,"Per diem rate, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,UHC Medicare,UHC Medicare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SIZE WISE PULSATE AIR MATTRESS,33150568,CDM,279,RC,,,,,,Inpatient,,,37.5,37.5,Wellcare,Wellcare,37.5,,,,,,,case rate,37.5,37.5,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health PPO CPD,Meritain Health PPO CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna/Commercial Product,Aetna/Commercial Product,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Meritain Health CPD,Meritain Health CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Starmark CPD,Starmark CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Aetna Medicare,Aetna Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Ambetter ,Ambetter ,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access,Anthem Blue Access,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access Choice,Anthem Blue Access Choice,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Blue Preferred,Anthem Blue Preferred,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Pathway,Anthem Pathway,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Alliance,Anthem Alliance,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Anthem Medicare,Anthem Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna,Cigna,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna PPO,Cigna PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Cigna Medicare Advantage,Cigna Medicare Advantage,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Essence,Essence,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink HMO,Healthlink HMO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Healthlink PPO,Healthlink PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,HomeState Health Plan,HomeState Health Plan,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Humana Gold,Humana Gold,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Medicaid MO,Medicaid MO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Medica,Medica,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Tricare,Tricare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC All Payer,UHC All Payer,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Exchange,UHC Exchange,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicaid,UHC Medicaid,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,UMR CPD,UMR CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,UHC Medicare,UHC Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SPECIALTY MATTRESS            ,33150569,CDM,279,RC,,,,,,Inpatient,,,156,156,Wellcare,Wellcare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Meritain Health PPO CPD,Meritain Health PPO CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna/Commercial Product,Aetna/Commercial Product,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Meritain Health CPD,Meritain Health CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Starmark CPD,Starmark CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Aetna Medicare,Aetna Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Ambetter ,Ambetter ,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Access,Anthem Blue Access,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Access Choice,Anthem Blue Access Choice,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Blue Preferred,Anthem Blue Preferred,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Pathway,Anthem Pathway,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Alliance,Anthem Alliance,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Anthem Medicare,Anthem Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna,Cigna,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna PPO,Cigna PPO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Cigna Medicare Advantage,Cigna Medicare Advantage,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Essence,Essence,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthlink HMO,Healthlink HMO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Healthlink PPO,Healthlink PPO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,HomeState Health Plan,HomeState Health Plan,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Humana Gold,Humana Gold,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Medicaid MO,Medicaid MO,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Medica,Medica,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Tricare,Tricare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC All Payer,UHC All Payer,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Exchange,UHC Exchange,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Medicaid,UHC Medicaid,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,UMR CPD,UMR CPD,3,,,,,,,per diem,3,3,"Per diem rate, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,UHC Medicare,UHC Medicare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
T-PUMP DAILY RENTAL           ,33150570,CDM,279,RC,,,,,,Inpatient,,,3,3,Wellcare,Wellcare,3,,,,,,,case rate,3,3,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health PPO CPD,Meritain Health PPO CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna/Commercial Product,Aetna/Commercial Product,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Meritain Health CPD,Meritain Health CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Starmark CPD,Starmark CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Aetna Medicare,Aetna Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Ambetter ,Ambetter ,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access,Anthem Blue Access,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Access Choice,Anthem Blue Access Choice,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Blue Preferred,Anthem Blue Preferred,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Pathway,Anthem Pathway,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Alliance,Anthem Alliance,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Anthem Medicare,Anthem Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna,Cigna,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna PPO,Cigna PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Cigna Medicare Advantage,Cigna Medicare Advantage,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Essence,Essence,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink HMO,Healthlink HMO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Healthlink PPO,Healthlink PPO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,HomeState Health Plan,HomeState Health Plan,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Humana Gold,Humana Gold,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Medicaid MO,Medicaid MO,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Medica,Medica,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Tricare,Tricare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC All Payer,UHC All Payer,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Exchange,UHC Exchange,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicaid,UHC Medicaid,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,UMR CPD,UMR CPD,135,,,,,,,per diem,135,135,"Per diem rate, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,UHC Medicare,UHC Medicare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
VERSATILE-1 PUMP DAILY RENTAL ,33150571,CDM,279,RC,,,,,,Inpatient,,,135,135,Wellcare,Wellcare,135,,,,,,,case rate,135,135,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health PPO CPD,Meritain Health PPO CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna/Commercial Product,Aetna/Commercial Product,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Meritain Health CPD,Meritain Health CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Starmark CPD,Starmark CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Aetna Medicare,Aetna Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Ambetter ,Ambetter ,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access,Anthem Blue Access,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Access Choice,Anthem Blue Access Choice,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Blue Preferred,Anthem Blue Preferred,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Pathway,Anthem Pathway,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Alliance,Anthem Alliance,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Anthem Medicare,Anthem Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna,Cigna,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna PPO,Cigna PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Cigna Medicare Advantage,Cigna Medicare Advantage,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Essence,Essence,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink HMO,Healthlink HMO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Healthlink PPO,Healthlink PPO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,HomeState Health Plan,HomeState Health Plan,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Humana Gold,Humana Gold,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medicaid MO,Medicaid MO,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Medica,Medica,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Tricare,Tricare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC All Payer,UHC All Payer,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Exchange,UHC Exchange,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicaid,UHC Medicaid,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UMR CPD,UMR CPD,41.5,,,,,,,per diem,41.5,41.5,"Per diem rate, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,UHC Medicare,UHC Medicare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
WALKER MATRIX CAM-A/S         ,33150572,CDM,279,RC,,,,,,Inpatient,,,41.5,41.5,Wellcare,Wellcare,41.5,,,,,,,case rate,41.5,41.5,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health PPO CPD,Meritain Health PPO CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna/Commercial Product,Aetna/Commercial Product,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Meritain Health CPD,Meritain Health CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Starmark CPD,Starmark CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Aetna Medicare,Aetna Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Ambetter ,Ambetter ,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access,Anthem Blue Access,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Access Choice,Anthem Blue Access Choice,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Blue Preferred,Anthem Blue Preferred,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Pathway,Anthem Pathway,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Alliance,Anthem Alliance,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Anthem Medicare,Anthem Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna,Cigna,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna PPO,Cigna PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Cigna Medicare Advantage,Cigna Medicare Advantage,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Essence,Essence,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink HMO,Healthlink HMO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Healthlink PPO,Healthlink PPO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,HomeState Health Plan,HomeState Health Plan,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Humana Gold,Humana Gold,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Medicaid MO,Medicaid MO,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Medica,Medica,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Tricare,Tricare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC All Payer,UHC All Payer,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Exchange,UHC Exchange,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicaid,UHC Medicaid,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,UMR CPD,UMR CPD,7,,,,,,,per diem,7,7,"Per diem rate, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,UHC Medicare,UHC Medicare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
"WHEELCHAIR, SELF PROPULSION DA",33150573,CDM,279,RC,,,,,,Inpatient,,,7,7,Wellcare,Wellcare,7,,,,,,,case rate,7,7,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Meritain Health PPO CPD,Meritain Health PPO CPD,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Aetna/Commercial Product,Aetna/Commercial Product,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Meritain Health CPD,Meritain Health CPD,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Starmark CPD,Starmark CPD,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Aetna Medicare,Aetna Medicare,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Ambetter ,Ambetter ,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Blue Access,Anthem Blue Access,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Blue Access Choice,Anthem Blue Access Choice,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Blue Preferred,Anthem Blue Preferred,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Pathway,Anthem Pathway,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Alliance,Anthem Alliance,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Anthem Medicare,Anthem Medicare,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Cigna,Cigna,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Cigna PPO,Cigna PPO,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Cigna Medicare Advantage,Cigna Medicare Advantage,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Essence,Essence,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Healthlink HMO,Healthlink HMO,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Healthlink PPO,Healthlink PPO,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,HomeState Health Plan,HomeState Health Plan,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Humana Gold,Humana Gold,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Medicaid MO,Medicaid MO,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Medica,Medica,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Tricare,Tricare,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,UHC All Payer,UHC All Payer,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,UHC Exchange,UHC Exchange,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,UHC Medicaid,UHC Medicaid,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,UMR CPD,UMR CPD,132.5,,,,,,,per diem,132.5,132.5,"Per diem rate, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,UHC Medicare,UHC Medicare,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
MATTRESS DOLPHIN REPL - RENTAL,33150575,CDM,279,RC,,,,,,Inpatient,,,132.5,132.5,Wellcare,Wellcare,132.5,,,,,,,case rate,132.5,132.5,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health PPO CPD,Meritain Health PPO CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna/Commercial Product,Aetna/Commercial Product,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Meritain Health CPD,Meritain Health CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Starmark CPD,Starmark CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Aetna Medicare,Aetna Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Ambetter ,Ambetter ,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access,Anthem Blue Access,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Access Choice,Anthem Blue Access Choice,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Blue Preferred,Anthem Blue Preferred,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Pathway,Anthem Pathway,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Alliance,Anthem Alliance,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Anthem Medicare,Anthem Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna,Cigna,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna PPO,Cigna PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Cigna Medicare Advantage,Cigna Medicare Advantage,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Essence,Essence,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink HMO,Healthlink HMO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Healthlink PPO,Healthlink PPO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,HomeState Health Plan,HomeState Health Plan,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Humana Gold,Humana Gold,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Medicaid MO,Medicaid MO,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Medica,Medica,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Tricare,Tricare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC All Payer,UHC All Payer,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Exchange,UHC Exchange,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicaid,UHC Medicaid,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,UMR CPD,UMR CPD,105,,,,,,,per diem,105,105,"Per diem rate, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,UHC Medicare,UHC Medicare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
DOLPHIN CHAIR PAD RENTAL      ,33150577,CDM,279,RC,,,,,,Inpatient,,,105,105,Wellcare,Wellcare,105,,,,,,,case rate,105,105,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Meritain Health PPO CPD,Meritain Health PPO CPD,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Aetna/Commercial Product,Aetna/Commercial Product,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Meritain Health CPD,Meritain Health CPD,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Starmark CPD,Starmark CPD,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Aetna Medicare,Aetna Medicare,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Ambetter ,Ambetter ,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Blue Access,Anthem Blue Access,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Blue Access Choice,Anthem Blue Access Choice,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Blue Preferred,Anthem Blue Preferred,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Pathway,Anthem Pathway,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Alliance,Anthem Alliance,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Anthem Medicare,Anthem Medicare,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Cigna,Cigna,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Cigna PPO,Cigna PPO,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Cigna Medicare Advantage,Cigna Medicare Advantage,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Essence,Essence,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Healthlink HMO,Healthlink HMO,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Healthlink PPO,Healthlink PPO,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,HomeState Health Plan,HomeState Health Plan,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Humana Gold,Humana Gold,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Medicaid MO,Medicaid MO,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Medica,Medica,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Tricare,Tricare,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,UHC All Payer,UHC All Payer,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,UHC Exchange,UHC Exchange,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,UHC Medicaid,UHC Medicaid,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,UMR CPD,UMR CPD,115.75,,,,,,,per diem,115.75,115.75,"Per diem rate, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,UHC Medicare,UHC Medicare,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
V60 VENTILATOR WITH STAND DAIL,33150578,CDM,279,RC,,,,,,Inpatient,,,115.75,115.75,Wellcare,Wellcare,115.75,,,,,,,case rate,115.75,115.75,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health PPO CPD,Meritain Health PPO CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna/Commercial Product,Aetna/Commercial Product,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Meritain Health CPD,Meritain Health CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Starmark CPD,Starmark CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Aetna Medicare,Aetna Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Ambetter ,Ambetter ,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access,Anthem Blue Access,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Access Choice,Anthem Blue Access Choice,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Blue Preferred,Anthem Blue Preferred,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Pathway,Anthem Pathway,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Alliance,Anthem Alliance,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Anthem Medicare,Anthem Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna,Cigna,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna PPO,Cigna PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Cigna Medicare Advantage,Cigna Medicare Advantage,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Essence,Essence,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink HMO,Healthlink HMO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Healthlink PPO,Healthlink PPO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,HomeState Health Plan,HomeState Health Plan,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Humana Gold,Humana Gold,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Medicaid MO,Medicaid MO,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Medica,Medica,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Tricare,Tricare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC All Payer,UHC All Payer,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Exchange,UHC Exchange,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicaid,UHC Medicaid,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,UMR CPD,UMR CPD,30,,,,,,,per diem,30,30,"Per diem rate, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,UHC Medicare,UHC Medicare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
REGENCY XL 2000 WHEELCHAIR    ,33150579,CDM,279,RC,,,,,,Inpatient,,,30,30,Wellcare,Wellcare,30,,,,,,,case rate,30,30,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Meritain Health PPO CPD,Meritain Health PPO CPD,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Aetna/Commercial Product,Aetna/Commercial Product,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Meritain Health CPD,Meritain Health CPD,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Starmark CPD,Starmark CPD,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Aetna Medicare,Aetna Medicare,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Ambetter ,Ambetter ,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Blue Access,Anthem Blue Access,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Blue Access Choice,Anthem Blue Access Choice,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Blue Preferred,Anthem Blue Preferred,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Pathway,Anthem Pathway,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Alliance,Anthem Alliance,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Anthem Medicare,Anthem Medicare,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Cigna,Cigna,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Cigna PPO,Cigna PPO,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Cigna Medicare Advantage,Cigna Medicare Advantage,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Essence,Essence,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Healthlink HMO,Healthlink HMO,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Healthlink PPO,Healthlink PPO,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,HomeState Health Plan,HomeState Health Plan,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Humana Gold,Humana Gold,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Medicaid MO,Medicaid MO,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Medica,Medica,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Tricare,Tricare,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,UHC All Payer,UHC All Payer,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,UHC Exchange,UHC Exchange,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,UHC Medicaid,UHC Medicaid,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,UMR CPD,UMR CPD,450,,,,,,,per diem,450,450,"Per diem rate, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,UHC Medicare,UHC Medicare,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
LIFE VEST (ZOLL)              ,33150594,CDM,279,RC,,,,,,Inpatient,,,450,450,Wellcare,Wellcare,450,,,,,,,case rate,450,450,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Meritain Health PPO CPD,Meritain Health PPO CPD,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Aetna/Commercial Product,Aetna/Commercial Product,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Meritain Health CPD,Meritain Health CPD,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Starmark CPD,Starmark CPD,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Aetna Medicare,Aetna Medicare,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Ambetter ,Ambetter ,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Blue Access,Anthem Blue Access,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Blue Access Choice,Anthem Blue Access Choice,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Blue Preferred,Anthem Blue Preferred,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Pathway,Anthem Pathway,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Alliance,Anthem Alliance,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Anthem Medicare,Anthem Medicare,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Cigna,Cigna,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Cigna PPO,Cigna PPO,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Cigna Medicare Advantage,Cigna Medicare Advantage,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Essence,Essence,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Healthlink HMO,Healthlink HMO,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Healthlink PPO,Healthlink PPO,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,HomeState Health Plan,HomeState Health Plan,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Humana Gold,Humana Gold,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Medicaid MO,Medicaid MO,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Medica,Medica,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Tricare,Tricare,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,UHC All Payer,UHC All Payer,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,UHC Exchange,UHC Exchange,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,UHC Medicaid,UHC Medicaid,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,UMR CPD,UMR CPD,33.25,,,,,,,per diem,33.25,33.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,UHC Medicare,UHC Medicare,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 3 IN      ,33150595,CDM,279,RC,,,,,,Inpatient,,,33.25,33.25,Wellcare,Wellcare,33.25,,,,,,,case rate,33.25,33.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Meritain Health PPO CPD,Meritain Health PPO CPD,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Aetna/Commercial Product,Aetna/Commercial Product,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Meritain Health CPD,Meritain Health CPD,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Starmark CPD,Starmark CPD,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Aetna Medicare,Aetna Medicare,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Ambetter ,Ambetter ,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Blue Access,Anthem Blue Access,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Blue Access Choice,Anthem Blue Access Choice,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Blue Preferred,Anthem Blue Preferred,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Pathway,Anthem Pathway,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Alliance,Anthem Alliance,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Anthem Medicare,Anthem Medicare,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Cigna,Cigna,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Cigna PPO,Cigna PPO,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Cigna Medicare Advantage,Cigna Medicare Advantage,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Essence,Essence,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Healthlink HMO,Healthlink HMO,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Healthlink PPO,Healthlink PPO,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,HomeState Health Plan,HomeState Health Plan,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Humana Gold,Humana Gold,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Medicaid MO,Medicaid MO,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Medica,Medica,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Tricare,Tricare,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,UHC All Payer,UHC All Payer,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,UHC Exchange,UHC Exchange,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,UHC Medicaid,UHC Medicaid,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,UMR CPD,UMR CPD,66.25,,,,,,,per diem,66.25,66.25,"Per diem rate, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,UHC Medicare,UHC Medicare,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SKIN GUARD MATTRESS 8 IN      ,33150596,CDM,279,RC,,,,,,Inpatient,,,66.25,66.25,Wellcare,Wellcare,66.25,,,,,,,case rate,66.25,66.25,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Meritain Health PPO CPD,Meritain Health PPO CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Aetna/Commercial Product,Aetna/Commercial Product,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Meritain Health CPD,Meritain Health CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Starmark CPD,Starmark CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Aetna Medicare,Aetna Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Ambetter ,Ambetter ,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access,Anthem Blue Access,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Blue Access Choice,Anthem Blue Access Choice,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Blue Preferred,Anthem Blue Preferred,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Pathway,Anthem Pathway,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Alliance,Anthem Alliance,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Anthem Medicare,Anthem Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Cigna,Cigna,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Cigna PPO,Cigna PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Cigna Medicare Advantage,Cigna Medicare Advantage,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Essence,Essence,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Healthlink HMO,Healthlink HMO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Healthlink PPO,Healthlink PPO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,HomeState Health Plan,HomeState Health Plan,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Humana Gold,Humana Gold,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Medicaid MO,Medicaid MO,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Medica,Medica,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Tricare,Tricare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,UHC All Payer,UHC All Payer,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,UHC Exchange,UHC Exchange,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,UHC Medicaid,UHC Medicaid,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,UMR CPD,UMR CPD,156,,,,,,,per diem,156,156,"Per diem rate, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,UHC Medicare,UHC Medicare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
SLEEVE ARM EXOSOFT XL TALL    ,33152345,CDM,270,RC,,,,,,Inpatient,,,156,156,Wellcare,Wellcare,156,,,,,,,case rate,156,156,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL RT ,33152354,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS RT ,33152355,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MED RT,33152356,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG RT ,33152357,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XS LT ,33152358,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA SM LT ,33152359,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA MD LT ,33152360,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA LG LT ,33152361,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health PPO CPD,Meritain Health PPO CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna/Commercial Product,Aetna/Commercial Product,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Meritain Health CPD,Meritain Health CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Starmark CPD,Starmark CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Aetna Medicare,Aetna Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Ambetter ,Ambetter ,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access,Anthem Blue Access,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Access Choice,Anthem Blue Access Choice,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Blue Preferred,Anthem Blue Preferred,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Pathway,Anthem Pathway,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Alliance,Anthem Alliance,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Anthem Medicare,Anthem Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna,Cigna,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna PPO,Cigna PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Cigna Medicare Advantage,Cigna Medicare Advantage,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Essence,Essence,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink HMO,Healthlink HMO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Healthlink PPO,Healthlink PPO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,HomeState Health Plan,HomeState Health Plan,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Humana Gold,Humana Gold,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Medicaid MO,Medicaid MO,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Medica,Medica,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Tricare,Tricare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC All Payer,UHC All Payer,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Exchange,UHC Exchange,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicaid,UHC Medicaid,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,UMR CPD,UMR CPD,29,,,,,,,per diem,29,29,"Per diem rate, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,UHC Medicare,UHC Medicare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
BRACE WRIST THUMB SPICA XL LT ,33152362,CDM,270,RC,,,,,,Inpatient,,,29,29,Wellcare,Wellcare,29,,,,,,,case rate,29,29,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS SM   ,33152364,CDM,270,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health PPO CPD,Meritain Health PPO CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna/Commercial Product,Aetna/Commercial Product,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Meritain Health CPD,Meritain Health CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Starmark CPD,Starmark CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Aetna Medicare,Aetna Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Ambetter ,Ambetter ,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access,Anthem Blue Access,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Access Choice,Anthem Blue Access Choice,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Blue Preferred,Anthem Blue Preferred,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Pathway,Anthem Pathway,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Alliance,Anthem Alliance,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Anthem Medicare,Anthem Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna,Cigna,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna PPO,Cigna PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Cigna Medicare Advantage,Cigna Medicare Advantage,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Essence,Essence,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink HMO,Healthlink HMO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Healthlink PPO,Healthlink PPO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,HomeState Health Plan,HomeState Health Plan,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Humana Gold,Humana Gold,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Medicaid MO,Medicaid MO,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Medica,Medica,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Tricare,Tricare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC All Payer,UHC All Payer,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Exchange,UHC Exchange,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicaid,UHC Medicaid,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,UMR CPD,UMR CPD,28,,,,,,,per diem,28,28,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,UHC Medicare,UHC Medicare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS MED  ,33152365,CDM,270,RC,,,,,,Inpatient,,,28,28,Wellcare,Wellcare,28,,,,,,,case rate,28,28,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Meritain Health PPO CPD,Meritain Health PPO CPD,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Aetna/Commercial Product,Aetna/Commercial Product,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Meritain Health CPD,Meritain Health CPD,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Starmark CPD,Starmark CPD,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Aetna Medicare,Aetna Medicare,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Ambetter ,Ambetter ,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Blue Access,Anthem Blue Access,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Blue Access Choice,Anthem Blue Access Choice,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Blue Preferred,Anthem Blue Preferred,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Pathway,Anthem Pathway,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Alliance,Anthem Alliance,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Anthem Medicare,Anthem Medicare,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Cigna,Cigna,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Cigna PPO,Cigna PPO,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Cigna Medicare Advantage,Cigna Medicare Advantage,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Essence,Essence,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Healthlink HMO,Healthlink HMO,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Healthlink PPO,Healthlink PPO,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,HomeState Health Plan,HomeState Health Plan,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Humana Gold,Humana Gold,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Medicaid MO,Medicaid MO,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Medica,Medica,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Tricare,Tricare,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,UHC All Payer,UHC All Payer,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,UHC Exchange,UHC Exchange,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,UHC Medicaid,UHC Medicaid,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,UMR CPD,UMR CPD,26,,,,,,,per diem,26,26,"Per diem rate, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,UHC Medicare,UHC Medicare,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
SHOE MED-SURG DARCO MENS LG   ,33152366,CDM,270,RC,,,,,,Inpatient,,,26,26,Wellcare,Wellcare,26,,,,,,,case rate,26,26,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health PPO CPD,Meritain Health PPO CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/Commercial Product,Aetna/Commercial Product,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health CPD,Meritain Health CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Starmark CPD,Starmark CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna Medicare,Aetna Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Ambetter ,Ambetter ,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access,Anthem Blue Access,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access Choice,Anthem Blue Access Choice,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Preferred,Anthem Blue Preferred,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Pathway,Anthem Pathway,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Alliance,Anthem Alliance,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Medicare,Anthem Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna,Cigna,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna PPO,Cigna PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna Medicare Advantage,Cigna Medicare Advantage,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Essence,Essence,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink HMO,Healthlink HMO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink PPO,Healthlink PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,HomeState Health Plan,HomeState Health Plan,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Humana Gold,Humana Gold,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Medicaid MO,Medicaid MO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Medica,Medica,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Tricare,Tricare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC All Payer,UHC All Payer,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Exchange,UHC Exchange,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicaid,UHC Medicaid,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,UMR CPD,UMR CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicare,UHC Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM SM  ,33152375,CDM,270,RC,,,,,,Inpatient,,,152,152,Wellcare,Wellcare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health PPO CPD,Meritain Health PPO CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/Commercial Product,Aetna/Commercial Product,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health CPD,Meritain Health CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Starmark CPD,Starmark CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna Medicare,Aetna Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Ambetter ,Ambetter ,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access,Anthem Blue Access,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access Choice,Anthem Blue Access Choice,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Preferred,Anthem Blue Preferred,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Pathway,Anthem Pathway,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Alliance,Anthem Alliance,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Medicare,Anthem Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna,Cigna,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna PPO,Cigna PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna Medicare Advantage,Cigna Medicare Advantage,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Essence,Essence,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink HMO,Healthlink HMO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink PPO,Healthlink PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,HomeState Health Plan,HomeState Health Plan,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Humana Gold,Humana Gold,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Medicaid MO,Medicaid MO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Medica,Medica,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Tricare,Tricare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC All Payer,UHC All Payer,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Exchange,UHC Exchange,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicaid,UHC Medicaid,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,UMR CPD,UMR CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicare,UHC Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM MED ,33152376,CDM,270,RC,,,,,,Inpatient,,,152,152,Wellcare,Wellcare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health PPO CPD,Meritain Health PPO CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna/Commercial Product,Aetna/Commercial Product,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Meritain Health CPD,Meritain Health CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Starmark CPD,Starmark CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Aetna Medicare,Aetna Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Ambetter ,Ambetter ,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access,Anthem Blue Access,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Access Choice,Anthem Blue Access Choice,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Blue Preferred,Anthem Blue Preferred,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Pathway,Anthem Pathway,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Alliance,Anthem Alliance,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Anthem Medicare,Anthem Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna,Cigna,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna PPO,Cigna PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Cigna Medicare Advantage,Cigna Medicare Advantage,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Essence,Essence,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink HMO,Healthlink HMO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Healthlink PPO,Healthlink PPO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,HomeState Health Plan,HomeState Health Plan,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Humana Gold,Humana Gold,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Medicaid MO,Medicaid MO,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Medica,Medica,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Tricare,Tricare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC All Payer,UHC All Payer,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Exchange,UHC Exchange,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicaid,UHC Medicaid,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,UMR CPD,UMR CPD,152,,,,,,,per diem,152,152,"Per diem rate, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,UHC Medicare,UHC Medicare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
IMMOBILIZER KNEE AQUAFORM LG  ,33152377,CDM,270,RC,,,,,,Inpatient,,,152,152,Wellcare,Wellcare,152,,,,,,,case rate,152,152,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health PPO CPD,Meritain Health PPO CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/Commercial Product,Aetna/Commercial Product,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health CPD,Meritain Health CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Starmark CPD,Starmark CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna Medicare,Aetna Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Ambetter ,Ambetter ,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access,Anthem Blue Access,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access Choice,Anthem Blue Access Choice,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Preferred,Anthem Blue Preferred,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Pathway,Anthem Pathway,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Alliance,Anthem Alliance,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Medicare,Anthem Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna,Cigna,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna PPO,Cigna PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna Medicare Advantage,Cigna Medicare Advantage,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Essence,Essence,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink HMO,Healthlink HMO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink PPO,Healthlink PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,HomeState Health Plan,HomeState Health Plan,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Humana Gold,Humana Gold,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Medicaid MO,Medicaid MO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Medica,Medica,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Tricare,Tricare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC All Payer,UHC All Payer,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Exchange,UHC Exchange,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicaid,UHC Medicaid,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,UMR CPD,UMR CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicare,UHC Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN SM      ,33152378,CDM,270,RC,,,,,,Inpatient,,,476,476,Wellcare,Wellcare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health PPO CPD,Meritain Health PPO CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/Commercial Product,Aetna/Commercial Product,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health CPD,Meritain Health CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Starmark CPD,Starmark CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna Medicare,Aetna Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Ambetter ,Ambetter ,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access,Anthem Blue Access,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access Choice,Anthem Blue Access Choice,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Preferred,Anthem Blue Preferred,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Pathway,Anthem Pathway,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Alliance,Anthem Alliance,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Medicare,Anthem Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna,Cigna,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna PPO,Cigna PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna Medicare Advantage,Cigna Medicare Advantage,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Essence,Essence,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink HMO,Healthlink HMO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink PPO,Healthlink PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,HomeState Health Plan,HomeState Health Plan,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Humana Gold,Humana Gold,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Medicaid MO,Medicaid MO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Medica,Medica,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Tricare,Tricare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC All Payer,UHC All Payer,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Exchange,UHC Exchange,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicaid,UHC Medicaid,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,UMR CPD,UMR CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicare,UHC Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN MED     ,33152379,CDM,270,RC,,,,,,Inpatient,,,476,476,Wellcare,Wellcare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health PPO CPD,Meritain Health PPO CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/Commercial Product,Aetna/Commercial Product,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health CPD,Meritain Health CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Starmark CPD,Starmark CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna Medicare,Aetna Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Ambetter ,Ambetter ,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access,Anthem Blue Access,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access Choice,Anthem Blue Access Choice,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Preferred,Anthem Blue Preferred,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Pathway,Anthem Pathway,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Alliance,Anthem Alliance,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Medicare,Anthem Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna,Cigna,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna PPO,Cigna PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna Medicare Advantage,Cigna Medicare Advantage,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Essence,Essence,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink HMO,Healthlink HMO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink PPO,Healthlink PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,HomeState Health Plan,HomeState Health Plan,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Humana Gold,Humana Gold,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Medicaid MO,Medicaid MO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Medica,Medica,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Tricare,Tricare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC All Payer,UHC All Payer,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Exchange,UHC Exchange,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicaid,UHC Medicaid,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,UMR CPD,UMR CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicare,UHC Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN LG      ,33152380,CDM,270,RC,,,,,,Inpatient,,,476,476,Wellcare,Wellcare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health PPO CPD,Meritain Health PPO CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna/Commercial Product,Aetna/Commercial Product,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Meritain Health CPD,Meritain Health CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Starmark CPD,Starmark CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Aetna Medicare,Aetna Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Ambetter ,Ambetter ,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access,Anthem Blue Access,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Access Choice,Anthem Blue Access Choice,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Blue Preferred,Anthem Blue Preferred,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Pathway,Anthem Pathway,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Alliance,Anthem Alliance,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Anthem Medicare,Anthem Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna,Cigna,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna PPO,Cigna PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Cigna Medicare Advantage,Cigna Medicare Advantage,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Essence,Essence,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink HMO,Healthlink HMO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Healthlink PPO,Healthlink PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,HomeState Health Plan,HomeState Health Plan,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Humana Gold,Humana Gold,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Medicaid MO,Medicaid MO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Medica,Medica,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Tricare,Tricare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC All Payer,UHC All Payer,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Exchange,UHC Exchange,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicaid,UHC Medicaid,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,UMR CPD,UMR CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,UHC Medicare,UHC Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
HELMET HARD SHELL TAN X-LG    ,33152381,CDM,270,RC,,,,,,Inpatient,,,476,476,Wellcare,Wellcare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Meritain Health PPO CPD,Meritain Health PPO CPD,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Aetna/Commercial Product,Aetna/Commercial Product,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Meritain Health CPD,Meritain Health CPD,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Starmark CPD,Starmark CPD,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Aetna Medicare,Aetna Medicare,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Ambetter ,Ambetter ,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Blue Access,Anthem Blue Access,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Blue Access Choice,Anthem Blue Access Choice,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Blue Preferred,Anthem Blue Preferred,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Pathway,Anthem Pathway,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Alliance,Anthem Alliance,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Anthem Medicare,Anthem Medicare,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Cigna,Cigna,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Cigna PPO,Cigna PPO,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Cigna Medicare Advantage,Cigna Medicare Advantage,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Essence,Essence,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Healthlink HMO,Healthlink HMO,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Healthlink PPO,Healthlink PPO,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,HomeState Health Plan,HomeState Health Plan,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Humana Gold,Humana Gold,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Medicaid MO,Medicaid MO,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Medica,Medica,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Tricare,Tricare,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,UHC All Payer,UHC All Payer,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,UHC Exchange,UHC Exchange,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,UHC Medicaid,UHC Medicaid,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,UMR CPD,UMR CPD,186,,,,,,,per diem,186,186,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,UHC Medicare,UHC Medicare,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL MIAMI JR      ,33152382,CDM,270,RC,,,,,,Inpatient,,,186,186,Wellcare,Wellcare,186,,,,,,,case rate,186,186,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Meritain Health PPO CPD,Meritain Health PPO CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna/Commercial Product,Aetna/Commercial Product,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Meritain Health CPD,Meritain Health CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Starmark CPD,Starmark CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna Medicare,Aetna Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Ambetter ,Ambetter ,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Access,Anthem Blue Access,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Access Choice,Anthem Blue Access Choice,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Preferred,Anthem Blue Preferred,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Pathway,Anthem Pathway,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Alliance,Anthem Alliance,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Medicare,Anthem Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna,Cigna,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna PPO,Cigna PPO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna Medicare Advantage,Cigna Medicare Advantage,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Essence,Essence,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthlink HMO,Healthlink HMO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthlink PPO,Healthlink PPO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,HomeState Health Plan,HomeState Health Plan,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Humana Gold,Humana Gold,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Medicaid MO,Medicaid MO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Medica,Medica,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Tricare,Tricare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC All Payer,UHC All Payer,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Exchange,UHC Exchange,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Medicaid,UHC Medicaid,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,UMR CPD,UMR CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Medicare,UHC Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SLING ARM ADULT UNIVERSAL     ,33152383,CDM,270,RC,,,,,,Inpatient,,,16,16,Wellcare,Wellcare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health PPO CPD,Meritain Health PPO CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/Commercial Product,Aetna/Commercial Product,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health CPD,Meritain Health CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Starmark CPD,Starmark CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna Medicare,Aetna Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Ambetter ,Ambetter ,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access,Anthem Blue Access,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access Choice,Anthem Blue Access Choice,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Preferred,Anthem Blue Preferred,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Pathway,Anthem Pathway,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Alliance,Anthem Alliance,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Medicare,Anthem Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna,Cigna,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna PPO,Cigna PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna Medicare Advantage,Cigna Medicare Advantage,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Essence,Essence,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink HMO,Healthlink HMO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink PPO,Healthlink PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,HomeState Health Plan,HomeState Health Plan,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Humana Gold,Humana Gold,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Medicaid MO,Medicaid MO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Medica,Medica,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Tricare,Tricare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC All Payer,UHC All Payer,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Exchange,UHC Exchange,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicaid,UHC Medicaid,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,UMR CPD,UMR CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicare,UHC Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG LT,33152386,CDM,270,RC,,,,,,Inpatient,,,341,341,Wellcare,Wellcare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health PPO CPD,Meritain Health PPO CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/Commercial Product,Aetna/Commercial Product,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health CPD,Meritain Health CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Starmark CPD,Starmark CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna Medicare,Aetna Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Ambetter ,Ambetter ,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access,Anthem Blue Access,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access Choice,Anthem Blue Access Choice,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Preferred,Anthem Blue Preferred,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Pathway,Anthem Pathway,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Alliance,Anthem Alliance,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Medicare,Anthem Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna,Cigna,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna PPO,Cigna PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna Medicare Advantage,Cigna Medicare Advantage,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Essence,Essence,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink HMO,Healthlink HMO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink PPO,Healthlink PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,HomeState Health Plan,HomeState Health Plan,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Humana Gold,Humana Gold,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Medicaid MO,Medicaid MO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Medica,Medica,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Tricare,Tricare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC All Payer,UHC All Payer,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Exchange,UHC Exchange,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicaid,UHC Medicaid,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,UMR CPD,UMR CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicare,UHC Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD LT ,33152387,CDM,270,RC,,,,,,Inpatient,,,341,341,Wellcare,Wellcare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health PPO CPD,Meritain Health PPO CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/Commercial Product,Aetna/Commercial Product,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health CPD,Meritain Health CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Starmark CPD,Starmark CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna Medicare,Aetna Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Ambetter ,Ambetter ,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access,Anthem Blue Access,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access Choice,Anthem Blue Access Choice,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Preferred,Anthem Blue Preferred,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Pathway,Anthem Pathway,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Alliance,Anthem Alliance,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Medicare,Anthem Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna,Cigna,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna PPO,Cigna PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna Medicare Advantage,Cigna Medicare Advantage,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Essence,Essence,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink HMO,Healthlink HMO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink PPO,Healthlink PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,HomeState Health Plan,HomeState Health Plan,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Humana Gold,Humana Gold,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Medicaid MO,Medicaid MO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Medica,Medica,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Tricare,Tricare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC All Payer,UHC All Payer,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Exchange,UHC Exchange,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicaid,UHC Medicaid,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,UMR CPD,UMR CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicare,UHC Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED MED/LG RT,33152388,CDM,270,RC,,,,,,Inpatient,,,341,341,Wellcare,Wellcare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health PPO CPD,Meritain Health PPO CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna/Commercial Product,Aetna/Commercial Product,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Meritain Health CPD,Meritain Health CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Starmark CPD,Starmark CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Aetna Medicare,Aetna Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Ambetter ,Ambetter ,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access,Anthem Blue Access,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Access Choice,Anthem Blue Access Choice,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Blue Preferred,Anthem Blue Preferred,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Pathway,Anthem Pathway,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Alliance,Anthem Alliance,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Anthem Medicare,Anthem Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna,Cigna,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna PPO,Cigna PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Cigna Medicare Advantage,Cigna Medicare Advantage,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Essence,Essence,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink HMO,Healthlink HMO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Healthlink PPO,Healthlink PPO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,HomeState Health Plan,HomeState Health Plan,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Humana Gold,Humana Gold,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Medicaid MO,Medicaid MO,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Medica,Medica,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Tricare,Tricare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC All Payer,UHC All Payer,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Exchange,UHC Exchange,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicaid,UHC Medicaid,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,UMR CPD,UMR CPD,341,,,,,,,per diem,341,341,"Per diem rate, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,UHC Medicare,UHC Medicare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
SPLINT FOREARM BASED SM/MD RT ,33152389,CDM,270,RC,,,,,,Inpatient,,,341,341,Wellcare,Wellcare,341,,,,,,,case rate,341,341,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Meritain Health PPO CPD,Meritain Health PPO CPD,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Aetna/Commercial Product,Aetna/Commercial Product,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Meritain Health CPD,Meritain Health CPD,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Starmark CPD,Starmark CPD,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Aetna Medicare,Aetna Medicare,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Ambetter ,Ambetter ,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Blue Access,Anthem Blue Access,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Blue Access Choice,Anthem Blue Access Choice,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Blue Preferred,Anthem Blue Preferred,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Pathway,Anthem Pathway,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Alliance,Anthem Alliance,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Anthem Medicare,Anthem Medicare,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Cigna,Cigna,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Cigna PPO,Cigna PPO,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Cigna Medicare Advantage,Cigna Medicare Advantage,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Essence,Essence,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Healthlink HMO,Healthlink HMO,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Healthlink PPO,Healthlink PPO,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,HomeState Health Plan,HomeState Health Plan,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Humana Gold,Humana Gold,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Medicaid MO,Medicaid MO,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Medica,Medica,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Tricare,Tricare,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,UHC All Payer,UHC All Payer,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,UHC Exchange,UHC Exchange,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,UHC Medicaid,UHC Medicaid,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,UMR CPD,UMR CPD,100,,,,,,,per diem,100,100,"Per diem rate, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,UHC Medicare,UHC Medicare,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
BRACE KNEE HINGED ADJUSTABLE M,33152390,CDM,270,RC,,,,,,Inpatient,,,100,100,Wellcare,Wellcare,100,,,,,,,case rate,100,100,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Meritain Health PPO CPD,Meritain Health PPO CPD,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Aetna/Commercial Product,Aetna/Commercial Product,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Meritain Health CPD,Meritain Health CPD,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Starmark CPD,Starmark CPD,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Aetna Medicare,Aetna Medicare,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Ambetter ,Ambetter ,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Blue Access,Anthem Blue Access,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Blue Access Choice,Anthem Blue Access Choice,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Blue Preferred,Anthem Blue Preferred,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Pathway,Anthem Pathway,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Alliance,Anthem Alliance,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Anthem Medicare,Anthem Medicare,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Cigna,Cigna,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Cigna PPO,Cigna PPO,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Cigna Medicare Advantage,Cigna Medicare Advantage,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Essence,Essence,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Healthlink HMO,Healthlink HMO,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Healthlink PPO,Healthlink PPO,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,HomeState Health Plan,HomeState Health Plan,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Humana Gold,Humana Gold,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Medicaid MO,Medicaid MO,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Medica,Medica,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Tricare,Tricare,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,UHC All Payer,UHC All Payer,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,UHC Exchange,UHC Exchange,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,UHC Medicaid,UHC Medicaid,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,UMR CPD,UMR CPD,24.59,,,,,,,per diem,24.59,24.59,"Per diem rate, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,UHC Medicare,UHC Medicare,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
PILLOW HEEL PRESUR RELIEF UNIV,33152395,CDM,270,RC,,,,,,Inpatient,,,24.59,24.59,Wellcare,Wellcare,24.59,,,,,,,case rate,24.59,24.59,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Meritain Health PPO CPD,Meritain Health PPO CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Aetna/Commercial Product,Aetna/Commercial Product,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Meritain Health CPD,Meritain Health CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Starmark CPD,Starmark CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Aetna Medicare,Aetna Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Ambetter ,Ambetter ,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Blue Access,Anthem Blue Access,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Blue Access Choice,Anthem Blue Access Choice,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Blue Preferred,Anthem Blue Preferred,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Pathway,Anthem Pathway,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Alliance,Anthem Alliance,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Anthem Medicare,Anthem Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Cigna,Cigna,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Cigna PPO,Cigna PPO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Cigna Medicare Advantage,Cigna Medicare Advantage,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Essence,Essence,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Healthlink HMO,Healthlink HMO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Healthlink PPO,Healthlink PPO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,HomeState Health Plan,HomeState Health Plan,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Humana Gold,Humana Gold,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Medicaid MO,Medicaid MO,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Medica,Medica,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Tricare,Tricare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,UHC All Payer,UHC All Payer,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,UHC Exchange,UHC Exchange,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,UHC Medicaid,UHC Medicaid,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,UMR CPD,UMR CPD,120,,,,,,,per diem,120,120,"Per diem rate, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,UHC Medicare,UHC Medicare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
BOOT DUAL AFO MED             ,33152400,CDM,270,RC,,,,,,Inpatient,,,120,120,Wellcare,Wellcare,120,,,,,,,case rate,120,120,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Meritain Health PPO CPD,Meritain Health PPO CPD,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Aetna/Commercial Product,Aetna/Commercial Product,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Meritain Health CPD,Meritain Health CPD,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Starmark CPD,Starmark CPD,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Aetna Medicare,Aetna Medicare,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Ambetter ,Ambetter ,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Blue Access,Anthem Blue Access,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Blue Access Choice,Anthem Blue Access Choice,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Blue Preferred,Anthem Blue Preferred,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Pathway,Anthem Pathway,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Alliance,Anthem Alliance,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Anthem Medicare,Anthem Medicare,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Cigna,Cigna,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Cigna PPO,Cigna PPO,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Cigna Medicare Advantage,Cigna Medicare Advantage,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Essence,Essence,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Healthlink HMO,Healthlink HMO,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Healthlink PPO,Healthlink PPO,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,HomeState Health Plan,HomeState Health Plan,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Humana Gold,Humana Gold,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Medicaid MO,Medicaid MO,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Medica,Medica,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Tricare,Tricare,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,UHC All Payer,UHC All Payer,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,UHC Exchange,UHC Exchange,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,UHC Medicaid,UHC Medicaid,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,UMR CPD,UMR CPD,256,,,,,,,per diem,256,256,"Per diem rate, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,UHC Medicare,UHC Medicare,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
HARNESS CHEST BUTTERFLY FML LG,33152401,CDM,270,RC,,,,,,Inpatient,,,256,256,Wellcare,Wellcare,256,,,,,,,case rate,256,256,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Meritain Health PPO CPD,Meritain Health PPO CPD,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Aetna/Commercial Product,Aetna/Commercial Product,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Meritain Health CPD,Meritain Health CPD,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Starmark CPD,Starmark CPD,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Aetna Medicare,Aetna Medicare,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Ambetter ,Ambetter ,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Blue Access,Anthem Blue Access,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Blue Access Choice,Anthem Blue Access Choice,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Blue Preferred,Anthem Blue Preferred,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Pathway,Anthem Pathway,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Alliance,Anthem Alliance,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Anthem Medicare,Anthem Medicare,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Cigna,Cigna,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Cigna PPO,Cigna PPO,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Cigna Medicare Advantage,Cigna Medicare Advantage,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Essence,Essence,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Healthlink HMO,Healthlink HMO,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Healthlink PPO,Healthlink PPO,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,HomeState Health Plan,HomeState Health Plan,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Humana Gold,Humana Gold,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Medicaid MO,Medicaid MO,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Medica,Medica,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Tricare,Tricare,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,UHC All Payer,UHC All Payer,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,UHC Exchange,UHC Exchange,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,UHC Medicaid,UHC Medicaid,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,UMR CPD,UMR CPD,49,,,,,,,per diem,49,49,"Per diem rate, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,UHC Medicare,UHC Medicare,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
SPLINT THUMB BILATERAL        ,33152402,CDM,270,RC,,,,,,Inpatient,,,49,49,Wellcare,Wellcare,49,,,,,,,case rate,49,49,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Meritain Health PPO CPD,Meritain Health PPO CPD,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Aetna/Commercial Product,Aetna/Commercial Product,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Meritain Health CPD,Meritain Health CPD,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Starmark CPD,Starmark CPD,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Aetna Medicare,Aetna Medicare,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Ambetter ,Ambetter ,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Blue Access,Anthem Blue Access,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Blue Access Choice,Anthem Blue Access Choice,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Blue Preferred,Anthem Blue Preferred,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Pathway,Anthem Pathway,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Alliance,Anthem Alliance,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Anthem Medicare,Anthem Medicare,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Cigna,Cigna,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Cigna PPO,Cigna PPO,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Cigna Medicare Advantage,Cigna Medicare Advantage,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Essence,Essence,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Healthlink HMO,Healthlink HMO,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Healthlink PPO,Healthlink PPO,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,HomeState Health Plan,HomeState Health Plan,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Humana Gold,Humana Gold,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Medicaid MO,Medicaid MO,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Medica,Medica,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Tricare,Tricare,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,UHC All Payer,UHC All Payer,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,UHC Exchange,UHC Exchange,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,UHC Medicaid,UHC Medicaid,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,UMR CPD,UMR CPD,64,,,,,,,per diem,64,64,"Per diem rate, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,UHC Medicare,UHC Medicare,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
BRACE LUMBAR MUELLER REMOV PAD,33152403,CDM,270,RC,,,,,,Inpatient,,,64,64,Wellcare,Wellcare,64,,,,,,,case rate,64,64,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Meritain Health PPO CPD,Meritain Health PPO CPD,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Aetna/Commercial Product,Aetna/Commercial Product,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Meritain Health CPD,Meritain Health CPD,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Starmark CPD,Starmark CPD,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Aetna Medicare,Aetna Medicare,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Ambetter ,Ambetter ,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Blue Access,Anthem Blue Access,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Blue Access Choice,Anthem Blue Access Choice,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Blue Preferred,Anthem Blue Preferred,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Pathway,Anthem Pathway,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Alliance,Anthem Alliance,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Anthem Medicare,Anthem Medicare,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Cigna,Cigna,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Cigna PPO,Cigna PPO,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Cigna Medicare Advantage,Cigna Medicare Advantage,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Essence,Essence,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Healthlink HMO,Healthlink HMO,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Healthlink PPO,Healthlink PPO,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,HomeState Health Plan,HomeState Health Plan,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Humana Gold,Humana Gold,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Medicaid MO,Medicaid MO,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Medica,Medica,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Tricare,Tricare,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,UHC All Payer,UHC All Payer,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,UHC Exchange,UHC Exchange,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,UHC Medicaid,UHC Medicaid,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,UMR CPD,UMR CPD,262,,,,,,,per diem,262,262,"Per diem rate, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,UHC Medicare,UHC Medicare,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
COLLAR CERVICAL HEADMASTER JUN,33152421,CDM,270,RC,,,,,,Inpatient,,,262,262,Wellcare,Wellcare,262,,,,,,,case rate,262,262,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM LT,33152422,CDM,270,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD LT,33152423,CDM,270,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM LG LT,33152424,CDM,270,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM SM RT,33152425,CDM,270,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health PPO CPD,Meritain Health PPO CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna/Commercial Product,Aetna/Commercial Product,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Meritain Health CPD,Meritain Health CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Starmark CPD,Starmark CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Aetna Medicare,Aetna Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Ambetter ,Ambetter ,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access,Anthem Blue Access,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Access Choice,Anthem Blue Access Choice,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Blue Preferred,Anthem Blue Preferred,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Pathway,Anthem Pathway,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Alliance,Anthem Alliance,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Anthem Medicare,Anthem Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna,Cigna,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna PPO,Cigna PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Cigna Medicare Advantage,Cigna Medicare Advantage,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Essence,Essence,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink HMO,Healthlink HMO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Healthlink PPO,Healthlink PPO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,HomeState Health Plan,HomeState Health Plan,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Humana Gold,Humana Gold,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Medicaid MO,Medicaid MO,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Medica,Medica,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Tricare,Tricare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC All Payer,UHC All Payer,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Exchange,UHC Exchange,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicaid,UHC Medicaid,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,UMR CPD,UMR CPD,77,,,,,,,per diem,77,77,"Per diem rate, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,UHC Medicare,UHC Medicare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
BRACE HUMRUS FX AQUAFORM MD RT,33152426,CDM,270,RC,,,,,,Inpatient,,,77,77,Wellcare,Wellcare,77,,,,,,,case rate,77,77,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Meritain Health PPO CPD,Meritain Health PPO CPD,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Aetna/Commercial Product,Aetna/Commercial Product,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Meritain Health CPD,Meritain Health CPD,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Starmark CPD,Starmark CPD,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Aetna Medicare,Aetna Medicare,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Ambetter ,Ambetter ,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Blue Access,Anthem Blue Access,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Blue Access Choice,Anthem Blue Access Choice,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Blue Preferred,Anthem Blue Preferred,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Pathway,Anthem Pathway,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Alliance,Anthem Alliance,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Anthem Medicare,Anthem Medicare,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Cigna,Cigna,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Cigna PPO,Cigna PPO,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Cigna Medicare Advantage,Cigna Medicare Advantage,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Essence,Essence,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Healthlink HMO,Healthlink HMO,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Healthlink PPO,Healthlink PPO,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,HomeState Health Plan,HomeState Health Plan,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Humana Gold,Humana Gold,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Medicaid MO,Medicaid MO,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Medica,Medica,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Tricare,Tricare,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,UHC All Payer,UHC All Payer,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,UHC Exchange,UHC Exchange,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,UHC Medicaid,UHC Medicaid,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,UMR CPD,UMR CPD,12.95,,,,,,,per diem,12.95,12.95,"Per diem rate, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,UHC Medicare,UHC Medicare,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING ENTERAL PUMP W/   ,33154081,CDM,279,RC,,,,,,Inpatient,,,12.95,12.95,Wellcare,Wellcare,12.95,,,,,,,case rate,12.95,12.95,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Meritain Health PPO CPD,Meritain Health PPO CPD,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Aetna/Commercial Product,Aetna/Commercial Product,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Meritain Health CPD,Meritain Health CPD,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Starmark CPD,Starmark CPD,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Aetna Medicare,Aetna Medicare,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Ambetter ,Ambetter ,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Blue Access,Anthem Blue Access,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Blue Access Choice,Anthem Blue Access Choice,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Blue Preferred,Anthem Blue Preferred,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Pathway,Anthem Pathway,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Alliance,Anthem Alliance,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Anthem Medicare,Anthem Medicare,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Cigna,Cigna,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Cigna PPO,Cigna PPO,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Cigna Medicare Advantage,Cigna Medicare Advantage,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Essence,Essence,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Healthlink HMO,Healthlink HMO,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Healthlink PPO,Healthlink PPO,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,HomeState Health Plan,HomeState Health Plan,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Humana Gold,Humana Gold,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Medicaid MO,Medicaid MO,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Medica,Medica,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Tricare,Tricare,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,UHC All Payer,UHC All Payer,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,UHC Exchange,UHC Exchange,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,UHC Medicaid,UHC Medicaid,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,UMR CPD,UMR CPD,4.82,,,,,,,per diem,4.82,4.82,"Per diem rate, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,UHC Medicare,UHC Medicare,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
SET FEEDING KANGAROO GRAVITY  ,33154082,CDM,279,RC,,,,,,Inpatient,,,4.82,4.82,Wellcare,Wellcare,4.82,,,,,,,case rate,4.82,4.82,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Meritain Health PPO CPD,Meritain Health PPO CPD,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Aetna/Commercial Product,Aetna/Commercial Product,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Meritain Health CPD,Meritain Health CPD,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Starmark CPD,Starmark CPD,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Aetna Medicare,Aetna Medicare,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Ambetter ,Ambetter ,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Blue Access,Anthem Blue Access,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Blue Access Choice,Anthem Blue Access Choice,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Blue Preferred,Anthem Blue Preferred,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Pathway,Anthem Pathway,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Alliance,Anthem Alliance,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Anthem Medicare,Anthem Medicare,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Cigna,Cigna,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Cigna PPO,Cigna PPO,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Cigna Medicare Advantage,Cigna Medicare Advantage,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Essence,Essence,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Healthlink HMO,Healthlink HMO,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Healthlink PPO,Healthlink PPO,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,HomeState Health Plan,HomeState Health Plan,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Humana Gold,Humana Gold,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Medicaid MO,Medicaid MO,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Medica,Medica,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Tricare,Tricare,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,UHC All Payer,UHC All Payer,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,UHC Exchange,UHC Exchange,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,UHC Medicaid,UHC Medicaid,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,UMR CPD,UMR CPD,3.62,,,,,,,per diem,3.62,3.62,"Per diem rate, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,UHC Medicare,UHC Medicare,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
POSITIONER HEAD FOAM SURGICAL ,33154138,CDM,270,RC,,,,,,Inpatient,,,3.62,3.62,Wellcare,Wellcare,3.62,,,,,,,case rate,3.62,3.62,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Meritain Health PPO CPD,Meritain Health PPO CPD,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Aetna/Commercial Product,Aetna/Commercial Product,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Meritain Health CPD,Meritain Health CPD,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Starmark CPD,Starmark CPD,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Aetna Medicare,Aetna Medicare,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Ambetter ,Ambetter ,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Blue Access,Anthem Blue Access,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Blue Access Choice,Anthem Blue Access Choice,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Blue Preferred,Anthem Blue Preferred,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Pathway,Anthem Pathway,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Alliance,Anthem Alliance,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Anthem Medicare,Anthem Medicare,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Cigna,Cigna,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Cigna PPO,Cigna PPO,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Cigna Medicare Advantage,Cigna Medicare Advantage,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Essence,Essence,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Healthlink HMO,Healthlink HMO,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Healthlink PPO,Healthlink PPO,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,HomeState Health Plan,HomeState Health Plan,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Humana Gold,Humana Gold,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Medicaid MO,Medicaid MO,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Medica,Medica,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Tricare,Tricare,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,UHC All Payer,UHC All Payer,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,UHC Exchange,UHC Exchange,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,UHC Medicaid,UHC Medicaid,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,UMR CPD,UMR CPD,11.64,,,,,,,per diem,11.64,11.64,"Per diem rate, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,UHC Medicare,UHC Medicare,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PROTECTOR HEEL AND ELBOW      ,33154139,CDM,270,RC,,,,,,Inpatient,,,11.64,11.64,Wellcare,Wellcare,11.64,,,,,,,case rate,11.64,11.64,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Meritain Health PPO CPD,Meritain Health PPO CPD,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Aetna/Commercial Product,Aetna/Commercial Product,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Meritain Health CPD,Meritain Health CPD,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Starmark CPD,Starmark CPD,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Aetna Medicare,Aetna Medicare,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Ambetter ,Ambetter ,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Blue Access,Anthem Blue Access,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Blue Access Choice,Anthem Blue Access Choice,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Blue Preferred,Anthem Blue Preferred,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Pathway,Anthem Pathway,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Alliance,Anthem Alliance,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Anthem Medicare,Anthem Medicare,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Cigna,Cigna,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Cigna PPO,Cigna PPO,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Cigna Medicare Advantage,Cigna Medicare Advantage,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Essence,Essence,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Healthlink HMO,Healthlink HMO,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Healthlink PPO,Healthlink PPO,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,HomeState Health Plan,HomeState Health Plan,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Humana Gold,Humana Gold,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Medicaid MO,Medicaid MO,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Medica,Medica,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Tricare,Tricare,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,UHC All Payer,UHC All Payer,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,UHC Exchange,UHC Exchange,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,UHC Medicaid,UHC Medicaid,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,UMR CPD,UMR CPD,91.13,,,,,,,per diem,91.13,91.13,"Per diem rate, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,UHC Medicare,UHC Medicare,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
PAD CONVOLUTED BED OVERLAY    ,33154217,CDM,279,RC,,,,,,Inpatient,,,91.13,91.13,Wellcare,Wellcare,91.13,,,,,,,case rate,91.13,91.13,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Meritain Health PPO CPD,Meritain Health PPO CPD,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Aetna/Commercial Product,Aetna/Commercial Product,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Meritain Health CPD,Meritain Health CPD,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Starmark CPD,Starmark CPD,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Aetna Medicare,Aetna Medicare,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Ambetter ,Ambetter ,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Blue Access,Anthem Blue Access,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Blue Access Choice,Anthem Blue Access Choice,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Blue Preferred,Anthem Blue Preferred,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Pathway,Anthem Pathway,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Alliance,Anthem Alliance,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Anthem Medicare,Anthem Medicare,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Cigna,Cigna,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Cigna PPO,Cigna PPO,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Cigna Medicare Advantage,Cigna Medicare Advantage,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Essence,Essence,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Healthlink HMO,Healthlink HMO,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Healthlink PPO,Healthlink PPO,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,HomeState Health Plan,HomeState Health Plan,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Humana Gold,Humana Gold,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Medicaid MO,Medicaid MO,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Medica,Medica,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Tricare,Tricare,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,UHC All Payer,UHC All Payer,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,UHC Exchange,UHC Exchange,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,UHC Medicaid,UHC Medicaid,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,UMR CPD,UMR CPD,25.93,,,,,,,per diem,25.93,25.93,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,UHC Medicare,UHC Medicare,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM DARK TONE     ,33154271,CDM,270,RC,,,,,,Inpatient,,,25.93,25.93,Wellcare,Wellcare,25.93,,,,,,,case rate,25.93,25.93,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Meritain Health PPO CPD,Meritain Health PPO CPD,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Aetna/Commercial Product,Aetna/Commercial Product,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Meritain Health CPD,Meritain Health CPD,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Starmark CPD,Starmark CPD,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Aetna Medicare,Aetna Medicare,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Ambetter ,Ambetter ,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Blue Access,Anthem Blue Access,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Blue Access Choice,Anthem Blue Access Choice,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Blue Preferred,Anthem Blue Preferred,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Pathway,Anthem Pathway,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Alliance,Anthem Alliance,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Anthem Medicare,Anthem Medicare,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Cigna,Cigna,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Cigna PPO,Cigna PPO,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Cigna Medicare Advantage,Cigna Medicare Advantage,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Essence,Essence,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Healthlink HMO,Healthlink HMO,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Healthlink PPO,Healthlink PPO,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,HomeState Health Plan,HomeState Health Plan,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Humana Gold,Humana Gold,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Medicaid MO,Medicaid MO,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Medica,Medica,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Tricare,Tricare,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,UHC All Payer,UHC All Payer,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,UHC Exchange,UHC Exchange,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,UHC Medicaid,UHC Medicaid,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,UMR CPD,UMR CPD,23.85,,,,,,,per diem,23.85,23.85,"Per diem rate, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,UHC Medicare,UHC Medicare,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
SLEEVE SKIN ARM MEDIUM LIGHT  ,33154272,CDM,270,RC,,,,,,Inpatient,,,23.85,23.85,Wellcare,Wellcare,23.85,,,,,,,case rate,23.85,23.85,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Meritain Health PPO CPD,Meritain Health PPO CPD,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Aetna/Commercial Product,Aetna/Commercial Product,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Meritain Health CPD,Meritain Health CPD,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Starmark CPD,Starmark CPD,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Aetna Medicare,Aetna Medicare,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Ambetter ,Ambetter ,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Blue Access,Anthem Blue Access,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Blue Access Choice,Anthem Blue Access Choice,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Blue Preferred,Anthem Blue Preferred,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Pathway,Anthem Pathway,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Alliance,Anthem Alliance,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Anthem Medicare,Anthem Medicare,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Cigna,Cigna,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Cigna PPO,Cigna PPO,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Cigna Medicare Advantage,Cigna Medicare Advantage,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Essence,Essence,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Healthlink HMO,Healthlink HMO,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Healthlink PPO,Healthlink PPO,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,HomeState Health Plan,HomeState Health Plan,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Humana Gold,Humana Gold,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Medicaid MO,Medicaid MO,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Medica,Medica,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Tricare,Tricare,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,UHC All Payer,UHC All Payer,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,UHC Exchange,UHC Exchange,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,UHC Medicaid,UHC Medicaid,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,UMR CPD,UMR CPD,18.3,,,,,,,per diem,18.3,18.3,"Per diem rate, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,UHC Medicare,UHC Medicare,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
WEDGE POSITIONING 22X12X9IN   ,33154289,CDM,270,RC,,,,,,Inpatient,,,18.3,18.3,Wellcare,Wellcare,18.3,,,,,,,case rate,18.3,18.3,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Meritain Health PPO CPD,Meritain Health PPO CPD,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Aetna/Commercial Product,Aetna/Commercial Product,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Meritain Health CPD,Meritain Health CPD,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Starmark CPD,Starmark CPD,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Aetna Medicare,Aetna Medicare,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Ambetter ,Ambetter ,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Blue Access,Anthem Blue Access,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Blue Access Choice,Anthem Blue Access Choice,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Blue Preferred,Anthem Blue Preferred,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Pathway,Anthem Pathway,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Alliance,Anthem Alliance,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Anthem Medicare,Anthem Medicare,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Cigna,Cigna,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Cigna PPO,Cigna PPO,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Cigna Medicare Advantage,Cigna Medicare Advantage,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Essence,Essence,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Healthlink HMO,Healthlink HMO,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Healthlink PPO,Healthlink PPO,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,HomeState Health Plan,HomeState Health Plan,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Humana Gold,Humana Gold,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Medicaid MO,Medicaid MO,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Medica,Medica,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Tricare,Tricare,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,UHC All Payer,UHC All Payer,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,UHC Exchange,UHC Exchange,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,UHC Medicaid,UHC Medicaid,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,UMR CPD,UMR CPD,129.78,,,,,,,per diem,129.78,129.78,"Per diem rate, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,UHC Medicare,UHC Medicare,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Lift Belt for Roomer and Singe,33154373,CDM,279,RC,,,,,,Inpatient,,,129.78,129.78,Wellcare,Wellcare,129.78,,,,,,,case rate,129.78,129.78,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health PPO CPD,Meritain Health PPO CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/Commercial Product,Aetna/Commercial Product,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health CPD,Meritain Health CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Starmark CPD,Starmark CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna Medicare,Aetna Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Ambetter ,Ambetter ,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access,Anthem Blue Access,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access Choice,Anthem Blue Access Choice,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Preferred,Anthem Blue Preferred,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Pathway,Anthem Pathway,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Alliance,Anthem Alliance,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Medicare,Anthem Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna,Cigna,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna PPO,Cigna PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna Medicare Advantage,Cigna Medicare Advantage,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Essence,Essence,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink HMO,Healthlink HMO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink PPO,Healthlink PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,HomeState Health Plan,HomeState Health Plan,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Humana Gold,Humana Gold,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medicaid MO,Medicaid MO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medica,Medica,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Tricare,Tricare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC All Payer,UHC All Payer,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Exchange,UHC Exchange,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicaid,UHC Medicaid,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UMR CPD,UMR CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicare,UHC Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Pediatric  w/R ,33154379,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Wellcare,Wellcare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health PPO CPD,Meritain Health PPO CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/Commercial Product,Aetna/Commercial Product,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health CPD,Meritain Health CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Starmark CPD,Starmark CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna Medicare,Aetna Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Ambetter ,Ambetter ,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access,Anthem Blue Access,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access Choice,Anthem Blue Access Choice,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Preferred,Anthem Blue Preferred,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Pathway,Anthem Pathway,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Alliance,Anthem Alliance,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Medicare,Anthem Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna,Cigna,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna PPO,Cigna PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna Medicare Advantage,Cigna Medicare Advantage,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Essence,Essence,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink HMO,Healthlink HMO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink PPO,Healthlink PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,HomeState Health Plan,HomeState Health Plan,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Humana Gold,Humana Gold,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medicaid MO,Medicaid MO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medica,Medica,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Tricare,Tricare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC All Payer,UHC All Payer,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Exchange,UHC Exchange,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicaid,UHC Medicaid,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UMR CPD,UMR CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicare,UHC Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Reg  w/Replace ,33154380,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Wellcare,Wellcare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health PPO CPD,Meritain Health PPO CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/Commercial Product,Aetna/Commercial Product,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health CPD,Meritain Health CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Starmark CPD,Starmark CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna Medicare,Aetna Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Ambetter ,Ambetter ,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access,Anthem Blue Access,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access Choice,Anthem Blue Access Choice,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Preferred,Anthem Blue Preferred,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Pathway,Anthem Pathway,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Alliance,Anthem Alliance,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Medicare,Anthem Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna,Cigna,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna PPO,Cigna PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna Medicare Advantage,Cigna Medicare Advantage,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Essence,Essence,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink HMO,Healthlink HMO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink PPO,Healthlink PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,HomeState Health Plan,HomeState Health Plan,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Humana Gold,Humana Gold,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medicaid MO,Medicaid MO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medica,Medica,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Tricare,Tricare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC All Payer,UHC All Payer,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Exchange,UHC Exchange,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicaid,UHC Medicaid,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UMR CPD,UMR CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicare,UHC Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Super short  w ,33154381,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Wellcare,Wellcare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health PPO CPD,Meritain Health PPO CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/Commercial Product,Aetna/Commercial Product,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health CPD,Meritain Health CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Starmark CPD,Starmark CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna Medicare,Aetna Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Ambetter ,Ambetter ,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access,Anthem Blue Access,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access Choice,Anthem Blue Access Choice,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Preferred,Anthem Blue Preferred,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Pathway,Anthem Pathway,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Alliance,Anthem Alliance,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Medicare,Anthem Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna,Cigna,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna PPO,Cigna PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna Medicare Advantage,Cigna Medicare Advantage,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Essence,Essence,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink HMO,Healthlink HMO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink PPO,Healthlink PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,HomeState Health Plan,HomeState Health Plan,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Humana Gold,Humana Gold,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medicaid MO,Medicaid MO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medica,Medica,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Tricare,Tricare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC All Payer,UHC All Payer,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Exchange,UHC Exchange,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicaid,UHC Medicaid,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UMR CPD,UMR CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicare,UHC Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar XS  w/Replacem ,33154382,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Wellcare,Wellcare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Meritain Health PPO CPD,Meritain Health PPO CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Aetna/Commercial Product,Aetna/Commercial Product,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Meritain Health CPD,Meritain Health CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Starmark CPD,Starmark CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Aetna Medicare,Aetna Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Ambetter ,Ambetter ,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Blue Access,Anthem Blue Access,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Blue Access Choice,Anthem Blue Access Choice,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Blue Preferred,Anthem Blue Preferred,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Pathway,Anthem Pathway,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Alliance,Anthem Alliance,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Anthem Medicare,Anthem Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Cigna,Cigna,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Cigna PPO,Cigna PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Cigna Medicare Advantage,Cigna Medicare Advantage,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Essence,Essence,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Healthlink HMO,Healthlink HMO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Healthlink PPO,Healthlink PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,HomeState Health Plan,HomeState Health Plan,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Humana Gold,Humana Gold,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Medicaid MO,Medicaid MO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Medica,Medica,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Tricare,Tricare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,UHC All Payer,UHC All Payer,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,UHC Exchange,UHC Exchange,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,UHC Medicaid,UHC Medicaid,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,UMR CPD,UMR CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,UHC Medicare,UHC Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
18IN Univ Knee Immobilizer Ext,33154383,CDM,270,RC,,,,,,Inpatient,,,101.97,101.97,Wellcare,Wellcare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Meritain Health PPO CPD,Meritain Health PPO CPD,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Aetna/Commercial Product,Aetna/Commercial Product,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Meritain Health CPD,Meritain Health CPD,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Starmark CPD,Starmark CPD,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Aetna Medicare,Aetna Medicare,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Ambetter ,Ambetter ,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Blue Access,Anthem Blue Access,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Blue Access Choice,Anthem Blue Access Choice,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Blue Preferred,Anthem Blue Preferred,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Pathway,Anthem Pathway,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Alliance,Anthem Alliance,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Anthem Medicare,Anthem Medicare,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Cigna,Cigna,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Cigna PPO,Cigna PPO,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Cigna Medicare Advantage,Cigna Medicare Advantage,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Essence,Essence,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Healthlink HMO,Healthlink HMO,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Healthlink PPO,Healthlink PPO,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,HomeState Health Plan,HomeState Health Plan,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Humana Gold,Humana Gold,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Medicaid MO,Medicaid MO,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Medica,Medica,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Tricare,Tricare,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,UHC All Payer,UHC All Payer,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,UHC Exchange,UHC Exchange,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,UHC Medicaid,UHC Medicaid,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,UMR CPD,UMR CPD,62.36,,,,,,,per diem,62.36,62.36,"Per diem rate, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,UHC Medicare,UHC Medicare,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
ABD Binders 2XL               ,33154384,CDM,270,RC,,,,,,Inpatient,,,62.36,62.36,Wellcare,Wellcare,62.36,,,,,,,case rate,62.36,62.36,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health PPO CPD,Meritain Health PPO CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/Commercial Product,Aetna/Commercial Product,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health CPD,Meritain Health CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Starmark CPD,Starmark CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna Medicare,Aetna Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Ambetter ,Ambetter ,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access,Anthem Blue Access,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access Choice,Anthem Blue Access Choice,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Preferred,Anthem Blue Preferred,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Pathway,Anthem Pathway,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Alliance,Anthem Alliance,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Medicare,Anthem Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna,Cigna,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna PPO,Cigna PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna Medicare Advantage,Cigna Medicare Advantage,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Essence,Essence,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink HMO,Healthlink HMO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink PPO,Healthlink PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,HomeState Health Plan,HomeState Health Plan,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Humana Gold,Humana Gold,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medicaid MO,Medicaid MO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medica,Medica,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Tricare,Tricare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC All Payer,UHC All Payer,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Exchange,UHC Exchange,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicaid,UHC Medicaid,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UMR CPD,UMR CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicare,UHC Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right L,33154385,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Wellcare,Wellcare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health PPO CPD,Meritain Health PPO CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/Commercial Product,Aetna/Commercial Product,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health CPD,Meritain Health CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Starmark CPD,Starmark CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna Medicare,Aetna Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Ambetter ,Ambetter ,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access,Anthem Blue Access,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access Choice,Anthem Blue Access Choice,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Preferred,Anthem Blue Preferred,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Pathway,Anthem Pathway,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Alliance,Anthem Alliance,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Medicare,Anthem Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna,Cigna,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna PPO,Cigna PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna Medicare Advantage,Cigna Medicare Advantage,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Essence,Essence,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink HMO,Healthlink HMO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink PPO,Healthlink PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,HomeState Health Plan,HomeState Health Plan,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Humana Gold,Humana Gold,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medicaid MO,Medicaid MO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medica,Medica,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Tricare,Tricare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC All Payer,UHC All Payer,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Exchange,UHC Exchange,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicaid,UHC Medicaid,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UMR CPD,UMR CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicare,UHC Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right M,33154386,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Wellcare,Wellcare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health PPO CPD,Meritain Health PPO CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna/Commercial Product,Aetna/Commercial Product,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Meritain Health CPD,Meritain Health CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Starmark CPD,Starmark CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Aetna Medicare,Aetna Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Ambetter ,Ambetter ,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access,Anthem Blue Access,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Access Choice,Anthem Blue Access Choice,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Blue Preferred,Anthem Blue Preferred,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Pathway,Anthem Pathway,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Alliance,Anthem Alliance,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Anthem Medicare,Anthem Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna,Cigna,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna PPO,Cigna PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Cigna Medicare Advantage,Cigna Medicare Advantage,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Essence,Essence,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink HMO,Healthlink HMO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Healthlink PPO,Healthlink PPO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,HomeState Health Plan,HomeState Health Plan,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Humana Gold,Humana Gold,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medicaid MO,Medicaid MO,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Medica,Medica,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Tricare,Tricare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC All Payer,UHC All Payer,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Exchange,UHC Exchange,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicaid,UHC Medicaid,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UMR CPD,UMR CPD,18.54,,,,,,,per diem,18.54,18.54,"Per diem rate, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,UHC Medicare,UHC Medicare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Adjuster Lift or Level Right S,33154387,CDM,270,RC,,,,,,Inpatient,,,18.54,18.54,Wellcare,Wellcare,18.54,,,,,,,case rate,18.54,18.54,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Meritain Health PPO CPD,Meritain Health PPO CPD,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Aetna/Commercial Product,Aetna/Commercial Product,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Meritain Health CPD,Meritain Health CPD,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Starmark CPD,Starmark CPD,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Aetna Medicare,Aetna Medicare,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Ambetter ,Ambetter ,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Blue Access,Anthem Blue Access,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Blue Access Choice,Anthem Blue Access Choice,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Blue Preferred,Anthem Blue Preferred,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Pathway,Anthem Pathway,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Alliance,Anthem Alliance,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Anthem Medicare,Anthem Medicare,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Cigna,Cigna,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Cigna PPO,Cigna PPO,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Cigna Medicare Advantage,Cigna Medicare Advantage,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Essence,Essence,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Healthlink HMO,Healthlink HMO,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Healthlink PPO,Healthlink PPO,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,HomeState Health Plan,HomeState Health Plan,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Humana Gold,Humana Gold,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Medicaid MO,Medicaid MO,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Medica,Medica,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Tricare,Tricare,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,UHC All Payer,UHC All Payer,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,UHC Exchange,UHC Exchange,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,UHC Medicaid,UHC Medicaid,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,UMR CPD,UMR CPD,277.95,,,,,,,per diem,277.95,277.95,"Per diem rate, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,UHC Medicare,UHC Medicare,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
Aspen QuikDraw Pro White-Med. ,33154389,CDM,270,RC,,,,,,Inpatient,,,277.95,277.95,Wellcare,Wellcare,277.95,,,,,,,case rate,277.95,277.95,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Meritain Health PPO CPD,Meritain Health PPO CPD,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Aetna/Commercial Product,Aetna/Commercial Product,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Meritain Health CPD,Meritain Health CPD,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Starmark CPD,Starmark CPD,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Aetna Medicare,Aetna Medicare,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Ambetter ,Ambetter ,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Blue Access,Anthem Blue Access,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Blue Access Choice,Anthem Blue Access Choice,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Blue Preferred,Anthem Blue Preferred,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Pathway,Anthem Pathway,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Alliance,Anthem Alliance,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Anthem Medicare,Anthem Medicare,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Cigna,Cigna,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Cigna PPO,Cigna PPO,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Cigna Medicare Advantage,Cigna Medicare Advantage,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Essence,Essence,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Healthlink HMO,Healthlink HMO,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Healthlink PPO,Healthlink PPO,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,HomeState Health Plan,HomeState Health Plan,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Humana Gold,Humana Gold,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Medicaid MO,Medicaid MO,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Medica,Medica,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Tricare,Tricare,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,UHC All Payer,UHC All Payer,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,UHC Exchange,UHC Exchange,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,UHC Medicaid,UHC Medicaid,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,UMR CPD,UMR CPD,66.68,,,,,,,per diem,66.68,66.68,"Per diem rate, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,UHC Medicare,UHC Medicare,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
DARCO Off-loading Shoe        ,33154393,CDM,270,RC,,,,,,Inpatient,,,66.68,66.68,Wellcare,Wellcare,66.68,,,,,,,case rate,66.68,66.68,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Meritain Health PPO CPD,Meritain Health PPO CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna/Commercial Product,Aetna/Commercial Product,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Meritain Health CPD,Meritain Health CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Starmark CPD,Starmark CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna Medicare,Aetna Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Ambetter ,Ambetter ,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Access,Anthem Blue Access,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Access Choice,Anthem Blue Access Choice,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Preferred,Anthem Blue Preferred,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Pathway,Anthem Pathway,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Alliance,Anthem Alliance,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Medicare,Anthem Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna,Cigna,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna PPO,Cigna PPO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna Medicare Advantage,Cigna Medicare Advantage,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Essence,Essence,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthlink HMO,Healthlink HMO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthlink PPO,Healthlink PPO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,HomeState Health Plan,HomeState Health Plan,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Humana Gold,Humana Gold,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Medicaid MO,Medicaid MO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Medica,Medica,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Tricare,Tricare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC All Payer,UHC All Payer,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Exchange,UHC Exchange,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Medicaid,UHC Medicaid,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UMR CPD,UMR CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Medicare,UHC Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe L       ,33154394,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Wellcare,Wellcare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Meritain Health PPO CPD,Meritain Health PPO CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna/Commercial Product,Aetna/Commercial Product,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Meritain Health CPD,Meritain Health CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Starmark CPD,Starmark CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Aetna Medicare,Aetna Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Ambetter ,Ambetter ,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Access,Anthem Blue Access,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Access Choice,Anthem Blue Access Choice,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Blue Preferred,Anthem Blue Preferred,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Pathway,Anthem Pathway,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Alliance,Anthem Alliance,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Anthem Medicare,Anthem Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna,Cigna,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna PPO,Cigna PPO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Cigna Medicare Advantage,Cigna Medicare Advantage,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Essence,Essence,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthlink HMO,Healthlink HMO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Healthlink PPO,Healthlink PPO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,HomeState Health Plan,HomeState Health Plan,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Humana Gold,Humana Gold,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Medicaid MO,Medicaid MO,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Medica,Medica,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Tricare,Tricare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC All Payer,UHC All Payer,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Exchange,UHC Exchange,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Medicaid,UHC Medicaid,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UMR CPD,UMR CPD,55.47,,,,,,,per diem,55.47,55.47,"Per diem rate, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,UHC Medicare,UHC Medicare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Orthowedge Shoe XL      ,33154395,CDM,270,RC,,,,,,Inpatient,,,55.47,55.47,Wellcare,Wellcare,55.47,,,,,,,case rate,55.47,55.47,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Meritain Health PPO CPD,Meritain Health PPO CPD,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Aetna/Commercial Product,Aetna/Commercial Product,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Meritain Health CPD,Meritain Health CPD,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Starmark CPD,Starmark CPD,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Aetna Medicare,Aetna Medicare,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Ambetter ,Ambetter ,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Blue Access,Anthem Blue Access,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Blue Access Choice,Anthem Blue Access Choice,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Blue Preferred,Anthem Blue Preferred,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Pathway,Anthem Pathway,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Alliance,Anthem Alliance,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Anthem Medicare,Anthem Medicare,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Cigna,Cigna,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Cigna PPO,Cigna PPO,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Cigna Medicare Advantage,Cigna Medicare Advantage,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Essence,Essence,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Healthlink HMO,Healthlink HMO,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Healthlink PPO,Healthlink PPO,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,HomeState Health Plan,HomeState Health Plan,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Humana Gold,Humana Gold,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Medicaid MO,Medicaid MO,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Medica,Medica,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Tricare,Tricare,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,UHC All Payer,UHC All Payer,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,UHC Exchange,UHC Exchange,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,UHC Medicaid,UHC Medicaid,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,UMR CPD,UMR CPD,27.66,,,,,,,per diem,27.66,27.66,"Per diem rate, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,UHC Medicare,UHC Medicare,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
Darco Small/Med Rocker Cast Bo,33154396,CDM,270,RC,,,,,,Inpatient,,,27.66,27.66,Wellcare,Wellcare,27.66,,,,,,,case rate,27.66,27.66,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health PPO CPD,Meritain Health PPO CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/Commercial Product,Aetna/Commercial Product,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health CPD,Meritain Health CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Starmark CPD,Starmark CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna Medicare,Aetna Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Ambetter ,Ambetter ,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access,Anthem Blue Access,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access Choice,Anthem Blue Access Choice,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Preferred,Anthem Blue Preferred,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Pathway,Anthem Pathway,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Alliance,Anthem Alliance,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Medicare,Anthem Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna,Cigna,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna PPO,Cigna PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna Medicare Advantage,Cigna Medicare Advantage,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Essence,Essence,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink HMO,Healthlink HMO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink PPO,Healthlink PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,HomeState Health Plan,HomeState Health Plan,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Humana Gold,Humana Gold,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medicaid MO,Medicaid MO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medica,Medica,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Tricare,Tricare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC All Payer,UHC All Payer,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Exchange,UHC Exchange,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicaid,UHC Medicaid,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UMR CPD,UMR CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicare,UHC Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock Large Arm Sling     ,33154399,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Wellcare,Wellcare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health PPO CPD,Meritain Health PPO CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/Commercial Product,Aetna/Commercial Product,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health CPD,Meritain Health CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Starmark CPD,Starmark CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna Medicare,Aetna Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Ambetter ,Ambetter ,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access,Anthem Blue Access,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access Choice,Anthem Blue Access Choice,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Preferred,Anthem Blue Preferred,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Pathway,Anthem Pathway,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Alliance,Anthem Alliance,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Medicare,Anthem Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna,Cigna,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna PPO,Cigna PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna Medicare Advantage,Cigna Medicare Advantage,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Essence,Essence,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink HMO,Healthlink HMO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink PPO,Healthlink PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,HomeState Health Plan,HomeState Health Plan,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Humana Gold,Humana Gold,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medicaid MO,Medicaid MO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medica,Medica,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Tricare,Tricare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC All Payer,UHC All Payer,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Exchange,UHC Exchange,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicaid,UHC Medicaid,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UMR CPD,UMR CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicare,UHC Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock SMALL Arm Sling     ,33154400,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Wellcare,Wellcare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health PPO CPD,Meritain Health PPO CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna/Commercial Product,Aetna/Commercial Product,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Meritain Health CPD,Meritain Health CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Starmark CPD,Starmark CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Aetna Medicare,Aetna Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Ambetter ,Ambetter ,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access,Anthem Blue Access,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Access Choice,Anthem Blue Access Choice,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Blue Preferred,Anthem Blue Preferred,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Pathway,Anthem Pathway,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Alliance,Anthem Alliance,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Anthem Medicare,Anthem Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna,Cigna,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna PPO,Cigna PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Cigna Medicare Advantage,Cigna Medicare Advantage,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Essence,Essence,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink HMO,Healthlink HMO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Healthlink PPO,Healthlink PPO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,HomeState Health Plan,HomeState Health Plan,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Humana Gold,Humana Gold,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medicaid MO,Medicaid MO,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Medica,Medica,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Tricare,Tricare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC All Payer,UHC All Payer,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Exchange,UHC Exchange,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicaid,UHC Medicaid,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UMR CPD,UMR CPD,18.39,,,,,,,per diem,18.39,18.39,"Per diem rate, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,UHC Medicare,UHC Medicare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
For Stock X- Large Arm Sling  ,33154401,CDM,270,RC,,,,,,Inpatient,,,18.39,18.39,Wellcare,Wellcare,18.39,,,,,,,case rate,18.39,18.39,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health PPO CPD,Meritain Health PPO CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/Commercial Product,Aetna/Commercial Product,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health CPD,Meritain Health CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Starmark CPD,Starmark CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna Medicare,Aetna Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Ambetter ,Ambetter ,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access,Anthem Blue Access,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access Choice,Anthem Blue Access Choice,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Preferred,Anthem Blue Preferred,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Pathway,Anthem Pathway,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Alliance,Anthem Alliance,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Medicare,Anthem Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna,Cigna,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna PPO,Cigna PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna Medicare Advantage,Cigna Medicare Advantage,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Essence,Essence,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink HMO,Healthlink HMO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink PPO,Healthlink PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,HomeState Health Plan,HomeState Health Plan,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Humana Gold,Humana Gold,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medicaid MO,Medicaid MO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medica,Medica,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Tricare,Tricare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC All Payer,UHC All Payer,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Exchange,UHC Exchange,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicaid,UHC Medicaid,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UMR CPD,UMR CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicare,UHC Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Large Walker Boot w/Air       ,33154404,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Wellcare,Wellcare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health PPO CPD,Meritain Health PPO CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/Commercial Product,Aetna/Commercial Product,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health CPD,Meritain Health CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Starmark CPD,Starmark CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna Medicare,Aetna Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Ambetter ,Ambetter ,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access,Anthem Blue Access,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access Choice,Anthem Blue Access Choice,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Preferred,Anthem Blue Preferred,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Pathway,Anthem Pathway,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Alliance,Anthem Alliance,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Medicare,Anthem Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna,Cigna,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna PPO,Cigna PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna Medicare Advantage,Cigna Medicare Advantage,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Essence,Essence,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink HMO,Healthlink HMO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink PPO,Healthlink PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,HomeState Health Plan,HomeState Health Plan,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Humana Gold,Humana Gold,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medicaid MO,Medicaid MO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medica,Medica,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Tricare,Tricare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC All Payer,UHC All Payer,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Exchange,UHC Exchange,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicaid,UHC Medicaid,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UMR CPD,UMR CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicare,UHC Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Medium Walker Boot w/Air      ,33154405,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Wellcare,Wellcare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health PPO CPD,Meritain Health PPO CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna/Commercial Product,Aetna/Commercial Product,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Meritain Health CPD,Meritain Health CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Starmark CPD,Starmark CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Aetna Medicare,Aetna Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Ambetter ,Ambetter ,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access,Anthem Blue Access,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Access Choice,Anthem Blue Access Choice,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Blue Preferred,Anthem Blue Preferred,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Pathway,Anthem Pathway,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Alliance,Anthem Alliance,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Anthem Medicare,Anthem Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna,Cigna,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna PPO,Cigna PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Cigna Medicare Advantage,Cigna Medicare Advantage,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Essence,Essence,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink HMO,Healthlink HMO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Healthlink PPO,Healthlink PPO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,HomeState Health Plan,HomeState Health Plan,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Humana Gold,Humana Gold,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medicaid MO,Medicaid MO,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Medica,Medica,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Tricare,Tricare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC All Payer,UHC All Payer,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Exchange,UHC Exchange,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicaid,UHC Medicaid,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UMR CPD,UMR CPD,200.85,,,,,,,per diem,200.85,200.85,"Per diem rate, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,UHC Medicare,UHC Medicare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami J collar Large  w/Replac,33154406,CDM,270,RC,,,,,,Inpatient,,,200.85,200.85,Wellcare,Wellcare,200.85,,,,,,,case rate,200.85,200.85,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Meritain Health PPO CPD,Meritain Health PPO CPD,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Aetna/Commercial Product,Aetna/Commercial Product,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Meritain Health CPD,Meritain Health CPD,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Starmark CPD,Starmark CPD,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Aetna Medicare,Aetna Medicare,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Ambetter ,Ambetter ,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Blue Access,Anthem Blue Access,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Blue Access Choice,Anthem Blue Access Choice,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Blue Preferred,Anthem Blue Preferred,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Pathway,Anthem Pathway,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Alliance,Anthem Alliance,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Anthem Medicare,Anthem Medicare,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Cigna,Cigna,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Cigna PPO,Cigna PPO,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Cigna Medicare Advantage,Cigna Medicare Advantage,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Essence,Essence,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Healthlink HMO,Healthlink HMO,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Healthlink PPO,Healthlink PPO,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,HomeState Health Plan,HomeState Health Plan,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Humana Gold,Humana Gold,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Medicaid MO,Medicaid MO,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Medica,Medica,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Tricare,Tricare,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,UHC All Payer,UHC All Payer,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,UHC Exchange,UHC Exchange,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,UHC Medicaid,UHC Medicaid,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,UMR CPD,UMR CPD,216.3,,,,,,,per diem,216.3,216.3,"Per diem rate, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,UHC Medicare,UHC Medicare,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Miami LSO Belt                ,33154407,CDM,270,RC,,,,,,Inpatient,,,216.3,216.3,Wellcare,Wellcare,216.3,,,,,,,case rate,216.3,216.3,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health PPO CPD,Meritain Health PPO CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/Commercial Product,Aetna/Commercial Product,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health CPD,Meritain Health CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Starmark CPD,Starmark CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna Medicare,Aetna Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Ambetter ,Ambetter ,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access,Anthem Blue Access,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access Choice,Anthem Blue Access Choice,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Preferred,Anthem Blue Preferred,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Pathway,Anthem Pathway,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Alliance,Anthem Alliance,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Medicare,Anthem Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna,Cigna,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna PPO,Cigna PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna Medicare Advantage,Cigna Medicare Advantage,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Essence,Essence,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink HMO,Healthlink HMO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink PPO,Healthlink PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,HomeState Health Plan,HomeState Health Plan,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Humana Gold,Humana Gold,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medicaid MO,Medicaid MO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medica,Medica,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Tricare,Tricare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC All Payer,UHC All Payer,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Exchange,UHC Exchange,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicaid,UHC Medicaid,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UMR CPD,UMR CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicare,UHC Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154410,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Wellcare,Wellcare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health PPO CPD,Meritain Health PPO CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/Commercial Product,Aetna/Commercial Product,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health CPD,Meritain Health CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Starmark CPD,Starmark CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna Medicare,Aetna Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Ambetter ,Ambetter ,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access,Anthem Blue Access,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access Choice,Anthem Blue Access Choice,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Preferred,Anthem Blue Preferred,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Pathway,Anthem Pathway,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Alliance,Anthem Alliance,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Medicare,Anthem Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna,Cigna,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna PPO,Cigna PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna Medicare Advantage,Cigna Medicare Advantage,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Essence,Essence,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink HMO,Healthlink HMO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink PPO,Healthlink PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,HomeState Health Plan,HomeState Health Plan,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Humana Gold,Humana Gold,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medicaid MO,Medicaid MO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medica,Medica,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Tricare,Tricare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC All Payer,UHC All Payer,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Exchange,UHC Exchange,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicaid,UHC Medicaid,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UMR CPD,UMR CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicare,UHC Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154411,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Wellcare,Wellcare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health PPO CPD,Meritain Health PPO CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna/Commercial Product,Aetna/Commercial Product,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Meritain Health CPD,Meritain Health CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Starmark CPD,Starmark CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Aetna Medicare,Aetna Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Ambetter ,Ambetter ,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access,Anthem Blue Access,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Access Choice,Anthem Blue Access Choice,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Blue Preferred,Anthem Blue Preferred,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Pathway,Anthem Pathway,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Alliance,Anthem Alliance,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Anthem Medicare,Anthem Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna,Cigna,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna PPO,Cigna PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Cigna Medicare Advantage,Cigna Medicare Advantage,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Essence,Essence,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink HMO,Healthlink HMO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Healthlink PPO,Healthlink PPO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,HomeState Health Plan,HomeState Health Plan,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Humana Gold,Humana Gold,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medicaid MO,Medicaid MO,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Medica,Medica,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Tricare,Tricare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC All Payer,UHC All Payer,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Exchange,UHC Exchange,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicaid,UHC Medicaid,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UMR CPD,UMR CPD,80.34,,,,,,,per diem,80.34,80.34,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,UHC Medicare,UHC Medicare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154412,CDM,270,RC,,,,,,Inpatient,,,80.34,80.34,Wellcare,Wellcare,80.34,,,,,,,case rate,80.34,80.34,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Meritain Health PPO CPD,Meritain Health PPO CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Aetna/Commercial Product,Aetna/Commercial Product,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Meritain Health CPD,Meritain Health CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Starmark CPD,Starmark CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Aetna Medicare,Aetna Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Ambetter ,Ambetter ,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Access,Anthem Blue Access,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Access Choice,Anthem Blue Access Choice,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Blue Preferred,Anthem Blue Preferred,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Pathway,Anthem Pathway,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Alliance,Anthem Alliance,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Anthem Medicare,Anthem Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Cigna,Cigna,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Cigna PPO,Cigna PPO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Cigna Medicare Advantage,Cigna Medicare Advantage,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Essence,Essence,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Healthlink HMO,Healthlink HMO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Healthlink PPO,Healthlink PPO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,HomeState Health Plan,HomeState Health Plan,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Humana Gold,Humana Gold,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Medicaid MO,Medicaid MO,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Medica,Medica,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Tricare,Tricare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,UHC All Payer,UHC All Payer,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,UHC Exchange,UHC Exchange,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,UHC Medicaid,UHC Medicaid,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,UMR CPD,UMR CPD,83.43,,,,,,,per diem,83.43,83.43,"Per diem rate, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,UHC Medicare,UHC Medicare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Ossur Neoprene Wrap Hinged Kne,33154413,CDM,270,RC,,,,,,Inpatient,,,83.43,83.43,Wellcare,Wellcare,83.43,,,,,,,case rate,83.43,83.43,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Large      ,33154415,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Medium     ,33154416,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's Small      ,33154417,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Men's X-Large    ,33154418,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Large    ,33154419,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Post Op Shoe Women's Meduim   ,33154420,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154421,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Replacement Pads for Miami J c,33154422,CDM,270,RC,,,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Left,33154423,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Large Righ,33154424,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Lef,33154425,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Medium Rig,33154426,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Left,33154427,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health PPO CPD,Meritain Health PPO CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna/Commercial Product,Aetna/Commercial Product,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Meritain Health CPD,Meritain Health CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Starmark CPD,Starmark CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Aetna Medicare,Aetna Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Ambetter ,Ambetter ,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access,Anthem Blue Access,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Access Choice,Anthem Blue Access Choice,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Blue Preferred,Anthem Blue Preferred,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Pathway,Anthem Pathway,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Alliance,Anthem Alliance,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Anthem Medicare,Anthem Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna,Cigna,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna PPO,Cigna PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Cigna Medicare Advantage,Cigna Medicare Advantage,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Essence,Essence,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink HMO,Healthlink HMO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Healthlink PPO,Healthlink PPO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,HomeState Health Plan,HomeState Health Plan,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Humana Gold,Humana Gold,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medicaid MO,Medicaid MO,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Medica,Medica,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Tricare,Tricare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC All Payer,UHC All Payer,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Exchange,UHC Exchange,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicaid,UHC Medicaid,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UMR CPD,UMR CPD,185.25,,,,,,,per diem,185.25,185.25,"Per diem rate, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,UHC Medicare,UHC Medicare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Resting Hand Splint Small Righ,33154428,CDM,270,RC,,,,,,Inpatient,,,185.25,185.25,Wellcare,Wellcare,185.25,,,,,,,case rate,185.25,185.25,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health PPO CPD,Meritain Health PPO CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna/Commercial Product,Aetna/Commercial Product,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Meritain Health CPD,Meritain Health CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Starmark CPD,Starmark CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Aetna Medicare,Aetna Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Ambetter ,Ambetter ,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access,Anthem Blue Access,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Access Choice,Anthem Blue Access Choice,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Blue Preferred,Anthem Blue Preferred,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Pathway,Anthem Pathway,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Alliance,Anthem Alliance,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Anthem Medicare,Anthem Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna,Cigna,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna PPO,Cigna PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Cigna Medicare Advantage,Cigna Medicare Advantage,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Essence,Essence,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink HMO,Healthlink HMO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Healthlink PPO,Healthlink PPO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,HomeState Health Plan,HomeState Health Plan,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Humana Gold,Humana Gold,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medicaid MO,Medicaid MO,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Medica,Medica,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Tricare,Tricare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC All Payer,UHC All Payer,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Exchange,UHC Exchange,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicaid,UHC Medicaid,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UMR CPD,UMR CPD,154.35,,,,,,,per diem,154.35,154.35,"Per diem rate, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,UHC Medicare,UHC Medicare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Small Walker Boot w/Air       ,33154429,CDM,270,RC,,,,,,Inpatient,,,154.35,154.35,Wellcare,Wellcare,154.35,,,,,,,case rate,154.35,154.35,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Meritain Health PPO CPD,Meritain Health PPO CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Aetna/Commercial Product,Aetna/Commercial Product,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Meritain Health CPD,Meritain Health CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Starmark CPD,Starmark CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Aetna Medicare,Aetna Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Ambetter ,Ambetter ,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Access,Anthem Blue Access,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Access Choice,Anthem Blue Access Choice,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Blue Preferred,Anthem Blue Preferred,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Pathway,Anthem Pathway,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Alliance,Anthem Alliance,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Anthem Medicare,Anthem Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Cigna,Cigna,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Cigna PPO,Cigna PPO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Cigna Medicare Advantage,Cigna Medicare Advantage,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Essence,Essence,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Healthlink HMO,Healthlink HMO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Healthlink PPO,Healthlink PPO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,HomeState Health Plan,HomeState Health Plan,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Humana Gold,Humana Gold,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Medicaid MO,Medicaid MO,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Medica,Medica,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Tricare,Tricare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,UHC All Payer,UHC All Payer,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,UHC Exchange,UHC Exchange,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,UHC Medicaid,UHC Medicaid,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,UMR CPD,UMR CPD,21.48,,,,,,,per diem,21.48,21.48,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,UHC Medicare,UHC Medicare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2IN      ,33154430,CDM,270,RC,,,,,,Inpatient,,,21.48,21.48,Wellcare,Wellcare,21.48,,,,,,,case rate,21.48,21.48,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Meritain Health PPO CPD,Meritain Health PPO CPD,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Aetna/Commercial Product,Aetna/Commercial Product,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Meritain Health CPD,Meritain Health CPD,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Starmark CPD,Starmark CPD,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Aetna Medicare,Aetna Medicare,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Ambetter ,Ambetter ,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Blue Access,Anthem Blue Access,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Blue Access Choice,Anthem Blue Access Choice,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Blue Preferred,Anthem Blue Preferred,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Pathway,Anthem Pathway,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Alliance,Anthem Alliance,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Anthem Medicare,Anthem Medicare,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Cigna,Cigna,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Cigna PPO,Cigna PPO,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Cigna Medicare Advantage,Cigna Medicare Advantage,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Essence,Essence,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Healthlink HMO,Healthlink HMO,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Healthlink PPO,Healthlink PPO,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,HomeState Health Plan,HomeState Health Plan,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Humana Gold,Humana Gold,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Medicaid MO,Medicaid MO,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Medica,Medica,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Tricare,Tricare,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,UHC All Payer,UHC All Payer,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,UHC Exchange,UHC Exchange,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,UHC Medicaid,UHC Medicaid,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,UMR CPD,UMR CPD,21.17,,,,,,,per diem,21.17,21.17,"Per diem rate, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,UHC Medicare,UHC Medicare,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Soft Cervical Collar 2.5IN    ,33154432,CDM,270,RC,,,,,,Inpatient,,,21.17,21.17,Wellcare,Wellcare,21.17,,,,,,,case rate,21.17,21.17,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Meritain Health PPO CPD,Meritain Health PPO CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Aetna/Commercial Product,Aetna/Commercial Product,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Meritain Health CPD,Meritain Health CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Starmark CPD,Starmark CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Aetna Medicare,Aetna Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Ambetter ,Ambetter ,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Blue Access,Anthem Blue Access,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Blue Access Choice,Anthem Blue Access Choice,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Blue Preferred,Anthem Blue Preferred,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Pathway,Anthem Pathway,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Alliance,Anthem Alliance,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Anthem Medicare,Anthem Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Cigna,Cigna,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Cigna PPO,Cigna PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Cigna Medicare Advantage,Cigna Medicare Advantage,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Essence,Essence,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Healthlink HMO,Healthlink HMO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Healthlink PPO,Healthlink PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,HomeState Health Plan,HomeState Health Plan,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Humana Gold,Humana Gold,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Medicaid MO,Medicaid MO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Medica,Medica,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Tricare,Tricare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,UHC All Payer,UHC All Payer,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,UHC Exchange,UHC Exchange,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,UHC Medicaid,UHC Medicaid,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,UMR CPD,UMR CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,UHC Medicare,UHC Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 10.5 Universal Wrist & F,33154435,CDM,270,RC,,,,,,Inpatient,,,58.4,58.4,Wellcare,Wellcare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Meritain Health PPO CPD,Meritain Health PPO CPD,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Aetna/Commercial Product,Aetna/Commercial Product,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Meritain Health CPD,Meritain Health CPD,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Starmark CPD,Starmark CPD,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Aetna Medicare,Aetna Medicare,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Ambetter ,Ambetter ,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Blue Access,Anthem Blue Access,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Blue Access Choice,Anthem Blue Access Choice,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Blue Preferred,Anthem Blue Preferred,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Pathway,Anthem Pathway,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Alliance,Anthem Alliance,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Anthem Medicare,Anthem Medicare,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Cigna,Cigna,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Cigna PPO,Cigna PPO,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Cigna Medicare Advantage,Cigna Medicare Advantage,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Essence,Essence,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Healthlink HMO,Healthlink HMO,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Healthlink PPO,Healthlink PPO,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,HomeState Health Plan,HomeState Health Plan,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Humana Gold,Humana Gold,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Medicaid MO,Medicaid MO,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Medica,Medica,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Tricare,Tricare,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,UHC All Payer,UHC All Payer,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,UHC Exchange,UHC Exchange,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,UHC Medicaid,UHC Medicaid,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,UMR CPD,UMR CPD,43.11,,,,,,,per diem,43.11,43.11,"Per diem rate, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,UHC Medicare,UHC Medicare,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Titan 8IN Universal Wrist Supp,33154436,CDM,270,RC,,,,,,Inpatient,,,43.11,43.11,Wellcare,Wellcare,43.11,,,,,,,case rate,43.11,43.11,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154437,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154438,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154439,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Meritain Health PPO CPD,Meritain Health PPO CPD,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Aetna/Commercial Product,Aetna/Commercial Product,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Meritain Health CPD,Meritain Health CPD,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Starmark CPD,Starmark CPD,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Aetna Medicare,Aetna Medicare,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Ambetter ,Ambetter ,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Blue Access,Anthem Blue Access,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Blue Access Choice,Anthem Blue Access Choice,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Blue Preferred,Anthem Blue Preferred,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Pathway,Anthem Pathway,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Alliance,Anthem Alliance,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Anthem Medicare,Anthem Medicare,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Cigna,Cigna,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Cigna PPO,Cigna PPO,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Cigna Medicare Advantage,Cigna Medicare Advantage,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Essence,Essence,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Healthlink HMO,Healthlink HMO,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Healthlink PPO,Healthlink PPO,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,HomeState Health Plan,HomeState Health Plan,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Humana Gold,Humana Gold,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Medicaid MO,Medicaid MO,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Medica,Medica,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Tricare,Tricare,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,UHC All Payer,UHC All Payer,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,UHC Exchange,UHC Exchange,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,UHC Medicaid,UHC Medicaid,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,UMR CPD,UMR CPD,40.26,,,,,,,per diem,40.26,40.26,"Per diem rate, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,UHC Medicare,UHC Medicare,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Large             ,33154440,CDM,270,RC,,,,,,Inpatient,,,40.26,40.26,Wellcare,Wellcare,40.26,,,,,,,case rate,40.26,40.26,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Meritain Health PPO CPD,Meritain Health PPO CPD,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Aetna/Commercial Product,Aetna/Commercial Product,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Meritain Health CPD,Meritain Health CPD,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Starmark CPD,Starmark CPD,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Aetna Medicare,Aetna Medicare,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Ambetter ,Ambetter ,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Blue Access,Anthem Blue Access,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Blue Access Choice,Anthem Blue Access Choice,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Blue Preferred,Anthem Blue Preferred,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Pathway,Anthem Pathway,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Alliance,Anthem Alliance,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Anthem Medicare,Anthem Medicare,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Cigna,Cigna,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Cigna PPO,Cigna PPO,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Cigna Medicare Advantage,Cigna Medicare Advantage,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Essence,Essence,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Healthlink HMO,Healthlink HMO,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Healthlink PPO,Healthlink PPO,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,HomeState Health Plan,HomeState Health Plan,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Humana Gold,Humana Gold,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Medicaid MO,Medicaid MO,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Medica,Medica,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Tricare,Tricare,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,UHC All Payer,UHC All Payer,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,UHC Exchange,UHC Exchange,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,UHC Medicaid,UHC Medicaid,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,UMR CPD,UMR CPD,34.89,,,,,,,per diem,34.89,34.89,"Per diem rate, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,UHC Medicare,UHC Medicare,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
ABD Binders Small             ,33154441,CDM,270,RC,,,,,,Inpatient,,,34.89,34.89,Wellcare,Wellcare,34.89,,,,,,,case rate,34.89,34.89,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154442,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health PPO CPD,Meritain Health PPO CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna/Commercial Product,Aetna/Commercial Product,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Meritain Health CPD,Meritain Health CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Starmark CPD,Starmark CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Aetna Medicare,Aetna Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Ambetter ,Ambetter ,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access,Anthem Blue Access,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Access Choice,Anthem Blue Access Choice,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Blue Preferred,Anthem Blue Preferred,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Pathway,Anthem Pathway,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Alliance,Anthem Alliance,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Anthem Medicare,Anthem Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna,Cigna,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna PPO,Cigna PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Cigna Medicare Advantage,Cigna Medicare Advantage,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Essence,Essence,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink HMO,Healthlink HMO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Healthlink PPO,Healthlink PPO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,HomeState Health Plan,HomeState Health Plan,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Humana Gold,Humana Gold,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medicaid MO,Medicaid MO,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Medica,Medica,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Tricare,Tricare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC All Payer,UHC All Payer,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Exchange,UHC Exchange,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicaid,UHC Medicaid,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UMR CPD,UMR CPD,24.57,,,,,,,per diem,24.57,24.57,"Per diem rate, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,UHC Medicare,UHC Medicare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
Velpeau Shoulder Immobilizer S,33154443,CDM,270,RC,,,,,,Inpatient,,,24.57,24.57,Wellcare,Wellcare,24.57,,,,,,,case rate,24.57,24.57,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Meritain Health PPO CPD,Meritain Health PPO CPD,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Aetna/Commercial Product,Aetna/Commercial Product,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Meritain Health CPD,Meritain Health CPD,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Starmark CPD,Starmark CPD,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Aetna Medicare,Aetna Medicare,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Ambetter ,Ambetter ,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Blue Access,Anthem Blue Access,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Blue Access Choice,Anthem Blue Access Choice,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Blue Preferred,Anthem Blue Preferred,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Pathway,Anthem Pathway,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Alliance,Anthem Alliance,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Anthem Medicare,Anthem Medicare,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Cigna,Cigna,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Cigna PPO,Cigna PPO,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Cigna Medicare Advantage,Cigna Medicare Advantage,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Essence,Essence,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Healthlink HMO,Healthlink HMO,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Healthlink PPO,Healthlink PPO,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,HomeState Health Plan,HomeState Health Plan,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Humana Gold,Humana Gold,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Medicaid MO,Medicaid MO,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Medica,Medica,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Tricare,Tricare,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,UHC All Payer,UHC All Payer,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,UHC Exchange,UHC Exchange,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,UHC Medicaid,UHC Medicaid,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,UMR CPD,UMR CPD,49.84,,,,,,,per diem,49.84,49.84,"Per diem rate, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,UHC Medicare,UHC Medicare,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
ABD Binders Extra Large       ,33154444,CDM,270,RC,,,,,,Inpatient,,,49.84,49.84,Wellcare,Wellcare,49.84,,,,,,,case rate,49.84,49.84,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Meritain Health PPO CPD,Meritain Health PPO CPD,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Aetna/Commercial Product,Aetna/Commercial Product,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Meritain Health CPD,Meritain Health CPD,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Starmark CPD,Starmark CPD,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Aetna Medicare,Aetna Medicare,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Ambetter ,Ambetter ,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Blue Access,Anthem Blue Access,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Blue Access Choice,Anthem Blue Access Choice,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Blue Preferred,Anthem Blue Preferred,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Pathway,Anthem Pathway,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Alliance,Anthem Alliance,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Anthem Medicare,Anthem Medicare,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Cigna,Cigna,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Cigna PPO,Cigna PPO,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Cigna Medicare Advantage,Cigna Medicare Advantage,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Essence,Essence,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Healthlink HMO,Healthlink HMO,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Healthlink PPO,Healthlink PPO,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,HomeState Health Plan,HomeState Health Plan,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Humana Gold,Humana Gold,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Medicaid MO,Medicaid MO,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Medica,Medica,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Tricare,Tricare,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,UHC All Payer,UHC All Payer,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,UHC Exchange,UHC Exchange,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,UHC Medicaid,UHC Medicaid,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,UMR CPD,UMR CPD,144.46,,,,,,,per diem,144.46,144.46,"Per diem rate, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,UHC Medicare,UHC Medicare,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
Waffle Boot                   ,33154445,CDM,270,RC,,,,,,Inpatient,,,144.46,144.46,Wellcare,Wellcare,144.46,,,,,,,case rate,144.46,144.46,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Meritain Health PPO CPD,Meritain Health PPO CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna/Commercial Product,Aetna/Commercial Product,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Meritain Health CPD,Meritain Health CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Starmark CPD,Starmark CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna Medicare,Aetna Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Ambetter ,Ambetter ,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Access,Anthem Blue Access,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Access Choice,Anthem Blue Access Choice,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Preferred,Anthem Blue Preferred,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Pathway,Anthem Pathway,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Alliance,Anthem Alliance,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Medicare,Anthem Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna,Cigna,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna PPO,Cigna PPO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna Medicare Advantage,Cigna Medicare Advantage,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Essence,Essence,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthlink HMO,Healthlink HMO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthlink PPO,Healthlink PPO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,HomeState Health Plan,HomeState Health Plan,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Humana Gold,Humana Gold,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Medicaid MO,Medicaid MO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Medica,Medica,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Tricare,Tricare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC All Payer,UHC All Payer,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Exchange,UHC Exchange,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Medicaid,UHC Medicaid,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UMR CPD,UMR CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Medicare,UHC Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Regular,33154451,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Wellcare,Wellcare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Meritain Health PPO CPD,Meritain Health PPO CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna/Commercial Product,Aetna/Commercial Product,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Meritain Health CPD,Meritain Health CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Starmark CPD,Starmark CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Aetna Medicare,Aetna Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Ambetter ,Ambetter ,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Access,Anthem Blue Access,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Access Choice,Anthem Blue Access Choice,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Blue Preferred,Anthem Blue Preferred,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Pathway,Anthem Pathway,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Alliance,Anthem Alliance,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Anthem Medicare,Anthem Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna,Cigna,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna PPO,Cigna PPO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Cigna Medicare Advantage,Cigna Medicare Advantage,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Essence,Essence,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthlink HMO,Healthlink HMO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Healthlink PPO,Healthlink PPO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,HomeState Health Plan,HomeState Health Plan,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Humana Gold,Humana Gold,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Medicaid MO,Medicaid MO,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Medica,Medica,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Tricare,Tricare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC All Payer,UHC All Payer,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Exchange,UHC Exchange,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Medicaid,UHC Medicaid,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UMR CPD,UMR CPD,216.15,,,,,,,per diem,216.15,216.15,"Per diem rate, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,UHC Medicare,UHC Medicare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
LEEDER BOOT Ambulatory Large  ,33154452,CDM,270,RC,,,,,,Inpatient,,,216.15,216.15,Wellcare,Wellcare,216.15,,,,,,,case rate,216.15,216.15,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Meritain Health PPO CPD,Meritain Health PPO CPD,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Aetna/Commercial Product,Aetna/Commercial Product,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Meritain Health CPD,Meritain Health CPD,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Starmark CPD,Starmark CPD,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Aetna Medicare,Aetna Medicare,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Ambetter ,Ambetter ,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Blue Access,Anthem Blue Access,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Blue Access Choice,Anthem Blue Access Choice,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Blue Preferred,Anthem Blue Preferred,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Pathway,Anthem Pathway,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Alliance,Anthem Alliance,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Anthem Medicare,Anthem Medicare,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Cigna,Cigna,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Cigna PPO,Cigna PPO,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Cigna Medicare Advantage,Cigna Medicare Advantage,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Essence,Essence,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Healthlink HMO,Healthlink HMO,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Healthlink PPO,Healthlink PPO,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,HomeState Health Plan,HomeState Health Plan,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Humana Gold,Humana Gold,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Medicaid MO,Medicaid MO,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Medica,Medica,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Tricare,Tricare,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,UHC All Payer,UHC All Payer,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,UHC Exchange,UHC Exchange,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,UHC Medicaid,UHC Medicaid,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,UMR CPD,UMR CPD,70.11,,,,,,,per diem,70.11,70.11,"Per diem rate, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,UHC Medicare,UHC Medicare,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
Knee Immobilizer 16IN         ,33154459,CDM,270,RC,,,,,,Inpatient,,,70.11,70.11,Wellcare,Wellcare,70.11,,,,,,,case rate,70.11,70.11,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Meritain Health PPO CPD,Meritain Health PPO CPD,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Aetna/Commercial Product,Aetna/Commercial Product,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Meritain Health CPD,Meritain Health CPD,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Starmark CPD,Starmark CPD,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Aetna Medicare,Aetna Medicare,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Ambetter ,Ambetter ,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Blue Access,Anthem Blue Access,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Blue Access Choice,Anthem Blue Access Choice,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Blue Preferred,Anthem Blue Preferred,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Pathway,Anthem Pathway,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Alliance,Anthem Alliance,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Anthem Medicare,Anthem Medicare,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Cigna,Cigna,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Cigna PPO,Cigna PPO,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Cigna Medicare Advantage,Cigna Medicare Advantage,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Essence,Essence,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Healthlink HMO,Healthlink HMO,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Healthlink PPO,Healthlink PPO,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,HomeState Health Plan,HomeState Health Plan,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Humana Gold,Humana Gold,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Medicaid MO,Medicaid MO,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Medica,Medica,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Tricare,Tricare,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,UHC All Payer,UHC All Payer,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,UHC Exchange,UHC Exchange,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,UHC Medicaid,UHC Medicaid,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,UMR CPD,UMR CPD,114.33,,,,,,,per diem,114.33,114.33,"Per diem rate, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,UHC Medicare,UHC Medicare,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
20IN Univ Knee Immobilizer Ext,33154460,CDM,270,RC,,,,,,Inpatient,,,114.33,114.33,Wellcare,Wellcare,114.33,,,,,,,case rate,114.33,114.33,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Meritain Health PPO CPD,Meritain Health PPO CPD,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Aetna/Commercial Product,Aetna/Commercial Product,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Meritain Health CPD,Meritain Health CPD,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Starmark CPD,Starmark CPD,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Aetna Medicare,Aetna Medicare,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Ambetter ,Ambetter ,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Blue Access,Anthem Blue Access,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Blue Access Choice,Anthem Blue Access Choice,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Blue Preferred,Anthem Blue Preferred,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Pathway,Anthem Pathway,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Alliance,Anthem Alliance,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Anthem Medicare,Anthem Medicare,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Cigna,Cigna,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Cigna PPO,Cigna PPO,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Cigna Medicare Advantage,Cigna Medicare Advantage,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Essence,Essence,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Healthlink HMO,Healthlink HMO,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Healthlink PPO,Healthlink PPO,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,HomeState Health Plan,HomeState Health Plan,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Humana Gold,Humana Gold,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Medicaid MO,Medicaid MO,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Medica,Medica,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Tricare,Tricare,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,UHC All Payer,UHC All Payer,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,UHC Exchange,UHC Exchange,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,UHC Medicaid,UHC Medicaid,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,UMR CPD,UMR CPD,46.2,,,,,,,per diem,46.2,46.2,"Per diem rate, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,UHC Medicare,UHC Medicare,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Philadelphia Collar           ,33154462,CDM,270,RC,,,,,,Inpatient,,,46.2,46.2,Wellcare,Wellcare,46.2,,,,,,,case rate,46.2,46.2,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Meritain Health PPO CPD,Meritain Health PPO CPD,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Aetna/Commercial Product,Aetna/Commercial Product,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Meritain Health CPD,Meritain Health CPD,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Starmark CPD,Starmark CPD,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Aetna Medicare,Aetna Medicare,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Ambetter ,Ambetter ,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Blue Access,Anthem Blue Access,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Blue Access Choice,Anthem Blue Access Choice,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Blue Preferred,Anthem Blue Preferred,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Pathway,Anthem Pathway,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Alliance,Anthem Alliance,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Anthem Medicare,Anthem Medicare,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Cigna,Cigna,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Cigna PPO,Cigna PPO,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Cigna Medicare Advantage,Cigna Medicare Advantage,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Essence,Essence,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Healthlink HMO,Healthlink HMO,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Healthlink PPO,Healthlink PPO,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,HomeState Health Plan,HomeState Health Plan,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Humana Gold,Humana Gold,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Medicaid MO,Medicaid MO,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Medica,Medica,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Tricare,Tricare,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,UHC All Payer,UHC All Payer,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,UHC Exchange,UHC Exchange,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,UHC Medicaid,UHC Medicaid,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,UMR CPD,UMR CPD,336.81,,,,,,,per diem,336.81,336.81,"Per diem rate, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,UHC Medicare,UHC Medicare,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
Aspen Quick Draw Lumbar Brace ,33154463,CDM,270,RC,,,,,,Inpatient,,,336.81,336.81,Wellcare,Wellcare,336.81,,,,,,,case rate,336.81,336.81,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health PPO CPD,Meritain Health PPO CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna/Commercial Product,Aetna/Commercial Product,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Meritain Health CPD,Meritain Health CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Starmark CPD,Starmark CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Aetna Medicare,Aetna Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Ambetter ,Ambetter ,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access,Anthem Blue Access,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Access Choice,Anthem Blue Access Choice,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Blue Preferred,Anthem Blue Preferred,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Pathway,Anthem Pathway,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Alliance,Anthem Alliance,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Anthem Medicare,Anthem Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna,Cigna,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna PPO,Cigna PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Cigna Medicare Advantage,Cigna Medicare Advantage,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Essence,Essence,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink HMO,Healthlink HMO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Healthlink PPO,Healthlink PPO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,HomeState Health Plan,HomeState Health Plan,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Humana Gold,Humana Gold,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Medicaid MO,Medicaid MO,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Medica,Medica,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Tricare,Tricare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC All Payer,UHC All Payer,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Exchange,UHC Exchange,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicaid,UHC Medicaid,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,UMR CPD,UMR CPD,60,,,,,,,per diem,60,60,"Per diem rate, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,UHC Medicare,UHC Medicare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
TILT IN SPACE WC              ,33154468,CDM,279,RC,,,,,,Inpatient,,,60,60,Wellcare,Wellcare,60,,,,,,,case rate,60,60,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Meritain Health PPO CPD,Meritain Health PPO CPD,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Aetna/Commercial Product,Aetna/Commercial Product,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Meritain Health CPD,Meritain Health CPD,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Starmark CPD,Starmark CPD,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Aetna Medicare,Aetna Medicare,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Ambetter ,Ambetter ,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Blue Access,Anthem Blue Access,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Blue Access Choice,Anthem Blue Access Choice,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Blue Preferred,Anthem Blue Preferred,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Pathway,Anthem Pathway,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Alliance,Anthem Alliance,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Anthem Medicare,Anthem Medicare,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Cigna,Cigna,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Cigna PPO,Cigna PPO,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Cigna Medicare Advantage,Cigna Medicare Advantage,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Essence,Essence,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Healthlink HMO,Healthlink HMO,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Healthlink PPO,Healthlink PPO,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,HomeState Health Plan,HomeState Health Plan,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Humana Gold,Humana Gold,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Medicaid MO,Medicaid MO,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Medica,Medica,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Tricare,Tricare,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,UHC All Payer,UHC All Payer,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,UHC Exchange,UHC Exchange,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,UHC Medicaid,UHC Medicaid,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,UMR CPD,UMR CPD,16.01,,,,,,,per diem,16.01,16.01,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,UHC Medicare,UHC Medicare,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,33163207,CDM,279,RC,,,,,,Inpatient,,,16.01,16.01,Wellcare,Wellcare,16.01,,,,,,,case rate,16.01,16.01,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Meritain Health PPO CPD,Meritain Health PPO CPD,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Aetna/Commercial Product,Aetna/Commercial Product,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Meritain Health CPD,Meritain Health CPD,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Starmark CPD,Starmark CPD,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Aetna Medicare,Aetna Medicare,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Ambetter ,Ambetter ,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Blue Access,Anthem Blue Access,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Blue Access Choice,Anthem Blue Access Choice,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Blue Preferred,Anthem Blue Preferred,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Pathway,Anthem Pathway,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Alliance,Anthem Alliance,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Anthem Medicare,Anthem Medicare,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Cigna,Cigna,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Cigna PPO,Cigna PPO,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Cigna Medicare Advantage,Cigna Medicare Advantage,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Essence,Essence,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Healthlink HMO,Healthlink HMO,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Healthlink PPO,Healthlink PPO,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,HomeState Health Plan,HomeState Health Plan,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Humana Gold,Humana Gold,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Medicaid MO,Medicaid MO,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Medica,Medica,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Tricare,Tricare,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,UHC All Payer,UHC All Payer,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,UHC Exchange,UHC Exchange,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,UHC Medicaid,UHC Medicaid,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,UMR CPD,UMR CPD,162.06,,,,,,,per diem,162.06,162.06,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,UHC Medicare,UHC Medicare,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR STRAP XL    ,33170447,CDM,270,RC,,,,,,Inpatient,,,162.06,162.06,Wellcare,Wellcare,162.06,,,,,,,case rate,162.06,162.06,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Meritain Health PPO CPD,Meritain Health PPO CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna/Commercial Product,Aetna/Commercial Product,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Meritain Health CPD,Meritain Health CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Starmark CPD,Starmark CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna Medicare,Aetna Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Ambetter ,Ambetter ,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access,Anthem Blue Access,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access Choice,Anthem Blue Access Choice,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Preferred,Anthem Blue Preferred,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Pathway,Anthem Pathway,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Alliance,Anthem Alliance,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Medicare,Anthem Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna,Cigna,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna PPO,Cigna PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna Medicare Advantage,Cigna Medicare Advantage,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Essence,Essence,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthlink HMO,Healthlink HMO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthlink PPO,Healthlink PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,HomeState Health Plan,HomeState Health Plan,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Humana Gold,Humana Gold,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Medicaid MO,Medicaid MO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Medica,Medica,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Tricare,Tricare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC All Payer,UHC All Payer,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Exchange,UHC Exchange,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Medicaid,UHC Medicaid,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,UMR CPD,UMR CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Medicare,UHC Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BOOT PODUS W/TSFR PAD/STRAP XL,33170451,CDM,270,RC,,,,,,Inpatient,,,12,12,Wellcare,Wellcare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Meritain Health PPO CPD,Meritain Health PPO CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna/Commercial Product,Aetna/Commercial Product,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Meritain Health CPD,Meritain Health CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Starmark CPD,Starmark CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Aetna Medicare,Aetna Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Ambetter ,Ambetter ,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access,Anthem Blue Access,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Access Choice,Anthem Blue Access Choice,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Blue Preferred,Anthem Blue Preferred,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Pathway,Anthem Pathway,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Alliance,Anthem Alliance,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Anthem Medicare,Anthem Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna,Cigna,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna PPO,Cigna PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Cigna Medicare Advantage,Cigna Medicare Advantage,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Essence,Essence,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthlink HMO,Healthlink HMO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Healthlink PPO,Healthlink PPO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,HomeState Health Plan,HomeState Health Plan,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Humana Gold,Humana Gold,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Medicaid MO,Medicaid MO,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Medica,Medica,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Tricare,Tricare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC All Payer,UHC All Payer,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Exchange,UHC Exchange,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Medicaid,UHC Medicaid,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,UMR CPD,UMR CPD,63,,,,,,,per diem,63,63,"Per diem rate, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,UHC Medicare,UHC Medicare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABD 9 30-45            ,33175774,CDM,270,RC,,,,,,Inpatient,,,63,63,Wellcare,Wellcare,63,,,,,,,case rate,63,63,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Meritain Health PPO CPD,Meritain Health PPO CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna/Commercial Product,Aetna/Commercial Product,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Meritain Health CPD,Meritain Health CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Starmark CPD,Starmark CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Aetna Medicare,Aetna Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Ambetter ,Ambetter ,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Access,Anthem Blue Access,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Access Choice,Anthem Blue Access Choice,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Blue Preferred,Anthem Blue Preferred,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Pathway,Anthem Pathway,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Alliance,Anthem Alliance,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Anthem Medicare,Anthem Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna,Cigna,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna PPO,Cigna PPO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Cigna Medicare Advantage,Cigna Medicare Advantage,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Essence,Essence,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthlink HMO,Healthlink HMO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Healthlink PPO,Healthlink PPO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,HomeState Health Plan,HomeState Health Plan,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Humana Gold,Humana Gold,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Medicaid MO,Medicaid MO,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Medica,Medica,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Tricare,Tricare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC All Payer,UHC All Payer,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Exchange,UHC Exchange,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Medicaid,UHC Medicaid,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,UMR CPD,UMR CPD,16,,,,,,,per diem,16,16,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,UHC Medicare,UHC Medicare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 10 UNIVERSAL ,33175776,CDM,270,RC,,,,,,Inpatient,,,16,16,Wellcare,Wellcare,16,,,,,,,case rate,16,16,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Meritain Health PPO CPD,Meritain Health PPO CPD,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Aetna/Commercial Product,Aetna/Commercial Product,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Meritain Health CPD,Meritain Health CPD,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Starmark CPD,Starmark CPD,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Aetna Medicare,Aetna Medicare,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Ambetter ,Ambetter ,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Blue Access,Anthem Blue Access,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Blue Access Choice,Anthem Blue Access Choice,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Blue Preferred,Anthem Blue Preferred,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Pathway,Anthem Pathway,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Alliance,Anthem Alliance,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Anthem Medicare,Anthem Medicare,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Cigna,Cigna,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Cigna PPO,Cigna PPO,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Cigna Medicare Advantage,Cigna Medicare Advantage,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Essence,Essence,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Healthlink HMO,Healthlink HMO,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Healthlink PPO,Healthlink PPO,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,HomeState Health Plan,HomeState Health Plan,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Humana Gold,Humana Gold,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Medicaid MO,Medicaid MO,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Medica,Medica,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Tricare,Tricare,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,UHC All Payer,UHC All Payer,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,UHC Exchange,UHC Exchange,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,UHC Medicaid,UHC Medicaid,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,UMR CPD,UMR CPD,19,,,,,,,per diem,19,19,"Per diem rate, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,UHC Medicare,UHC Medicare,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
BINDER ABDOMINAL 12 UNIVERSAL ,33175777,CDM,270,RC,,,,,,Inpatient,,,19,19,Wellcare,Wellcare,19,,,,,,,case rate,19,19,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Meritain Health PPO CPD,Meritain Health PPO CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Aetna/Commercial Product,Aetna/Commercial Product,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Meritain Health CPD,Meritain Health CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Starmark CPD,Starmark CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Aetna Medicare,Aetna Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Ambetter ,Ambetter ,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Blue Access,Anthem Blue Access,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Blue Access Choice,Anthem Blue Access Choice,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Blue Preferred,Anthem Blue Preferred,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Pathway,Anthem Pathway,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Alliance,Anthem Alliance,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Anthem Medicare,Anthem Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Cigna,Cigna,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Cigna PPO,Cigna PPO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Cigna Medicare Advantage,Cigna Medicare Advantage,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Essence,Essence,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Healthlink HMO,Healthlink HMO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Healthlink PPO,Healthlink PPO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,HomeState Health Plan,HomeState Health Plan,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Humana Gold,Humana Gold,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Medicaid MO,Medicaid MO,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Medica,Medica,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Tricare,Tricare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,UHC All Payer,UHC All Payer,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,UHC Exchange,UHC Exchange,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,UHC Medicaid,UHC Medicaid,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,UMR CPD,UMR CPD,195,,,,,,,per diem,195,195,"Per diem rate, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,UHC Medicare,UHC Medicare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
MULTIBOOT REGULAR             ,33176640,CDM,270,RC,,,,,,Inpatient,,,195,195,Wellcare,Wellcare,195,,,,,,,case rate,195,195,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health PPO CPD,Meritain Health PPO CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/Commercial Product,Aetna/Commercial Product,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health CPD,Meritain Health CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Starmark CPD,Starmark CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna Medicare,Aetna Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Ambetter ,Ambetter ,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access,Anthem Blue Access,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access Choice,Anthem Blue Access Choice,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Preferred,Anthem Blue Preferred,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Pathway,Anthem Pathway,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Alliance,Anthem Alliance,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Medicare,Anthem Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna,Cigna,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna PPO,Cigna PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna Medicare Advantage,Cigna Medicare Advantage,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Essence,Essence,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink HMO,Healthlink HMO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink PPO,Healthlink PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,HomeState Health Plan,HomeState Health Plan,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Humana Gold,Humana Gold,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Medicaid MO,Medicaid MO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Medica,Medica,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Tricare,Tricare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC All Payer,UHC All Payer,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Exchange,UHC Exchange,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicaid,UHC Medicaid,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,UMR CPD,UMR CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicare,UHC Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FDG CNTNR PATROL PUMP EZ  ,33176839,CDM,279,RC,,,,,,Inpatient,,,9,9,Wellcare,Wellcare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health PPO CPD,Meritain Health PPO CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna/Commercial Product,Aetna/Commercial Product,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Meritain Health CPD,Meritain Health CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Starmark CPD,Starmark CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Aetna Medicare,Aetna Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Ambetter ,Ambetter ,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access,Anthem Blue Access,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Access Choice,Anthem Blue Access Choice,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Blue Preferred,Anthem Blue Preferred,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Pathway,Anthem Pathway,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Alliance,Anthem Alliance,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Anthem Medicare,Anthem Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna,Cigna,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna PPO,Cigna PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Cigna Medicare Advantage,Cigna Medicare Advantage,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Essence,Essence,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink HMO,Healthlink HMO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Healthlink PPO,Healthlink PPO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,HomeState Health Plan,HomeState Health Plan,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Humana Gold,Humana Gold,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medicaid MO,Medicaid MO,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Medica,Medica,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Tricare,Tricare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC All Payer,UHC All Payer,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Exchange,UHC Exchange,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicaid,UHC Medicaid,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UMR CPD,UMR CPD,17.6,,,,,,,per diem,17.6,17.6,"Per diem rate, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,UHC Medicare,UHC Medicare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
SLING ARM LG                  ,33176911,CDM,270,RC,,,,,,Inpatient,,,17.6,17.6,Wellcare,Wellcare,17.6,,,,,,,case rate,17.6,17.6,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Meritain Health PPO CPD,Meritain Health PPO CPD,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Aetna/Commercial Product,Aetna/Commercial Product,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Meritain Health CPD,Meritain Health CPD,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Starmark CPD,Starmark CPD,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Aetna Medicare,Aetna Medicare,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Ambetter ,Ambetter ,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Blue Access,Anthem Blue Access,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Blue Access Choice,Anthem Blue Access Choice,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Blue Preferred,Anthem Blue Preferred,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Pathway,Anthem Pathway,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Alliance,Anthem Alliance,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Anthem Medicare,Anthem Medicare,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Cigna,Cigna,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Cigna PPO,Cigna PPO,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Cigna Medicare Advantage,Cigna Medicare Advantage,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Essence,Essence,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Healthlink HMO,Healthlink HMO,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Healthlink PPO,Healthlink PPO,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,HomeState Health Plan,HomeState Health Plan,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Humana Gold,Humana Gold,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Medicaid MO,Medicaid MO,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Medica,Medica,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Tricare,Tricare,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,UHC All Payer,UHC All Payer,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,UHC Exchange,UHC Exchange,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,UHC Medicaid,UHC Medicaid,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,UMR CPD,UMR CPD,194,,,,,,,per diem,194,194,"Per diem rate, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,UHC Medicare,UHC Medicare,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
BOOT SOFPRO AMB AFO FLC LG    ,33194422,CDM,270,RC,,,,,,Inpatient,,,194,194,Wellcare,Wellcare,194,,,,,,,case rate,194,194,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Meritain Health PPO CPD,Meritain Health PPO CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Aetna/Commercial Product,Aetna/Commercial Product,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Meritain Health CPD,Meritain Health CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Starmark CPD,Starmark CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Aetna Medicare,Aetna Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Ambetter ,Ambetter ,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Blue Access,Anthem Blue Access,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Blue Access Choice,Anthem Blue Access Choice,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Blue Preferred,Anthem Blue Preferred,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Pathway,Anthem Pathway,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Alliance,Anthem Alliance,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Anthem Medicare,Anthem Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Cigna,Cigna,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Cigna PPO,Cigna PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Cigna Medicare Advantage,Cigna Medicare Advantage,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Essence,Essence,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Healthlink HMO,Healthlink HMO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Healthlink PPO,Healthlink PPO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,HomeState Health Plan,HomeState Health Plan,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Humana Gold,Humana Gold,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Medicaid MO,Medicaid MO,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Medica,Medica,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Tricare,Tricare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,UHC All Payer,UHC All Payer,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,UHC Exchange,UHC Exchange,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,UHC Medicaid,UHC Medicaid,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,UMR CPD,UMR CPD,340.2,,,,,,,per diem,340.2,340.2,"Per diem rate, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,UHC Medicare,UHC Medicare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW WRIST HAND ORTHO STATIC ,33195576,CDM,274,RC,L3763,CPT,,,,Inpatient,,,340.2,340.2,Wellcare,Wellcare,340.2,,,,,,,case rate,340.2,340.2,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Meritain Health PPO CPD,Meritain Health PPO CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Aetna/Commercial Product,Aetna/Commercial Product,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Meritain Health CPD,Meritain Health CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Starmark CPD,Starmark CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Aetna Medicare,Aetna Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Ambetter ,Ambetter ,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Blue Access,Anthem Blue Access,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Blue Access Choice,Anthem Blue Access Choice,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Blue Preferred,Anthem Blue Preferred,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Pathway,Anthem Pathway,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Alliance,Anthem Alliance,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Anthem Medicare,Anthem Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Cigna,Cigna,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Cigna PPO,Cigna PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Cigna Medicare Advantage,Cigna Medicare Advantage,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Essence,Essence,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Healthlink HMO,Healthlink HMO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Healthlink PPO,Healthlink PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,HomeState Health Plan,HomeState Health Plan,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Humana Gold,Humana Gold,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Medicaid MO,Medicaid MO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Medica,Medica,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Tricare,Tricare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,UHC All Payer,UHC All Payer,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,UHC Exchange,UHC Exchange,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,UHC Medicaid,UHC Medicaid,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,UMR CPD,UMR CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,UHC Medicare,UHC Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
ELBOW ORTHO (EO) STAT CUST FAB,33195578,CDM,274,RC,L3702,CPT,,,,Inpatient,,,210,210,Wellcare,Wellcare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FINGER ORTHO PIP DIP JOINT    ,33195586,CDM,274,RC,L3925,CPT,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Meritain Health PPO CPD,Meritain Health PPO CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Aetna/Commercial Product,Aetna/Commercial Product,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Meritain Health CPD,Meritain Health CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Starmark CPD,Starmark CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Aetna Medicare,Aetna Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Ambetter ,Ambetter ,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Access,Anthem Blue Access,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Access Choice,Anthem Blue Access Choice,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Preferred,Anthem Blue Preferred,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Pathway,Anthem Pathway,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Alliance,Anthem Alliance,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Anthem Medicare,Anthem Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Cigna,Cigna,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Cigna PPO,Cigna PPO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Cigna Medicare Advantage,Cigna Medicare Advantage,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Essence,Essence,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Healthlink HMO,Healthlink HMO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Healthlink PPO,Healthlink PPO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,HomeState Health Plan,HomeState Health Plan,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Humana Gold,Humana Gold,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Medicaid MO,Medicaid MO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Medica,Medica,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Tricare,Tricare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,UHC All Payer,UHC All Payer,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,UHC Exchange,UHC Exchange,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,UHC Medicaid,UHC Medicaid,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,UMR CPD,UMR CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,UHC Medicare,UHC Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) DYNAMIC ,33195600,CDM,274,RC,L3921,CPT,,,,Inpatient,,,243.6,243.6,Wellcare,Wellcare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Meritain Health PPO CPD,Meritain Health PPO CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Aetna/Commercial Product,Aetna/Commercial Product,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Meritain Health CPD,Meritain Health CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Starmark CPD,Starmark CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Aetna Medicare,Aetna Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Ambetter ,Ambetter ,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Blue Access,Anthem Blue Access,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Blue Access Choice,Anthem Blue Access Choice,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Blue Preferred,Anthem Blue Preferred,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Pathway,Anthem Pathway,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Alliance,Anthem Alliance,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Anthem Medicare,Anthem Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Cigna,Cigna,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Cigna PPO,Cigna PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Cigna Medicare Advantage,Cigna Medicare Advantage,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Essence,Essence,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Healthlink HMO,Healthlink HMO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Healthlink PPO,Healthlink PPO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,HomeState Health Plan,HomeState Health Plan,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Humana Gold,Humana Gold,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Medicaid MO,Medicaid MO,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Medica,Medica,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Tricare,Tricare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,UHC All Payer,UHC All Payer,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,UHC Exchange,UHC Exchange,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,UHC Medicaid,UHC Medicaid,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,UMR CPD,UMR CPD,210,,,,,,,per diem,210,210,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,UHC Medicare,UHC Medicare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HFO) STATIC  ,33195601,CDM,274,RC,L3913,CPT,,,,Inpatient,,,210,210,Wellcare,Wellcare,210,,,,,,,case rate,210,210,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Meritain Health PPO CPD,Meritain Health PPO CPD,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Aetna/Commercial Product,Aetna/Commercial Product,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Meritain Health CPD,Meritain Health CPD,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Starmark CPD,Starmark CPD,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Aetna Medicare,Aetna Medicare,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Ambetter ,Ambetter ,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Blue Access,Anthem Blue Access,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Blue Access Choice,Anthem Blue Access Choice,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Blue Preferred,Anthem Blue Preferred,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Pathway,Anthem Pathway,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Alliance,Anthem Alliance,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Anthem Medicare,Anthem Medicare,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Cigna,Cigna,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Cigna PPO,Cigna PPO,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Cigna Medicare Advantage,Cigna Medicare Advantage,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Essence,Essence,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Healthlink HMO,Healthlink HMO,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Healthlink PPO,Healthlink PPO,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,HomeState Health Plan,HomeState Health Plan,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Humana Gold,Humana Gold,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Medicaid MO,Medicaid MO,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Medica,Medica,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Tricare,Tricare,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,UHC All Payer,UHC All Payer,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,UHC Exchange,UHC Exchange,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,UHC Medicaid,UHC Medicaid,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,UMR CPD,UMR CPD,113,,,,,,,per diem,113,113,"Per diem rate, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,UHC Medicare,UHC Medicare,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
HAND FING ORTHO (HVO) FLX GLV ,33195602,CDM,274,RC,L3912,CPT,,,,Inpatient,,,113,113,Wellcare,Wellcare,113,,,,,,,case rate,113,113,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Meritain Health PPO CPD,Meritain Health PPO CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Aetna/Commercial Product,Aetna/Commercial Product,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Meritain Health CPD,Meritain Health CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Starmark CPD,Starmark CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Aetna Medicare,Aetna Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Ambetter ,Ambetter ,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Access,Anthem Blue Access,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Access Choice,Anthem Blue Access Choice,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Blue Preferred,Anthem Blue Preferred,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Pathway,Anthem Pathway,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Alliance,Anthem Alliance,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Anthem Medicare,Anthem Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Cigna,Cigna,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Cigna PPO,Cigna PPO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Cigna Medicare Advantage,Cigna Medicare Advantage,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Essence,Essence,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Healthlink HMO,Healthlink HMO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Healthlink PPO,Healthlink PPO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,HomeState Health Plan,HomeState Health Plan,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Humana Gold,Humana Gold,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Medicaid MO,Medicaid MO,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Medica,Medica,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Tricare,Tricare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,UHC All Payer,UHC All Payer,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,UHC Exchange,UHC Exchange,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,UHC Medicaid,UHC Medicaid,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,UMR CPD,UMR CPD,243.6,,,,,,,per diem,243.6,243.6,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,UHC Medicare,UHC Medicare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO (WHO) STATIC ,33195642,CDM,274,RC,L3906,CPT,,,,Inpatient,,,243.6,243.6,Wellcare,Wellcare,243.6,,,,,,,case rate,243.6,243.6,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Meritain Health PPO CPD,Meritain Health PPO CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Aetna/Commercial Product,Aetna/Commercial Product,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Meritain Health CPD,Meritain Health CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Starmark CPD,Starmark CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Aetna Medicare,Aetna Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Ambetter ,Ambetter ,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Access,Anthem Blue Access,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Access Choice,Anthem Blue Access Choice,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Blue Preferred,Anthem Blue Preferred,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Pathway,Anthem Pathway,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Alliance,Anthem Alliance,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Anthem Medicare,Anthem Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Cigna,Cigna,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Cigna PPO,Cigna PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Cigna Medicare Advantage,Cigna Medicare Advantage,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Essence,Essence,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Healthlink HMO,Healthlink HMO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Healthlink PPO,Healthlink PPO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,HomeState Health Plan,HomeState Health Plan,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Humana Gold,Humana Gold,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Medicaid MO,Medicaid MO,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Medica,Medica,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Tricare,Tricare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,UHC All Payer,UHC All Payer,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,UHC Exchange,UHC Exchange,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,UHC Medicaid,UHC Medicaid,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,UMR CPD,UMR CPD,130.2,,,,,,,per diem,130.2,130.2,"Per diem rate, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,UHC Medicare,UHC Medicare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
WRIST HAND ORTHO W EXT COCKUP ,33195643,CDM,274,RC,L3908,CPT,,,,Inpatient,,,130.2,130.2,Wellcare,Wellcare,130.2,,,,,,,case rate,130.2,130.2,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Meritain Health PPO CPD,Meritain Health PPO CPD,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Aetna/Commercial Product,Aetna/Commercial Product,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Meritain Health CPD,Meritain Health CPD,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Starmark CPD,Starmark CPD,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Aetna Medicare,Aetna Medicare,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Ambetter ,Ambetter ,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Blue Access,Anthem Blue Access,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Blue Access Choice,Anthem Blue Access Choice,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Blue Preferred,Anthem Blue Preferred,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Pathway,Anthem Pathway,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Alliance,Anthem Alliance,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Anthem Medicare,Anthem Medicare,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Cigna,Cigna,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Cigna PPO,Cigna PPO,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Cigna Medicare Advantage,Cigna Medicare Advantage,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Essence,Essence,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Healthlink HMO,Healthlink HMO,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Healthlink PPO,Healthlink PPO,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,HomeState Health Plan,HomeState Health Plan,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Humana Gold,Humana Gold,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Medicaid MO,Medicaid MO,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Medica,Medica,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Tricare,Tricare,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,UHC All Payer,UHC All Payer,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,UHC Exchange,UHC Exchange,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,UHC Medicaid,UHC Medicaid,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,UMR CPD,UMR CPD,331,,,,,,,per diem,331,331,"Per diem rate, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,UHC Medicare,UHC Medicare,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
W/H/F ORTHO (WHFO) STATIC     ,33195661,CDM,274,RC,L3808,CPT,,,,Inpatient,,,331,331,Wellcare,Wellcare,331,,,,,,,case rate,331,331,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Meritain Health PPO CPD,Meritain Health PPO CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Aetna/Commercial Product,Aetna/Commercial Product,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Meritain Health CPD,Meritain Health CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Starmark CPD,Starmark CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Aetna Medicare,Aetna Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Ambetter ,Ambetter ,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Blue Access,Anthem Blue Access,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Blue Access Choice,Anthem Blue Access Choice,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Blue Preferred,Anthem Blue Preferred,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Pathway,Anthem Pathway,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Alliance,Anthem Alliance,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Anthem Medicare,Anthem Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Cigna,Cigna,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Cigna PPO,Cigna PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Cigna Medicare Advantage,Cigna Medicare Advantage,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Essence,Essence,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Healthlink HMO,Healthlink HMO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Healthlink PPO,Healthlink PPO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,HomeState Health Plan,HomeState Health Plan,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Humana Gold,Humana Gold,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Medicaid MO,Medicaid MO,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Medica,Medica,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Tricare,Tricare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,UHC All Payer,UHC All Payer,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,UHC Exchange,UHC Exchange,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,UHC Medicaid,UHC Medicaid,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,UMR CPD,UMR CPD,113.4,,,,,,,per diem,113.4,113.4,"Per diem rate, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,UHC Medicare,UHC Medicare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
FO W/O JOINTS CUSTOM          ,33195665,CDM,274,RC,L3933,HCPCS,,,,Inpatient,,,113.4,113.4,Wellcare,Wellcare,113.4,,,,,,,case rate,113.4,113.4,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health PPO CPD,Meritain Health PPO CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna/Commercial Product,Aetna/Commercial Product,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Meritain Health CPD,Meritain Health CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Starmark CPD,Starmark CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Aetna Medicare,Aetna Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Ambetter ,Ambetter ,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access,Anthem Blue Access,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Access Choice,Anthem Blue Access Choice,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Blue Preferred,Anthem Blue Preferred,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Pathway,Anthem Pathway,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Alliance,Anthem Alliance,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Anthem Medicare,Anthem Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna,Cigna,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna PPO,Cigna PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Cigna Medicare Advantage,Cigna Medicare Advantage,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Essence,Essence,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink HMO,Healthlink HMO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Healthlink PPO,Healthlink PPO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,HomeState Health Plan,HomeState Health Plan,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Humana Gold,Humana Gold,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Medicaid MO,Medicaid MO,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Medica,Medica,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Tricare,Tricare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC All Payer,UHC All Payer,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Exchange,UHC Exchange,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicaid,UHC Medicaid,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,UMR CPD,UMR CPD,9,,,,,,,per diem,9,9,"Per diem rate, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,UHC Medicare,UHC Medicare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET FEED SPIKE PROXIMAL E-PUMP,33198631,CDM,279,RC,,,,,,Inpatient,,,9,9,Wellcare,Wellcare,9,,,,,,,case rate,9,9,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Meritain Health PPO CPD,Meritain Health PPO CPD,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Aetna/Commercial Product,Aetna/Commercial Product,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Meritain Health CPD,Meritain Health CPD,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Starmark CPD,Starmark CPD,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Aetna Medicare,Aetna Medicare,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Ambetter ,Ambetter ,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Blue Access,Anthem Blue Access,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Blue Access Choice,Anthem Blue Access Choice,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Blue Preferred,Anthem Blue Preferred,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Pathway,Anthem Pathway,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Alliance,Anthem Alliance,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Anthem Medicare,Anthem Medicare,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Cigna,Cigna,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Cigna PPO,Cigna PPO,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Cigna Medicare Advantage,Cigna Medicare Advantage,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Essence,Essence,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Healthlink HMO,Healthlink HMO,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Healthlink PPO,Healthlink PPO,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,HomeState Health Plan,HomeState Health Plan,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Humana Gold,Humana Gold,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Medicaid MO,Medicaid MO,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Medica,Medica,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Tricare,Tricare,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,UHC All Payer,UHC All Payer,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,UHC Exchange,UHC Exchange,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,UHC Medicaid,UHC Medicaid,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,UMR CPD,UMR CPD,11.28,,,,,,,per diem,11.28,11.28,"Per diem rate, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,UHC Medicare,UHC Medicare,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
SET EPUMP FEED FLUSH 1000ML   ,33198789,CDM,279,RC,,,,,,Inpatient,,,11.28,11.28,Wellcare,Wellcare,11.28,,,,,,,case rate,11.28,11.28,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Meritain Health PPO CPD,Meritain Health PPO CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna/Commercial Product,Aetna/Commercial Product,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Meritain Health CPD,Meritain Health CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Starmark CPD,Starmark CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Aetna Medicare,Aetna Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Ambetter ,Ambetter ,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access,Anthem Blue Access,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Access Choice,Anthem Blue Access Choice,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Blue Preferred,Anthem Blue Preferred,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Pathway,Anthem Pathway,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Alliance,Anthem Alliance,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Anthem Medicare,Anthem Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna,Cigna,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna PPO,Cigna PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Cigna Medicare Advantage,Cigna Medicare Advantage,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Essence,Essence,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthlink HMO,Healthlink HMO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Healthlink PPO,Healthlink PPO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,HomeState Health Plan,HomeState Health Plan,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Humana Gold,Humana Gold,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Medicaid MO,Medicaid MO,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Medica,Medica,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Tricare,Tricare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC All Payer,UHC All Payer,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Exchange,UHC Exchange,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Medicaid,UHC Medicaid,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,UMR CPD,UMR CPD,12,,,,,,,per diem,12,12,"Per diem rate, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,UHC Medicare,UHC Medicare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV FIRM MED 3X17IN   ,33199603,CDM,270,RC,,,,,,Inpatient,,,12,12,Wellcare,Wellcare,12,,,,,,,case rate,12,12,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Meritain Health PPO CPD,Meritain Health PPO CPD,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Aetna/Commercial Product,Aetna/Commercial Product,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Meritain Health CPD,Meritain Health CPD,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Starmark CPD,Starmark CPD,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Aetna Medicare,Aetna Medicare,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Ambetter ,Ambetter ,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Blue Access,Anthem Blue Access,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Blue Access Choice,Anthem Blue Access Choice,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Blue Preferred,Anthem Blue Preferred,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Pathway,Anthem Pathway,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Alliance,Anthem Alliance,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Anthem Medicare,Anthem Medicare,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Cigna,Cigna,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Cigna PPO,Cigna PPO,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Cigna Medicare Advantage,Cigna Medicare Advantage,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Essence,Essence,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Healthlink HMO,Healthlink HMO,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Healthlink PPO,Healthlink PPO,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,HomeState Health Plan,HomeState Health Plan,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Humana Gold,Humana Gold,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Medicaid MO,Medicaid MO,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Medica,Medica,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Tricare,Tricare,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,UHC All Payer,UHC All Payer,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,UHC Exchange,UHC Exchange,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,UHC Medicaid,UHC Medicaid,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,UMR CPD,UMR CPD,14,,,,,,,per diem,14,14,"Per diem rate, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,UHC Medicare,UHC Medicare,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
COLLAR CERV SOFT SML 2.75X15IN,33199604,CDM,270,RC,,,,,,Inpatient,,,14,14,Wellcare,Wellcare,14,,,,,,,case rate,14,14,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Meritain Health PPO CPD,Meritain Health PPO CPD,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Aetna/Commercial Product,Aetna/Commercial Product,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Meritain Health CPD,Meritain Health CPD,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Starmark CPD,Starmark CPD,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Aetna Medicare,Aetna Medicare,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Ambetter ,Ambetter ,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Blue Access,Anthem Blue Access,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Blue Access Choice,Anthem Blue Access Choice,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Blue Preferred,Anthem Blue Preferred,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Pathway,Anthem Pathway,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Alliance,Anthem Alliance,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Anthem Medicare,Anthem Medicare,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Cigna,Cigna,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Cigna PPO,Cigna PPO,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Cigna Medicare Advantage,Cigna Medicare Advantage,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Essence,Essence,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Healthlink HMO,Healthlink HMO,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Healthlink PPO,Healthlink PPO,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,HomeState Health Plan,HomeState Health Plan,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Humana Gold,Humana Gold,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Medicaid MO,Medicaid MO,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Medica,Medica,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Tricare,Tricare,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,UHC All Payer,UHC All Payer,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,UHC Exchange,UHC Exchange,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,UHC Medicaid,UHC Medicaid,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,UMR CPD,UMR CPD,337.31,,,,,,,per diem,337.31,337.31,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,UHC Medicare,UHC Medicare,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,33516002,CDM,510,RC,97607,CPT,,,,Inpatient,,,337.31,337.31,Wellcare,Wellcare,337.31,,,,,,,case rate,337.31,337.31,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Meritain Health PPO CPD,Meritain Health PPO CPD,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Aetna/Commercial Product,Aetna/Commercial Product,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Meritain Health CPD,Meritain Health CPD,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Starmark CPD,Starmark CPD,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Aetna Medicare,Aetna Medicare,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Ambetter ,Ambetter ,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Blue Access,Anthem Blue Access,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Blue Access Choice,Anthem Blue Access Choice,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Blue Preferred,Anthem Blue Preferred,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Pathway,Anthem Pathway,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Alliance,Anthem Alliance,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Anthem Medicare,Anthem Medicare,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Cigna,Cigna,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Cigna PPO,Cigna PPO,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Cigna Medicare Advantage,Cigna Medicare Advantage,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Essence,Essence,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Healthlink HMO,Healthlink HMO,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Healthlink PPO,Healthlink PPO,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,HomeState Health Plan,HomeState Health Plan,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Humana Gold,Humana Gold,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Medicaid MO,Medicaid MO,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Medica,Medica,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Tricare,Tricare,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,UHC All Payer,UHC All Payer,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,UHC Exchange,UHC Exchange,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,UHC Medicaid,UHC Medicaid,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,UMR CPD,UMR CPD,245.79,,,,,,,per diem,245.79,245.79,"Per diem rate, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,UHC Medicare,UHC Medicare,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
Dplx Scan Veins Extrem        ,33516003,CDM,510,RC,,,,,,Inpatient,,,245.79,245.79,Wellcare,Wellcare,245.79,,,,,,,case rate,245.79,245.79,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Meritain Health PPO CPD,Meritain Health PPO CPD,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Aetna/Commercial Product,Aetna/Commercial Product,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Meritain Health CPD,Meritain Health CPD,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Starmark CPD,Starmark CPD,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Aetna Medicare,Aetna Medicare,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Ambetter ,Ambetter ,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Blue Access,Anthem Blue Access,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Blue Access Choice,Anthem Blue Access Choice,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Blue Preferred,Anthem Blue Preferred,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Pathway,Anthem Pathway,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Alliance,Anthem Alliance,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Anthem Medicare,Anthem Medicare,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Cigna,Cigna,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Cigna PPO,Cigna PPO,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Cigna Medicare Advantage,Cigna Medicare Advantage,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Essence,Essence,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Healthlink HMO,Healthlink HMO,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Healthlink PPO,Healthlink PPO,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,HomeState Health Plan,HomeState Health Plan,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Humana Gold,Humana Gold,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Medicaid MO,Medicaid MO,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Medica,Medica,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Tricare,Tricare,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,UHC All Payer,UHC All Payer,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,UHC Exchange,UHC Exchange,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,UHC Medicaid,UHC Medicaid,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,UMR CPD,UMR CPD,919.6,,,,,,,per diem,919.6,919.6,"Per diem rate, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,UHC Medicare,UHC Medicare,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
DEBRIDE SUBQ TIS FIRST 20CM   ,33516021,CDM,761,RC,11042,CPT,,,,Inpatient,,,919.6,919.6,Wellcare,Wellcare,919.6,,,,,,,case rate,919.6,919.6,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Meritain Health PPO CPD,Meritain Health PPO CPD,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Aetna/Commercial Product,Aetna/Commercial Product,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Meritain Health CPD,Meritain Health CPD,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Starmark CPD,Starmark CPD,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Aetna Medicare,Aetna Medicare,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Ambetter ,Ambetter ,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Blue Access,Anthem Blue Access,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Blue Access Choice,Anthem Blue Access Choice,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Blue Preferred,Anthem Blue Preferred,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Pathway,Anthem Pathway,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Alliance,Anthem Alliance,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Anthem Medicare,Anthem Medicare,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Cigna,Cigna,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Cigna PPO,Cigna PPO,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Cigna Medicare Advantage,Cigna Medicare Advantage,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Essence,Essence,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Healthlink HMO,Healthlink HMO,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Healthlink PPO,Healthlink PPO,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,HomeState Health Plan,HomeState Health Plan,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Humana Gold,Humana Gold,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Medicaid MO,Medicaid MO,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Medica,Medica,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Tricare,Tricare,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,UHC All Payer,UHC All Payer,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,UHC Exchange,UHC Exchange,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,UHC Medicaid,UHC Medicaid,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,UMR CPD,UMR CPD,153.04,,,,,,,per diem,153.04,153.04,"Per diem rate, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,UHC Medicare,UHC Medicare,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
NON-SELECTIVE DEBRIDEMENT     ,34000030,CDM,420,RC,97602,CPT,,,GP,Inpatient,,,153.04,153.04,Wellcare,Wellcare,153.04,,,,,,,case rate,153.04,153.04,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING UNNA BOOT           ,34000031,CDM,420,RC,29580,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Meritain Health PPO CPD,Meritain Health PPO CPD,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Aetna/Commercial Product,Aetna/Commercial Product,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Meritain Health CPD,Meritain Health CPD,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Starmark CPD,Starmark CPD,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Aetna Medicare,Aetna Medicare,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Ambetter ,Ambetter ,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Blue Access,Anthem Blue Access,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Blue Access Choice,Anthem Blue Access Choice,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Blue Preferred,Anthem Blue Preferred,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Pathway,Anthem Pathway,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Alliance,Anthem Alliance,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Anthem Medicare,Anthem Medicare,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Cigna,Cigna,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Cigna PPO,Cigna PPO,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Cigna Medicare Advantage,Cigna Medicare Advantage,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Essence,Essence,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Healthlink HMO,Healthlink HMO,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Healthlink PPO,Healthlink PPO,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,HomeState Health Plan,HomeState Health Plan,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Humana Gold,Humana Gold,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Medicaid MO,Medicaid MO,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Medica,Medica,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Tricare,Tricare,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,UHC All Payer,UHC All Payer,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,UHC Exchange,UHC Exchange,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,UHC Medicaid,UHC Medicaid,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,UMR CPD,UMR CPD,294.88,,,,,,,per diem,294.88,294.88,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,UHC Medicare,UHC Medicare,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY EVAL         ,34000041,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,294.88,294.88,Wellcare,Wellcare,294.88,,,,,,,case rate,294.88,294.88,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Meritain Health PPO CPD,Meritain Health PPO CPD,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Aetna/Commercial Product,Aetna/Commercial Product,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Meritain Health CPD,Meritain Health CPD,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Starmark CPD,Starmark CPD,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Aetna Medicare,Aetna Medicare,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Ambetter ,Ambetter ,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Blue Access,Anthem Blue Access,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Blue Access Choice,Anthem Blue Access Choice,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Blue Preferred,Anthem Blue Preferred,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Pathway,Anthem Pathway,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Alliance,Anthem Alliance,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Anthem Medicare,Anthem Medicare,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Cigna,Cigna,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Cigna PPO,Cigna PPO,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Cigna Medicare Advantage,Cigna Medicare Advantage,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Essence,Essence,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Healthlink HMO,Healthlink HMO,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Healthlink PPO,Healthlink PPO,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,HomeState Health Plan,HomeState Health Plan,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Humana Gold,Humana Gold,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Medicaid MO,Medicaid MO,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Medica,Medica,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Tricare,Tricare,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,UHC All Payer,UHC All Payer,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,UHC Exchange,UHC Exchange,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,UHC Medicaid,UHC Medicaid,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,UMR CPD,UMR CPD,204.34,,,,,,,per diem,204.34,204.34,"Per diem rate, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,UHC Medicare,UHC Medicare,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION LOW COMPLEXITY  ,34000042,CDM,424,RC,97161,CPT,,,,Inpatient,,,204.34,204.34,Wellcare,Wellcare,204.34,,,,,,,case rate,204.34,204.34,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Meritain Health PPO CPD,Meritain Health PPO CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Aetna/Commercial Product,Aetna/Commercial Product,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Meritain Health CPD,Meritain Health CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Starmark CPD,Starmark CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Aetna Medicare,Aetna Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Ambetter ,Ambetter ,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Access,Anthem Blue Access,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Access Choice,Anthem Blue Access Choice,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Preferred,Anthem Blue Preferred,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Pathway,Anthem Pathway,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Alliance,Anthem Alliance,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Anthem Medicare,Anthem Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Cigna,Cigna,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Cigna PPO,Cigna PPO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Cigna Medicare Advantage,Cigna Medicare Advantage,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Essence,Essence,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Healthlink HMO,Healthlink HMO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Healthlink PPO,Healthlink PPO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,HomeState Health Plan,HomeState Health Plan,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Humana Gold,Humana Gold,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Medicaid MO,Medicaid MO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Medica,Medica,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Tricare,Tricare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,UHC All Payer,UHC All Payer,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,UHC Exchange,UHC Exchange,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,UHC Medicaid,UHC Medicaid,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,UMR CPD,UMR CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,UHC Medicare,UHC Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVALUATION MOD COMPLEXITY  ,34000043,CDM,424,RC,97162,CPT,,,,Inpatient,,,209.49,209.49,Wellcare,Wellcare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Meritain Health PPO CPD,Meritain Health PPO CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Aetna/Commercial Product,Aetna/Commercial Product,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Meritain Health CPD,Meritain Health CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Starmark CPD,Starmark CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Aetna Medicare,Aetna Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Ambetter ,Ambetter ,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Access,Anthem Blue Access,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Access Choice,Anthem Blue Access Choice,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Blue Preferred,Anthem Blue Preferred,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Pathway,Anthem Pathway,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Alliance,Anthem Alliance,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Anthem Medicare,Anthem Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Cigna,Cigna,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Cigna PPO,Cigna PPO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Cigna Medicare Advantage,Cigna Medicare Advantage,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Essence,Essence,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Healthlink HMO,Healthlink HMO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Healthlink PPO,Healthlink PPO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,HomeState Health Plan,HomeState Health Plan,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Humana Gold,Humana Gold,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Medicaid MO,Medicaid MO,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Medica,Medica,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Tricare,Tricare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,UHC All Payer,UHC All Payer,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,UHC Exchange,UHC Exchange,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,UHC Medicaid,UHC Medicaid,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,UMR CPD,UMR CPD,209.49,,,,,,,per diem,209.49,209.49,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,UHC Medicare,UHC Medicare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 45 MIN,34000044,CDM,424,RC,97163,CPT,,,,Inpatient,,,209.49,209.49,Wellcare,Wellcare,209.49,,,,,,,case rate,209.49,209.49,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Meritain Health PPO CPD,Meritain Health PPO CPD,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Aetna/Commercial Product,Aetna/Commercial Product,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Meritain Health CPD,Meritain Health CPD,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Starmark CPD,Starmark CPD,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Aetna Medicare,Aetna Medicare,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Ambetter ,Ambetter ,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Blue Access,Anthem Blue Access,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Blue Access Choice,Anthem Blue Access Choice,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Blue Preferred,Anthem Blue Preferred,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Pathway,Anthem Pathway,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Alliance,Anthem Alliance,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Anthem Medicare,Anthem Medicare,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Cigna,Cigna,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Cigna PPO,Cigna PPO,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Cigna Medicare Advantage,Cigna Medicare Advantage,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Essence,Essence,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Healthlink HMO,Healthlink HMO,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Healthlink PPO,Healthlink PPO,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,HomeState Health Plan,HomeState Health Plan,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Humana Gold,Humana Gold,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Medicaid MO,Medicaid MO,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Medica,Medica,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Tricare,Tricare,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,UHC All Payer,UHC All Payer,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,UHC Exchange,UHC Exchange,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,UHC Medicaid,UHC Medicaid,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,UMR CPD,UMR CPD,194.92,,,,,,,per diem,194.92,194.92,"Per diem rate, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,UHC Medicare,UHC Medicare,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT EVAL HIGH COMPLEXITY 60 MIN,34000045,CDM,424,RC,97163,CPT,,,,Inpatient,,,194.92,194.92,Wellcare,Wellcare,194.92,,,,,,,case rate,194.92,194.92,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Meritain Health PPO CPD,Meritain Health PPO CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna/Commercial Product,Aetna/Commercial Product,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Meritain Health CPD,Meritain Health CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Starmark CPD,Starmark CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna Medicare,Aetna Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Ambetter ,Ambetter ,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Access,Anthem Blue Access,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Access Choice,Anthem Blue Access Choice,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Preferred,Anthem Blue Preferred,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Pathway,Anthem Pathway,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Alliance,Anthem Alliance,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Medicare,Anthem Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna,Cigna,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna PPO,Cigna PPO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna Medicare Advantage,Cigna Medicare Advantage,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Essence,Essence,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthlink HMO,Healthlink HMO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthlink PPO,Healthlink PPO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,HomeState Health Plan,HomeState Health Plan,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Humana Gold,Humana Gold,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Medicaid MO,Medicaid MO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Medica,Medica,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Tricare,Tricare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC All Payer,UHC All Payer,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Exchange,UHC Exchange,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Medicaid,UHC Medicaid,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UMR CPD,UMR CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Medicare,UHC Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 15 MINUTE     ,34000046,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Wellcare,Wellcare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Meritain Health PPO CPD,Meritain Health PPO CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna/Commercial Product,Aetna/Commercial Product,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Meritain Health CPD,Meritain Health CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Starmark CPD,Starmark CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Aetna Medicare,Aetna Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Ambetter ,Ambetter ,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Access,Anthem Blue Access,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Access Choice,Anthem Blue Access Choice,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Blue Preferred,Anthem Blue Preferred,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Pathway,Anthem Pathway,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Alliance,Anthem Alliance,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Anthem Medicare,Anthem Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna,Cigna,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna PPO,Cigna PPO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Cigna Medicare Advantage,Cigna Medicare Advantage,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Essence,Essence,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthlink HMO,Healthlink HMO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Healthlink PPO,Healthlink PPO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,HomeState Health Plan,HomeState Health Plan,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Humana Gold,Humana Gold,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Medicaid MO,Medicaid MO,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Medica,Medica,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Tricare,Tricare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC All Payer,UHC All Payer,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Exchange,UHC Exchange,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Medicaid,UHC Medicaid,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UMR CPD,UMR CPD,163.91,,,,,,,per diem,163.91,163.91,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,UHC Medicare,UHC Medicare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 30 MIN        ,34000047,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,163.91,163.91,Wellcare,Wellcare,163.91,,,,,,,case rate,163.91,163.91,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Meritain Health PPO CPD,Meritain Health PPO CPD,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Aetna/Commercial Product,Aetna/Commercial Product,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Meritain Health CPD,Meritain Health CPD,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Starmark CPD,Starmark CPD,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Aetna Medicare,Aetna Medicare,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Ambetter ,Ambetter ,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Blue Access,Anthem Blue Access,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Blue Access Choice,Anthem Blue Access Choice,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Blue Preferred,Anthem Blue Preferred,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Pathway,Anthem Pathway,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Alliance,Anthem Alliance,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Anthem Medicare,Anthem Medicare,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Cigna,Cigna,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Cigna PPO,Cigna PPO,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Cigna Medicare Advantage,Cigna Medicare Advantage,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Essence,Essence,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Healthlink HMO,Healthlink HMO,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Healthlink PPO,Healthlink PPO,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,HomeState Health Plan,HomeState Health Plan,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Humana Gold,Humana Gold,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Medicaid MO,Medicaid MO,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Medica,Medica,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Tricare,Tricare,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,UHC All Payer,UHC All Payer,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,UHC Exchange,UHC Exchange,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,UHC Medicaid,UHC Medicaid,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,UMR CPD,UMR CPD,168.83,,,,,,,per diem,168.83,168.83,"Per diem rate, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,UHC Medicare,UHC Medicare,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT INITIAL EVAL 45 MIN        ,34000048,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,168.83,168.83,Wellcare,Wellcare,168.83,,,,,,,case rate,168.83,168.83,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Meritain Health PPO CPD,Meritain Health PPO CPD,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Aetna/Commercial Product,Aetna/Commercial Product,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Meritain Health CPD,Meritain Health CPD,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Starmark CPD,Starmark CPD,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Aetna Medicare,Aetna Medicare,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Ambetter ,Ambetter ,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Blue Access,Anthem Blue Access,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Blue Access Choice,Anthem Blue Access Choice,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Blue Preferred,Anthem Blue Preferred,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Pathway,Anthem Pathway,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Alliance,Anthem Alliance,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Anthem Medicare,Anthem Medicare,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Cigna,Cigna,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Cigna PPO,Cigna PPO,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Cigna Medicare Advantage,Cigna Medicare Advantage,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Essence,Essence,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Healthlink HMO,Healthlink HMO,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Healthlink PPO,Healthlink PPO,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,HomeState Health Plan,HomeState Health Plan,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Humana Gold,Humana Gold,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Medicaid MO,Medicaid MO,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Medica,Medica,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Tricare,Tricare,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,UHC All Payer,UHC All Payer,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,UHC Exchange,UHC Exchange,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,UHC Medicaid,UHC Medicaid,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,UMR CPD,UMR CPD,182.61,,,,,,,per diem,182.61,182.61,"Per diem rate, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,UHC Medicare,UHC Medicare,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
PT EVAL 60 MIN                ,34000049,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,182.61,182.61,Wellcare,Wellcare,182.61,,,,,,,case rate,182.61,182.61,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Meritain Health PPO CPD,Meritain Health PPO CPD,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Aetna/Commercial Product,Aetna/Commercial Product,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Meritain Health CPD,Meritain Health CPD,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Starmark CPD,Starmark CPD,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Aetna Medicare,Aetna Medicare,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Ambetter ,Ambetter ,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Blue Access,Anthem Blue Access,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Blue Access Choice,Anthem Blue Access Choice,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Blue Preferred,Anthem Blue Preferred,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Pathway,Anthem Pathway,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Alliance,Anthem Alliance,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Anthem Medicare,Anthem Medicare,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Cigna,Cigna,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Cigna PPO,Cigna PPO,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Cigna Medicare Advantage,Cigna Medicare Advantage,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Essence,Essence,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Healthlink HMO,Healthlink HMO,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Healthlink PPO,Healthlink PPO,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,HomeState Health Plan,HomeState Health Plan,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Humana Gold,Humana Gold,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Medicaid MO,Medicaid MO,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Medica,Medica,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Tricare,Tricare,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,UHC All Payer,UHC All Payer,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,UHC Exchange,UHC Exchange,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,UHC Medicaid,UHC Medicaid,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,UMR CPD,UMR CPD,239.16,,,,,,,per diem,239.16,239.16,"Per diem rate, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,UHC Medicare,UHC Medicare,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
GAIT TRAINING 15 MIN          ,34000050,CDM,420,RC,97116,CPT,,,GP,Inpatient,,,239.16,239.16,Wellcare,Wellcare,239.16,,,,,,,case rate,239.16,239.16,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Meritain Health PPO CPD,Meritain Health PPO CPD,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Aetna/Commercial Product,Aetna/Commercial Product,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Meritain Health CPD,Meritain Health CPD,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Starmark CPD,Starmark CPD,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Aetna Medicare,Aetna Medicare,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Ambetter ,Ambetter ,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Blue Access,Anthem Blue Access,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Blue Access Choice,Anthem Blue Access Choice,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Blue Preferred,Anthem Blue Preferred,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Pathway,Anthem Pathway,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Alliance,Anthem Alliance,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Anthem Medicare,Anthem Medicare,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Cigna,Cigna,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Cigna PPO,Cigna PPO,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Cigna Medicare Advantage,Cigna Medicare Advantage,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Essence,Essence,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Healthlink HMO,Healthlink HMO,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Healthlink PPO,Healthlink PPO,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,HomeState Health Plan,HomeState Health Plan,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Humana Gold,Humana Gold,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Medicaid MO,Medicaid MO,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Medica,Medica,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Tricare,Tricare,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,UHC All Payer,UHC All Payer,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,UHC Exchange,UHC Exchange,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,UHC Medicaid,UHC Medicaid,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,UMR CPD,UMR CPD,14.18,,,,,,,per diem,14.18,14.18,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,UHC Medicare,UHC Medicare,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34000070,CDM,420,RC,97010,CPT,,,GP,Inpatient,,,14.18,14.18,Wellcare,Wellcare,14.18,,,,,,,case rate,14.18,14.18,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Meritain Health PPO CPD,Meritain Health PPO CPD,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Aetna/Commercial Product,Aetna/Commercial Product,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Meritain Health CPD,Meritain Health CPD,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Starmark CPD,Starmark CPD,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Aetna Medicare,Aetna Medicare,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Ambetter ,Ambetter ,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Blue Access,Anthem Blue Access,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Blue Access Choice,Anthem Blue Access Choice,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Blue Preferred,Anthem Blue Preferred,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Pathway,Anthem Pathway,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Alliance,Anthem Alliance,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Anthem Medicare,Anthem Medicare,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Cigna,Cigna,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Cigna PPO,Cigna PPO,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Cigna Medicare Advantage,Cigna Medicare Advantage,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Essence,Essence,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Healthlink HMO,Healthlink HMO,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Healthlink PPO,Healthlink PPO,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,HomeState Health Plan,HomeState Health Plan,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Humana Gold,Humana Gold,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Medicaid MO,Medicaid MO,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Medica,Medica,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Tricare,Tricare,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,UHC All Payer,UHC All Payer,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,UHC Exchange,UHC Exchange,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,UHC Medicaid,UHC Medicaid,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,UMR CPD,UMR CPD,37.84,,,,,,,per diem,37.84,37.84,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,UHC Medicare,UHC Medicare,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34000090,CDM,420,RC,97016,CPT,,,GP,Inpatient,,,37.84,37.84,Wellcare,Wellcare,37.84,,,,,,,case rate,37.84,37.84,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Meritain Health PPO CPD,Meritain Health PPO CPD,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Aetna/Commercial Product,Aetna/Commercial Product,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Meritain Health CPD,Meritain Health CPD,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Starmark CPD,Starmark CPD,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Aetna Medicare,Aetna Medicare,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Ambetter ,Ambetter ,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Blue Access,Anthem Blue Access,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Blue Access Choice,Anthem Blue Access Choice,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Blue Preferred,Anthem Blue Preferred,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Pathway,Anthem Pathway,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Alliance,Anthem Alliance,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Anthem Medicare,Anthem Medicare,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Cigna,Cigna,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Cigna PPO,Cigna PPO,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Cigna Medicare Advantage,Cigna Medicare Advantage,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Essence,Essence,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Healthlink HMO,Healthlink HMO,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Healthlink PPO,Healthlink PPO,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,HomeState Health Plan,HomeState Health Plan,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Humana Gold,Humana Gold,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Medicaid MO,Medicaid MO,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Medica,Medica,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Tricare,Tricare,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,UHC All Payer,UHC All Payer,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,UHC Exchange,UHC Exchange,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,UHC Medicaid,UHC Medicaid,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,UMR CPD,UMR CPD,117.44,,,,,,,per diem,117.44,117.44,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,UHC Medicare,UHC Medicare,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34000100,CDM,420,RC,97124,CPT,,,GP,Inpatient,,,117.44,117.44,Wellcare,Wellcare,117.44,,,,,,,case rate,117.44,117.44,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Meritain Health PPO CPD,Meritain Health PPO CPD,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Aetna/Commercial Product,Aetna/Commercial Product,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Meritain Health CPD,Meritain Health CPD,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Starmark CPD,Starmark CPD,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Aetna Medicare,Aetna Medicare,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Ambetter ,Ambetter ,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Blue Access,Anthem Blue Access,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Blue Access Choice,Anthem Blue Access Choice,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Blue Preferred,Anthem Blue Preferred,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Pathway,Anthem Pathway,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Alliance,Anthem Alliance,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Anthem Medicare,Anthem Medicare,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Cigna,Cigna,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Cigna PPO,Cigna PPO,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Cigna Medicare Advantage,Cigna Medicare Advantage,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Essence,Essence,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Healthlink HMO,Healthlink HMO,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Healthlink PPO,Healthlink PPO,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,HomeState Health Plan,HomeState Health Plan,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Humana Gold,Humana Gold,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Medicaid MO,Medicaid MO,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Medica,Medica,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Tricare,Tricare,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,UHC All Payer,UHC All Payer,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,UHC Exchange,UHC Exchange,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,UHC Medicaid,UHC Medicaid,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,UMR CPD,UMR CPD,74.46,,,,,,,per diem,74.46,74.46,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,UHC Medicare,UHC Medicare,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34000120,CDM,420,RC,97018,CPT,,,GP,Inpatient,,,74.46,74.46,Wellcare,Wellcare,74.46,,,,,,,case rate,74.46,74.46,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Meritain Health PPO CPD,Meritain Health PPO CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Aetna/Commercial Product,Aetna/Commercial Product,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Meritain Health CPD,Meritain Health CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Starmark CPD,Starmark CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Aetna Medicare,Aetna Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Ambetter ,Ambetter ,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Blue Access,Anthem Blue Access,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Blue Access Choice,Anthem Blue Access Choice,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Blue Preferred,Anthem Blue Preferred,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Pathway,Anthem Pathway,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Alliance,Anthem Alliance,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Anthem Medicare,Anthem Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Cigna,Cigna,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Cigna PPO,Cigna PPO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Cigna Medicare Advantage,Cigna Medicare Advantage,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Essence,Essence,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Healthlink HMO,Healthlink HMO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Healthlink PPO,Healthlink PPO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,HomeState Health Plan,HomeState Health Plan,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Humana Gold,Humana Gold,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Medicaid MO,Medicaid MO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Medica,Medica,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Tricare,Tricare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,UHC All Payer,UHC All Payer,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,UHC Exchange,UHC Exchange,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,UHC Medicaid,UHC Medicaid,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,UMR CPD,UMR CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,UHC Medicare,UHC Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
PHYSICAL THERAPY RE-EVALUATION,34000140,CDM,424,RC,97164,CPT,,,GP,Inpatient,,,171.83,171.83,Wellcare,Wellcare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Meritain Health PPO CPD,Meritain Health PPO CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna/Commercial Product,Aetna/Commercial Product,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Meritain Health CPD,Meritain Health CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Starmark CPD,Starmark CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna Medicare,Aetna Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Ambetter ,Ambetter ,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Access,Anthem Blue Access,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Access Choice,Anthem Blue Access Choice,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Preferred,Anthem Blue Preferred,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Pathway,Anthem Pathway,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Alliance,Anthem Alliance,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Medicare,Anthem Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna,Cigna,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna PPO,Cigna PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna Medicare Advantage,Cigna Medicare Advantage,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Essence,Essence,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Healthlink HMO,Healthlink HMO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Healthlink PPO,Healthlink PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,HomeState Health Plan,HomeState Health Plan,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Humana Gold,Humana Gold,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Medicaid MO,Medicaid MO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Medica,Medica,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Tricare,Tricare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,UHC All Payer,UHC All Payer,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Exchange,UHC Exchange,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Medicaid,UHC Medicaid,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,UMR CPD,UMR CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Medicare,UHC Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000155,CDM,423,RC,97150,CPT,,,GP,Inpatient,,,131.81,131.81,Wellcare,Wellcare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Meritain Health PPO CPD,Meritain Health PPO CPD,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Aetna/Commercial Product,Aetna/Commercial Product,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Meritain Health CPD,Meritain Health CPD,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Starmark CPD,Starmark CPD,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Aetna Medicare,Aetna Medicare,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Ambetter ,Ambetter ,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Blue Access,Anthem Blue Access,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Blue Access Choice,Anthem Blue Access Choice,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Blue Preferred,Anthem Blue Preferred,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Pathway,Anthem Pathway,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Alliance,Anthem Alliance,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Anthem Medicare,Anthem Medicare,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Cigna,Cigna,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Cigna PPO,Cigna PPO,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Cigna Medicare Advantage,Cigna Medicare Advantage,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Essence,Essence,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Healthlink HMO,Healthlink HMO,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Healthlink PPO,Healthlink PPO,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,HomeState Health Plan,HomeState Health Plan,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Humana Gold,Humana Gold,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Medicaid MO,Medicaid MO,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Medica,Medica,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Tricare,Tricare,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,UHC All Payer,UHC All Payer,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,UHC Exchange,UHC Exchange,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,UHC Medicaid,UHC Medicaid,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,UMR CPD,UMR CPD,113.17,,,,,,,per diem,113.17,113.17,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,UHC Medicare,UHC Medicare,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000156,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,113.17,113.17,Wellcare,Wellcare,113.17,,,,,,,case rate,113.17,113.17,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Meritain Health PPO CPD,Meritain Health PPO CPD,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Aetna/Commercial Product,Aetna/Commercial Product,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Meritain Health CPD,Meritain Health CPD,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Starmark CPD,Starmark CPD,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Aetna Medicare,Aetna Medicare,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Ambetter ,Ambetter ,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Blue Access,Anthem Blue Access,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Blue Access Choice,Anthem Blue Access Choice,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Blue Preferred,Anthem Blue Preferred,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Pathway,Anthem Pathway,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Alliance,Anthem Alliance,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Anthem Medicare,Anthem Medicare,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Cigna,Cigna,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Cigna PPO,Cigna PPO,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Cigna Medicare Advantage,Cigna Medicare Advantage,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Essence,Essence,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Healthlink HMO,Healthlink HMO,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Healthlink PPO,Healthlink PPO,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,HomeState Health Plan,HomeState Health Plan,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Humana Gold,Humana Gold,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Medicaid MO,Medicaid MO,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Medica,Medica,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Tricare,Tricare,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,UHC All Payer,UHC All Payer,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,UHC Exchange,UHC Exchange,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,UHC Medicaid,UHC Medicaid,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,UMR CPD,UMR CPD,124.09,,,,,,,per diem,124.09,124.09,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,UHC Medicare,UHC Medicare,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE-GROUP   ,34000157,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,124.09,124.09,Wellcare,Wellcare,124.09,,,,,,,case rate,124.09,124.09,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Meritain Health PPO CPD,Meritain Health PPO CPD,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Aetna/Commercial Product,Aetna/Commercial Product,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Meritain Health CPD,Meritain Health CPD,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Starmark CPD,Starmark CPD,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Aetna Medicare,Aetna Medicare,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Ambetter ,Ambetter ,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Blue Access,Anthem Blue Access,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Blue Access Choice,Anthem Blue Access Choice,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Blue Preferred,Anthem Blue Preferred,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Pathway,Anthem Pathway,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Alliance,Anthem Alliance,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Anthem Medicare,Anthem Medicare,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Cigna,Cigna,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Cigna PPO,Cigna PPO,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Cigna Medicare Advantage,Cigna Medicare Advantage,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Essence,Essence,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Healthlink HMO,Healthlink HMO,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Healthlink PPO,Healthlink PPO,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,HomeState Health Plan,HomeState Health Plan,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Humana Gold,Humana Gold,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Medicaid MO,Medicaid MO,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Medica,Medica,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Tricare,Tricare,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,UHC All Payer,UHC All Payer,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,UHC Exchange,UHC Exchange,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,UHC Medicaid,UHC Medicaid,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,UMR CPD,UMR CPD,97.81,,,,,,,per diem,97.81,97.81,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,UHC Medicare,UHC Medicare,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROC-GROUP 15 MIN ,34000158,CDM,420,RC,97150,CPT,,,GP,Inpatient,,,97.81,97.81,Wellcare,Wellcare,97.81,,,,,,,case rate,97.81,97.81,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Meritain Health PPO CPD,Meritain Health PPO CPD,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Aetna/Commercial Product,Aetna/Commercial Product,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Meritain Health CPD,Meritain Health CPD,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Starmark CPD,Starmark CPD,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Aetna Medicare,Aetna Medicare,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Ambetter ,Ambetter ,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Blue Access,Anthem Blue Access,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Blue Access Choice,Anthem Blue Access Choice,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Blue Preferred,Anthem Blue Preferred,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Pathway,Anthem Pathway,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Alliance,Anthem Alliance,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Anthem Medicare,Anthem Medicare,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Cigna,Cigna,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Cigna PPO,Cigna PPO,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Cigna Medicare Advantage,Cigna Medicare Advantage,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Essence,Essence,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Healthlink HMO,Healthlink HMO,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Healthlink PPO,Healthlink PPO,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,HomeState Health Plan,HomeState Health Plan,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Humana Gold,Humana Gold,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Medicaid MO,Medicaid MO,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Medica,Medica,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Tricare,Tricare,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,UHC All Payer,UHC All Payer,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,UHC Exchange,UHC Exchange,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,UHC Medicaid,UHC Medicaid,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,UMR CPD,UMR CPD,84.01,,,,,,,per diem,84.01,84.01,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,UHC Medicare,UHC Medicare,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34000176,CDM,420,RC,97533,CPT,,,GP,Inpatient,,,84.01,84.01,Wellcare,Wellcare,84.01,,,,,,,case rate,84.01,84.01,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34000270,CDM,420,RC,97022,CPT,,,GP,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Meritain Health PPO CPD,Meritain Health PPO CPD,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Aetna/Commercial Product,Aetna/Commercial Product,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Meritain Health CPD,Meritain Health CPD,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Starmark CPD,Starmark CPD,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Aetna Medicare,Aetna Medicare,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Ambetter ,Ambetter ,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Blue Access,Anthem Blue Access,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Blue Access Choice,Anthem Blue Access Choice,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Blue Preferred,Anthem Blue Preferred,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Pathway,Anthem Pathway,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Alliance,Anthem Alliance,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Anthem Medicare,Anthem Medicare,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Cigna,Cigna,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Cigna PPO,Cigna PPO,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Cigna Medicare Advantage,Cigna Medicare Advantage,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Essence,Essence,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Healthlink HMO,Healthlink HMO,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Healthlink PPO,Healthlink PPO,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,HomeState Health Plan,HomeState Health Plan,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Humana Gold,Humana Gold,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Medicaid MO,Medicaid MO,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Medica,Medica,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Tricare,Tricare,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,UHC All Payer,UHC All Payer,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,UHC Exchange,UHC Exchange,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,UHC Medicaid,UHC Medicaid,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,UMR CPD,UMR CPD,75.54,,,,,,,per diem,75.54,75.54,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,UHC Medicare,UHC Medicare,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34000290,CDM,420,RC,97034,CPT,,,GP,Inpatient,,,75.54,75.54,Wellcare,Wellcare,75.54,,,,,,,case rate,75.54,75.54,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34000305,CDM,420,RC,97024,CPT,,,GP,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Meritain Health PPO CPD,Meritain Health PPO CPD,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Aetna/Commercial Product,Aetna/Commercial Product,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Meritain Health CPD,Meritain Health CPD,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Starmark CPD,Starmark CPD,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Aetna Medicare,Aetna Medicare,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Ambetter ,Ambetter ,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Blue Access,Anthem Blue Access,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Blue Access Choice,Anthem Blue Access Choice,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Blue Preferred,Anthem Blue Preferred,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Pathway,Anthem Pathway,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Alliance,Anthem Alliance,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Anthem Medicare,Anthem Medicare,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Cigna,Cigna,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Cigna PPO,Cigna PPO,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Cigna Medicare Advantage,Cigna Medicare Advantage,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Essence,Essence,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Healthlink HMO,Healthlink HMO,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Healthlink PPO,Healthlink PPO,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,HomeState Health Plan,HomeState Health Plan,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Humana Gold,Humana Gold,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Medicaid MO,Medicaid MO,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Medica,Medica,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Tricare,Tricare,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,UHC All Payer,UHC All Payer,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,UHC Exchange,UHC Exchange,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,UHC Medicaid,UHC Medicaid,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,UMR CPD,UMR CPD,97.17,,,,,,,per diem,97.17,97.17,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,UHC Medicare,UHC Medicare,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34000465,CDM,420,RC,97033,CPT,,,GP,Inpatient,,,97.17,97.17,Wellcare,Wellcare,97.17,,,,,,,case rate,97.17,97.17,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Meritain Health PPO CPD,Meritain Health PPO CPD,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Aetna/Commercial Product,Aetna/Commercial Product,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Meritain Health CPD,Meritain Health CPD,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Starmark CPD,Starmark CPD,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Aetna Medicare,Aetna Medicare,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Ambetter ,Ambetter ,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Blue Access,Anthem Blue Access,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Blue Access Choice,Anthem Blue Access Choice,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Blue Preferred,Anthem Blue Preferred,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Pathway,Anthem Pathway,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Alliance,Anthem Alliance,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Anthem Medicare,Anthem Medicare,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Cigna,Cigna,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Cigna PPO,Cigna PPO,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Cigna Medicare Advantage,Cigna Medicare Advantage,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Essence,Essence,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Healthlink HMO,Healthlink HMO,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Healthlink PPO,Healthlink PPO,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,HomeState Health Plan,HomeState Health Plan,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Humana Gold,Humana Gold,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Medicaid MO,Medicaid MO,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Medica,Medica,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Tricare,Tricare,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,UHC All Payer,UHC All Payer,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,UHC Exchange,UHC Exchange,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,UHC Medicaid,UHC Medicaid,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,UMR CPD,UMR CPD,118.18,,,,,,,per diem,118.18,118.18,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,UHC Medicare,UHC Medicare,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34000470,CDM,420,RC,97762,CPT,,,GP,Inpatient,,,118.18,118.18,Wellcare,Wellcare,118.18,,,,,,,case rate,118.18,118.18,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Meritain Health PPO CPD,Meritain Health PPO CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Aetna/Commercial Product,Aetna/Commercial Product,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Meritain Health CPD,Meritain Health CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Starmark CPD,Starmark CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Aetna Medicare,Aetna Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Ambetter ,Ambetter ,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Blue Access,Anthem Blue Access,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Blue Access Choice,Anthem Blue Access Choice,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Blue Preferred,Anthem Blue Preferred,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Pathway,Anthem Pathway,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Alliance,Anthem Alliance,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Anthem Medicare,Anthem Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Cigna,Cigna,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Cigna PPO,Cigna PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Cigna Medicare Advantage,Cigna Medicare Advantage,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Essence,Essence,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Healthlink HMO,Healthlink HMO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Healthlink PPO,Healthlink PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,HomeState Health Plan,HomeState Health Plan,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Humana Gold,Humana Gold,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Medicaid MO,Medicaid MO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Medica,Medica,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Tricare,Tricare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,UHC All Payer,UHC All Payer,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,UHC Exchange,UHC Exchange,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,UHC Medicaid,UHC Medicaid,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,UMR CPD,UMR CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,UHC Medicare,UHC Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
TRACTION                      ,34000560,CDM,420,RC,97012,CPT,,,GP,Inpatient,,,75.32,75.32,Wellcare,Wellcare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
ULTRAVIOLET                   ,34000565,CDM,420,RC,97028,CPT,,,GP,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Meritain Health PPO CPD,Meritain Health PPO CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Aetna/Commercial Product,Aetna/Commercial Product,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Meritain Health CPD,Meritain Health CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Starmark CPD,Starmark CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Aetna Medicare,Aetna Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Ambetter ,Ambetter ,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Blue Access,Anthem Blue Access,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Blue Access Choice,Anthem Blue Access Choice,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Blue Preferred,Anthem Blue Preferred,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Pathway,Anthem Pathway,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Alliance,Anthem Alliance,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Anthem Medicare,Anthem Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Cigna,Cigna,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Cigna PPO,Cigna PPO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Cigna Medicare Advantage,Cigna Medicare Advantage,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Essence,Essence,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Healthlink HMO,Healthlink HMO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Healthlink PPO,Healthlink PPO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,HomeState Health Plan,HomeState Health Plan,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Humana Gold,Humana Gold,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Medicaid MO,Medicaid MO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Medica,Medica,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Tricare,Tricare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,UHC All Payer,UHC All Payer,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,UHC Exchange,UHC Exchange,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,UHC Medicaid,UHC Medicaid,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,UMR CPD,UMR CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,UHC Medicare,UHC Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
TEST PHYSICAL PERFORM 15 MIN  ,34000650,CDM,420,RC,97750,CPT,,,GP,Inpatient,,,115.83,115.83,Wellcare,Wellcare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Meritain Health PPO CPD,Meritain Health PPO CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Aetna/Commercial Product,Aetna/Commercial Product,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Meritain Health CPD,Meritain Health CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Starmark CPD,Starmark CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Aetna Medicare,Aetna Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Ambetter ,Ambetter ,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Blue Access,Anthem Blue Access,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Blue Access Choice,Anthem Blue Access Choice,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Blue Preferred,Anthem Blue Preferred,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Pathway,Anthem Pathway,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Alliance,Anthem Alliance,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Anthem Medicare,Anthem Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Cigna,Cigna,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Cigna PPO,Cigna PPO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Cigna Medicare Advantage,Cigna Medicare Advantage,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Essence,Essence,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Healthlink HMO,Healthlink HMO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Healthlink PPO,Healthlink PPO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,HomeState Health Plan,HomeState Health Plan,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Humana Gold,Humana Gold,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Medicaid MO,Medicaid MO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Medica,Medica,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Tricare,Tricare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,UHC All Payer,UHC All Payer,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,UHC Exchange,UHC Exchange,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,UHC Medicaid,UHC Medicaid,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,UMR CPD,UMR CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,UHC Medicare,UHC Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34000702,CDM,420,RC,97761,CPT,,,GP,Inpatient,,,127.22,127.22,Wellcare,Wellcare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Meritain Health PPO CPD,Meritain Health PPO CPD,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Aetna/Commercial Product,Aetna/Commercial Product,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Meritain Health CPD,Meritain Health CPD,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Starmark CPD,Starmark CPD,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Aetna Medicare,Aetna Medicare,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Ambetter ,Ambetter ,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Blue Access,Anthem Blue Access,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Blue Access Choice,Anthem Blue Access Choice,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Blue Preferred,Anthem Blue Preferred,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Pathway,Anthem Pathway,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Alliance,Anthem Alliance,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Anthem Medicare,Anthem Medicare,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Cigna,Cigna,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Cigna PPO,Cigna PPO,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Cigna Medicare Advantage,Cigna Medicare Advantage,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Essence,Essence,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Healthlink HMO,Healthlink HMO,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Healthlink PPO,Healthlink PPO,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,HomeState Health Plan,HomeState Health Plan,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Humana Gold,Humana Gold,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Medicaid MO,Medicaid MO,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Medica,Medica,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Tricare,Tricare,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,UHC All Payer,UHC All Payer,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,UHC Exchange,UHC Exchange,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,UHC Medicaid,UHC Medicaid,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,UMR CPD,UMR CPD,466.05,,,,,,,per diem,466.05,466.05,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,UHC Medicare,UHC Medicare,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34000790,CDM,420,RC,97112,CPT,,,GP,Inpatient,,,466.05,466.05,Wellcare,Wellcare,466.05,,,,,,,case rate,466.05,466.05,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Meritain Health PPO CPD,Meritain Health PPO CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Aetna/Commercial Product,Aetna/Commercial Product,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Meritain Health CPD,Meritain Health CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Starmark CPD,Starmark CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Aetna Medicare,Aetna Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Ambetter ,Ambetter ,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Blue Access,Anthem Blue Access,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Blue Access Choice,Anthem Blue Access Choice,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Blue Preferred,Anthem Blue Preferred,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Pathway,Anthem Pathway,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Alliance,Anthem Alliance,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Anthem Medicare,Anthem Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Cigna,Cigna,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Cigna PPO,Cigna PPO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Cigna Medicare Advantage,Cigna Medicare Advantage,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Essence,Essence,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Healthlink HMO,Healthlink HMO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Healthlink PPO,Healthlink PPO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,HomeState Health Plan,HomeState Health Plan,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Humana Gold,Humana Gold,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Medicaid MO,Medicaid MO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Medica,Medica,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Tricare,Tricare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,UHC All Payer,UHC All Payer,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,UHC Exchange,UHC Exchange,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,UHC Medicaid,UHC Medicaid,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,UMR CPD,UMR CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,UHC Medicare,UHC Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34010000,CDM,420,RC,95831,CPT,,,GP,Inpatient,,,79.07,79.07,Wellcare,Wellcare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Meritain Health PPO CPD,Meritain Health PPO CPD,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Aetna/Commercial Product,Aetna/Commercial Product,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Meritain Health CPD,Meritain Health CPD,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Starmark CPD,Starmark CPD,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Aetna Medicare,Aetna Medicare,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Ambetter ,Ambetter ,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Blue Access,Anthem Blue Access,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Blue Access Choice,Anthem Blue Access Choice,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Blue Preferred,Anthem Blue Preferred,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Pathway,Anthem Pathway,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Alliance,Anthem Alliance,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Anthem Medicare,Anthem Medicare,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Cigna,Cigna,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Cigna PPO,Cigna PPO,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Cigna Medicare Advantage,Cigna Medicare Advantage,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Essence,Essence,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Healthlink HMO,Healthlink HMO,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Healthlink PPO,Healthlink PPO,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,HomeState Health Plan,HomeState Health Plan,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Humana Gold,Humana Gold,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Medicaid MO,Medicaid MO,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Medica,Medica,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Tricare,Tricare,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,UHC All Payer,UHC All Payer,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,UHC Exchange,UHC Exchange,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,UHC Medicaid,UHC Medicaid,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,UMR CPD,UMR CPD,75.22,,,,,,,per diem,75.22,75.22,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,UHC Medicare,UHC Medicare,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34010001,CDM,420,RC,95832,CPT,,,GP,Inpatient,,,75.22,75.22,Wellcare,Wellcare,75.22,,,,,,,case rate,75.22,75.22,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Meritain Health PPO CPD,Meritain Health PPO CPD,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Aetna/Commercial Product,Aetna/Commercial Product,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Meritain Health CPD,Meritain Health CPD,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Starmark CPD,Starmark CPD,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Aetna Medicare,Aetna Medicare,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Ambetter ,Ambetter ,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Blue Access,Anthem Blue Access,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Blue Access Choice,Anthem Blue Access Choice,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Blue Preferred,Anthem Blue Preferred,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Pathway,Anthem Pathway,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Alliance,Anthem Alliance,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Anthem Medicare,Anthem Medicare,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Cigna,Cigna,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Cigna PPO,Cigna PPO,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Cigna Medicare Advantage,Cigna Medicare Advantage,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Essence,Essence,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Healthlink HMO,Healthlink HMO,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Healthlink PPO,Healthlink PPO,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,HomeState Health Plan,HomeState Health Plan,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Humana Gold,Humana Gold,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Medicaid MO,Medicaid MO,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Medica,Medica,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Tricare,Tricare,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,UHC All Payer,UHC All Payer,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,UHC Exchange,UHC Exchange,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,UHC Medicaid,UHC Medicaid,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,UMR CPD,UMR CPD,91.8,,,,,,,per diem,91.8,91.8,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,UHC Medicare,UHC Medicare,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34010002,CDM,420,RC,95833,CPT,,,GP,Inpatient,,,91.8,91.8,Wellcare,Wellcare,91.8,,,,,,,case rate,91.8,91.8,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Meritain Health PPO CPD,Meritain Health PPO CPD,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Aetna/Commercial Product,Aetna/Commercial Product,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Meritain Health CPD,Meritain Health CPD,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Starmark CPD,Starmark CPD,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Aetna Medicare,Aetna Medicare,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Ambetter ,Ambetter ,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Blue Access,Anthem Blue Access,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Blue Access Choice,Anthem Blue Access Choice,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Blue Preferred,Anthem Blue Preferred,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Pathway,Anthem Pathway,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Alliance,Anthem Alliance,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Anthem Medicare,Anthem Medicare,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Cigna,Cigna,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Cigna PPO,Cigna PPO,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Cigna Medicare Advantage,Cigna Medicare Advantage,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Essence,Essence,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Healthlink HMO,Healthlink HMO,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Healthlink PPO,Healthlink PPO,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,HomeState Health Plan,HomeState Health Plan,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Humana Gold,Humana Gold,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Medicaid MO,Medicaid MO,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Medica,Medica,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Tricare,Tricare,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,UHC All Payer,UHC All Payer,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,UHC Exchange,UHC Exchange,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,UHC Medicaid,UHC Medicaid,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,UMR CPD,UMR CPD,100.65,,,,,,,per diem,100.65,100.65,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,UHC Medicare,UHC Medicare,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34010003,CDM,420,RC,95834,CPT,,,GP,Inpatient,,,100.65,100.65,Wellcare,Wellcare,100.65,,,,,,,case rate,100.65,100.65,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34010006,CDM,420,RC,95851,CPT,,,GP,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Meritain Health PPO CPD,Meritain Health PPO CPD,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Aetna/Commercial Product,Aetna/Commercial Product,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Meritain Health CPD,Meritain Health CPD,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Starmark CPD,Starmark CPD,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Aetna Medicare,Aetna Medicare,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Ambetter ,Ambetter ,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Blue Access,Anthem Blue Access,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Blue Access Choice,Anthem Blue Access Choice,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Blue Preferred,Anthem Blue Preferred,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Pathway,Anthem Pathway,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Alliance,Anthem Alliance,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Anthem Medicare,Anthem Medicare,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Cigna,Cigna,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Cigna PPO,Cigna PPO,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Cigna Medicare Advantage,Cigna Medicare Advantage,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Essence,Essence,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Healthlink HMO,Healthlink HMO,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Healthlink PPO,Healthlink PPO,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,HomeState Health Plan,HomeState Health Plan,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Humana Gold,Humana Gold,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Medicaid MO,Medicaid MO,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Medica,Medica,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Tricare,Tricare,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,UHC All Payer,UHC All Payer,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,UHC Exchange,UHC Exchange,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,UHC Medicaid,UHC Medicaid,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,UMR CPD,UMR CPD,62.81,,,,,,,per diem,62.81,62.81,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,UHC Medicare,UHC Medicare,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34010007,CDM,420,RC,95852,CPT,,,GP,Inpatient,,,62.81,62.81,Wellcare,Wellcare,62.81,,,,,,,case rate,62.81,62.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Meritain Health PPO CPD,Meritain Health PPO CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna/Commercial Product,Aetna/Commercial Product,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Meritain Health CPD,Meritain Health CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Starmark CPD,Starmark CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Aetna Medicare,Aetna Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Ambetter ,Ambetter ,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Access,Anthem Blue Access,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Access Choice,Anthem Blue Access Choice,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Blue Preferred,Anthem Blue Preferred,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Pathway,Anthem Pathway,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Alliance,Anthem Alliance,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Anthem Medicare,Anthem Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna,Cigna,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna PPO,Cigna PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Cigna Medicare Advantage,Cigna Medicare Advantage,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Essence,Essence,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Healthlink HMO,Healthlink HMO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Healthlink PPO,Healthlink PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,HomeState Health Plan,HomeState Health Plan,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Humana Gold,Humana Gold,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Medicaid MO,Medicaid MO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Medica,Medica,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Tricare,Tricare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,UHC All Payer,UHC All Payer,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Exchange,UHC Exchange,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Medicaid,UHC Medicaid,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,UMR CPD,UMR CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,UHC Medicare,UHC Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34010020,CDM,420,RC,97140,CPT,,,GP,Inpatient,,,131.81,131.81,Wellcare,Wellcare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34010040,CDM,420,RC,97110,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Meritain Health PPO CPD,Meritain Health PPO CPD,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Aetna/Commercial Product,Aetna/Commercial Product,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Meritain Health CPD,Meritain Health CPD,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Starmark CPD,Starmark CPD,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Aetna Medicare,Aetna Medicare,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Ambetter ,Ambetter ,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Blue Access,Anthem Blue Access,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Blue Access Choice,Anthem Blue Access Choice,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Blue Preferred,Anthem Blue Preferred,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Pathway,Anthem Pathway,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Alliance,Anthem Alliance,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Anthem Medicare,Anthem Medicare,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Cigna,Cigna,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Cigna PPO,Cigna PPO,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Cigna Medicare Advantage,Cigna Medicare Advantage,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Essence,Essence,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Healthlink HMO,Healthlink HMO,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Healthlink PPO,Healthlink PPO,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,HomeState Health Plan,HomeState Health Plan,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Humana Gold,Humana Gold,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Medicaid MO,Medicaid MO,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Medica,Medica,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Tricare,Tricare,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,UHC All Payer,UHC All Payer,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,UHC Exchange,UHC Exchange,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,UHC Medicaid,UHC Medicaid,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,UMR CPD,UMR CPD,87.34,,,,,,,per diem,87.34,87.34,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,UHC Medicare,UHC Medicare,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34010075,CDM,420,RC,97542,CPT,,,GP,Inpatient,,,87.34,87.34,Wellcare,Wellcare,87.34,,,,,,,case rate,87.34,87.34,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Meritain Health PPO CPD,Meritain Health PPO CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Aetna/Commercial Product,Aetna/Commercial Product,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Meritain Health CPD,Meritain Health CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Starmark CPD,Starmark CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Aetna Medicare,Aetna Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Ambetter ,Ambetter ,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Blue Access,Anthem Blue Access,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Blue Access Choice,Anthem Blue Access Choice,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Blue Preferred,Anthem Blue Preferred,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Pathway,Anthem Pathway,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Alliance,Anthem Alliance,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Anthem Medicare,Anthem Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Cigna,Cigna,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Cigna PPO,Cigna PPO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Cigna Medicare Advantage,Cigna Medicare Advantage,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Essence,Essence,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Healthlink HMO,Healthlink HMO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Healthlink PPO,Healthlink PPO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,HomeState Health Plan,HomeState Health Plan,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Humana Gold,Humana Gold,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Medicaid MO,Medicaid MO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Medica,Medica,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Tricare,Tricare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,UHC All Payer,UHC All Payer,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,UHC Exchange,UHC Exchange,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,UHC Medicaid,UHC Medicaid,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,UMR CPD,UMR CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,UHC Medicare,UHC Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
PT EDUCAT/TRAINING 30/MIN     ,34010076,CDM,420,RC,98960,CPT,,,,Inpatient,,,349.86,349.86,Wellcare,Wellcare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Meritain Health PPO CPD,Meritain Health PPO CPD,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Aetna/Commercial Product,Aetna/Commercial Product,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Meritain Health CPD,Meritain Health CPD,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Starmark CPD,Starmark CPD,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Aetna Medicare,Aetna Medicare,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Ambetter ,Ambetter ,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Blue Access,Anthem Blue Access,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Blue Access Choice,Anthem Blue Access Choice,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Blue Preferred,Anthem Blue Preferred,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Pathway,Anthem Pathway,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Alliance,Anthem Alliance,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Anthem Medicare,Anthem Medicare,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Cigna,Cigna,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Cigna PPO,Cigna PPO,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Cigna Medicare Advantage,Cigna Medicare Advantage,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Essence,Essence,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Healthlink HMO,Healthlink HMO,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Healthlink PPO,Healthlink PPO,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,HomeState Health Plan,HomeState Health Plan,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Humana Gold,Humana Gold,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Medicaid MO,Medicaid MO,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Medica,Medica,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Tricare,Tricare,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,UHC All Payer,UHC All Payer,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,UHC Exchange,UHC Exchange,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,UHC Medicaid,UHC Medicaid,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,UMR CPD,UMR CPD,104.32,,,,,,,per diem,104.32,104.32,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,UHC Medicare,UHC Medicare,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34010090,CDM,420,RC,97035,CPT,,,GP,Inpatient,,,104.32,104.32,Wellcare,Wellcare,104.32,,,,,,,case rate,104.32,104.32,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Meritain Health PPO CPD,Meritain Health PPO CPD,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Aetna/Commercial Product,Aetna/Commercial Product,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Meritain Health CPD,Meritain Health CPD,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Starmark CPD,Starmark CPD,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Aetna Medicare,Aetna Medicare,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Ambetter ,Ambetter ,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Blue Access,Anthem Blue Access,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Blue Access Choice,Anthem Blue Access Choice,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Blue Preferred,Anthem Blue Preferred,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Pathway,Anthem Pathway,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Alliance,Anthem Alliance,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Anthem Medicare,Anthem Medicare,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Cigna,Cigna,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Cigna PPO,Cigna PPO,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Cigna Medicare Advantage,Cigna Medicare Advantage,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Essence,Essence,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Healthlink HMO,Healthlink HMO,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Healthlink PPO,Healthlink PPO,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,HomeState Health Plan,HomeState Health Plan,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Humana Gold,Humana Gold,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Medicaid MO,Medicaid MO,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Medica,Medica,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Tricare,Tricare,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,UHC All Payer,UHC All Payer,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,UHC Exchange,UHC Exchange,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,UHC Medicaid,UHC Medicaid,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,UMR CPD,UMR CPD,114.99,,,,,,,per diem,114.99,114.99,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,UHC Medicare,UHC Medicare,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34010105,CDM,420,RC,97032,CPT,,,GP,Inpatient,,,114.99,114.99,Wellcare,Wellcare,114.99,,,,,,,case rate,114.99,114.99,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Meritain Health PPO CPD,Meritain Health PPO CPD,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Aetna/Commercial Product,Aetna/Commercial Product,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Meritain Health CPD,Meritain Health CPD,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Starmark CPD,Starmark CPD,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Aetna Medicare,Aetna Medicare,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Ambetter ,Ambetter ,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Blue Access,Anthem Blue Access,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Blue Access Choice,Anthem Blue Access Choice,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Blue Preferred,Anthem Blue Preferred,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Pathway,Anthem Pathway,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Alliance,Anthem Alliance,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Anthem Medicare,Anthem Medicare,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Cigna,Cigna,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Cigna PPO,Cigna PPO,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Cigna Medicare Advantage,Cigna Medicare Advantage,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Essence,Essence,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Healthlink HMO,Healthlink HMO,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Healthlink PPO,Healthlink PPO,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,HomeState Health Plan,HomeState Health Plan,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Humana Gold,Humana Gold,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Medicaid MO,Medicaid MO,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Medica,Medica,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Tricare,Tricare,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,UHC All Payer,UHC All Payer,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,UHC Exchange,UHC Exchange,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,UHC Medicaid,UHC Medicaid,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,UMR CPD,UMR CPD,166.05,,,,,,,per diem,166.05,166.05,"Per diem rate, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,UHC Medicare,UHC Medicare,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
HOME MGT TRAINING 15 MIN      ,34010130,CDM,420,RC,97535,CPT,,,GP,Inpatient,,,166.05,166.05,Wellcare,Wellcare,166.05,,,,,,,case rate,166.05,166.05,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Meritain Health PPO CPD,Meritain Health PPO CPD,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Aetna/Commercial Product,Aetna/Commercial Product,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Meritain Health CPD,Meritain Health CPD,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Starmark CPD,Starmark CPD,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Aetna Medicare,Aetna Medicare,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Ambetter ,Ambetter ,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Blue Access,Anthem Blue Access,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Blue Access Choice,Anthem Blue Access Choice,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Blue Preferred,Anthem Blue Preferred,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Pathway,Anthem Pathway,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Alliance,Anthem Alliance,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Anthem Medicare,Anthem Medicare,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Cigna,Cigna,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Cigna PPO,Cigna PPO,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Cigna Medicare Advantage,Cigna Medicare Advantage,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Essence,Essence,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Healthlink HMO,Healthlink HMO,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Healthlink PPO,Healthlink PPO,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,HomeState Health Plan,HomeState Health Plan,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Humana Gold,Humana Gold,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Medicaid MO,Medicaid MO,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Medica,Medica,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Tricare,Tricare,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,UHC All Payer,UHC All Payer,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,UHC Exchange,UHC Exchange,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,UHC Medicaid,UHC Medicaid,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,UMR CPD,UMR CPD,103.98,,,,,,,per diem,103.98,103.98,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,UHC Medicare,UHC Medicare,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34010155,CDM,420,RC,97760,CPT,,,GP,Inpatient,,,103.98,103.98,Wellcare,Wellcare,103.98,,,,,,,case rate,103.98,103.98,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Meritain Health PPO CPD,Meritain Health PPO CPD,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Aetna/Commercial Product,Aetna/Commercial Product,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Meritain Health CPD,Meritain Health CPD,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Starmark CPD,Starmark CPD,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Aetna Medicare,Aetna Medicare,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Ambetter ,Ambetter ,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Blue Access,Anthem Blue Access,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Blue Access Choice,Anthem Blue Access Choice,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Blue Preferred,Anthem Blue Preferred,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Pathway,Anthem Pathway,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Alliance,Anthem Alliance,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Anthem Medicare,Anthem Medicare,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Cigna,Cigna,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Cigna PPO,Cigna PPO,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Cigna Medicare Advantage,Cigna Medicare Advantage,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Essence,Essence,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Healthlink HMO,Healthlink HMO,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Healthlink PPO,Healthlink PPO,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,HomeState Health Plan,HomeState Health Plan,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Humana Gold,Humana Gold,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Medicaid MO,Medicaid MO,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Medica,Medica,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Tricare,Tricare,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,UHC All Payer,UHC All Payer,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,UHC Exchange,UHC Exchange,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,UHC Medicaid,UHC Medicaid,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,UMR CPD,UMR CPD,154.65,,,,,,,per diem,154.65,154.65,"Per diem rate, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,UHC Medicare,UHC Medicare,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
OTHOTIC FIT/TRAIN SUBSEQ15MIN ,34010156,CDM,420,RC,97763,CPT,,,GP,Inpatient,,,154.65,154.65,Wellcare,Wellcare,154.65,,,,,,,case rate,154.65,154.65,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Meritain Health PPO CPD,Meritain Health PPO CPD,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Aetna/Commercial Product,Aetna/Commercial Product,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Meritain Health CPD,Meritain Health CPD,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Starmark CPD,Starmark CPD,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Aetna Medicare,Aetna Medicare,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Ambetter ,Ambetter ,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Blue Access,Anthem Blue Access,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Blue Access Choice,Anthem Blue Access Choice,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Blue Preferred,Anthem Blue Preferred,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Pathway,Anthem Pathway,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Alliance,Anthem Alliance,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Anthem Medicare,Anthem Medicare,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Cigna,Cigna,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Cigna PPO,Cigna PPO,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Cigna Medicare Advantage,Cigna Medicare Advantage,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Essence,Essence,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Healthlink HMO,Healthlink HMO,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Healthlink PPO,Healthlink PPO,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,HomeState Health Plan,HomeState Health Plan,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Humana Gold,Humana Gold,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Medicaid MO,Medicaid MO,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Medica,Medica,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Tricare,Tricare,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,UHC All Payer,UHC All Payer,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,UHC Exchange,UHC Exchange,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,UHC Medicaid,UHC Medicaid,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,UMR CPD,UMR CPD,128.44,,,,,,,per diem,128.44,128.44,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,UHC Medicare,UHC Medicare,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34010160,CDM,420,RC,97530,CPT,,,GP,Inpatient,,,128.44,128.44,Wellcare,Wellcare,128.44,,,,,,,case rate,128.44,128.44,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Meritain Health PPO CPD,Meritain Health PPO CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Aetna/Commercial Product,Aetna/Commercial Product,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Meritain Health CPD,Meritain Health CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Starmark CPD,Starmark CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Aetna Medicare,Aetna Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Ambetter ,Ambetter ,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Blue Access,Anthem Blue Access,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Blue Access Choice,Anthem Blue Access Choice,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Blue Preferred,Anthem Blue Preferred,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Pathway,Anthem Pathway,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Alliance,Anthem Alliance,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Anthem Medicare,Anthem Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Cigna,Cigna,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Cigna PPO,Cigna PPO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Cigna Medicare Advantage,Cigna Medicare Advantage,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Essence,Essence,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Healthlink HMO,Healthlink HMO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Healthlink PPO,Healthlink PPO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,HomeState Health Plan,HomeState Health Plan,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Humana Gold,Humana Gold,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Medicaid MO,Medicaid MO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Medica,Medica,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Tricare,Tricare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,UHC All Payer,UHC All Payer,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,UHC Exchange,UHC Exchange,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,UHC Medicaid,UHC Medicaid,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,UMR CPD,UMR CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,UHC Medicare,UHC Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34010185,CDM,420,RC,97755,CPT,,,GP,Inpatient,,,86.62,86.62,Wellcare,Wellcare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34010195,CDM,420,RC,97036,CPT,,,GP,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Meritain Health PPO CPD,Meritain Health PPO CPD,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Aetna/Commercial Product,Aetna/Commercial Product,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Meritain Health CPD,Meritain Health CPD,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Starmark CPD,Starmark CPD,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Aetna Medicare,Aetna Medicare,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Ambetter ,Ambetter ,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Blue Access,Anthem Blue Access,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Blue Access Choice,Anthem Blue Access Choice,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Blue Preferred,Anthem Blue Preferred,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Pathway,Anthem Pathway,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Alliance,Anthem Alliance,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Anthem Medicare,Anthem Medicare,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Cigna,Cigna,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Cigna PPO,Cigna PPO,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Cigna Medicare Advantage,Cigna Medicare Advantage,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Essence,Essence,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Healthlink HMO,Healthlink HMO,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Healthlink PPO,Healthlink PPO,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,HomeState Health Plan,HomeState Health Plan,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Humana Gold,Humana Gold,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Medicaid MO,Medicaid MO,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Medica,Medica,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Tricare,Tricare,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,UHC All Payer,UHC All Payer,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,UHC Exchange,UHC Exchange,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,UHC Medicaid,UHC Medicaid,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,UMR CPD,UMR CPD,147.54,,,,,,,per diem,147.54,147.54,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,UHC Medicare,UHC Medicare,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34010200,CDM,420,RC,29125,CPT,,,GP,Inpatient,,,147.54,147.54,Wellcare,Wellcare,147.54,,,,,,,case rate,147.54,147.54,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Meritain Health PPO CPD,Meritain Health PPO CPD,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Aetna/Commercial Product,Aetna/Commercial Product,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Meritain Health CPD,Meritain Health CPD,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Starmark CPD,Starmark CPD,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Aetna Medicare,Aetna Medicare,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Ambetter ,Ambetter ,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Blue Access,Anthem Blue Access,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Blue Access Choice,Anthem Blue Access Choice,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Blue Preferred,Anthem Blue Preferred,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Pathway,Anthem Pathway,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Alliance,Anthem Alliance,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Anthem Medicare,Anthem Medicare,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Cigna,Cigna,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Cigna PPO,Cigna PPO,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Cigna Medicare Advantage,Cigna Medicare Advantage,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Essence,Essence,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Healthlink HMO,Healthlink HMO,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Healthlink PPO,Healthlink PPO,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,HomeState Health Plan,HomeState Health Plan,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Humana Gold,Humana Gold,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Medicaid MO,Medicaid MO,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Medica,Medica,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Tricare,Tricare,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,UHC All Payer,UHC All Payer,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,UHC Exchange,UHC Exchange,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,UHC Medicaid,UHC Medicaid,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,UMR CPD,UMR CPD,142.06,,,,,,,per diem,142.06,142.06,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,UHC Medicare,UHC Medicare,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34010205,CDM,420,RC,29126,CPT,,,GP,Inpatient,,,142.06,142.06,Wellcare,Wellcare,142.06,,,,,,,case rate,142.06,142.06,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Meritain Health PPO CPD,Meritain Health PPO CPD,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Aetna/Commercial Product,Aetna/Commercial Product,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Meritain Health CPD,Meritain Health CPD,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Starmark CPD,Starmark CPD,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Aetna Medicare,Aetna Medicare,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Ambetter ,Ambetter ,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Blue Access,Anthem Blue Access,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Blue Access Choice,Anthem Blue Access Choice,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Blue Preferred,Anthem Blue Preferred,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Pathway,Anthem Pathway,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Alliance,Anthem Alliance,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Anthem Medicare,Anthem Medicare,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Cigna,Cigna,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Cigna PPO,Cigna PPO,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Cigna Medicare Advantage,Cigna Medicare Advantage,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Essence,Essence,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Healthlink HMO,Healthlink HMO,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Healthlink PPO,Healthlink PPO,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,HomeState Health Plan,HomeState Health Plan,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Humana Gold,Humana Gold,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Medicaid MO,Medicaid MO,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Medica,Medica,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Tricare,Tricare,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,UHC All Payer,UHC All Payer,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,UHC Exchange,UHC Exchange,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,UHC Medicaid,UHC Medicaid,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,UMR CPD,UMR CPD,161.12,,,,,,,per diem,161.12,161.12,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,UHC Medicare,UHC Medicare,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34010210,CDM,420,RC,29130,CPT,,,GP,Inpatient,,,161.12,161.12,Wellcare,Wellcare,161.12,,,,,,,case rate,161.12,161.12,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Meritain Health PPO CPD,Meritain Health PPO CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Aetna/Commercial Product,Aetna/Commercial Product,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Meritain Health CPD,Meritain Health CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Starmark CPD,Starmark CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Aetna Medicare,Aetna Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Ambetter ,Ambetter ,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Blue Access,Anthem Blue Access,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Blue Access Choice,Anthem Blue Access Choice,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Blue Preferred,Anthem Blue Preferred,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Pathway,Anthem Pathway,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Alliance,Anthem Alliance,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Anthem Medicare,Anthem Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Cigna,Cigna,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Cigna PPO,Cigna PPO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Cigna Medicare Advantage,Cigna Medicare Advantage,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Essence,Essence,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Healthlink HMO,Healthlink HMO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Healthlink PPO,Healthlink PPO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,HomeState Health Plan,HomeState Health Plan,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Humana Gold,Humana Gold,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Medicaid MO,Medicaid MO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Medica,Medica,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Tricare,Tricare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,UHC All Payer,UHC All Payer,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,UHC Exchange,UHC Exchange,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,UHC Medicaid,UHC Medicaid,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,UMR CPD,UMR CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,UHC Medicare,UHC Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34010215,CDM,420,RC,29131,CPT,,,GP,Inpatient,,,28.41,28.41,Wellcare,Wellcare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING THORAX              ,34010220,CDM,420,RC,29200,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Meritain Health PPO CPD,Meritain Health PPO CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Aetna/Commercial Product,Aetna/Commercial Product,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Meritain Health CPD,Meritain Health CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Starmark CPD,Starmark CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Aetna Medicare,Aetna Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Ambetter ,Ambetter ,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Blue Access,Anthem Blue Access,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Blue Access Choice,Anthem Blue Access Choice,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Blue Preferred,Anthem Blue Preferred,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Pathway,Anthem Pathway,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Alliance,Anthem Alliance,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Anthem Medicare,Anthem Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Cigna,Cigna,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Cigna PPO,Cigna PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Cigna Medicare Advantage,Cigna Medicare Advantage,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Essence,Essence,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Healthlink HMO,Healthlink HMO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Healthlink PPO,Healthlink PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,HomeState Health Plan,HomeState Health Plan,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Humana Gold,Humana Gold,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Medicaid MO,Medicaid MO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Medica,Medica,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Tricare,Tricare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,UHC All Payer,UHC All Payer,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,UHC Exchange,UHC Exchange,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,UHC Medicaid,UHC Medicaid,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,UMR CPD,UMR CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,UHC Medicare,UHC Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34010230,CDM,420,RC,29240,CPT,,,GP,Inpatient,,,151.49,151.49,Wellcare,Wellcare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34010235,CDM,420,RC,29260,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Meritain Health PPO CPD,Meritain Health PPO CPD,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Aetna/Commercial Product,Aetna/Commercial Product,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Meritain Health CPD,Meritain Health CPD,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Starmark CPD,Starmark CPD,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Aetna Medicare,Aetna Medicare,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Ambetter ,Ambetter ,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Blue Access,Anthem Blue Access,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Blue Access Choice,Anthem Blue Access Choice,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Blue Preferred,Anthem Blue Preferred,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Pathway,Anthem Pathway,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Alliance,Anthem Alliance,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Anthem Medicare,Anthem Medicare,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Cigna,Cigna,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Cigna PPO,Cigna PPO,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Cigna Medicare Advantage,Cigna Medicare Advantage,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Essence,Essence,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Healthlink HMO,Healthlink HMO,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Healthlink PPO,Healthlink PPO,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,HomeState Health Plan,HomeState Health Plan,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Humana Gold,Humana Gold,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Medicaid MO,Medicaid MO,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Medica,Medica,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Tricare,Tricare,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,UHC All Payer,UHC All Payer,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,UHC Exchange,UHC Exchange,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,UHC Medicaid,UHC Medicaid,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,UMR CPD,UMR CPD,164.51,,,,,,,per diem,164.51,164.51,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,UHC Medicare,UHC Medicare,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT LEG        ,34010240,CDM,420,RC,29515,CPT,,,GP,Inpatient,,,164.51,164.51,Wellcare,Wellcare,164.51,,,,,,,case rate,164.51,164.51,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HIP                 ,34010245,CDM,420,RC,29520,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Meritain Health PPO CPD,Meritain Health PPO CPD,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Aetna/Commercial Product,Aetna/Commercial Product,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Meritain Health CPD,Meritain Health CPD,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Starmark CPD,Starmark CPD,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Aetna Medicare,Aetna Medicare,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Ambetter ,Ambetter ,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Blue Access,Anthem Blue Access,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Blue Access Choice,Anthem Blue Access Choice,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Blue Preferred,Anthem Blue Preferred,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Pathway,Anthem Pathway,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Alliance,Anthem Alliance,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Anthem Medicare,Anthem Medicare,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Cigna,Cigna,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Cigna PPO,Cigna PPO,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Cigna Medicare Advantage,Cigna Medicare Advantage,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Essence,Essence,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Healthlink HMO,Healthlink HMO,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Healthlink PPO,Healthlink PPO,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,HomeState Health Plan,HomeState Health Plan,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Humana Gold,Humana Gold,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Medicaid MO,Medicaid MO,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Medica,Medica,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Tricare,Tricare,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,UHC All Payer,UHC All Payer,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,UHC Exchange,UHC Exchange,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,UHC Medicaid,UHC Medicaid,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,UMR CPD,UMR CPD,141.52,,,,,,,per diem,141.52,141.52,"Per diem rate, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,UHC Medicare,UHC Medicare,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING KNEE                ,34010250,CDM,420,RC,29530,CPT,,,GP,Inpatient,,,141.52,141.52,Wellcare,Wellcare,141.52,,,,,,,case rate,141.52,141.52,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Meritain Health PPO CPD,Meritain Health PPO CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Aetna/Commercial Product,Aetna/Commercial Product,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Meritain Health CPD,Meritain Health CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Starmark CPD,Starmark CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Aetna Medicare,Aetna Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Ambetter ,Ambetter ,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Blue Access,Anthem Blue Access,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Blue Access Choice,Anthem Blue Access Choice,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Blue Preferred,Anthem Blue Preferred,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Pathway,Anthem Pathway,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Alliance,Anthem Alliance,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Anthem Medicare,Anthem Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Cigna,Cigna,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Cigna PPO,Cigna PPO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Cigna Medicare Advantage,Cigna Medicare Advantage,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Essence,Essence,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Healthlink HMO,Healthlink HMO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Healthlink PPO,Healthlink PPO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,HomeState Health Plan,HomeState Health Plan,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Humana Gold,Humana Gold,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Medicaid MO,Medicaid MO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Medica,Medica,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Tricare,Tricare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,UHC All Payer,UHC All Payer,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,UHC Exchange,UHC Exchange,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,UHC Medicaid,UHC Medicaid,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,UMR CPD,UMR CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,UHC Medicare,UHC Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING ANKLE AND/OR FOOT   ,34010255,CDM,420,RC,29540,CPT,,,GP,Inpatient,,,138.69,138.69,Wellcare,Wellcare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING TOES                ,34010260,CDM,420,RC,29550,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Meritain Health PPO CPD,Meritain Health PPO CPD,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Aetna/Commercial Product,Aetna/Commercial Product,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Meritain Health CPD,Meritain Health CPD,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Starmark CPD,Starmark CPD,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Aetna Medicare,Aetna Medicare,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Ambetter ,Ambetter ,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Blue Access,Anthem Blue Access,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Blue Access Choice,Anthem Blue Access Choice,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Blue Preferred,Anthem Blue Preferred,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Pathway,Anthem Pathway,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Alliance,Anthem Alliance,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Anthem Medicare,Anthem Medicare,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Cigna,Cigna,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Cigna PPO,Cigna PPO,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Cigna Medicare Advantage,Cigna Medicare Advantage,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Essence,Essence,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Healthlink HMO,Healthlink HMO,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Healthlink PPO,Healthlink PPO,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,HomeState Health Plan,HomeState Health Plan,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Humana Gold,Humana Gold,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Medicaid MO,Medicaid MO,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Medica,Medica,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Tricare,Tricare,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,UHC All Payer,UHC All Payer,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,UHC Exchange,UHC Exchange,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,UHC Medicaid,UHC Medicaid,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,UMR CPD,UMR CPD,66.27,,,,,,,per diem,66.27,66.27,"Per diem rate, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,UHC Medicare,UHC Medicare,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
ELEC STIM WOUND UNATTENDED    ,34010270,CDM,420,RC,G0281,HCPCS,,,,Inpatient,,,66.27,66.27,Wellcare,Wellcare,66.27,,,,,,,case rate,66.27,66.27,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Meritain Health PPO CPD,Meritain Health PPO CPD,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Aetna/Commercial Product,Aetna/Commercial Product,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Meritain Health CPD,Meritain Health CPD,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Starmark CPD,Starmark CPD,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Aetna Medicare,Aetna Medicare,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Ambetter ,Ambetter ,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Blue Access,Anthem Blue Access,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Blue Access Choice,Anthem Blue Access Choice,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Blue Preferred,Anthem Blue Preferred,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Pathway,Anthem Pathway,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Alliance,Anthem Alliance,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Anthem Medicare,Anthem Medicare,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Cigna,Cigna,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Cigna PPO,Cigna PPO,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Cigna Medicare Advantage,Cigna Medicare Advantage,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Essence,Essence,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Healthlink HMO,Healthlink HMO,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Healthlink PPO,Healthlink PPO,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,HomeState Health Plan,HomeState Health Plan,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Humana Gold,Humana Gold,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Medicaid MO,Medicaid MO,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Medica,Medica,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Tricare,Tricare,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,UHC All Payer,UHC All Payer,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,UHC Exchange,UHC Exchange,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,UHC Medicaid,UHC Medicaid,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,UMR CPD,UMR CPD,77.06,,,,,,,per diem,77.06,77.06,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,UHC Medicare,UHC Medicare,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34010280,CDM,420,RC,97537,CPT,,,GP,Inpatient,,,77.06,77.06,Wellcare,Wellcare,77.06,,,,,,,case rate,77.06,77.06,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Meritain Health PPO CPD,Meritain Health PPO CPD,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Aetna/Commercial Product,Aetna/Commercial Product,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Meritain Health CPD,Meritain Health CPD,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Starmark CPD,Starmark CPD,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Aetna Medicare,Aetna Medicare,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Ambetter ,Ambetter ,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Blue Access,Anthem Blue Access,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Blue Access Choice,Anthem Blue Access Choice,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Blue Preferred,Anthem Blue Preferred,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Pathway,Anthem Pathway,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Alliance,Anthem Alliance,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Anthem Medicare,Anthem Medicare,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Cigna,Cigna,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Cigna PPO,Cigna PPO,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Cigna Medicare Advantage,Cigna Medicare Advantage,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Essence,Essence,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Healthlink HMO,Healthlink HMO,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Healthlink PPO,Healthlink PPO,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,HomeState Health Plan,HomeState Health Plan,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Humana Gold,Humana Gold,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Medicaid MO,Medicaid MO,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Medica,Medica,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Tricare,Tricare,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,UHC All Payer,UHC All Payer,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,UHC Exchange,UHC Exchange,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,UHC Medicaid,UHC Medicaid,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,UMR CPD,UMR CPD,190.44,,,,,,,per diem,190.44,190.44,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,UHC Medicare,UHC Medicare,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER<=50SQCM  ,34010285,CDM,420,RC,97605,CPT,,,GP,Inpatient,,,190.44,190.44,Wellcare,Wellcare,190.44,,,,,,,case rate,190.44,190.44,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP >50 SQ CM     ,34010286,CDM,420,RC,97608,CPT,,,GP,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Meritain Health PPO CPD,Meritain Health PPO CPD,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Aetna/Commercial Product,Aetna/Commercial Product,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Meritain Health CPD,Meritain Health CPD,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Starmark CPD,Starmark CPD,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Aetna Medicare,Aetna Medicare,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Ambetter ,Ambetter ,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Blue Access,Anthem Blue Access,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Blue Access Choice,Anthem Blue Access Choice,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Blue Preferred,Anthem Blue Preferred,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Pathway,Anthem Pathway,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Alliance,Anthem Alliance,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Anthem Medicare,Anthem Medicare,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Cigna,Cigna,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Cigna PPO,Cigna PPO,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Cigna Medicare Advantage,Cigna Medicare Advantage,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Essence,Essence,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Healthlink HMO,Healthlink HMO,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Healthlink PPO,Healthlink PPO,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,HomeState Health Plan,HomeState Health Plan,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Humana Gold,Humana Gold,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Medicaid MO,Medicaid MO,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Medica,Medica,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Tricare,Tricare,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,UHC All Payer,UHC All Payer,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,UHC Exchange,UHC Exchange,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,UHC Medicaid,UHC Medicaid,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,UMR CPD,UMR CPD,213.22,,,,,,,per diem,213.22,213.22,"Per diem rate, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,UHC Medicare,UHC Medicare,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NPWT DISP EQUIP <=50 SQ CM    ,34010287,CDM,420,RC,97607,CPT,,,GP,Inpatient,,,213.22,213.22,Wellcare,Wellcare,213.22,,,,,,,case rate,213.22,213.22,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Meritain Health PPO CPD,Meritain Health PPO CPD,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Aetna/Commercial Product,Aetna/Commercial Product,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Meritain Health CPD,Meritain Health CPD,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Starmark CPD,Starmark CPD,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Aetna Medicare,Aetna Medicare,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Ambetter ,Ambetter ,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Blue Access,Anthem Blue Access,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Blue Access Choice,Anthem Blue Access Choice,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Blue Preferred,Anthem Blue Preferred,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Pathway,Anthem Pathway,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Alliance,Anthem Alliance,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Anthem Medicare,Anthem Medicare,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Cigna,Cigna,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Cigna PPO,Cigna PPO,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Cigna Medicare Advantage,Cigna Medicare Advantage,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Essence,Essence,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Healthlink HMO,Healthlink HMO,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Healthlink PPO,Healthlink PPO,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,HomeState Health Plan,HomeState Health Plan,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Humana Gold,Humana Gold,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Medicaid MO,Medicaid MO,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Medica,Medica,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Tricare,Tricare,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,UHC All Payer,UHC All Payer,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,UHC Exchange,UHC Exchange,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,UHC Medicaid,UHC Medicaid,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,UMR CPD,UMR CPD,144.53,,,,,,,per diem,144.53,144.53,"Per diem rate, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,UHC Medicare,UHC Medicare,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
NEG PRESS WOUND THER >50SQCM  ,34010290,CDM,420,RC,97606,CPT,,,GP,Inpatient,,,144.53,144.53,Wellcare,Wellcare,144.53,,,,,,,case rate,144.53,144.53,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Meritain Health PPO CPD,Meritain Health PPO CPD,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Aetna/Commercial Product,Aetna/Commercial Product,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Meritain Health CPD,Meritain Health CPD,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Starmark CPD,Starmark CPD,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Aetna Medicare,Aetna Medicare,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Ambetter ,Ambetter ,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Blue Access,Anthem Blue Access,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Blue Access Choice,Anthem Blue Access Choice,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Blue Preferred,Anthem Blue Preferred,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Pathway,Anthem Pathway,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Alliance,Anthem Alliance,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Anthem Medicare,Anthem Medicare,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Cigna,Cigna,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Cigna PPO,Cigna PPO,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Cigna Medicare Advantage,Cigna Medicare Advantage,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Essence,Essence,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Healthlink HMO,Healthlink HMO,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Healthlink PPO,Healthlink PPO,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,HomeState Health Plan,HomeState Health Plan,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Humana Gold,Humana Gold,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Medicaid MO,Medicaid MO,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Medica,Medica,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Tricare,Tricare,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,UHC All Payer,UHC All Payer,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,UHC Exchange,UHC Exchange,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,UHC Medicaid,UHC Medicaid,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,UMR CPD,UMR CPD,69.17,,,,,,,per diem,69.17,69.17,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,UHC Medicare,UHC Medicare,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34010295,CDM,420,RC,90901,CPT,,,GP,Inpatient,,,69.17,69.17,Wellcare,Wellcare,69.17,,,,,,,case rate,69.17,69.17,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Meritain Health PPO CPD,Meritain Health PPO CPD,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Aetna/Commercial Product,Aetna/Commercial Product,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Meritain Health CPD,Meritain Health CPD,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Starmark CPD,Starmark CPD,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Aetna Medicare,Aetna Medicare,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Ambetter ,Ambetter ,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Blue Access,Anthem Blue Access,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Blue Access Choice,Anthem Blue Access Choice,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Blue Preferred,Anthem Blue Preferred,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Pathway,Anthem Pathway,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Alliance,Anthem Alliance,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Anthem Medicare,Anthem Medicare,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Cigna,Cigna,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Cigna PPO,Cigna PPO,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Cigna Medicare Advantage,Cigna Medicare Advantage,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Essence,Essence,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Healthlink HMO,Healthlink HMO,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Healthlink PPO,Healthlink PPO,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,HomeState Health Plan,HomeState Health Plan,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Humana Gold,Humana Gold,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Medicaid MO,Medicaid MO,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Medica,Medica,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Tricare,Tricare,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,UHC All Payer,UHC All Payer,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,UHC Exchange,UHC Exchange,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,UHC Medicaid,UHC Medicaid,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,UMR CPD,UMR CPD,210.83,,,,,,,per diem,210.83,210.83,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,UHC Medicare,UHC Medicare,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34020001,CDM,420,RC,97597,CPT,,,GP,Inpatient,,,210.83,210.83,Wellcare,Wellcare,210.83,,,,,,,case rate,210.83,210.83,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Meritain Health PPO CPD,Meritain Health PPO CPD,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Aetna/Commercial Product,Aetna/Commercial Product,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Meritain Health CPD,Meritain Health CPD,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Starmark CPD,Starmark CPD,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Aetna Medicare,Aetna Medicare,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Ambetter ,Ambetter ,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Blue Access,Anthem Blue Access,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Blue Access Choice,Anthem Blue Access Choice,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Blue Preferred,Anthem Blue Preferred,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Pathway,Anthem Pathway,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Alliance,Anthem Alliance,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Anthem Medicare,Anthem Medicare,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Cigna,Cigna,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Cigna PPO,Cigna PPO,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Cigna Medicare Advantage,Cigna Medicare Advantage,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Essence,Essence,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Healthlink HMO,Healthlink HMO,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Healthlink PPO,Healthlink PPO,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,HomeState Health Plan,HomeState Health Plan,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Humana Gold,Humana Gold,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Medicaid MO,Medicaid MO,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Medica,Medica,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Tricare,Tricare,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,UHC All Payer,UHC All Payer,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,UHC Exchange,UHC Exchange,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,UHC Medicaid,UHC Medicaid,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,UMR CPD,UMR CPD,186.15,,,,,,,per diem,186.15,186.15,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,UHC Medicare,UHC Medicare,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34020002,CDM,420,RC,97598,CPT,,,GP,Inpatient,,,186.15,186.15,Wellcare,Wellcare,186.15,,,,,,,case rate,186.15,186.15,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Meritain Health PPO CPD,Meritain Health PPO CPD,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Aetna/Commercial Product,Aetna/Commercial Product,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Meritain Health CPD,Meritain Health CPD,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Starmark CPD,Starmark CPD,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Aetna Medicare,Aetna Medicare,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Ambetter ,Ambetter ,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Blue Access,Anthem Blue Access,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Blue Access Choice,Anthem Blue Access Choice,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Blue Preferred,Anthem Blue Preferred,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Pathway,Anthem Pathway,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Alliance,Anthem Alliance,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Anthem Medicare,Anthem Medicare,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Cigna,Cigna,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Cigna PPO,Cigna PPO,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Cigna Medicare Advantage,Cigna Medicare Advantage,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Essence,Essence,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Healthlink HMO,Healthlink HMO,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Healthlink PPO,Healthlink PPO,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,HomeState Health Plan,HomeState Health Plan,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Humana Gold,Humana Gold,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Medicaid MO,Medicaid MO,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Medica,Medica,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Tricare,Tricare,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,UHC All Payer,UHC All Payer,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,UHC Exchange,UHC Exchange,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,UHC Medicaid,UHC Medicaid,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,UMR CPD,UMR CPD,149.64,,,,,,,per diem,149.64,149.64,"Per diem rate, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,UHC Medicare,UHC Medicare,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
VESTIBULAR REHAB              ,34020003,CDM,420,RC,95992,CPT,,,,Inpatient,,,149.64,149.64,Wellcare,Wellcare,149.64,,,,,,,case rate,149.64,149.64,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Meritain Health PPO CPD,Meritain Health PPO CPD,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Aetna/Commercial Product,Aetna/Commercial Product,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Meritain Health CPD,Meritain Health CPD,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Starmark CPD,Starmark CPD,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Aetna Medicare,Aetna Medicare,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Ambetter ,Ambetter ,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Blue Access,Anthem Blue Access,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Blue Access Choice,Anthem Blue Access Choice,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Blue Preferred,Anthem Blue Preferred,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Pathway,Anthem Pathway,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Alliance,Anthem Alliance,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Anthem Medicare,Anthem Medicare,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Cigna,Cigna,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Cigna PPO,Cigna PPO,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Cigna Medicare Advantage,Cigna Medicare Advantage,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Essence,Essence,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Healthlink HMO,Healthlink HMO,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Healthlink PPO,Healthlink PPO,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,HomeState Health Plan,HomeState Health Plan,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Humana Gold,Humana Gold,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Medicaid MO,Medicaid MO,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Medica,Medica,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Tricare,Tricare,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,UHC All Payer,UHC All Payer,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,UHC Exchange,UHC Exchange,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,UHC Medicaid,UHC Medicaid,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,UMR CPD,UMR CPD,2.17,,,,,,,per diem,2.17,2.17,"Per diem rate, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,UHC Medicare,UHC Medicare,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
DAILY CLINIC NOTE 15MIN       ,34020004,CDM,420,RC,,,,,,Inpatient,,,2.17,2.17,Wellcare,Wellcare,2.17,,,,,,,case rate,2.17,2.17,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Meritain Health PPO CPD,Meritain Health PPO CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Aetna/Commercial Product,Aetna/Commercial Product,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Meritain Health CPD,Meritain Health CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Starmark CPD,Starmark CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Aetna Medicare,Aetna Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Ambetter ,Ambetter ,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Access,Anthem Blue Access,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Access Choice,Anthem Blue Access Choice,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Preferred,Anthem Blue Preferred,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Pathway,Anthem Pathway,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Alliance,Anthem Alliance,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Anthem Medicare,Anthem Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Cigna,Cigna,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Cigna PPO,Cigna PPO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Cigna Medicare Advantage,Cigna Medicare Advantage,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Essence,Essence,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Healthlink HMO,Healthlink HMO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Healthlink PPO,Healthlink PPO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,HomeState Health Plan,HomeState Health Plan,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Humana Gold,Humana Gold,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Medicaid MO,Medicaid MO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Medica,Medica,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Tricare,Tricare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,UHC All Payer,UHC All Payer,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,UHC Exchange,UHC Exchange,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,UHC Medicaid,UHC Medicaid,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,UMR CPD,UMR CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,UHC Medicare,UHC Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
1 EXT W/ OR W/O PARASPINA     ,34020005,CDM,420,RC,95860,CPT,,,,Inpatient,,,194.19,194.19,Wellcare,Wellcare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Meritain Health PPO CPD,Meritain Health PPO CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Aetna/Commercial Product,Aetna/Commercial Product,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Meritain Health CPD,Meritain Health CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Starmark CPD,Starmark CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Aetna Medicare,Aetna Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Ambetter ,Ambetter ,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Access,Anthem Blue Access,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Access Choice,Anthem Blue Access Choice,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Blue Preferred,Anthem Blue Preferred,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Pathway,Anthem Pathway,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Alliance,Anthem Alliance,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Anthem Medicare,Anthem Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Cigna,Cigna,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Cigna PPO,Cigna PPO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Cigna Medicare Advantage,Cigna Medicare Advantage,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Essence,Essence,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Healthlink HMO,Healthlink HMO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Healthlink PPO,Healthlink PPO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,HomeState Health Plan,HomeState Health Plan,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Humana Gold,Humana Gold,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Medicaid MO,Medicaid MO,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Medica,Medica,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Tricare,Tricare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,UHC All Payer,UHC All Payer,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,UHC Exchange,UHC Exchange,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,UHC Medicaid,UHC Medicaid,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,UMR CPD,UMR CPD,194.19,,,,,,,per diem,194.19,194.19,"Per diem rate, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,UHC Medicare,UHC Medicare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
2 EXT W/ OR W/O PARASPINA     ,34020006,CDM,420,RC,95861,CPT,,,,Inpatient,,,194.19,194.19,Wellcare,Wellcare,194.19,,,,,,,case rate,194.19,194.19,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Meritain Health PPO CPD,Meritain Health PPO CPD,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Aetna/Commercial Product,Aetna/Commercial Product,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Meritain Health CPD,Meritain Health CPD,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Starmark CPD,Starmark CPD,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Aetna Medicare,Aetna Medicare,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Ambetter ,Ambetter ,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Blue Access,Anthem Blue Access,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Blue Access Choice,Anthem Blue Access Choice,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Blue Preferred,Anthem Blue Preferred,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Pathway,Anthem Pathway,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Alliance,Anthem Alliance,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Anthem Medicare,Anthem Medicare,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Cigna,Cigna,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Cigna PPO,Cigna PPO,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Cigna Medicare Advantage,Cigna Medicare Advantage,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Essence,Essence,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Healthlink HMO,Healthlink HMO,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Healthlink PPO,Healthlink PPO,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,HomeState Health Plan,HomeState Health Plan,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Humana Gold,Humana Gold,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Medicaid MO,Medicaid MO,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Medica,Medica,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Tricare,Tricare,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,UHC All Payer,UHC All Payer,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,UHC Exchange,UHC Exchange,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,UHC Medicaid,UHC Medicaid,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,UMR CPD,UMR CPD,112.01,,,,,,,per diem,112.01,112.01,"Per diem rate, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,UHC Medicare,UHC Medicare,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
NERVE COND SENSORY            ,34020007,CDM,420,RC,,,,,,Inpatient,,,112.01,112.01,Wellcare,Wellcare,112.01,,,,,,,case rate,112.01,112.01,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Meritain Health PPO CPD,Meritain Health PPO CPD,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Aetna/Commercial Product,Aetna/Commercial Product,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Meritain Health CPD,Meritain Health CPD,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Starmark CPD,Starmark CPD,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Aetna Medicare,Aetna Medicare,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Ambetter ,Ambetter ,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Blue Access,Anthem Blue Access,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Blue Access Choice,Anthem Blue Access Choice,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Blue Preferred,Anthem Blue Preferred,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Pathway,Anthem Pathway,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Alliance,Anthem Alliance,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Anthem Medicare,Anthem Medicare,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Cigna,Cigna,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Cigna PPO,Cigna PPO,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Cigna Medicare Advantage,Cigna Medicare Advantage,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Essence,Essence,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Healthlink HMO,Healthlink HMO,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Healthlink PPO,Healthlink PPO,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,HomeState Health Plan,HomeState Health Plan,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Humana Gold,Humana Gold,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Medicaid MO,Medicaid MO,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Medica,Medica,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Tricare,Tricare,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,UHC All Payer,UHC All Payer,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,UHC Exchange,UHC Exchange,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,UHC Medicaid,UHC Medicaid,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,UMR CPD,UMR CPD,154.84,,,,,,,per diem,154.84,154.84,"Per diem rate, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,UHC Medicare,UHC Medicare,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
HOME EVALUATION 15 MIN        ,34020008,CDM,424,RC,97535,CPT,,,,Inpatient,,,154.84,154.84,Wellcare,Wellcare,154.84,,,,,,,case rate,154.84,154.84,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Meritain Health PPO CPD,Meritain Health PPO CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Aetna/Commercial Product,Aetna/Commercial Product,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Meritain Health CPD,Meritain Health CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Starmark CPD,Starmark CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Aetna Medicare,Aetna Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Ambetter ,Ambetter ,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Access,Anthem Blue Access,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Access Choice,Anthem Blue Access Choice,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Preferred,Anthem Blue Preferred,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Pathway,Anthem Pathway,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Alliance,Anthem Alliance,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Anthem Medicare,Anthem Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Cigna,Cigna,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Cigna PPO,Cigna PPO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Cigna Medicare Advantage,Cigna Medicare Advantage,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Essence,Essence,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Healthlink HMO,Healthlink HMO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Healthlink PPO,Healthlink PPO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,HomeState Health Plan,HomeState Health Plan,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Humana Gold,Humana Gold,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Medicaid MO,Medicaid MO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Medica,Medica,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Tricare,Tricare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,UHC All Payer,UHC All Payer,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,UHC Exchange,UHC Exchange,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,UHC Medicaid,UHC Medicaid,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,UMR CPD,UMR CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,UHC Medicare,UHC Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15      ,34020009,CDM,420,RC,97750,CPT,,,,Inpatient,,,138.25,138.25,Wellcare,Wellcare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Meritain Health PPO CPD,Meritain Health PPO CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Aetna/Commercial Product,Aetna/Commercial Product,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Meritain Health CPD,Meritain Health CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Starmark CPD,Starmark CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Aetna Medicare,Aetna Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Ambetter ,Ambetter ,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Access,Anthem Blue Access,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Access Choice,Anthem Blue Access Choice,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Preferred,Anthem Blue Preferred,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Pathway,Anthem Pathway,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Alliance,Anthem Alliance,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Medicare,Anthem Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Cigna,Cigna,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Cigna PPO,Cigna PPO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Cigna Medicare Advantage,Cigna Medicare Advantage,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Essence,Essence,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Healthlink HMO,Healthlink HMO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Healthlink PPO,Healthlink PPO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,HomeState Health Plan,HomeState Health Plan,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Humana Gold,Humana Gold,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Medicaid MO,Medicaid MO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Medica,Medica,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Tricare,Tricare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,UHC All Payer,UHC All Payer,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,UHC Exchange,UHC Exchange,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,UHC Medicaid,UHC Medicaid,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,UMR CPD,UMR CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,UHC Medicare,UHC Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT ADL/FUNCTINAL ACT 15 MIN   ,34020010,CDM,420,RC,,,,,,Inpatient,,,160.26,160.26,Wellcare,Wellcare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health PPO CPD,Meritain Health PPO CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/Commercial Product,Aetna/Commercial Product,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health CPD,Meritain Health CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Starmark CPD,Starmark CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna Medicare,Aetna Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Ambetter ,Ambetter ,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access,Anthem Blue Access,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access Choice,Anthem Blue Access Choice,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Preferred,Anthem Blue Preferred,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Pathway,Anthem Pathway,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Alliance,Anthem Alliance,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Medicare,Anthem Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna,Cigna,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna PPO,Cigna PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna Medicare Advantage,Cigna Medicare Advantage,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Essence,Essence,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink HMO,Healthlink HMO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink PPO,Healthlink PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,HomeState Health Plan,HomeState Health Plan,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Humana Gold,Humana Gold,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medicaid MO,Medicaid MO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medica,Medica,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Tricare,Tricare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC All Payer,UHC All Payer,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Exchange,UHC Exchange,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicaid,UHC Medicaid,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UMR CPD,UMR CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicare,UHC Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT GAIT TRAINING II 15 MIN    ,34020011,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Wellcare,Wellcare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Meritain Health PPO CPD,Meritain Health PPO CPD,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Aetna/Commercial Product,Aetna/Commercial Product,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Meritain Health CPD,Meritain Health CPD,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Starmark CPD,Starmark CPD,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Aetna Medicare,Aetna Medicare,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Ambetter ,Ambetter ,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Blue Access,Anthem Blue Access,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Blue Access Choice,Anthem Blue Access Choice,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Blue Preferred,Anthem Blue Preferred,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Pathway,Anthem Pathway,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Alliance,Anthem Alliance,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Anthem Medicare,Anthem Medicare,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Cigna,Cigna,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Cigna PPO,Cigna PPO,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Cigna Medicare Advantage,Cigna Medicare Advantage,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Essence,Essence,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Healthlink HMO,Healthlink HMO,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Healthlink PPO,Healthlink PPO,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,HomeState Health Plan,HomeState Health Plan,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Humana Gold,Humana Gold,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Medicaid MO,Medicaid MO,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Medica,Medica,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Tricare,Tricare,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,UHC All Payer,UHC All Payer,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,UHC Exchange,UHC Exchange,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,UHC Medicaid,UHC Medicaid,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,UMR CPD,UMR CPD,180.95,,,,,,,per diem,180.95,180.95,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,UHC Medicare,UHC Medicare,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED BAL TRAIN I 15,34020012,CDM,420,RC,,,,,,Inpatient,,,180.95,180.95,Wellcare,Wellcare,180.95,,,,,,,case rate,180.95,180.95,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Meritain Health PPO CPD,Meritain Health PPO CPD,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Aetna/Commercial Product,Aetna/Commercial Product,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Meritain Health CPD,Meritain Health CPD,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Starmark CPD,Starmark CPD,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Aetna Medicare,Aetna Medicare,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Ambetter ,Ambetter ,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Blue Access,Anthem Blue Access,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Blue Access Choice,Anthem Blue Access Choice,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Blue Preferred,Anthem Blue Preferred,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Pathway,Anthem Pathway,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Alliance,Anthem Alliance,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Anthem Medicare,Anthem Medicare,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Cigna,Cigna,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Cigna PPO,Cigna PPO,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Cigna Medicare Advantage,Cigna Medicare Advantage,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Essence,Essence,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Healthlink HMO,Healthlink HMO,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Healthlink PPO,Healthlink PPO,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,HomeState Health Plan,HomeState Health Plan,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Humana Gold,Humana Gold,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Medicaid MO,Medicaid MO,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Medica,Medica,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Tricare,Tricare,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,UHC All Payer,UHC All Payer,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,UHC Exchange,UHC Exchange,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,UHC Medicaid,UHC Medicaid,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,UMR CPD,UMR CPD,197.77,,,,,,,per diem,197.77,197.77,"Per diem rate, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,UHC Medicare,UHC Medicare,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT MUSCLE RE-ED/BAL TR II 15  ,34020013,CDM,420,RC,,,,,,Inpatient,,,197.77,197.77,Wellcare,Wellcare,197.77,,,,,,,case rate,197.77,197.77,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Meritain Health PPO CPD,Meritain Health PPO CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna/Commercial Product,Aetna/Commercial Product,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Meritain Health CPD,Meritain Health CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Starmark CPD,Starmark CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna Medicare,Aetna Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Ambetter ,Ambetter ,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Access,Anthem Blue Access,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Access Choice,Anthem Blue Access Choice,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Preferred,Anthem Blue Preferred,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Pathway,Anthem Pathway,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Alliance,Anthem Alliance,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Medicare,Anthem Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna,Cigna,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna PPO,Cigna PPO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna Medicare Advantage,Cigna Medicare Advantage,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Essence,Essence,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthlink HMO,Healthlink HMO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthlink PPO,Healthlink PPO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,HomeState Health Plan,HomeState Health Plan,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Humana Gold,Humana Gold,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Medicaid MO,Medicaid MO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Medica,Medica,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Tricare,Tricare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC All Payer,UHC All Payer,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Exchange,UHC Exchange,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Medicaid,UHC Medicaid,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UMR CPD,UMR CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Medicare,UHC Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT PHONOPHORESIS 15MIN        ,34020014,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Wellcare,Wellcare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Meritain Health PPO CPD,Meritain Health PPO CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna/Commercial Product,Aetna/Commercial Product,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Meritain Health CPD,Meritain Health CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Starmark CPD,Starmark CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Aetna Medicare,Aetna Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Ambetter ,Ambetter ,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Access,Anthem Blue Access,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Access Choice,Anthem Blue Access Choice,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Blue Preferred,Anthem Blue Preferred,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Pathway,Anthem Pathway,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Alliance,Anthem Alliance,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Anthem Medicare,Anthem Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna,Cigna,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna PPO,Cigna PPO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Cigna Medicare Advantage,Cigna Medicare Advantage,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Essence,Essence,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthlink HMO,Healthlink HMO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Healthlink PPO,Healthlink PPO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,HomeState Health Plan,HomeState Health Plan,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Humana Gold,Humana Gold,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Medicaid MO,Medicaid MO,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Medica,Medica,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Tricare,Tricare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC All Payer,UHC All Payer,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Exchange,UHC Exchange,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Medicaid,UHC Medicaid,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UMR CPD,UMR CPD,163.84,,,,,,,per diem,163.84,163.84,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,UHC Medicare,UHC Medicare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT I 15 MIN   ,34020015,CDM,420,RC,,,,,,Inpatient,,,163.84,163.84,Wellcare,Wellcare,163.84,,,,,,,case rate,163.84,163.84,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health PPO CPD,Meritain Health PPO CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/Commercial Product,Aetna/Commercial Product,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health CPD,Meritain Health CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Starmark CPD,Starmark CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna Medicare,Aetna Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Ambetter ,Ambetter ,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access,Anthem Blue Access,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access Choice,Anthem Blue Access Choice,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Preferred,Anthem Blue Preferred,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Pathway,Anthem Pathway,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Alliance,Anthem Alliance,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Medicare,Anthem Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna,Cigna,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna PPO,Cigna PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna Medicare Advantage,Cigna Medicare Advantage,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Essence,Essence,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink HMO,Healthlink HMO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink PPO,Healthlink PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,HomeState Health Plan,HomeState Health Plan,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Humana Gold,Humana Gold,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medicaid MO,Medicaid MO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medica,Medica,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Tricare,Tricare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC All Payer,UHC All Payer,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Exchange,UHC Exchange,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicaid,UHC Medicaid,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UMR CPD,UMR CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicare,UHC Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC ACT II 15 MIN  ,34020016,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Wellcare,Wellcare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health PPO CPD,Meritain Health PPO CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna/Commercial Product,Aetna/Commercial Product,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Meritain Health CPD,Meritain Health CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Starmark CPD,Starmark CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Aetna Medicare,Aetna Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Ambetter ,Ambetter ,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access,Anthem Blue Access,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Access Choice,Anthem Blue Access Choice,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Blue Preferred,Anthem Blue Preferred,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Pathway,Anthem Pathway,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Alliance,Anthem Alliance,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Anthem Medicare,Anthem Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna,Cigna,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna PPO,Cigna PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Cigna Medicare Advantage,Cigna Medicare Advantage,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Essence,Essence,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink HMO,Healthlink HMO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Healthlink PPO,Healthlink PPO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,HomeState Health Plan,HomeState Health Plan,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Humana Gold,Humana Gold,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medicaid MO,Medicaid MO,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Medica,Medica,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Tricare,Tricare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC All Payer,UHC All Payer,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Exchange,UHC Exchange,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicaid,UHC Medicaid,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UMR CPD,UMR CPD,202.73,,,,,,,per diem,202.73,202.73,"Per diem rate, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,UHC Medicare,UHC Medicare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT THERAPEUTIC EXER II 15 MIN ,34020017,CDM,420,RC,,,,,,Inpatient,,,202.73,202.73,Wellcare,Wellcare,202.73,,,,,,,case rate,202.73,202.73,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Meritain Health PPO CPD,Meritain Health PPO CPD,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Aetna/Commercial Product,Aetna/Commercial Product,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Meritain Health CPD,Meritain Health CPD,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Starmark CPD,Starmark CPD,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Aetna Medicare,Aetna Medicare,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Ambetter ,Ambetter ,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Blue Access,Anthem Blue Access,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Blue Access Choice,Anthem Blue Access Choice,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Blue Preferred,Anthem Blue Preferred,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Pathway,Anthem Pathway,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Alliance,Anthem Alliance,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Anthem Medicare,Anthem Medicare,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Cigna,Cigna,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Cigna PPO,Cigna PPO,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Cigna Medicare Advantage,Cigna Medicare Advantage,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Essence,Essence,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Healthlink HMO,Healthlink HMO,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Healthlink PPO,Healthlink PPO,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,HomeState Health Plan,HomeState Health Plan,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Humana Gold,Humana Gold,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Medicaid MO,Medicaid MO,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Medica,Medica,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Tricare,Tricare,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,UHC All Payer,UHC All Payer,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,UHC Exchange,UHC Exchange,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,UHC Medicaid,UHC Medicaid,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,UMR CPD,UMR CPD,291.45,,,,,,,per diem,291.45,291.45,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,UHC Medicare,UHC Medicare,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020018,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,291.45,291.45,Wellcare,Wellcare,291.45,,,,,,,case rate,291.45,291.45,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Meritain Health PPO CPD,Meritain Health PPO CPD,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Aetna/Commercial Product,Aetna/Commercial Product,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Meritain Health CPD,Meritain Health CPD,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Starmark CPD,Starmark CPD,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Aetna Medicare,Aetna Medicare,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Ambetter ,Ambetter ,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Blue Access,Anthem Blue Access,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Blue Access Choice,Anthem Blue Access Choice,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Blue Preferred,Anthem Blue Preferred,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Pathway,Anthem Pathway,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Alliance,Anthem Alliance,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Anthem Medicare,Anthem Medicare,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Cigna,Cigna,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Cigna PPO,Cigna PPO,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Cigna Medicare Advantage,Cigna Medicare Advantage,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Essence,Essence,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Healthlink HMO,Healthlink HMO,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Healthlink PPO,Healthlink PPO,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,HomeState Health Plan,HomeState Health Plan,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Humana Gold,Humana Gold,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Medicaid MO,Medicaid MO,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Medica,Medica,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Tricare,Tricare,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,UHC All Payer,UHC All Payer,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,UHC Exchange,UHC Exchange,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,UHC Medicaid,UHC Medicaid,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,UMR CPD,UMR CPD,242.88,,,,,,,per diem,242.88,242.88,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,UHC Medicare,UHC Medicare,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75MIN,34020019,CDM,424,RC,97163,CPT,,,GP,Inpatient,,,242.88,242.88,Wellcare,Wellcare,242.88,,,,,,,case rate,242.88,242.88,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Meritain Health PPO CPD,Meritain Health PPO CPD,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Aetna/Commercial Product,Aetna/Commercial Product,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Meritain Health CPD,Meritain Health CPD,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Starmark CPD,Starmark CPD,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Aetna Medicare,Aetna Medicare,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Ambetter ,Ambetter ,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Blue Access,Anthem Blue Access,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Blue Access Choice,Anthem Blue Access Choice,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Blue Preferred,Anthem Blue Preferred,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Pathway,Anthem Pathway,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Alliance,Anthem Alliance,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Anthem Medicare,Anthem Medicare,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Cigna,Cigna,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Cigna PPO,Cigna PPO,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Cigna Medicare Advantage,Cigna Medicare Advantage,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Essence,Essence,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Healthlink HMO,Healthlink HMO,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Healthlink PPO,Healthlink PPO,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,HomeState Health Plan,HomeState Health Plan,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Humana Gold,Humana Gold,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Medicaid MO,Medicaid MO,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Medica,Medica,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Tricare,Tricare,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,UHC All Payer,UHC All Payer,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,UHC Exchange,UHC Exchange,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,UHC Medicaid,UHC Medicaid,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,UMR CPD,UMR CPD,48.57,,,,,,,per diem,48.57,48.57,"Per diem rate, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,UHC Medicare,UHC Medicare,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - LOW COMPLEX - 15 MIN,34020020,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,48.57,48.57,Wellcare,Wellcare,48.57,,,,,,,case rate,48.57,48.57,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Meritain Health PPO CPD,Meritain Health PPO CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Aetna/Commercial Product,Aetna/Commercial Product,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Meritain Health CPD,Meritain Health CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Starmark CPD,Starmark CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Aetna Medicare,Aetna Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Ambetter ,Ambetter ,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Blue Access,Anthem Blue Access,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Blue Access Choice,Anthem Blue Access Choice,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Blue Preferred,Anthem Blue Preferred,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Pathway,Anthem Pathway,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Alliance,Anthem Alliance,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Anthem Medicare,Anthem Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Cigna,Cigna,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Cigna PPO,Cigna PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Cigna Medicare Advantage,Cigna Medicare Advantage,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Essence,Essence,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Healthlink HMO,Healthlink HMO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Healthlink PPO,Healthlink PPO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,HomeState Health Plan,HomeState Health Plan,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Humana Gold,Humana Gold,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Medicaid MO,Medicaid MO,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Medica,Medica,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Tricare,Tricare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,UHC All Payer,UHC All Payer,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,UHC Exchange,UHC Exchange,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,UHC Medicaid,UHC Medicaid,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,UMR CPD,UMR CPD,161.2,,,,,,,per diem,161.2,161.2,"Per diem rate, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,UHC Medicare,UHC Medicare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - MOD COMPLEX - 30 MIN,34020021,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,161.2,161.2,Wellcare,Wellcare,161.2,,,,,,,case rate,161.2,161.2,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Meritain Health PPO CPD,Meritain Health PPO CPD,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Aetna/Commercial Product,Aetna/Commercial Product,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Meritain Health CPD,Meritain Health CPD,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Starmark CPD,Starmark CPD,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Aetna Medicare,Aetna Medicare,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Ambetter ,Ambetter ,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Blue Access,Anthem Blue Access,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Blue Access Choice,Anthem Blue Access Choice,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Blue Preferred,Anthem Blue Preferred,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Pathway,Anthem Pathway,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Alliance,Anthem Alliance,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Anthem Medicare,Anthem Medicare,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Cigna,Cigna,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Cigna PPO,Cigna PPO,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Cigna Medicare Advantage,Cigna Medicare Advantage,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Essence,Essence,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Healthlink HMO,Healthlink HMO,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Healthlink PPO,Healthlink PPO,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,HomeState Health Plan,HomeState Health Plan,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Humana Gold,Humana Gold,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Medicaid MO,Medicaid MO,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Medica,Medica,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Tricare,Tricare,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,UHC All Payer,UHC All Payer,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,UHC Exchange,UHC Exchange,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,UHC Medicaid,UHC Medicaid,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,UMR CPD,UMR CPD,145.72,,,,,,,per diem,145.72,145.72,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,UHC Medicare,UHC Medicare,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 45 MI,34020022,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,145.72,145.72,Wellcare,Wellcare,145.72,,,,,,,case rate,145.72,145.72,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Meritain Health PPO CPD,Meritain Health PPO CPD,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Aetna/Commercial Product,Aetna/Commercial Product,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Meritain Health CPD,Meritain Health CPD,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Starmark CPD,Starmark CPD,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Aetna Medicare,Aetna Medicare,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Ambetter ,Ambetter ,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Blue Access,Anthem Blue Access,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Blue Access Choice,Anthem Blue Access Choice,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Blue Preferred,Anthem Blue Preferred,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Pathway,Anthem Pathway,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Alliance,Anthem Alliance,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Anthem Medicare,Anthem Medicare,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Cigna,Cigna,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Cigna PPO,Cigna PPO,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Cigna Medicare Advantage,Cigna Medicare Advantage,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Essence,Essence,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Healthlink HMO,Healthlink HMO,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Healthlink PPO,Healthlink PPO,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,HomeState Health Plan,HomeState Health Plan,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Humana Gold,Humana Gold,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Medicaid MO,Medicaid MO,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Medica,Medica,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Tricare,Tricare,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,UHC All Payer,UHC All Payer,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,UHC Exchange,UHC Exchange,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,UHC Medicaid,UHC Medicaid,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,UMR CPD,UMR CPD,274.53,,,,,,,per diem,274.53,274.53,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,UHC Medicare,UHC Medicare,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX 60 MIN ,34020023,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,274.53,274.53,Wellcare,Wellcare,274.53,,,,,,,case rate,274.53,274.53,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Meritain Health PPO CPD,Meritain Health PPO CPD,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Aetna/Commercial Product,Aetna/Commercial Product,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Meritain Health CPD,Meritain Health CPD,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Starmark CPD,Starmark CPD,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Aetna Medicare,Aetna Medicare,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Ambetter ,Ambetter ,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Blue Access,Anthem Blue Access,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Blue Access Choice,Anthem Blue Access Choice,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Blue Preferred,Anthem Blue Preferred,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Pathway,Anthem Pathway,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Alliance,Anthem Alliance,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Anthem Medicare,Anthem Medicare,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Cigna,Cigna,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Cigna PPO,Cigna PPO,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Cigna Medicare Advantage,Cigna Medicare Advantage,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Essence,Essence,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Healthlink HMO,Healthlink HMO,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Healthlink PPO,Healthlink PPO,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,HomeState Health Plan,HomeState Health Plan,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Humana Gold,Humana Gold,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Medicaid MO,Medicaid MO,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Medica,Medica,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Tricare,Tricare,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,UHC All Payer,UHC All Payer,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,UHC Exchange,UHC Exchange,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,UHC Medicaid,UHC Medicaid,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,UMR CPD,UMR CPD,335.58,,,,,,,per diem,335.58,335.58,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,UHC Medicare,UHC Medicare,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 75 MI,34020024,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,335.58,335.58,Wellcare,Wellcare,335.58,,,,,,,case rate,335.58,335.58,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Meritain Health PPO CPD,Meritain Health PPO CPD,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Aetna/Commercial Product,Aetna/Commercial Product,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Meritain Health CPD,Meritain Health CPD,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Starmark CPD,Starmark CPD,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Aetna Medicare,Aetna Medicare,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Ambetter ,Ambetter ,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Blue Access,Anthem Blue Access,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Blue Access Choice,Anthem Blue Access Choice,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Blue Preferred,Anthem Blue Preferred,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Pathway,Anthem Pathway,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Alliance,Anthem Alliance,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Anthem Medicare,Anthem Medicare,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Cigna,Cigna,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Cigna PPO,Cigna PPO,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Cigna Medicare Advantage,Cigna Medicare Advantage,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Essence,Essence,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Healthlink HMO,Healthlink HMO,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Healthlink PPO,Healthlink PPO,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,HomeState Health Plan,HomeState Health Plan,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Humana Gold,Humana Gold,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Medicaid MO,Medicaid MO,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Medica,Medica,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Tricare,Tricare,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,UHC All Payer,UHC All Payer,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,UHC Exchange,UHC Exchange,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,UHC Medicaid,UHC Medicaid,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,UMR CPD,UMR CPD,396.63,,,,,,,per diem,396.63,396.63,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,UHC Medicare,UHC Medicare,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 90 MI,34020025,CDM,424,RC,97001,CPT,,,GP,Inpatient,,,396.63,396.63,Wellcare,Wellcare,396.63,,,,,,,case rate,396.63,396.63,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Meritain Health PPO CPD,Meritain Health PPO CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Aetna/Commercial Product,Aetna/Commercial Product,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Meritain Health CPD,Meritain Health CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Starmark CPD,Starmark CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Aetna Medicare,Aetna Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Ambetter ,Ambetter ,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Access,Anthem Blue Access,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Access Choice,Anthem Blue Access Choice,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Preferred,Anthem Blue Preferred,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Pathway,Anthem Pathway,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Alliance,Anthem Alliance,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Medicare,Anthem Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Cigna,Cigna,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Cigna PPO,Cigna PPO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Cigna Medicare Advantage,Cigna Medicare Advantage,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Essence,Essence,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Healthlink HMO,Healthlink HMO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Healthlink PPO,Healthlink PPO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,HomeState Health Plan,HomeState Health Plan,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Humana Gold,Humana Gold,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Medicaid MO,Medicaid MO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Medica,Medica,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Tricare,Tricare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,UHC All Payer,UHC All Payer,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,UHC Exchange,UHC Exchange,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,UHC Medicaid,UHC Medicaid,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,UMR CPD,UMR CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,UHC Medicare,UHC Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT MASSAGE 15 MIN             ,34020026,CDM,424,RC,,,,,,Inpatient,,,152.81,152.81,Wellcare,Wellcare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Meritain Health PPO CPD,Meritain Health PPO CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna/Commercial Product,Aetna/Commercial Product,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Meritain Health CPD,Meritain Health CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Starmark CPD,Starmark CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna Medicare,Aetna Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Ambetter ,Ambetter ,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Access,Anthem Blue Access,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Access Choice,Anthem Blue Access Choice,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Preferred,Anthem Blue Preferred,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Pathway,Anthem Pathway,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Alliance,Anthem Alliance,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Medicare,Anthem Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna,Cigna,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna PPO,Cigna PPO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna Medicare Advantage,Cigna Medicare Advantage,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Essence,Essence,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthlink HMO,Healthlink HMO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthlink PPO,Healthlink PPO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,HomeState Health Plan,HomeState Health Plan,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Humana Gold,Humana Gold,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Medicaid MO,Medicaid MO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Medica,Medica,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Tricare,Tricare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC All Payer,UHC All Payer,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Exchange,UHC Exchange,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Medicaid,UHC Medicaid,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UMR CPD,UMR CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Medicare,UHC Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 15 MIN        ,34020027,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Wellcare,Wellcare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Meritain Health PPO CPD,Meritain Health PPO CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna/Commercial Product,Aetna/Commercial Product,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Meritain Health CPD,Meritain Health CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Starmark CPD,Starmark CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Aetna Medicare,Aetna Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Ambetter ,Ambetter ,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Access,Anthem Blue Access,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Access Choice,Anthem Blue Access Choice,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Blue Preferred,Anthem Blue Preferred,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Pathway,Anthem Pathway,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Alliance,Anthem Alliance,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Anthem Medicare,Anthem Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna,Cigna,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna PPO,Cigna PPO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Cigna Medicare Advantage,Cigna Medicare Advantage,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Essence,Essence,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthlink HMO,Healthlink HMO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Healthlink PPO,Healthlink PPO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,HomeState Health Plan,HomeState Health Plan,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Humana Gold,Humana Gold,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Medicaid MO,Medicaid MO,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Medica,Medica,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Tricare,Tricare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC All Payer,UHC All Payer,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Exchange,UHC Exchange,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Medicaid,UHC Medicaid,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UMR CPD,UMR CPD,358.03,,,,,,,per diem,358.03,358.03,"Per diem rate, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,UHC Medicare,UHC Medicare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
PT REEVALUATION 60 MIN        ,34020028,CDM,424,RC,,,,,,Inpatient,,,358.03,358.03,Wellcare,Wellcare,358.03,,,,,,,case rate,358.03,358.03,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Meritain Health PPO CPD,Meritain Health PPO CPD,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Aetna/Commercial Product,Aetna/Commercial Product,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Meritain Health CPD,Meritain Health CPD,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Starmark CPD,Starmark CPD,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Aetna Medicare,Aetna Medicare,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Ambetter ,Ambetter ,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Blue Access,Anthem Blue Access,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Blue Access Choice,Anthem Blue Access Choice,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Blue Preferred,Anthem Blue Preferred,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Pathway,Anthem Pathway,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Alliance,Anthem Alliance,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Anthem Medicare,Anthem Medicare,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Cigna,Cigna,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Cigna PPO,Cigna PPO,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Cigna Medicare Advantage,Cigna Medicare Advantage,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Essence,Essence,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Healthlink HMO,Healthlink HMO,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Healthlink PPO,Healthlink PPO,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,HomeState Health Plan,HomeState Health Plan,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Humana Gold,Humana Gold,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Medicaid MO,Medicaid MO,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Medica,Medica,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Tricare,Tricare,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,UHC All Payer,UHC All Payer,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,UHC Exchange,UHC Exchange,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,UHC Medicaid,UHC Medicaid,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,UMR CPD,UMR CPD,334.47,,,,,,,per diem,334.47,334.47,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,UHC Medicare,UHC Medicare,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND > 50      ,34020029,CDM,420,RC,,,,,,Inpatient,,,334.47,334.47,Wellcare,Wellcare,334.47,,,,,,,case rate,334.47,334.47,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Meritain Health PPO CPD,Meritain Health PPO CPD,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Aetna/Commercial Product,Aetna/Commercial Product,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Meritain Health CPD,Meritain Health CPD,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Starmark CPD,Starmark CPD,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Aetna Medicare,Aetna Medicare,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Ambetter ,Ambetter ,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Blue Access,Anthem Blue Access,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Blue Access Choice,Anthem Blue Access Choice,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Blue Preferred,Anthem Blue Preferred,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Pathway,Anthem Pathway,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Alliance,Anthem Alliance,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Anthem Medicare,Anthem Medicare,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Cigna,Cigna,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Cigna PPO,Cigna PPO,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Cigna Medicare Advantage,Cigna Medicare Advantage,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Essence,Essence,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Healthlink HMO,Healthlink HMO,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Healthlink PPO,Healthlink PPO,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,HomeState Health Plan,HomeState Health Plan,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Humana Gold,Humana Gold,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Medicaid MO,Medicaid MO,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Medica,Medica,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Tricare,Tricare,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,UHC All Payer,UHC All Payer,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,UHC Exchange,UHC Exchange,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,UHC Medicaid,UHC Medicaid,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,UMR CPD,UMR CPD,243.14,,,,,,,per diem,243.14,243.14,"Per diem rate, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,UHC Medicare,UHC Medicare,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
NON SEL TISSUE DEBRIDEMNT     ,34020030,CDM,420,RC,,,,,,Inpatient,,,243.14,243.14,Wellcare,Wellcare,243.14,,,,,,,case rate,243.14,243.14,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Meritain Health PPO CPD,Meritain Health PPO CPD,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Aetna/Commercial Product,Aetna/Commercial Product,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Meritain Health CPD,Meritain Health CPD,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Starmark CPD,Starmark CPD,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Aetna Medicare,Aetna Medicare,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Ambetter ,Ambetter ,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Blue Access,Anthem Blue Access,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Blue Access Choice,Anthem Blue Access Choice,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Blue Preferred,Anthem Blue Preferred,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Pathway,Anthem Pathway,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Alliance,Anthem Alliance,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Anthem Medicare,Anthem Medicare,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Cigna,Cigna,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Cigna PPO,Cigna PPO,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Cigna Medicare Advantage,Cigna Medicare Advantage,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Essence,Essence,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Healthlink HMO,Healthlink HMO,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Healthlink PPO,Healthlink PPO,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,HomeState Health Plan,HomeState Health Plan,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Humana Gold,Humana Gold,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Medicaid MO,Medicaid MO,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Medica,Medica,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Tricare,Tricare,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,UHC All Payer,UHC All Payer,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,UHC Exchange,UHC Exchange,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,UHC Medicaid,UHC Medicaid,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,UMR CPD,UMR CPD,122.87,,,,,,,per diem,122.87,122.87,"Per diem rate, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,UHC Medicare,UHC Medicare,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
GAIT TRAINING LITE 15 MIN     ,34020031,CDM,420,RC,,,,,,Inpatient,,,122.87,122.87,Wellcare,Wellcare,122.87,,,,,,,case rate,122.87,122.87,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Meritain Health PPO CPD,Meritain Health PPO CPD,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Aetna/Commercial Product,Aetna/Commercial Product,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Meritain Health CPD,Meritain Health CPD,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Starmark CPD,Starmark CPD,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Aetna Medicare,Aetna Medicare,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Ambetter ,Ambetter ,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Blue Access,Anthem Blue Access,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Blue Access Choice,Anthem Blue Access Choice,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Blue Preferred,Anthem Blue Preferred,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Pathway,Anthem Pathway,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Alliance,Anthem Alliance,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Anthem Medicare,Anthem Medicare,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Cigna,Cigna,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Cigna PPO,Cigna PPO,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Cigna Medicare Advantage,Cigna Medicare Advantage,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Essence,Essence,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Healthlink HMO,Healthlink HMO,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Healthlink PPO,Healthlink PPO,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,HomeState Health Plan,HomeState Health Plan,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Humana Gold,Humana Gold,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Medicaid MO,Medicaid MO,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Medica,Medica,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Tricare,Tricare,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,UHC All Payer,UHC All Payer,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,UHC Exchange,UHC Exchange,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,UHC Medicaid,UHC Medicaid,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,UMR CPD,UMR CPD,117.05,,,,,,,per diem,117.05,117.05,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,UHC Medicare,UHC Medicare,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN EA      ,34020032,CDM,420,RC,,,,,,Inpatient,,,117.05,117.05,Wellcare,Wellcare,117.05,,,,,,,case rate,117.05,117.05,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Meritain Health PPO CPD,Meritain Health PPO CPD,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Aetna/Commercial Product,Aetna/Commercial Product,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Meritain Health CPD,Meritain Health CPD,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Starmark CPD,Starmark CPD,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Aetna Medicare,Aetna Medicare,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Ambetter ,Ambetter ,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Blue Access,Anthem Blue Access,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Blue Access Choice,Anthem Blue Access Choice,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Blue Preferred,Anthem Blue Preferred,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Pathway,Anthem Pathway,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Alliance,Anthem Alliance,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Anthem Medicare,Anthem Medicare,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Cigna,Cigna,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Cigna PPO,Cigna PPO,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Cigna Medicare Advantage,Cigna Medicare Advantage,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Essence,Essence,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Healthlink HMO,Healthlink HMO,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Healthlink PPO,Healthlink PPO,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,HomeState Health Plan,HomeState Health Plan,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Humana Gold,Humana Gold,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Medicaid MO,Medicaid MO,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Medica,Medica,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Tricare,Tricare,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,UHC All Payer,UHC All Payer,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,UHC Exchange,UHC Exchange,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,UHC Medicaid,UHC Medicaid,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,UMR CPD,UMR CPD,113.64,,,,,,,per diem,113.64,113.64,"Per diem rate, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,UHC Medicare,UHC Medicare,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT PROSTHETIC TRAINING 15     ,34020033,CDM,420,RC,,,,,,Inpatient,,,113.64,113.64,Wellcare,Wellcare,113.64,,,,,,,case rate,113.64,113.64,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Meritain Health PPO CPD,Meritain Health PPO CPD,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Aetna/Commercial Product,Aetna/Commercial Product,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Meritain Health CPD,Meritain Health CPD,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Starmark CPD,Starmark CPD,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Aetna Medicare,Aetna Medicare,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Ambetter ,Ambetter ,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Blue Access,Anthem Blue Access,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Blue Access Choice,Anthem Blue Access Choice,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Blue Preferred,Anthem Blue Preferred,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Pathway,Anthem Pathway,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Alliance,Anthem Alliance,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Anthem Medicare,Anthem Medicare,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Cigna,Cigna,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Cigna PPO,Cigna PPO,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Cigna Medicare Advantage,Cigna Medicare Advantage,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Essence,Essence,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Healthlink HMO,Healthlink HMO,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Healthlink PPO,Healthlink PPO,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,HomeState Health Plan,HomeState Health Plan,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Humana Gold,Humana Gold,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Medicaid MO,Medicaid MO,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Medica,Medica,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Tricare,Tricare,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,UHC All Payer,UHC All Payer,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,UHC Exchange,UHC Exchange,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,UHC Medicaid,UHC Medicaid,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,UMR CPD,UMR CPD,477.88,,,,,,,per diem,477.88,477.88,"Per diem rate, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,UHC Medicare,UHC Medicare,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT DEBRIDE WOUND NON          ,34020034,CDM,420,RC,,,,,,Inpatient,,,477.88,477.88,Wellcare,Wellcare,477.88,,,,,,,case rate,477.88,477.88,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Meritain Health PPO CPD,Meritain Health PPO CPD,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Aetna/Commercial Product,Aetna/Commercial Product,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Meritain Health CPD,Meritain Health CPD,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Starmark CPD,Starmark CPD,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Aetna Medicare,Aetna Medicare,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Ambetter ,Ambetter ,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Blue Access,Anthem Blue Access,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Blue Access Choice,Anthem Blue Access Choice,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Blue Preferred,Anthem Blue Preferred,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Pathway,Anthem Pathway,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Alliance,Anthem Alliance,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Anthem Medicare,Anthem Medicare,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Cigna,Cigna,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Cigna PPO,Cigna PPO,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Cigna Medicare Advantage,Cigna Medicare Advantage,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Essence,Essence,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Healthlink HMO,Healthlink HMO,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Healthlink PPO,Healthlink PPO,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,HomeState Health Plan,HomeState Health Plan,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Humana Gold,Humana Gold,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Medicaid MO,Medicaid MO,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Medica,Medica,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Tricare,Tricare,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,UHC All Payer,UHC All Payer,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,UHC Exchange,UHC Exchange,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,UHC Medicaid,UHC Medicaid,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,UMR CPD,UMR CPD,105.45,,,,,,,per diem,105.45,105.45,"Per diem rate, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,UHC Medicare,UHC Medicare,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
PT ORTHO/PROSTH CHECK 15      ,34020035,CDM,420,RC,,,,,,Inpatient,,,105.45,105.45,Wellcare,Wellcare,105.45,,,,,,,case rate,105.45,105.45,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health PPO CPD,Meritain Health PPO CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/Commercial Product,Aetna/Commercial Product,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health CPD,Meritain Health CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Starmark CPD,Starmark CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna Medicare,Aetna Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Ambetter ,Ambetter ,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access,Anthem Blue Access,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access Choice,Anthem Blue Access Choice,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Preferred,Anthem Blue Preferred,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Pathway,Anthem Pathway,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Alliance,Anthem Alliance,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Medicare,Anthem Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna,Cigna,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna PPO,Cigna PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna Medicare Advantage,Cigna Medicare Advantage,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Essence,Essence,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink HMO,Healthlink HMO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink PPO,Healthlink PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,HomeState Health Plan,HomeState Health Plan,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Humana Gold,Humana Gold,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medicaid MO,Medicaid MO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medica,Medica,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Tricare,Tricare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC All Payer,UHC All Payer,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Exchange,UHC Exchange,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicaid,UHC Medicaid,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UMR CPD,UMR CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicare,UHC Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT < 20       ,34020036,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Wellcare,Wellcare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health PPO CPD,Meritain Health PPO CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/Commercial Product,Aetna/Commercial Product,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health CPD,Meritain Health CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Starmark CPD,Starmark CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna Medicare,Aetna Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Ambetter ,Ambetter ,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access,Anthem Blue Access,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access Choice,Anthem Blue Access Choice,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Preferred,Anthem Blue Preferred,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Pathway,Anthem Pathway,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Alliance,Anthem Alliance,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Medicare,Anthem Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna,Cigna,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna PPO,Cigna PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna Medicare Advantage,Cigna Medicare Advantage,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Essence,Essence,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink HMO,Healthlink HMO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink PPO,Healthlink PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,HomeState Health Plan,HomeState Health Plan,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Humana Gold,Humana Gold,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medicaid MO,Medicaid MO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medica,Medica,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Tricare,Tricare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC All Payer,UHC All Payer,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Exchange,UHC Exchange,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicaid,UHC Medicaid,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UMR CPD,UMR CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicare,UHC Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
SELECT DEBRIDEMENT > 20       ,34020037,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Wellcare,Wellcare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health PPO CPD,Meritain Health PPO CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna/Commercial Product,Aetna/Commercial Product,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Meritain Health CPD,Meritain Health CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Starmark CPD,Starmark CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Aetna Medicare,Aetna Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Ambetter ,Ambetter ,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access,Anthem Blue Access,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Access Choice,Anthem Blue Access Choice,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Blue Preferred,Anthem Blue Preferred,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Pathway,Anthem Pathway,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Alliance,Anthem Alliance,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Anthem Medicare,Anthem Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna,Cigna,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna PPO,Cigna PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Cigna Medicare Advantage,Cigna Medicare Advantage,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Essence,Essence,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink HMO,Healthlink HMO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Healthlink PPO,Healthlink PPO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,HomeState Health Plan,HomeState Health Plan,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Humana Gold,Humana Gold,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medicaid MO,Medicaid MO,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Medica,Medica,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Tricare,Tricare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC All Payer,UHC All Payer,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Exchange,UHC Exchange,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicaid,UHC Medicaid,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UMR CPD,UMR CPD,324.72,,,,,,,per diem,324.72,324.72,"Per diem rate, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,UHC Medicare,UHC Medicare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
VACUUM ASSIST WOUND < 50      ,34020038,CDM,420,RC,,,,,,Inpatient,,,324.72,324.72,Wellcare,Wellcare,324.72,,,,,,,case rate,324.72,324.72,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Meritain Health PPO CPD,Meritain Health PPO CPD,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Aetna/Commercial Product,Aetna/Commercial Product,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Meritain Health CPD,Meritain Health CPD,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Starmark CPD,Starmark CPD,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Aetna Medicare,Aetna Medicare,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Ambetter ,Ambetter ,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Blue Access,Anthem Blue Access,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Blue Access Choice,Anthem Blue Access Choice,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Blue Preferred,Anthem Blue Preferred,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Pathway,Anthem Pathway,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Alliance,Anthem Alliance,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Anthem Medicare,Anthem Medicare,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Cigna,Cigna,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Cigna PPO,Cigna PPO,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Cigna Medicare Advantage,Cigna Medicare Advantage,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Essence,Essence,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Healthlink HMO,Healthlink HMO,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Healthlink PPO,Healthlink PPO,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,HomeState Health Plan,HomeState Health Plan,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Humana Gold,Humana Gold,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Medicaid MO,Medicaid MO,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Medica,Medica,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Tricare,Tricare,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,UHC All Payer,UHC All Payer,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,UHC Exchange,UHC Exchange,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,UHC Medicaid,UHC Medicaid,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,UMR CPD,UMR CPD,92.89,,,,,,,per diem,92.89,92.89,"Per diem rate, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,UHC Medicare,UHC Medicare,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PT ORTHOTIC FITTING 15 MIN    ,34020039,CDM,420,RC,97504,CPT,,,GP,Inpatient,,,92.89,92.89,Wellcare,Wellcare,92.89,,,,,,,case rate,92.89,92.89,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Meritain Health PPO CPD,Meritain Health PPO CPD,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Aetna/Commercial Product,Aetna/Commercial Product,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Meritain Health CPD,Meritain Health CPD,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Starmark CPD,Starmark CPD,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Aetna Medicare,Aetna Medicare,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Ambetter ,Ambetter ,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Blue Access,Anthem Blue Access,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Blue Access Choice,Anthem Blue Access Choice,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Blue Preferred,Anthem Blue Preferred,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Pathway,Anthem Pathway,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Alliance,Anthem Alliance,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Anthem Medicare,Anthem Medicare,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Cigna,Cigna,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Cigna PPO,Cigna PPO,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Cigna Medicare Advantage,Cigna Medicare Advantage,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Essence,Essence,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Healthlink HMO,Healthlink HMO,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Healthlink PPO,Healthlink PPO,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,HomeState Health Plan,HomeState Health Plan,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Humana Gold,Humana Gold,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Medicaid MO,Medicaid MO,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Medica,Medica,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Tricare,Tricare,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,UHC All Payer,UHC All Payer,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,UHC Exchange,UHC Exchange,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,UHC Medicaid,UHC Medicaid,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,UMR CPD,UMR CPD,19.67,,,,,,,per diem,19.67,19.67,"Per diem rate, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,UHC Medicare,UHC Medicare,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
PATIENT CONFERENCE            ,34020040,CDM,420,RC,,,,,,Inpatient,,,19.67,19.67,Wellcare,Wellcare,19.67,,,,,,,case rate,19.67,19.67,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Meritain Health PPO CPD,Meritain Health PPO CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Aetna/Commercial Product,Aetna/Commercial Product,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Meritain Health CPD,Meritain Health CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Starmark CPD,Starmark CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Aetna Medicare,Aetna Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Ambetter ,Ambetter ,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Blue Access,Anthem Blue Access,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Blue Access Choice,Anthem Blue Access Choice,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Blue Preferred,Anthem Blue Preferred,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Pathway,Anthem Pathway,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Alliance,Anthem Alliance,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Anthem Medicare,Anthem Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Cigna,Cigna,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Cigna PPO,Cigna PPO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Cigna Medicare Advantage,Cigna Medicare Advantage,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Essence,Essence,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Healthlink HMO,Healthlink HMO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Healthlink PPO,Healthlink PPO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,HomeState Health Plan,HomeState Health Plan,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Humana Gold,Humana Gold,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Medicaid MO,Medicaid MO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Medica,Medica,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Tricare,Tricare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,UHC All Payer,UHC All Payer,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,UHC Exchange,UHC Exchange,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,UHC Medicaid,UHC Medicaid,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,UMR CPD,UMR CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,UHC Medicare,UHC Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
GROUP THERAPY VISIT           ,34020043,CDM,941,RC,,,,,,Inpatient,,,26.52,26.52,Wellcare,Wellcare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Meritain Health PPO CPD,Meritain Health PPO CPD,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Aetna/Commercial Product,Aetna/Commercial Product,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Meritain Health CPD,Meritain Health CPD,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Starmark CPD,Starmark CPD,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Aetna Medicare,Aetna Medicare,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Ambetter ,Ambetter ,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Blue Access,Anthem Blue Access,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Blue Access Choice,Anthem Blue Access Choice,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Blue Preferred,Anthem Blue Preferred,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Pathway,Anthem Pathway,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Alliance,Anthem Alliance,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Anthem Medicare,Anthem Medicare,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Cigna,Cigna,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Cigna PPO,Cigna PPO,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Cigna Medicare Advantage,Cigna Medicare Advantage,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Essence,Essence,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Healthlink HMO,Healthlink HMO,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Healthlink PPO,Healthlink PPO,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,HomeState Health Plan,HomeState Health Plan,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Humana Gold,Humana Gold,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Medicaid MO,Medicaid MO,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Medica,Medica,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Tricare,Tricare,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,UHC All Payer,UHC All Payer,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,UHC Exchange,UHC Exchange,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,UHC Medicaid,UHC Medicaid,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,UMR CPD,UMR CPD,929.35,,,,,,,per diem,929.35,929.35,"Per diem rate, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,UHC Medicare,UHC Medicare,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
HCHG ED PHYS CARE LEVEL 4     ,34020047,CDM,981,RC,,,,,,Inpatient,,,929.35,929.35,Wellcare,Wellcare,929.35,,,,,,,case rate,929.35,929.35,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Meritain Health PPO CPD,Meritain Health PPO CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna/Commercial Product,Aetna/Commercial Product,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Meritain Health CPD,Meritain Health CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Starmark CPD,Starmark CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna Medicare,Aetna Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Ambetter ,Ambetter ,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Access,Anthem Blue Access,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Access Choice,Anthem Blue Access Choice,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Preferred,Anthem Blue Preferred,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Pathway,Anthem Pathway,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Alliance,Anthem Alliance,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Medicare,Anthem Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna,Cigna,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna PPO,Cigna PPO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna Medicare Advantage,Cigna Medicare Advantage,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Essence,Essence,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthlink HMO,Healthlink HMO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthlink PPO,Healthlink PPO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,HomeState Health Plan,HomeState Health Plan,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Humana Gold,Humana Gold,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Medicaid MO,Medicaid MO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Medica,Medica,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Tricare,Tricare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC All Payer,UHC All Payer,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Exchange,UHC Exchange,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Medicaid,UHC Medicaid,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UMR CPD,UMR CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Medicare,UHC Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTHOTIC/PROS USE - SUBSE/ENC ,34020048,CDM,420,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Wellcare,Wellcare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Meritain Health PPO CPD,Meritain Health PPO CPD,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Aetna/Commercial Product,Aetna/Commercial Product,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Meritain Health CPD,Meritain Health CPD,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Starmark CPD,Starmark CPD,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Aetna Medicare,Aetna Medicare,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Ambetter ,Ambetter ,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Blue Access,Anthem Blue Access,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Blue Access Choice,Anthem Blue Access Choice,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Blue Preferred,Anthem Blue Preferred,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Pathway,Anthem Pathway,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Alliance,Anthem Alliance,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Anthem Medicare,Anthem Medicare,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Cigna,Cigna,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Cigna PPO,Cigna PPO,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Cigna Medicare Advantage,Cigna Medicare Advantage,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Essence,Essence,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Healthlink HMO,Healthlink HMO,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Healthlink PPO,Healthlink PPO,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,HomeState Health Plan,HomeState Health Plan,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Humana Gold,Humana Gold,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Medicaid MO,Medicaid MO,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Medica,Medica,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Tricare,Tricare,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,UHC All Payer,UHC All Payer,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,UHC Exchange,UHC Exchange,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,UHC Medicaid,UHC Medicaid,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,UMR CPD,UMR CPD,103.25,,,,,,,per diem,103.25,103.25,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,UHC Medicare,UHC Medicare,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34020049,CDM,420,RC,97110,CPT,,,,Inpatient,,,103.25,103.25,Wellcare,Wellcare,103.25,,,,,,,case rate,103.25,103.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Meritain Health PPO CPD,Meritain Health PPO CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Aetna/Commercial Product,Aetna/Commercial Product,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Meritain Health CPD,Meritain Health CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Starmark CPD,Starmark CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Aetna Medicare,Aetna Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Ambetter ,Ambetter ,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Access,Anthem Blue Access,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Access Choice,Anthem Blue Access Choice,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Blue Preferred,Anthem Blue Preferred,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Pathway,Anthem Pathway,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Alliance,Anthem Alliance,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Anthem Medicare,Anthem Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Cigna,Cigna,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Cigna PPO,Cigna PPO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Cigna Medicare Advantage,Cigna Medicare Advantage,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Essence,Essence,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Healthlink HMO,Healthlink HMO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Healthlink PPO,Healthlink PPO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,HomeState Health Plan,HomeState Health Plan,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Humana Gold,Humana Gold,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Medicaid MO,Medicaid MO,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Medica,Medica,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Tricare,Tricare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,UHC All Payer,UHC All Payer,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,UHC Exchange,UHC Exchange,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,UHC Medicaid,UHC Medicaid,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,UMR CPD,UMR CPD,138.25,,,,,,,per diem,138.25,138.25,"Per diem rate, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,UHC Medicare,UHC Medicare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
GAIT TRAINING THERAPY         ,34020050,CDM,420,RC,97116,CPT,,,,Inpatient,,,138.25,138.25,Wellcare,Wellcare,138.25,,,,,,,case rate,138.25,138.25,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Meritain Health PPO CPD,Meritain Health PPO CPD,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Aetna/Commercial Product,Aetna/Commercial Product,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Meritain Health CPD,Meritain Health CPD,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Starmark CPD,Starmark CPD,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Aetna Medicare,Aetna Medicare,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Ambetter ,Ambetter ,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Blue Access,Anthem Blue Access,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Blue Access Choice,Anthem Blue Access Choice,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Blue Preferred,Anthem Blue Preferred,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Pathway,Anthem Pathway,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Alliance,Anthem Alliance,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Anthem Medicare,Anthem Medicare,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Cigna,Cigna,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Cigna PPO,Cigna PPO,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Cigna Medicare Advantage,Cigna Medicare Advantage,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Essence,Essence,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Healthlink HMO,Healthlink HMO,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Healthlink PPO,Healthlink PPO,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,HomeState Health Plan,HomeState Health Plan,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Humana Gold,Humana Gold,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Medicaid MO,Medicaid MO,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Medica,Medica,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Tricare,Tricare,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,UHC All Payer,UHC All Payer,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,UHC Exchange,UHC Exchange,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,UHC Medicaid,UHC Medicaid,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,UMR CPD,UMR CPD,449.82,,,,,,,per diem,449.82,449.82,"Per diem rate, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,UHC Medicare,UHC Medicare,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
PT EVAL - HIGH COMPLEX - 60 MI,34020053,CDM,424,RC,,,,,,Inpatient,,,449.82,449.82,Wellcare,Wellcare,449.82,,,,,,,case rate,449.82,449.82,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Meritain Health PPO CPD,Meritain Health PPO CPD,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Aetna/Commercial Product,Aetna/Commercial Product,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Meritain Health CPD,Meritain Health CPD,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Starmark CPD,Starmark CPD,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Aetna Medicare,Aetna Medicare,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Ambetter ,Ambetter ,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Blue Access,Anthem Blue Access,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Blue Access Choice,Anthem Blue Access Choice,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Blue Preferred,Anthem Blue Preferred,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Pathway,Anthem Pathway,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Alliance,Anthem Alliance,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Anthem Medicare,Anthem Medicare,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Cigna,Cigna,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Cigna PPO,Cigna PPO,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Cigna Medicare Advantage,Cigna Medicare Advantage,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Essence,Essence,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Healthlink HMO,Healthlink HMO,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Healthlink PPO,Healthlink PPO,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,HomeState Health Plan,HomeState Health Plan,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Humana Gold,Humana Gold,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Medicaid MO,Medicaid MO,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Medica,Medica,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Tricare,Tricare,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,UHC All Payer,UHC All Payer,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,UHC Exchange,UHC Exchange,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,UHC Medicaid,UHC Medicaid,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,UMR CPD,UMR CPD,0.01,,,,,,,per diem,0.01,0.01,"Per diem rate, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,UHC Medicare,UHC Medicare,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
BODY POS DISCH STATUS 20-39%  ,34033126,CDM,420,RC,G8982,HCPCS,,,,Inpatient,,,0.01,0.01,Wellcare,Wellcare,0.01,,,,,,,case rate,0.01,0.01,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34050015,CDM,420,RC,97026,CPT,,,GP,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
UNLISTED MOD ATTENDED 15MIN   ,34050040,CDM,420,RC,97039,CPT,,,GP,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Meritain Health PPO CPD,Meritain Health PPO CPD,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Aetna/Commercial Product,Aetna/Commercial Product,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Meritain Health CPD,Meritain Health CPD,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Starmark CPD,Starmark CPD,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Aetna Medicare,Aetna Medicare,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Ambetter ,Ambetter ,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Blue Access,Anthem Blue Access,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Blue Access Choice,Anthem Blue Access Choice,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Blue Preferred,Anthem Blue Preferred,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Pathway,Anthem Pathway,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Alliance,Anthem Alliance,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Anthem Medicare,Anthem Medicare,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Cigna,Cigna,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Cigna PPO,Cigna PPO,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Cigna Medicare Advantage,Cigna Medicare Advantage,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Essence,Essence,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Healthlink HMO,Healthlink HMO,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Healthlink PPO,Healthlink PPO,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,HomeState Health Plan,HomeState Health Plan,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Humana Gold,Humana Gold,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Medicaid MO,Medicaid MO,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Medica,Medica,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Tricare,Tricare,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,UHC All Payer,UHC All Payer,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,UHC Exchange,UHC Exchange,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,UHC Medicaid,UHC Medicaid,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,UMR CPD,UMR CPD,244.72,,,,,,,per diem,244.72,244.72,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,UHC Medicare,UHC Medicare,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,34050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,244.72,244.72,Wellcare,Wellcare,244.72,,,,,,,case rate,244.72,244.72,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Meritain Health PPO CPD,Meritain Health PPO CPD,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Aetna/Commercial Product,Aetna/Commercial Product,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Meritain Health CPD,Meritain Health CPD,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Starmark CPD,Starmark CPD,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Aetna Medicare,Aetna Medicare,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Ambetter ,Ambetter ,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Blue Access,Anthem Blue Access,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Blue Access Choice,Anthem Blue Access Choice,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Blue Preferred,Anthem Blue Preferred,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Pathway,Anthem Pathway,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Alliance,Anthem Alliance,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Anthem Medicare,Anthem Medicare,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Cigna,Cigna,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Cigna PPO,Cigna PPO,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Cigna Medicare Advantage,Cigna Medicare Advantage,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Essence,Essence,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Healthlink HMO,Healthlink HMO,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Healthlink PPO,Healthlink PPO,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,HomeState Health Plan,HomeState Health Plan,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Humana Gold,Humana Gold,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Medicaid MO,Medicaid MO,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Medica,Medica,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Tricare,Tricare,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,UHC All Payer,UHC All Payer,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,UHC Exchange,UHC Exchange,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,UHC Medicaid,UHC Medicaid,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,UMR CPD,UMR CPD,488.76,,,,,,,per diem,488.76,488.76,"Per diem rate, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,UHC Medicare,UHC Medicare,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
WORK HARD/COND INIT 2 HRS     ,34050105,CDM,420,RC,97545,CPT,,,GP,Inpatient,,,488.76,488.76,Wellcare,Wellcare,488.76,,,,,,,case rate,488.76,488.76,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Meritain Health PPO CPD,Meritain Health PPO CPD,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Aetna/Commercial Product,Aetna/Commercial Product,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Meritain Health CPD,Meritain Health CPD,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Starmark CPD,Starmark CPD,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Aetna Medicare,Aetna Medicare,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Ambetter ,Ambetter ,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Blue Access,Anthem Blue Access,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Blue Access Choice,Anthem Blue Access Choice,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Blue Preferred,Anthem Blue Preferred,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Pathway,Anthem Pathway,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Alliance,Anthem Alliance,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Anthem Medicare,Anthem Medicare,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Cigna,Cigna,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Cigna PPO,Cigna PPO,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Cigna Medicare Advantage,Cigna Medicare Advantage,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Essence,Essence,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Healthlink HMO,Healthlink HMO,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Healthlink PPO,Healthlink PPO,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,HomeState Health Plan,HomeState Health Plan,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Humana Gold,Humana Gold,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Medicaid MO,Medicaid MO,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Medica,Medica,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Tricare,Tricare,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,UHC All Payer,UHC All Payer,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,UHC Exchange,UHC Exchange,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,UHC Medicaid,UHC Medicaid,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,UMR CPD,UMR CPD,7.37,,,,,,,per diem,7.37,7.37,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,UHC Medicare,UHC Medicare,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34050140,CDM,420,RC,97113,CPT,,,GP,Inpatient,,,7.37,7.37,Wellcare,Wellcare,7.37,,,,,,,case rate,7.37,7.37,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING HAND OR FINGER      ,34050180,CDM,420,RC,29280,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY CYLNDR CAST THIGH-ANKLE ,34050200,CDM,420,RC,29365,CPT,,,GP,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Meritain Health PPO CPD,Meritain Health PPO CPD,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Aetna/Commercial Product,Aetna/Commercial Product,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Meritain Health CPD,Meritain Health CPD,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Starmark CPD,Starmark CPD,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Aetna Medicare,Aetna Medicare,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Ambetter ,Ambetter ,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Blue Access,Anthem Blue Access,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Blue Access Choice,Anthem Blue Access Choice,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Blue Preferred,Anthem Blue Preferred,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Pathway,Anthem Pathway,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Alliance,Anthem Alliance,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Anthem Medicare,Anthem Medicare,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Cigna,Cigna,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Cigna PPO,Cigna PPO,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Cigna Medicare Advantage,Cigna Medicare Advantage,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Essence,Essence,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Healthlink HMO,Healthlink HMO,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Healthlink PPO,Healthlink PPO,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,HomeState Health Plan,HomeState Health Plan,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Humana Gold,Humana Gold,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Medicaid MO,Medicaid MO,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Medica,Medica,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Tricare,Tricare,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,UHC All Payer,UHC All Payer,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,UHC Exchange,UHC Exchange,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,UHC Medicaid,UHC Medicaid,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,UMR CPD,UMR CPD,116.48,,,,,,,per diem,116.48,116.48,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,UHC Medicare,UHC Medicare,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34050220,CDM,420,RC,G0283,HCPCS,,,,Inpatient,,,116.48,116.48,Wellcare,Wellcare,116.48,,,,,,,case rate,116.48,116.48,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
MIST THERAPY                  ,34099979,CDM,420,RC,97610,CPT,,,,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Meritain Health PPO CPD,Meritain Health PPO CPD,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Aetna/Commercial Product,Aetna/Commercial Product,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Meritain Health CPD,Meritain Health CPD,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Starmark CPD,Starmark CPD,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Aetna Medicare,Aetna Medicare,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Ambetter ,Ambetter ,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Blue Access,Anthem Blue Access,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Blue Access Choice,Anthem Blue Access Choice,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Blue Preferred,Anthem Blue Preferred,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Pathway,Anthem Pathway,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Alliance,Anthem Alliance,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Anthem Medicare,Anthem Medicare,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Cigna,Cigna,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Cigna PPO,Cigna PPO,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Cigna Medicare Advantage,Cigna Medicare Advantage,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Essence,Essence,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Healthlink HMO,Healthlink HMO,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Healthlink PPO,Healthlink PPO,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,HomeState Health Plan,HomeState Health Plan,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Humana Gold,Humana Gold,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Medicaid MO,Medicaid MO,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Medica,Medica,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Tricare,Tricare,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,UHC All Payer,UHC All Payer,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,UHC Exchange,UHC Exchange,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,UHC Medicaid,UHC Medicaid,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,UMR CPD,UMR CPD,159.95,,,,,,,per diem,159.95,159.95,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,UHC Medicare,UHC Medicare,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34099980,CDM,420,RC,64550,CPT,,,GP,Inpatient,,,159.95,159.95,Wellcare,Wellcare,159.95,,,,,,,case rate,159.95,159.95,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Meritain Health PPO CPD,Meritain Health PPO CPD,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Aetna/Commercial Product,Aetna/Commercial Product,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Meritain Health CPD,Meritain Health CPD,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Starmark CPD,Starmark CPD,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Aetna Medicare,Aetna Medicare,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Ambetter ,Ambetter ,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Blue Access,Anthem Blue Access,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Blue Access Choice,Anthem Blue Access Choice,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Blue Preferred,Anthem Blue Preferred,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Pathway,Anthem Pathway,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Alliance,Anthem Alliance,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Anthem Medicare,Anthem Medicare,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Cigna,Cigna,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Cigna PPO,Cigna PPO,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Cigna Medicare Advantage,Cigna Medicare Advantage,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Essence,Essence,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Healthlink HMO,Healthlink HMO,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Healthlink PPO,Healthlink PPO,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,HomeState Health Plan,HomeState Health Plan,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Humana Gold,Humana Gold,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Medicaid MO,Medicaid MO,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Medica,Medica,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Tricare,Tricare,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,UHC All Payer,UHC All Payer,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,UHC Exchange,UHC Exchange,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,UHC Medicaid,UHC Medicaid,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,UMR CPD,UMR CPD,145.49,,,,,,,per diem,145.49,145.49,"Per diem rate, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,UHC Medicare,UHC Medicare,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
REC THERAPY EVALUATION        ,34099993,CDM,941,RC,,,,,,Inpatient,,,145.49,145.49,Wellcare,Wellcare,145.49,,,,,,,case rate,145.49,145.49,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Meritain Health PPO CPD,Meritain Health PPO CPD,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Aetna/Commercial Product,Aetna/Commercial Product,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Meritain Health CPD,Meritain Health CPD,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Starmark CPD,Starmark CPD,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Aetna Medicare,Aetna Medicare,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Ambetter ,Ambetter ,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Blue Access,Anthem Blue Access,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Blue Access Choice,Anthem Blue Access Choice,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Blue Preferred,Anthem Blue Preferred,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Pathway,Anthem Pathway,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Alliance,Anthem Alliance,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Anthem Medicare,Anthem Medicare,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Cigna,Cigna,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Cigna PPO,Cigna PPO,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Cigna Medicare Advantage,Cigna Medicare Advantage,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Essence,Essence,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Healthlink HMO,Healthlink HMO,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Healthlink PPO,Healthlink PPO,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,HomeState Health Plan,HomeState Health Plan,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Humana Gold,Humana Gold,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Medicaid MO,Medicaid MO,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Medica,Medica,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Tricare,Tricare,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,UHC All Payer,UHC All Payer,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,UHC Exchange,UHC Exchange,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,UHC Medicaid,UHC Medicaid,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,UMR CPD,UMR CPD,126.46,,,,,,,per diem,126.46,126.46,"Per diem rate, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,UHC Medicare,UHC Medicare,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
PHYSICAL THER UNLISTED 15 MIN ,34099999,CDM,420,RC,97139,CPT,,,GP,Inpatient,,,126.46,126.46,Wellcare,Wellcare,126.46,,,,,,,case rate,126.46,126.46,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Meritain Health PPO CPD,Meritain Health PPO CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Aetna/Commercial Product,Aetna/Commercial Product,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Meritain Health CPD,Meritain Health CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Starmark CPD,Starmark CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Aetna Medicare,Aetna Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Ambetter ,Ambetter ,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Blue Access,Anthem Blue Access,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Blue Access Choice,Anthem Blue Access Choice,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Blue Preferred,Anthem Blue Preferred,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Pathway,Anthem Pathway,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Alliance,Anthem Alliance,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Anthem Medicare,Anthem Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Cigna,Cigna,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Cigna PPO,Cigna PPO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Cigna Medicare Advantage,Cigna Medicare Advantage,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Essence,Essence,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Healthlink HMO,Healthlink HMO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Healthlink PPO,Healthlink PPO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,HomeState Health Plan,HomeState Health Plan,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Humana Gold,Humana Gold,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Medicaid MO,Medicaid MO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Medica,Medica,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Tricare,Tricare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,UHC All Payer,UHC All Payer,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,UHC Exchange,UHC Exchange,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,UHC Medicaid,UHC Medicaid,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,UMR CPD,UMR CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,UHC Medicare,UHC Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34200011,CDM,430,RC,97533,CPT,,,GO,Inpatient,,,99.99,99.99,Wellcare,Wellcare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Meritain Health PPO CPD,Meritain Health PPO CPD,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Aetna/Commercial Product,Aetna/Commercial Product,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Meritain Health CPD,Meritain Health CPD,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Starmark CPD,Starmark CPD,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Aetna Medicare,Aetna Medicare,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Ambetter ,Ambetter ,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Blue Access,Anthem Blue Access,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Blue Access Choice,Anthem Blue Access Choice,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Blue Preferred,Anthem Blue Preferred,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Pathway,Anthem Pathway,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Alliance,Anthem Alliance,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Anthem Medicare,Anthem Medicare,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Cigna,Cigna,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Cigna PPO,Cigna PPO,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Cigna Medicare Advantage,Cigna Medicare Advantage,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Essence,Essence,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Healthlink HMO,Healthlink HMO,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Healthlink PPO,Healthlink PPO,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,HomeState Health Plan,HomeState Health Plan,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Humana Gold,Humana Gold,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Medicaid MO,Medicaid MO,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Medica,Medica,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Tricare,Tricare,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,UHC All Payer,UHC All Payer,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,UHC Exchange,UHC Exchange,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,UHC Medicaid,UHC Medicaid,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,UMR CPD,UMR CPD,348.03,,,,,,,per diem,348.03,348.03,"Per diem rate, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,UHC Medicare,UHC Medicare,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
NEUROMUSCULAR RE-ED 15 MIN    ,34200030,CDM,430,RC,97112,CPT,,,GO,Inpatient,,,348.03,348.03,Wellcare,Wellcare,348.03,,,,,,,case rate,348.03,348.03,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Meritain Health PPO CPD,Meritain Health PPO CPD,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Aetna/Commercial Product,Aetna/Commercial Product,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Meritain Health CPD,Meritain Health CPD,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Starmark CPD,Starmark CPD,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Aetna Medicare,Aetna Medicare,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Ambetter ,Ambetter ,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Blue Access,Anthem Blue Access,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Blue Access Choice,Anthem Blue Access Choice,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Blue Preferred,Anthem Blue Preferred,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Pathway,Anthem Pathway,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Alliance,Anthem Alliance,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Anthem Medicare,Anthem Medicare,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Cigna,Cigna,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Cigna PPO,Cigna PPO,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Cigna Medicare Advantage,Cigna Medicare Advantage,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Essence,Essence,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Healthlink HMO,Healthlink HMO,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Healthlink PPO,Healthlink PPO,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,HomeState Health Plan,HomeState Health Plan,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Humana Gold,Humana Gold,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Medicaid MO,Medicaid MO,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Medica,Medica,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Tricare,Tricare,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,UHC All Payer,UHC All Payer,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,UHC Exchange,UHC Exchange,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,UHC Medicaid,UHC Medicaid,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,UMR CPD,UMR CPD,149.7,,,,,,,per diem,149.7,149.7,"Per diem rate, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,UHC Medicare,UHC Medicare,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
ELEC STIM NOT WOUND UNATTENDED,34200043,CDM,430,RC,97014,CPT,G0283,HCPCS,GOGO,Inpatient,,,149.7,149.7,Wellcare,Wellcare,149.7,,,,,,,case rate,149.7,149.7,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Meritain Health PPO CPD,Meritain Health PPO CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Aetna/Commercial Product,Aetna/Commercial Product,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Meritain Health CPD,Meritain Health CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Starmark CPD,Starmark CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Aetna Medicare,Aetna Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Ambetter ,Ambetter ,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Blue Access,Anthem Blue Access,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Blue Access Choice,Anthem Blue Access Choice,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Blue Preferred,Anthem Blue Preferred,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Pathway,Anthem Pathway,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Alliance,Anthem Alliance,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Anthem Medicare,Anthem Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Cigna,Cigna,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Cigna PPO,Cigna PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Cigna Medicare Advantage,Cigna Medicare Advantage,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Essence,Essence,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Healthlink HMO,Healthlink HMO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Healthlink PPO,Healthlink PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,HomeState Health Plan,HomeState Health Plan,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Humana Gold,Humana Gold,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Medicaid MO,Medicaid MO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Medica,Medica,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Tricare,Tricare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,UHC All Payer,UHC All Payer,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,UHC Exchange,UHC Exchange,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,UHC Medicaid,UHC Medicaid,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,UMR CPD,UMR CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,UHC Medicare,UHC Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 30 MIN   ,34200050,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,305.82,305.82,Wellcare,Wellcare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Meritain Health PPO CPD,Meritain Health PPO CPD,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Aetna/Commercial Product,Aetna/Commercial Product,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Meritain Health CPD,Meritain Health CPD,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Starmark CPD,Starmark CPD,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Aetna Medicare,Aetna Medicare,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Ambetter ,Ambetter ,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Blue Access,Anthem Blue Access,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Blue Access Choice,Anthem Blue Access Choice,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Blue Preferred,Anthem Blue Preferred,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Pathway,Anthem Pathway,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Alliance,Anthem Alliance,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Anthem Medicare,Anthem Medicare,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Cigna,Cigna,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Cigna PPO,Cigna PPO,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Cigna Medicare Advantage,Cigna Medicare Advantage,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Essence,Essence,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Healthlink HMO,Healthlink HMO,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Healthlink PPO,Healthlink PPO,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,HomeState Health Plan,HomeState Health Plan,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Humana Gold,Humana Gold,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Medicaid MO,Medicaid MO,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Medica,Medica,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Tricare,Tricare,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,UHC All Payer,UHC All Payer,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,UHC Exchange,UHC Exchange,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,UHC Medicaid,UHC Medicaid,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,UMR CPD,UMR CPD,396.61,,,,,,,per diem,396.61,396.61,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,UHC Medicare,UHC Medicare,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 45 MIN   ,34200051,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,396.61,396.61,Wellcare,Wellcare,396.61,,,,,,,case rate,396.61,396.61,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Meritain Health PPO CPD,Meritain Health PPO CPD,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Aetna/Commercial Product,Aetna/Commercial Product,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Meritain Health CPD,Meritain Health CPD,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Starmark CPD,Starmark CPD,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Aetna Medicare,Aetna Medicare,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Ambetter ,Ambetter ,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Blue Access,Anthem Blue Access,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Blue Access Choice,Anthem Blue Access Choice,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Blue Preferred,Anthem Blue Preferred,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Pathway,Anthem Pathway,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Alliance,Anthem Alliance,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Anthem Medicare,Anthem Medicare,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Cigna,Cigna,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Cigna PPO,Cigna PPO,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Cigna Medicare Advantage,Cigna Medicare Advantage,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Essence,Essence,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Healthlink HMO,Healthlink HMO,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Healthlink PPO,Healthlink PPO,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,HomeState Health Plan,HomeState Health Plan,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Humana Gold,Humana Gold,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Medicaid MO,Medicaid MO,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Medica,Medica,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Tricare,Tricare,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,UHC All Payer,UHC All Payer,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,UHC Exchange,UHC Exchange,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,UHC Medicaid,UHC Medicaid,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,UMR CPD,UMR CPD,382.26,,,,,,,per diem,382.26,382.26,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,UHC Medicare,UHC Medicare,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 60 MIN   ,34200052,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,382.26,382.26,Wellcare,Wellcare,382.26,,,,,,,case rate,382.26,382.26,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Meritain Health PPO CPD,Meritain Health PPO CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna/Commercial Product,Aetna/Commercial Product,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Meritain Health CPD,Meritain Health CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Starmark CPD,Starmark CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna Medicare,Aetna Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Ambetter ,Ambetter ,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Access,Anthem Blue Access,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Access Choice,Anthem Blue Access Choice,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Preferred,Anthem Blue Preferred,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Pathway,Anthem Pathway,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Alliance,Anthem Alliance,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Medicare,Anthem Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna,Cigna,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna PPO,Cigna PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna Medicare Advantage,Cigna Medicare Advantage,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Essence,Essence,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Healthlink HMO,Healthlink HMO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Healthlink PPO,Healthlink PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,HomeState Health Plan,HomeState Health Plan,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Humana Gold,Humana Gold,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Medicaid MO,Medicaid MO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Medica,Medica,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Tricare,Tricare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,UHC All Payer,UHC All Payer,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Exchange,UHC Exchange,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Medicaid,UHC Medicaid,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,UMR CPD,UMR CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Medicare,UHC Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
THER PROCEDURE-GROUP 15 MIN   ,34200053,CDM,433,RC,97150,CPT,,,GO,Inpatient,,,131.81,131.81,Wellcare,Wellcare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Meritain Health PPO CPD,Meritain Health PPO CPD,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Aetna/Commercial Product,Aetna/Commercial Product,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Meritain Health CPD,Meritain Health CPD,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Starmark CPD,Starmark CPD,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Aetna Medicare,Aetna Medicare,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Ambetter ,Ambetter ,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Blue Access,Anthem Blue Access,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Blue Access Choice,Anthem Blue Access Choice,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Blue Preferred,Anthem Blue Preferred,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Pathway,Anthem Pathway,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Alliance,Anthem Alliance,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Anthem Medicare,Anthem Medicare,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Cigna,Cigna,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Cigna PPO,Cigna PPO,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Cigna Medicare Advantage,Cigna Medicare Advantage,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Essence,Essence,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Healthlink HMO,Healthlink HMO,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Healthlink PPO,Healthlink PPO,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,HomeState Health Plan,HomeState Health Plan,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Humana Gold,Humana Gold,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Medicaid MO,Medicaid MO,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Medica,Medica,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Tricare,Tricare,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,UHC All Payer,UHC All Payer,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,UHC Exchange,UHC Exchange,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,UHC Medicaid,UHC Medicaid,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,UMR CPD,UMR CPD,21.67,,,,,,,per diem,21.67,21.67,"Per diem rate, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,UHC Medicare,UHC Medicare,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
HOT/COLD PACKS APPLICATION    ,34200055,CDM,430,RC,97010,CPT,,,GO,Inpatient,,,21.67,21.67,Wellcare,Wellcare,21.67,,,,,,,case rate,21.67,21.67,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Meritain Health PPO CPD,Meritain Health PPO CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna/Commercial Product,Aetna/Commercial Product,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Meritain Health CPD,Meritain Health CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Starmark CPD,Starmark CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Aetna Medicare,Aetna Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Ambetter ,Ambetter ,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Access,Anthem Blue Access,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Access Choice,Anthem Blue Access Choice,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Blue Preferred,Anthem Blue Preferred,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Pathway,Anthem Pathway,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Alliance,Anthem Alliance,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Anthem Medicare,Anthem Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna,Cigna,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna PPO,Cigna PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Cigna Medicare Advantage,Cigna Medicare Advantage,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Essence,Essence,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Healthlink HMO,Healthlink HMO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Healthlink PPO,Healthlink PPO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,HomeState Health Plan,HomeState Health Plan,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Humana Gold,Humana Gold,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Medicaid MO,Medicaid MO,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Medica,Medica,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Tricare,Tricare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,UHC All Payer,UHC All Payer,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Exchange,UHC Exchange,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Medicaid,UHC Medicaid,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,UMR CPD,UMR CPD,131.81,,,,,,,per diem,131.81,131.81,"Per diem rate, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,UHC Medicare,UHC Medicare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MANUAL THERAPY 15 MIN         ,34200061,CDM,430,RC,97140,CPT,,,GO,Inpatient,,,131.81,131.81,Wellcare,Wellcare,131.81,,,,,,,case rate,131.81,131.81,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Meritain Health PPO CPD,Meritain Health PPO CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Aetna/Commercial Product,Aetna/Commercial Product,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Meritain Health CPD,Meritain Health CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Starmark CPD,Starmark CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Aetna Medicare,Aetna Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Ambetter ,Ambetter ,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Blue Access,Anthem Blue Access,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Blue Access Choice,Anthem Blue Access Choice,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Blue Preferred,Anthem Blue Preferred,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Pathway,Anthem Pathway,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Alliance,Anthem Alliance,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Anthem Medicare,Anthem Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Cigna,Cigna,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Cigna PPO,Cigna PPO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Cigna Medicare Advantage,Cigna Medicare Advantage,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Essence,Essence,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Healthlink HMO,Healthlink HMO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Healthlink PPO,Healthlink PPO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,HomeState Health Plan,HomeState Health Plan,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Humana Gold,Humana Gold,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Medicaid MO,Medicaid MO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Medica,Medica,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Tricare,Tricare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,UHC All Payer,UHC All Payer,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,UHC Exchange,UHC Exchange,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,UHC Medicaid,UHC Medicaid,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,UMR CPD,UMR CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,UHC Medicare,UHC Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MASSAGE 15 MIN                ,34200070,CDM,430,RC,97124,CPT,,,GO,Inpatient,,,109.18,109.18,Wellcare,Wellcare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Meritain Health PPO CPD,Meritain Health PPO CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Aetna/Commercial Product,Aetna/Commercial Product,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Meritain Health CPD,Meritain Health CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Starmark CPD,Starmark CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Aetna Medicare,Aetna Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Ambetter ,Ambetter ,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Blue Access,Anthem Blue Access,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Blue Access Choice,Anthem Blue Access Choice,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Blue Preferred,Anthem Blue Preferred,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Pathway,Anthem Pathway,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Alliance,Anthem Alliance,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Anthem Medicare,Anthem Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Cigna,Cigna,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Cigna PPO,Cigna PPO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Cigna Medicare Advantage,Cigna Medicare Advantage,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Essence,Essence,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Healthlink HMO,Healthlink HMO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Healthlink PPO,Healthlink PPO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,HomeState Health Plan,HomeState Health Plan,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Humana Gold,Humana Gold,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Medicaid MO,Medicaid MO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Medica,Medica,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Tricare,Tricare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,UHC All Payer,UHC All Payer,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,UHC Exchange,UHC Exchange,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,UHC Medicaid,UHC Medicaid,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,UMR CPD,UMR CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,UHC Medicare,UHC Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
PARAFFIN BATH                 ,34200083,CDM,430,RC,97018,CPT,,,GO,Inpatient,,,95.61,95.61,Wellcare,Wellcare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Meritain Health PPO CPD,Meritain Health PPO CPD,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Aetna/Commercial Product,Aetna/Commercial Product,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Meritain Health CPD,Meritain Health CPD,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Starmark CPD,Starmark CPD,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Aetna Medicare,Aetna Medicare,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Ambetter ,Ambetter ,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Blue Access,Anthem Blue Access,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Blue Access Choice,Anthem Blue Access Choice,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Blue Preferred,Anthem Blue Preferred,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Pathway,Anthem Pathway,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Alliance,Anthem Alliance,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Anthem Medicare,Anthem Medicare,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Cigna,Cigna,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Cigna PPO,Cigna PPO,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Cigna Medicare Advantage,Cigna Medicare Advantage,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Essence,Essence,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Healthlink HMO,Healthlink HMO,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Healthlink PPO,Healthlink PPO,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,HomeState Health Plan,HomeState Health Plan,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Humana Gold,Humana Gold,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Medicaid MO,Medicaid MO,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Medica,Medica,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Tricare,Tricare,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,UHC All Payer,UHC All Payer,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,UHC Exchange,UHC Exchange,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,UHC Medicaid,UHC Medicaid,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,UMR CPD,UMR CPD,36.69,,,,,,,per diem,36.69,36.69,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,UHC Medicare,UHC Medicare,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISE 15 MIN   ,34200110,CDM,430,RC,97110,CPT,,,GO,Inpatient,,,36.69,36.69,Wellcare,Wellcare,36.69,,,,,,,case rate,36.69,36.69,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Meritain Health PPO CPD,Meritain Health PPO CPD,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Aetna/Commercial Product,Aetna/Commercial Product,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Meritain Health CPD,Meritain Health CPD,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Starmark CPD,Starmark CPD,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Aetna Medicare,Aetna Medicare,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Ambetter ,Ambetter ,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Blue Access,Anthem Blue Access,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Blue Access Choice,Anthem Blue Access Choice,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Blue Preferred,Anthem Blue Preferred,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Pathway,Anthem Pathway,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Alliance,Anthem Alliance,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Anthem Medicare,Anthem Medicare,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Cigna,Cigna,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Cigna PPO,Cigna PPO,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Cigna Medicare Advantage,Cigna Medicare Advantage,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Essence,Essence,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Healthlink HMO,Healthlink HMO,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Healthlink PPO,Healthlink PPO,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,HomeState Health Plan,HomeState Health Plan,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Humana Gold,Humana Gold,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Medicaid MO,Medicaid MO,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Medica,Medica,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Tricare,Tricare,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,UHC All Payer,UHC All Payer,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,UHC Exchange,UHC Exchange,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,UHC Medicaid,UHC Medicaid,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,UMR CPD,UMR CPD,171.77,,,,,,,per diem,171.77,171.77,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,UHC Medicare,UHC Medicare,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG ARM         ,34200134,CDM,430,RC,29105,CPT,,,GO,Inpatient,,,171.77,171.77,Wellcare,Wellcare,171.77,,,,,,,case rate,171.77,171.77,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
APPLY SPLINT LONG LEG         ,34200135,CDM,430,RC,29505,CPT,,,GO,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Meritain Health PPO CPD,Meritain Health PPO CPD,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Aetna/Commercial Product,Aetna/Commercial Product,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Meritain Health CPD,Meritain Health CPD,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Starmark CPD,Starmark CPD,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Aetna Medicare,Aetna Medicare,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Ambetter ,Ambetter ,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Blue Access,Anthem Blue Access,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Blue Access Choice,Anthem Blue Access Choice,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Blue Preferred,Anthem Blue Preferred,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Pathway,Anthem Pathway,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Alliance,Anthem Alliance,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Anthem Medicare,Anthem Medicare,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Cigna,Cigna,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Cigna PPO,Cigna PPO,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Cigna Medicare Advantage,Cigna Medicare Advantage,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Essence,Essence,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Healthlink HMO,Healthlink HMO,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Healthlink PPO,Healthlink PPO,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,HomeState Health Plan,HomeState Health Plan,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Humana Gold,Humana Gold,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Medicaid MO,Medicaid MO,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Medica,Medica,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Tricare,Tricare,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,UHC All Payer,UHC All Payer,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,UHC Exchange,UHC Exchange,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,UHC Medicaid,UHC Medicaid,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,UMR CPD,UMR CPD,101.08,,,,,,,per diem,101.08,101.08,"Per diem rate, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,UHC Medicare,UHC Medicare,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
ORTHOTIC PROSTH CHECK 15 MIN  ,34200136,CDM,430,RC,97762,CPT,,,GO,Inpatient,,,101.08,101.08,Wellcare,Wellcare,101.08,,,,,,,case rate,101.08,101.08,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Meritain Health PPO CPD,Meritain Health PPO CPD,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Aetna/Commercial Product,Aetna/Commercial Product,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Meritain Health CPD,Meritain Health CPD,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Starmark CPD,Starmark CPD,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Aetna Medicare,Aetna Medicare,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Ambetter ,Ambetter ,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Blue Access,Anthem Blue Access,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Blue Access Choice,Anthem Blue Access Choice,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Blue Preferred,Anthem Blue Preferred,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Pathway,Anthem Pathway,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Alliance,Anthem Alliance,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Anthem Medicare,Anthem Medicare,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Cigna,Cigna,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Cigna PPO,Cigna PPO,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Cigna Medicare Advantage,Cigna Medicare Advantage,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Essence,Essence,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Healthlink HMO,Healthlink HMO,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Healthlink PPO,Healthlink PPO,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,HomeState Health Plan,HomeState Health Plan,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Humana Gold,Humana Gold,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Medicaid MO,Medicaid MO,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Medica,Medica,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Tricare,Tricare,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,UHC All Payer,UHC All Payer,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,UHC Exchange,UHC Exchange,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,UHC Medicaid,UHC Medicaid,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,UMR CPD,UMR CPD,76.85,,,,,,,per diem,76.85,76.85,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,UHC Medicare,UHC Medicare,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECH      ,34200137,CDM,430,RC,,,,,,Inpatient,,,76.85,76.85,Wellcare,Wellcare,76.85,,,,,,,case rate,76.85,76.85,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Meritain Health PPO CPD,Meritain Health PPO CPD,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Aetna/Commercial Product,Aetna/Commercial Product,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Meritain Health CPD,Meritain Health CPD,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Starmark CPD,Starmark CPD,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Aetna Medicare,Aetna Medicare,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Ambetter ,Ambetter ,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Blue Access,Anthem Blue Access,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Blue Access Choice,Anthem Blue Access Choice,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Blue Preferred,Anthem Blue Preferred,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Pathway,Anthem Pathway,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Alliance,Anthem Alliance,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Anthem Medicare,Anthem Medicare,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Cigna,Cigna,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Cigna PPO,Cigna PPO,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Cigna Medicare Advantage,Cigna Medicare Advantage,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Essence,Essence,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Healthlink HMO,Healthlink HMO,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Healthlink PPO,Healthlink PPO,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,HomeState Health Plan,HomeState Health Plan,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Humana Gold,Humana Gold,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Medicaid MO,Medicaid MO,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Medica,Medica,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Tricare,Tricare,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,UHC All Payer,UHC All Payer,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,UHC Exchange,UHC Exchange,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,UHC Medicaid,UHC Medicaid,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,UMR CPD,UMR CPD,173.5,,,,,,,per diem,173.5,173.5,"Per diem rate, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,UHC Medicare,UHC Medicare,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL FUNCTIONAL ACT 15 MIN     ,34200138,CDM,430,RC,,,,,,Inpatient,,,173.5,173.5,Wellcare,Wellcare,173.5,,,,,,,case rate,173.5,173.5,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Meritain Health PPO CPD,Meritain Health PPO CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Aetna/Commercial Product,Aetna/Commercial Product,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Meritain Health CPD,Meritain Health CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Starmark CPD,Starmark CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Aetna Medicare,Aetna Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Ambetter ,Ambetter ,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Access,Anthem Blue Access,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Access Choice,Anthem Blue Access Choice,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Blue Preferred,Anthem Blue Preferred,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Pathway,Anthem Pathway,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Alliance,Anthem Alliance,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Anthem Medicare,Anthem Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Cigna,Cigna,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Cigna PPO,Cigna PPO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Cigna Medicare Advantage,Cigna Medicare Advantage,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Essence,Essence,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Healthlink HMO,Healthlink HMO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Healthlink PPO,Healthlink PPO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,HomeState Health Plan,HomeState Health Plan,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Humana Gold,Humana Gold,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Medicaid MO,Medicaid MO,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Medica,Medica,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Tricare,Tricare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,UHC All Payer,UHC All Payer,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,UHC Exchange,UHC Exchange,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,UHC Medicaid,UHC Medicaid,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,UMR CPD,UMR CPD,160.26,,,,,,,per diem,160.26,160.26,"Per diem rate, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,UHC Medicare,UHC Medicare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
ADL SELF CAR MGT TR 15 MIN    ,34200139,CDM,430,RC,,,,,,Inpatient,,,160.26,160.26,Wellcare,Wellcare,160.26,,,,,,,case rate,160.26,160.26,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Meritain Health PPO CPD,Meritain Health PPO CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Aetna/Commercial Product,Aetna/Commercial Product,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Meritain Health CPD,Meritain Health CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Starmark CPD,Starmark CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Aetna Medicare,Aetna Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Ambetter ,Ambetter ,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Access,Anthem Blue Access,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Access Choice,Anthem Blue Access Choice,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Blue Preferred,Anthem Blue Preferred,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Pathway,Anthem Pathway,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Alliance,Anthem Alliance,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Anthem Medicare,Anthem Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Cigna,Cigna,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Cigna PPO,Cigna PPO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Cigna Medicare Advantage,Cigna Medicare Advantage,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Essence,Essence,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Healthlink HMO,Healthlink HMO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Healthlink PPO,Healthlink PPO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,HomeState Health Plan,HomeState Health Plan,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Humana Gold,Humana Gold,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Medicaid MO,Medicaid MO,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Medica,Medica,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Tricare,Tricare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,UHC All Payer,UHC All Payer,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,UHC Exchange,UHC Exchange,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,UHC Medicaid,UHC Medicaid,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,UMR CPD,UMR CPD,152.81,,,,,,,per diem,152.81,152.81,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,UHC Medicare,UHC Medicare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEV 15 MIN   ,34200140,CDM,430,RC,,,,,,Inpatient,,,152.81,152.81,Wellcare,Wellcare,152.81,,,,,,,case rate,152.81,152.81,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Meritain Health PPO CPD,Meritain Health PPO CPD,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Aetna/Commercial Product,Aetna/Commercial Product,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Meritain Health CPD,Meritain Health CPD,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Starmark CPD,Starmark CPD,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Aetna Medicare,Aetna Medicare,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Ambetter ,Ambetter ,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Blue Access,Anthem Blue Access,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Blue Access Choice,Anthem Blue Access Choice,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Blue Preferred,Anthem Blue Preferred,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Pathway,Anthem Pathway,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Alliance,Anthem Alliance,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Anthem Medicare,Anthem Medicare,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Cigna,Cigna,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Cigna PPO,Cigna PPO,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Cigna Medicare Advantage,Cigna Medicare Advantage,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Essence,Essence,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Healthlink HMO,Healthlink HMO,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Healthlink PPO,Healthlink PPO,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,HomeState Health Plan,HomeState Health Plan,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Humana Gold,Humana Gold,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Medicaid MO,Medicaid MO,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Medica,Medica,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Tricare,Tricare,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,UHC All Payer,UHC All Payer,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,UHC Exchange,UHC Exchange,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,UHC Medicaid,UHC Medicaid,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,UMR CPD,UMR CPD,172.4,,,,,,,per diem,172.4,172.4,"Per diem rate, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,UHC Medicare,UHC Medicare,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
MUSCLE RE-ED BAL TR 15 MIN    ,34200141,CDM,430,RC,,,,,,Inpatient,,,172.4,172.4,Wellcare,Wellcare,172.4,,,,,,,case rate,172.4,172.4,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MIN    ,34200142,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACT II 15 MIN     ,34200143,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
THERAPY EXERCISE II 15 MIN    ,34200144,CDM,430,RC,,,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Meritain Health PPO CPD,Meritain Health PPO CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Aetna/Commercial Product,Aetna/Commercial Product,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Meritain Health CPD,Meritain Health CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Starmark CPD,Starmark CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Aetna Medicare,Aetna Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Ambetter ,Ambetter ,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Blue Access,Anthem Blue Access,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Blue Access Choice,Anthem Blue Access Choice,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Blue Preferred,Anthem Blue Preferred,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Pathway,Anthem Pathway,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Alliance,Anthem Alliance,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Anthem Medicare,Anthem Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Cigna,Cigna,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Cigna PPO,Cigna PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Cigna Medicare Advantage,Cigna Medicare Advantage,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Essence,Essence,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Healthlink HMO,Healthlink HMO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Healthlink PPO,Healthlink PPO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,HomeState Health Plan,HomeState Health Plan,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Humana Gold,Humana Gold,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Medicaid MO,Medicaid MO,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Medica,Medica,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Tricare,Tricare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,UHC All Payer,UHC All Payer,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,UHC Exchange,UHC Exchange,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,UHC Medicaid,UHC Medicaid,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,UMR CPD,UMR CPD,476,,,,,,,per diem,476,476,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,UHC Medicare,UHC Medicare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 90 MI,34200145,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,476,476,Wellcare,Wellcare,476,,,,,,,case rate,476,476,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Meritain Health PPO CPD,Meritain Health PPO CPD,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Aetna/Commercial Product,Aetna/Commercial Product,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Meritain Health CPD,Meritain Health CPD,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Starmark CPD,Starmark CPD,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Aetna Medicare,Aetna Medicare,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Ambetter ,Ambetter ,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Blue Access,Anthem Blue Access,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Blue Access Choice,Anthem Blue Access Choice,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Blue Preferred,Anthem Blue Preferred,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Pathway,Anthem Pathway,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Alliance,Anthem Alliance,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Anthem Medicare,Anthem Medicare,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Cigna,Cigna,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Cigna PPO,Cigna PPO,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Cigna Medicare Advantage,Cigna Medicare Advantage,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Essence,Essence,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Healthlink HMO,Healthlink HMO,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Healthlink PPO,Healthlink PPO,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,HomeState Health Plan,HomeState Health Plan,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Humana Gold,Humana Gold,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Medicaid MO,Medicaid MO,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Medica,Medica,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Tricare,Tricare,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,UHC All Payer,UHC All Payer,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,UHC Exchange,UHC Exchange,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,UHC Medicaid,UHC Medicaid,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,UMR CPD,UMR CPD,539.41,,,,,,,per diem,539.41,539.41,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,UHC Medicare,UHC Medicare,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 75 MI,34200146,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,539.41,539.41,Wellcare,Wellcare,539.41,,,,,,,case rate,539.41,539.41,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Meritain Health PPO CPD,Meritain Health PPO CPD,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Aetna/Commercial Product,Aetna/Commercial Product,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Meritain Health CPD,Meritain Health CPD,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Starmark CPD,Starmark CPD,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Aetna Medicare,Aetna Medicare,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Ambetter ,Ambetter ,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Blue Access,Anthem Blue Access,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Blue Access Choice,Anthem Blue Access Choice,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Blue Preferred,Anthem Blue Preferred,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Pathway,Anthem Pathway,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Alliance,Anthem Alliance,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Anthem Medicare,Anthem Medicare,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Cigna,Cigna,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Cigna PPO,Cigna PPO,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Cigna Medicare Advantage,Cigna Medicare Advantage,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Essence,Essence,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Healthlink HMO,Healthlink HMO,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Healthlink PPO,Healthlink PPO,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,HomeState Health Plan,HomeState Health Plan,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Humana Gold,Humana Gold,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Medicaid MO,Medicaid MO,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Medica,Medica,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Tricare,Tricare,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,UHC All Payer,UHC All Payer,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,UHC Exchange,UHC Exchange,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,UHC Medicaid,UHC Medicaid,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,UMR CPD,UMR CPD,587.37,,,,,,,per diem,587.37,587.37,"Per diem rate, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,UHC Medicare,UHC Medicare,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - HIGH COMPLEX - 60 MI,34200147,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,587.37,587.37,Wellcare,Wellcare,587.37,,,,,,,case rate,587.37,587.37,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Meritain Health PPO CPD,Meritain Health PPO CPD,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Aetna/Commercial Product,Aetna/Commercial Product,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Meritain Health CPD,Meritain Health CPD,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Starmark CPD,Starmark CPD,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Aetna Medicare,Aetna Medicare,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Ambetter ,Ambetter ,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Blue Access,Anthem Blue Access,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Blue Access Choice,Anthem Blue Access Choice,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Blue Preferred,Anthem Blue Preferred,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Pathway,Anthem Pathway,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Alliance,Anthem Alliance,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Anthem Medicare,Anthem Medicare,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Cigna,Cigna,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Cigna PPO,Cigna PPO,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Cigna Medicare Advantage,Cigna Medicare Advantage,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Essence,Essence,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Healthlink HMO,Healthlink HMO,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Healthlink PPO,Healthlink PPO,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,HomeState Health Plan,HomeState Health Plan,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Humana Gold,Humana Gold,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Medicaid MO,Medicaid MO,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Medica,Medica,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Tricare,Tricare,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,UHC All Payer,UHC All Payer,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,UHC Exchange,UHC Exchange,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,UHC Medicaid,UHC Medicaid,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,UMR CPD,UMR CPD,528.06,,,,,,,per diem,528.06,528.06,"Per diem rate, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,UHC Medicare,UHC Medicare,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - MOD COMPLEX - 45 MIN,34200148,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,528.06,528.06,Wellcare,Wellcare,528.06,,,,,,,case rate,528.06,528.06,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Meritain Health PPO CPD,Meritain Health PPO CPD,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Aetna/Commercial Product,Aetna/Commercial Product,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Meritain Health CPD,Meritain Health CPD,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Starmark CPD,Starmark CPD,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Aetna Medicare,Aetna Medicare,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Ambetter ,Ambetter ,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Blue Access,Anthem Blue Access,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Blue Access Choice,Anthem Blue Access Choice,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Blue Preferred,Anthem Blue Preferred,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Pathway,Anthem Pathway,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Alliance,Anthem Alliance,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Anthem Medicare,Anthem Medicare,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Cigna,Cigna,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Cigna PPO,Cigna PPO,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Cigna Medicare Advantage,Cigna Medicare Advantage,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Essence,Essence,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Healthlink HMO,Healthlink HMO,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Healthlink PPO,Healthlink PPO,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,HomeState Health Plan,HomeState Health Plan,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Humana Gold,Humana Gold,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Medicaid MO,Medicaid MO,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Medica,Medica,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Tricare,Tricare,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,UHC All Payer,UHC All Payer,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,UHC Exchange,UHC Exchange,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,UHC Medicaid,UHC Medicaid,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,UMR CPD,UMR CPD,545.88,,,,,,,per diem,545.88,545.88,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,UHC Medicare,UHC Medicare,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 15 MIN,34200149,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,545.88,545.88,Wellcare,Wellcare,545.88,,,,,,,case rate,545.88,545.88,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Meritain Health PPO CPD,Meritain Health PPO CPD,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Aetna/Commercial Product,Aetna/Commercial Product,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Meritain Health CPD,Meritain Health CPD,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Starmark CPD,Starmark CPD,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Aetna Medicare,Aetna Medicare,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Ambetter ,Ambetter ,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Blue Access,Anthem Blue Access,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Blue Access Choice,Anthem Blue Access Choice,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Blue Preferred,Anthem Blue Preferred,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Pathway,Anthem Pathway,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Alliance,Anthem Alliance,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Anthem Medicare,Anthem Medicare,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Cigna,Cigna,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Cigna PPO,Cigna PPO,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Cigna Medicare Advantage,Cigna Medicare Advantage,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Essence,Essence,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Healthlink HMO,Healthlink HMO,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Healthlink PPO,Healthlink PPO,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,HomeState Health Plan,HomeState Health Plan,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Humana Gold,Humana Gold,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Medicaid MO,Medicaid MO,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Medica,Medica,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Tricare,Tricare,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,UHC All Payer,UHC All Payer,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,UHC Exchange,UHC Exchange,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,UHC Medicaid,UHC Medicaid,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,UMR CPD,UMR CPD,581.29,,,,,,,per diem,581.29,581.29,"Per diem rate, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,UHC Medicare,UHC Medicare,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
OT EVAL - LOW COMPLEX - 30 MIN,34200150,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,581.29,581.29,Wellcare,Wellcare,581.29,,,,,,,case rate,581.29,581.29,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Meritain Health PPO CPD,Meritain Health PPO CPD,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Aetna/Commercial Product,Aetna/Commercial Product,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Meritain Health CPD,Meritain Health CPD,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Starmark CPD,Starmark CPD,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Aetna Medicare,Aetna Medicare,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Ambetter ,Ambetter ,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Blue Access,Anthem Blue Access,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Blue Access Choice,Anthem Blue Access Choice,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Blue Preferred,Anthem Blue Preferred,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Pathway,Anthem Pathway,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Alliance,Anthem Alliance,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Anthem Medicare,Anthem Medicare,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Cigna,Cigna,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Cigna PPO,Cigna PPO,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Cigna Medicare Advantage,Cigna Medicare Advantage,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Essence,Essence,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Healthlink HMO,Healthlink HMO,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Healthlink PPO,Healthlink PPO,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,HomeState Health Plan,HomeState Health Plan,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Humana Gold,Humana Gold,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Medicaid MO,Medicaid MO,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Medica,Medica,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Tricare,Tricare,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,UHC All Payer,UHC All Payer,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,UHC Exchange,UHC Exchange,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,UHC Medicaid,UHC Medicaid,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,UMR CPD,UMR CPD,112.79,,,,,,,per diem,112.79,112.79,"Per diem rate, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,UHC Medicare,UHC Medicare,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
ELECTRICAL STIMULATION AT     ,34200151,CDM,430,RC,,,,,,Inpatient,,,112.79,112.79,Wellcare,Wellcare,112.79,,,,,,,case rate,112.79,112.79,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Meritain Health PPO CPD,Meritain Health PPO CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna/Commercial Product,Aetna/Commercial Product,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Meritain Health CPD,Meritain Health CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Starmark CPD,Starmark CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna Medicare,Aetna Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Ambetter ,Ambetter ,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Access,Anthem Blue Access,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Access Choice,Anthem Blue Access Choice,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Preferred,Anthem Blue Preferred,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Pathway,Anthem Pathway,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Alliance,Anthem Alliance,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Medicare,Anthem Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna,Cigna,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna PPO,Cigna PPO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna Medicare Advantage,Cigna Medicare Advantage,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Essence,Essence,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthlink HMO,Healthlink HMO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthlink PPO,Healthlink PPO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,HomeState Health Plan,HomeState Health Plan,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Humana Gold,Humana Gold,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Medicaid MO,Medicaid MO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Medica,Medica,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Tricare,Tricare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC All Payer,UHC All Payer,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Exchange,UHC Exchange,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Medicaid,UHC Medicaid,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UMR CPD,UMR CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Medicare,UHC Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200152,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Wellcare,Wellcare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Meritain Health PPO CPD,Meritain Health PPO CPD,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Aetna/Commercial Product,Aetna/Commercial Product,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Meritain Health CPD,Meritain Health CPD,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Starmark CPD,Starmark CPD,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Aetna Medicare,Aetna Medicare,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Ambetter ,Ambetter ,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Blue Access,Anthem Blue Access,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Blue Access Choice,Anthem Blue Access Choice,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Blue Preferred,Anthem Blue Preferred,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Pathway,Anthem Pathway,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Alliance,Anthem Alliance,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Anthem Medicare,Anthem Medicare,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Cigna,Cigna,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Cigna PPO,Cigna PPO,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Cigna Medicare Advantage,Cigna Medicare Advantage,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Essence,Essence,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Healthlink HMO,Healthlink HMO,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Healthlink PPO,Healthlink PPO,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,HomeState Health Plan,HomeState Health Plan,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Humana Gold,Humana Gold,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Medicaid MO,Medicaid MO,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Medica,Medica,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Tricare,Tricare,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,UHC All Payer,UHC All Payer,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,UHC Exchange,UHC Exchange,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,UHC Medicaid,UHC Medicaid,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,UMR CPD,UMR CPD,355.13,,,,,,,per diem,355.13,355.13,"Per diem rate, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,UHC Medicare,UHC Medicare,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
GROUP THERAPEUTIC 15 min      ,34200153,CDM,430,RC,,,,,,Inpatient,,,355.13,355.13,Wellcare,Wellcare,355.13,,,,,,,case rate,355.13,355.13,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Meritain Health PPO CPD,Meritain Health PPO CPD,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Aetna/Commercial Product,Aetna/Commercial Product,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Meritain Health CPD,Meritain Health CPD,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Starmark CPD,Starmark CPD,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Aetna Medicare,Aetna Medicare,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Ambetter ,Ambetter ,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Blue Access,Anthem Blue Access,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Blue Access Choice,Anthem Blue Access Choice,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Blue Preferred,Anthem Blue Preferred,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Pathway,Anthem Pathway,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Alliance,Anthem Alliance,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Anthem Medicare,Anthem Medicare,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Cigna,Cigna,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Cigna PPO,Cigna PPO,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Cigna Medicare Advantage,Cigna Medicare Advantage,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Essence,Essence,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Healthlink HMO,Healthlink HMO,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Healthlink PPO,Healthlink PPO,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,HomeState Health Plan,HomeState Health Plan,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Humana Gold,Humana Gold,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Medicaid MO,Medicaid MO,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Medica,Medica,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Tricare,Tricare,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,UHC All Payer,UHC All Payer,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,UHC Exchange,UHC Exchange,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,UHC Medicaid,UHC Medicaid,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,UMR CPD,UMR CPD,322.23,,,,,,,per diem,322.23,322.23,"Per diem rate, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,UHC Medicare,UHC Medicare,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT ORTHOTIC FITTING 15 MI     ,34200154,CDM,430,RC,,,,,,Inpatient,,,322.23,322.23,Wellcare,Wellcare,322.23,,,,,,,case rate,322.23,322.23,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Meritain Health PPO CPD,Meritain Health PPO CPD,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Aetna/Commercial Product,Aetna/Commercial Product,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Meritain Health CPD,Meritain Health CPD,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Starmark CPD,Starmark CPD,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Aetna Medicare,Aetna Medicare,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Ambetter ,Ambetter ,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Blue Access,Anthem Blue Access,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Blue Access Choice,Anthem Blue Access Choice,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Blue Preferred,Anthem Blue Preferred,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Pathway,Anthem Pathway,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Alliance,Anthem Alliance,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Anthem Medicare,Anthem Medicare,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Cigna,Cigna,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Cigna PPO,Cigna PPO,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Cigna Medicare Advantage,Cigna Medicare Advantage,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Essence,Essence,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Healthlink HMO,Healthlink HMO,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Healthlink PPO,Healthlink PPO,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,HomeState Health Plan,HomeState Health Plan,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Humana Gold,Humana Gold,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Medicaid MO,Medicaid MO,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Medica,Medica,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Tricare,Tricare,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,UHC All Payer,UHC All Payer,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,UHC Exchange,UHC Exchange,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,UHC Medicaid,UHC Medicaid,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,UMR CPD,UMR CPD,350.89,,,,,,,per diem,350.89,350.89,"Per diem rate, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,UHC Medicare,UHC Medicare,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
OT THERAPEUTIC ACTIV          ,34200155,CDM,430,RC,,,,,,Inpatient,,,350.89,350.89,Wellcare,Wellcare,350.89,,,,,,,case rate,350.89,350.89,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Meritain Health PPO CPD,Meritain Health PPO CPD,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Aetna/Commercial Product,Aetna/Commercial Product,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Meritain Health CPD,Meritain Health CPD,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Starmark CPD,Starmark CPD,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Aetna Medicare,Aetna Medicare,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Ambetter ,Ambetter ,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Blue Access,Anthem Blue Access,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Blue Access Choice,Anthem Blue Access Choice,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Blue Preferred,Anthem Blue Preferred,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Pathway,Anthem Pathway,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Alliance,Anthem Alliance,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Anthem Medicare,Anthem Medicare,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Cigna,Cigna,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Cigna PPO,Cigna PPO,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Cigna Medicare Advantage,Cigna Medicare Advantage,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Essence,Essence,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Healthlink HMO,Healthlink HMO,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Healthlink PPO,Healthlink PPO,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,HomeState Health Plan,HomeState Health Plan,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Humana Gold,Humana Gold,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Medicaid MO,Medicaid MO,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Medica,Medica,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Tricare,Tricare,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,UHC All Payer,UHC All Payer,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,UHC Exchange,UHC Exchange,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,UHC Medicaid,UHC Medicaid,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,UMR CPD,UMR CPD,99.42,,,,,,,per diem,99.42,99.42,"Per diem rate, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,UHC Medicare,UHC Medicare,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
SENSORY INTEGRATION TECHN     ,34200156,CDM,430,RC,,,,,,Inpatient,,,99.42,99.42,Wellcare,Wellcare,99.42,,,,,,,case rate,99.42,99.42,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Meritain Health PPO CPD,Meritain Health PPO CPD,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Aetna/Commercial Product,Aetna/Commercial Product,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Meritain Health CPD,Meritain Health CPD,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Starmark CPD,Starmark CPD,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Aetna Medicare,Aetna Medicare,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Ambetter ,Ambetter ,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Blue Access,Anthem Blue Access,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Blue Access Choice,Anthem Blue Access Choice,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Blue Preferred,Anthem Blue Preferred,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Pathway,Anthem Pathway,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Alliance,Anthem Alliance,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Anthem Medicare,Anthem Medicare,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Cigna,Cigna,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Cigna PPO,Cigna PPO,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Cigna Medicare Advantage,Cigna Medicare Advantage,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Essence,Essence,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Healthlink HMO,Healthlink HMO,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Healthlink PPO,Healthlink PPO,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,HomeState Health Plan,HomeState Health Plan,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Humana Gold,Humana Gold,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Medicaid MO,Medicaid MO,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Medica,Medica,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Tricare,Tricare,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,UHC All Payer,UHC All Payer,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,UHC Exchange,UHC Exchange,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,UHC Medicaid,UHC Medicaid,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,UMR CPD,UMR CPD,100.53,,,,,,,per diem,100.53,100.53,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,UHC Medicare,UHC Medicare,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200157,CDM,430,RC,,,,,,Inpatient,,,100.53,100.53,Wellcare,Wellcare,100.53,,,,,,,case rate,100.53,100.53,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Meritain Health PPO CPD,Meritain Health PPO CPD,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Aetna/Commercial Product,Aetna/Commercial Product,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Meritain Health CPD,Meritain Health CPD,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Starmark CPD,Starmark CPD,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Aetna Medicare,Aetna Medicare,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Ambetter ,Ambetter ,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Blue Access,Anthem Blue Access,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Blue Access Choice,Anthem Blue Access Choice,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Blue Preferred,Anthem Blue Preferred,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Pathway,Anthem Pathway,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Alliance,Anthem Alliance,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Anthem Medicare,Anthem Medicare,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Cigna,Cigna,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Cigna PPO,Cigna PPO,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Cigna Medicare Advantage,Cigna Medicare Advantage,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Essence,Essence,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Healthlink HMO,Healthlink HMO,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Healthlink PPO,Healthlink PPO,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,HomeState Health Plan,HomeState Health Plan,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Humana Gold,Humana Gold,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Medicaid MO,Medicaid MO,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Medica,Medica,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Tricare,Tricare,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,UHC All Payer,UHC All Payer,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,UHC Exchange,UHC Exchange,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,UHC Medicaid,UHC Medicaid,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,UMR CPD,UMR CPD,187.74,,,,,,,per diem,187.74,187.74,"Per diem rate, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,UHC Medicare,UHC Medicare,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
OT ED/TRAIN SELF MGM          ,34200158,CDM,430,RC,,,,,,Inpatient,,,187.74,187.74,Wellcare,Wellcare,187.74,,,,,,,case rate,187.74,187.74,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Meritain Health PPO CPD,Meritain Health PPO CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna/Commercial Product,Aetna/Commercial Product,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Meritain Health CPD,Meritain Health CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Starmark CPD,Starmark CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Aetna Medicare,Aetna Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Ambetter ,Ambetter ,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Access,Anthem Blue Access,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Access Choice,Anthem Blue Access Choice,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Blue Preferred,Anthem Blue Preferred,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Pathway,Anthem Pathway,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Alliance,Anthem Alliance,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Anthem Medicare,Anthem Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna,Cigna,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna PPO,Cigna PPO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Cigna Medicare Advantage,Cigna Medicare Advantage,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Essence,Essence,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthlink HMO,Healthlink HMO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Healthlink PPO,Healthlink PPO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,HomeState Health Plan,HomeState Health Plan,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Humana Gold,Humana Gold,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Medicaid MO,Medicaid MO,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Medica,Medica,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Tricare,Tricare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC All Payer,UHC All Payer,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Exchange,UHC Exchange,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Medicaid,UHC Medicaid,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UMR CPD,UMR CPD,38.15,,,,,,,per diem,38.15,38.15,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,UHC Medicare,UHC Medicare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES 15      ,34200159,CDM,430,RC,,,,,,Inpatient,,,38.15,38.15,Wellcare,Wellcare,38.15,,,,,,,case rate,38.15,38.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
THERAPEUTIC ACTIVITIES 15     ,34200160,CDM,430,RC,,,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Meritain Health PPO CPD,Meritain Health PPO CPD,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Aetna/Commercial Product,Aetna/Commercial Product,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Meritain Health CPD,Meritain Health CPD,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Starmark CPD,Starmark CPD,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Aetna Medicare,Aetna Medicare,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Ambetter ,Ambetter ,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Blue Access,Anthem Blue Access,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Blue Access Choice,Anthem Blue Access Choice,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Blue Preferred,Anthem Blue Preferred,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Pathway,Anthem Pathway,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Alliance,Anthem Alliance,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Anthem Medicare,Anthem Medicare,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Cigna,Cigna,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Cigna PPO,Cigna PPO,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Cigna Medicare Advantage,Cigna Medicare Advantage,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Essence,Essence,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Healthlink HMO,Healthlink HMO,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Healthlink PPO,Healthlink PPO,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,HomeState Health Plan,HomeState Health Plan,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Humana Gold,Humana Gold,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Medicaid MO,Medicaid MO,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Medica,Medica,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Tricare,Tricare,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,UHC All Payer,UHC All Payer,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,UHC Exchange,UHC Exchange,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,UHC Medicaid,UHC Medicaid,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,UMR CPD,UMR CPD,210.45,,,,,,,per diem,210.45,210.45,"Per diem rate, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,UHC Medicare,UHC Medicare,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT EQUIPMENT EVAL 15 MIN      ,34200161,CDM,430,RC,,,,,,Inpatient,,,210.45,210.45,Wellcare,Wellcare,210.45,,,,,,,case rate,210.45,210.45,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Meritain Health PPO CPD,Meritain Health PPO CPD,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Aetna/Commercial Product,Aetna/Commercial Product,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Meritain Health CPD,Meritain Health CPD,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Starmark CPD,Starmark CPD,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Aetna Medicare,Aetna Medicare,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Ambetter ,Ambetter ,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Blue Access,Anthem Blue Access,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Blue Access Choice,Anthem Blue Access Choice,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Blue Preferred,Anthem Blue Preferred,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Pathway,Anthem Pathway,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Alliance,Anthem Alliance,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Anthem Medicare,Anthem Medicare,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Cigna,Cigna,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Cigna PPO,Cigna PPO,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Cigna Medicare Advantage,Cigna Medicare Advantage,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Essence,Essence,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Healthlink HMO,Healthlink HMO,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Healthlink PPO,Healthlink PPO,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,HomeState Health Plan,HomeState Health Plan,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Humana Gold,Humana Gold,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Medicaid MO,Medicaid MO,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Medica,Medica,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Tricare,Tricare,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,UHC All Payer,UHC All Payer,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,UHC Exchange,UHC Exchange,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,UHC Medicaid,UHC Medicaid,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,UMR CPD,UMR CPD,91.25,,,,,,,per diem,91.25,91.25,"Per diem rate, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,UHC Medicare,UHC Medicare,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT ORTHO/PROSTH CHECK 15      ,34200162,CDM,430,RC,,,,,,Inpatient,,,91.25,91.25,Wellcare,Wellcare,91.25,,,,,,,case rate,91.25,91.25,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Meritain Health PPO CPD,Meritain Health PPO CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Aetna/Commercial Product,Aetna/Commercial Product,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Meritain Health CPD,Meritain Health CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Starmark CPD,Starmark CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Aetna Medicare,Aetna Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Ambetter ,Ambetter ,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Blue Access,Anthem Blue Access,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Blue Access Choice,Anthem Blue Access Choice,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Blue Preferred,Anthem Blue Preferred,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Pathway,Anthem Pathway,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Alliance,Anthem Alliance,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Anthem Medicare,Anthem Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Cigna,Cigna,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Cigna PPO,Cigna PPO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Cigna Medicare Advantage,Cigna Medicare Advantage,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Essence,Essence,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Healthlink HMO,Healthlink HMO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Healthlink PPO,Healthlink PPO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,HomeState Health Plan,HomeState Health Plan,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Humana Gold,Humana Gold,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Medicaid MO,Medicaid MO,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Medica,Medica,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Tricare,Tricare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,UHC All Payer,UHC All Payer,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,UHC Exchange,UHC Exchange,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,UHC Medicaid,UHC Medicaid,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,UMR CPD,UMR CPD,95.61,,,,,,,per diem,95.61,95.61,"Per diem rate, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,UHC Medicare,UHC Medicare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
OT PATIENT CONFERENCE         ,34200163,CDM,430,RC,,,,,,Inpatient,,,95.61,95.61,Wellcare,Wellcare,95.61,,,,,,,case rate,95.61,95.61,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Meritain Health PPO CPD,Meritain Health PPO CPD,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Aetna/Commercial Product,Aetna/Commercial Product,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Meritain Health CPD,Meritain Health CPD,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Starmark CPD,Starmark CPD,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Aetna Medicare,Aetna Medicare,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Ambetter ,Ambetter ,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Blue Access,Anthem Blue Access,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Blue Access Choice,Anthem Blue Access Choice,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Blue Preferred,Anthem Blue Preferred,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Pathway,Anthem Pathway,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Alliance,Anthem Alliance,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Anthem Medicare,Anthem Medicare,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Cigna,Cigna,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Cigna PPO,Cigna PPO,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Cigna Medicare Advantage,Cigna Medicare Advantage,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Essence,Essence,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Healthlink HMO,Healthlink HMO,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Healthlink PPO,Healthlink PPO,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,HomeState Health Plan,HomeState Health Plan,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Humana Gold,Humana Gold,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Medicaid MO,Medicaid MO,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Medica,Medica,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Tricare,Tricare,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,UHC All Payer,UHC All Payer,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,UHC Exchange,UHC Exchange,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,UHC Medicaid,UHC Medicaid,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,UMR CPD,UMR CPD,83.66,,,,,,,per diem,83.66,83.66,"Per diem rate, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,UHC Medicare,UHC Medicare,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
COGNITIVE SKILLS DEVELOPMENT  ,34200171,CDM,430,RC,G0515,CPT,G0515,HCPCS,,Inpatient,,,83.66,83.66,Wellcare,Wellcare,83.66,,,,,,,case rate,83.66,83.66,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Meritain Health PPO CPD,Meritain Health PPO CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna/Commercial Product,Aetna/Commercial Product,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Meritain Health CPD,Meritain Health CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Starmark CPD,Starmark CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Aetna Medicare,Aetna Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Ambetter ,Ambetter ,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Access,Anthem Blue Access,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Access Choice,Anthem Blue Access Choice,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Blue Preferred,Anthem Blue Preferred,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Pathway,Anthem Pathway,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Alliance,Anthem Alliance,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Anthem Medicare,Anthem Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna,Cigna,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna PPO,Cigna PPO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Cigna Medicare Advantage,Cigna Medicare Advantage,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Essence,Essence,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthlink HMO,Healthlink HMO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Healthlink PPO,Healthlink PPO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,HomeState Health Plan,HomeState Health Plan,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Humana Gold,Humana Gold,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Medicaid MO,Medicaid MO,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Medica,Medica,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Tricare,Tricare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC All Payer,UHC All Payer,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Exchange,UHC Exchange,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Medicaid,UHC Medicaid,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UMR CPD,UMR CPD,126.93,,,,,,,per diem,126.93,126.93,"Per diem rate, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,UHC Medicare,UHC Medicare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ORTH/PROSTH MGT/TRAIN SBSQ ENC,34200172,CDM,430,RC,97763,CPT,,,,Inpatient,,,126.93,126.93,Wellcare,Wellcare,126.93,,,,,,,case rate,126.93,126.93,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Meritain Health PPO CPD,Meritain Health PPO CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Aetna/Commercial Product,Aetna/Commercial Product,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Meritain Health CPD,Meritain Health CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Starmark CPD,Starmark CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Aetna Medicare,Aetna Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Ambetter ,Ambetter ,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Blue Access,Anthem Blue Access,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Blue Access Choice,Anthem Blue Access Choice,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Blue Preferred,Anthem Blue Preferred,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Pathway,Anthem Pathway,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Alliance,Anthem Alliance,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Anthem Medicare,Anthem Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Cigna,Cigna,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Cigna PPO,Cigna PPO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Cigna Medicare Advantage,Cigna Medicare Advantage,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Essence,Essence,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Healthlink HMO,Healthlink HMO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Healthlink PPO,Healthlink PPO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,HomeState Health Plan,HomeState Health Plan,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Humana Gold,Humana Gold,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Medicaid MO,Medicaid MO,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Medica,Medica,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Tricare,Tricare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,UHC All Payer,UHC All Payer,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,UHC Exchange,UHC Exchange,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,UHC Medicaid,UHC Medicaid,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,UMR CPD,UMR CPD,86.62,,,,,,,per diem,86.62,86.62,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,UHC Medicare,UHC Medicare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34210000,CDM,430,RC,97755,CPT,,,GO,Inpatient,,,86.62,86.62,Wellcare,Wellcare,86.62,,,,,,,case rate,86.62,86.62,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
WHIRLPOOL                     ,34210005,CDM,430,RC,97022,CPT,,,GO,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Meritain Health PPO CPD,Meritain Health PPO CPD,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Aetna/Commercial Product,Aetna/Commercial Product,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Meritain Health CPD,Meritain Health CPD,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Starmark CPD,Starmark CPD,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Aetna Medicare,Aetna Medicare,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Ambetter ,Ambetter ,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Blue Access,Anthem Blue Access,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Blue Access Choice,Anthem Blue Access Choice,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Blue Preferred,Anthem Blue Preferred,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Pathway,Anthem Pathway,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Alliance,Anthem Alliance,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Anthem Medicare,Anthem Medicare,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Cigna,Cigna,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Cigna PPO,Cigna PPO,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Cigna Medicare Advantage,Cigna Medicare Advantage,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Essence,Essence,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Healthlink HMO,Healthlink HMO,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Healthlink PPO,Healthlink PPO,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,HomeState Health Plan,HomeState Health Plan,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Humana Gold,Humana Gold,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Medicaid MO,Medicaid MO,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Medica,Medica,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Tricare,Tricare,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,UHC All Payer,UHC All Payer,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,UHC Exchange,UHC Exchange,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,UHC Medicaid,UHC Medicaid,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,UMR CPD,UMR CPD,107.23,,,,,,,per diem,107.23,107.23,"Per diem rate, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,UHC Medicare,UHC Medicare,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
IONTOPHORESIS 15 MIN          ,34210035,CDM,430,RC,97033,CPT,,,GO,Inpatient,,,107.23,107.23,Wellcare,Wellcare,107.23,,,,,,,case rate,107.23,107.23,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Meritain Health PPO CPD,Meritain Health PPO CPD,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Aetna/Commercial Product,Aetna/Commercial Product,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Meritain Health CPD,Meritain Health CPD,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Starmark CPD,Starmark CPD,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Aetna Medicare,Aetna Medicare,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Ambetter ,Ambetter ,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Blue Access,Anthem Blue Access,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Blue Access Choice,Anthem Blue Access Choice,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Blue Preferred,Anthem Blue Preferred,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Pathway,Anthem Pathway,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Alliance,Anthem Alliance,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Anthem Medicare,Anthem Medicare,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Cigna,Cigna,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Cigna PPO,Cigna PPO,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Cigna Medicare Advantage,Cigna Medicare Advantage,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Essence,Essence,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Healthlink HMO,Healthlink HMO,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Healthlink PPO,Healthlink PPO,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,HomeState Health Plan,HomeState Health Plan,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Humana Gold,Humana Gold,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Medicaid MO,Medicaid MO,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Medica,Medica,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Tricare,Tricare,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,UHC All Payer,UHC All Payer,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,UHC Exchange,UHC Exchange,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,UHC Medicaid,UHC Medicaid,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,UMR CPD,UMR CPD,92.34,,,,,,,per diem,92.34,92.34,"Per diem rate, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,UHC Medicare,UHC Medicare,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
ULTRASOUND 15 MIN             ,34210040,CDM,430,RC,97035,CPT,,,GO,Inpatient,,,92.34,92.34,Wellcare,Wellcare,92.34,,,,,,,case rate,92.34,92.34,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Meritain Health PPO CPD,Meritain Health PPO CPD,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Aetna/Commercial Product,Aetna/Commercial Product,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Meritain Health CPD,Meritain Health CPD,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Starmark CPD,Starmark CPD,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Aetna Medicare,Aetna Medicare,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Ambetter ,Ambetter ,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Blue Access,Anthem Blue Access,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Blue Access Choice,Anthem Blue Access Choice,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Blue Preferred,Anthem Blue Preferred,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Pathway,Anthem Pathway,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Alliance,Anthem Alliance,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Anthem Medicare,Anthem Medicare,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Cigna,Cigna,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Cigna PPO,Cigna PPO,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Cigna Medicare Advantage,Cigna Medicare Advantage,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Essence,Essence,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Healthlink HMO,Healthlink HMO,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Healthlink PPO,Healthlink PPO,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,HomeState Health Plan,HomeState Health Plan,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Humana Gold,Humana Gold,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Medicaid MO,Medicaid MO,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Medica,Medica,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Tricare,Tricare,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,UHC All Payer,UHC All Payer,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,UHC Exchange,UHC Exchange,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,UHC Medicaid,UHC Medicaid,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,UMR CPD,UMR CPD,106.19,,,,,,,per diem,106.19,106.19,"Per diem rate, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,UHC Medicare,UHC Medicare,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
THER INT COG FUNC 1ST 15 MIN  ,34210053,CDM,430,RC,97129,CPT,,,G0,Inpatient,,,106.19,106.19,Wellcare,Wellcare,106.19,,,,,,,case rate,106.19,106.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Meritain Health PPO CPD,Meritain Health PPO CPD,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Aetna/Commercial Product,Aetna/Commercial Product,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Meritain Health CPD,Meritain Health CPD,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Starmark CPD,Starmark CPD,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Aetna Medicare,Aetna Medicare,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Ambetter ,Ambetter ,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Blue Access,Anthem Blue Access,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Blue Access Choice,Anthem Blue Access Choice,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Blue Preferred,Anthem Blue Preferred,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Pathway,Anthem Pathway,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Alliance,Anthem Alliance,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Anthem Medicare,Anthem Medicare,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Cigna,Cigna,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Cigna PPO,Cigna PPO,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Cigna Medicare Advantage,Cigna Medicare Advantage,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Essence,Essence,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Healthlink HMO,Healthlink HMO,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Healthlink PPO,Healthlink PPO,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,HomeState Health Plan,HomeState Health Plan,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Humana Gold,Humana Gold,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Medicaid MO,Medicaid MO,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Medica,Medica,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Tricare,Tricare,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,UHC All Payer,UHC All Payer,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,UHC Exchange,UHC Exchange,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,UHC Medicaid,UHC Medicaid,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,UMR CPD,UMR CPD,68.19,,,,,,,per diem,68.19,68.19,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,UHC Medicare,UHC Medicare,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34210055,CDM,430,RC,,,,,,Inpatient,,,68.19,68.19,Wellcare,Wellcare,68.19,,,,,,,case rate,68.19,68.19,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Meritain Health PPO CPD,Meritain Health PPO CPD,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Aetna/Commercial Product,Aetna/Commercial Product,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Meritain Health CPD,Meritain Health CPD,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Starmark CPD,Starmark CPD,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Aetna Medicare,Aetna Medicare,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Ambetter ,Ambetter ,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Blue Access,Anthem Blue Access,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Blue Access Choice,Anthem Blue Access Choice,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Blue Preferred,Anthem Blue Preferred,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Pathway,Anthem Pathway,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Alliance,Anthem Alliance,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Anthem Medicare,Anthem Medicare,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Cigna,Cigna,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Cigna PPO,Cigna PPO,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Cigna Medicare Advantage,Cigna Medicare Advantage,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Essence,Essence,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Healthlink HMO,Healthlink HMO,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Healthlink PPO,Healthlink PPO,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,HomeState Health Plan,HomeState Health Plan,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Humana Gold,Humana Gold,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Medicaid MO,Medicaid MO,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Medica,Medica,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Tricare,Tricare,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,UHC All Payer,UHC All Payer,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,UHC Exchange,UHC Exchange,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,UHC Medicaid,UHC Medicaid,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,UMR CPD,UMR CPD,137.55,,,,,,,per diem,137.55,137.55,"Per diem rate, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,UHC Medicare,UHC Medicare,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
WHEELCHAIR TRAINING 15 MIN    ,34210075,CDM,430,RC,97542,CPT,,,GO,Inpatient,,,137.55,137.55,Wellcare,Wellcare,137.55,,,,,,,case rate,137.55,137.55,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Meritain Health PPO CPD,Meritain Health PPO CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Aetna/Commercial Product,Aetna/Commercial Product,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Meritain Health CPD,Meritain Health CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Starmark CPD,Starmark CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Aetna Medicare,Aetna Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Ambetter ,Ambetter ,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Blue Access,Anthem Blue Access,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Blue Access Choice,Anthem Blue Access Choice,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Blue Preferred,Anthem Blue Preferred,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Pathway,Anthem Pathway,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Alliance,Anthem Alliance,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Anthem Medicare,Anthem Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Cigna,Cigna,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Cigna PPO,Cigna PPO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Cigna Medicare Advantage,Cigna Medicare Advantage,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Essence,Essence,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Healthlink HMO,Healthlink HMO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Healthlink PPO,Healthlink PPO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,HomeState Health Plan,HomeState Health Plan,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Humana Gold,Humana Gold,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Medicaid MO,Medicaid MO,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Medica,Medica,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Tricare,Tricare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,UHC All Payer,UHC All Payer,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,UHC Exchange,UHC Exchange,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,UHC Medicaid,UHC Medicaid,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,UMR CPD,UMR CPD,349.86,,,,,,,per diem,349.86,349.86,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,UHC Medicare,UHC Medicare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34210090,CDM,430,RC,97537,CPT,,,GO,Inpatient,,,349.86,349.86,Wellcare,Wellcare,349.86,,,,,,,case rate,349.86,349.86,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Meritain Health PPO CPD,Meritain Health PPO CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Aetna/Commercial Product,Aetna/Commercial Product,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Meritain Health CPD,Meritain Health CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Starmark CPD,Starmark CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Aetna Medicare,Aetna Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Ambetter ,Ambetter ,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Blue Access,Anthem Blue Access,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Blue Access Choice,Anthem Blue Access Choice,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Blue Preferred,Anthem Blue Preferred,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Pathway,Anthem Pathway,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Alliance,Anthem Alliance,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Anthem Medicare,Anthem Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Cigna,Cigna,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Cigna PPO,Cigna PPO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Cigna Medicare Advantage,Cigna Medicare Advantage,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Essence,Essence,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Healthlink HMO,Healthlink HMO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Healthlink PPO,Healthlink PPO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,HomeState Health Plan,HomeState Health Plan,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Humana Gold,Humana Gold,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Medicaid MO,Medicaid MO,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Medica,Medica,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Tricare,Tricare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,UHC All Payer,UHC All Payer,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,UHC Exchange,UHC Exchange,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,UHC Medicaid,UHC Medicaid,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,UMR CPD,UMR CPD,85.62,,,,,,,per diem,85.62,85.62,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,UHC Medicare,UHC Medicare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34210130,CDM,430,RC,97535,CPT,,,GO,Inpatient,,,85.62,85.62,Wellcare,Wellcare,85.62,,,,,,,case rate,85.62,85.62,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Meritain Health PPO CPD,Meritain Health PPO CPD,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Aetna/Commercial Product,Aetna/Commercial Product,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Meritain Health CPD,Meritain Health CPD,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Starmark CPD,Starmark CPD,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Aetna Medicare,Aetna Medicare,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Ambetter ,Ambetter ,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Blue Access,Anthem Blue Access,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Blue Access Choice,Anthem Blue Access Choice,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Blue Preferred,Anthem Blue Preferred,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Pathway,Anthem Pathway,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Alliance,Anthem Alliance,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Anthem Medicare,Anthem Medicare,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Cigna,Cigna,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Cigna PPO,Cigna PPO,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Cigna Medicare Advantage,Cigna Medicare Advantage,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Essence,Essence,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Healthlink HMO,Healthlink HMO,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Healthlink PPO,Healthlink PPO,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,HomeState Health Plan,HomeState Health Plan,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Humana Gold,Humana Gold,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Medicaid MO,Medicaid MO,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Medica,Medica,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Tricare,Tricare,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,UHC All Payer,UHC All Payer,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,UHC Exchange,UHC Exchange,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,UHC Medicaid,UHC Medicaid,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,UMR CPD,UMR CPD,111.31,,,,,,,per diem,111.31,111.31,"Per diem rate, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,UHC Medicare,UHC Medicare,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
SELF CARE MGT TRAINING 15 MIN ,34210131,CDM,430,RC,97535,CPT,,,,Inpatient,,,111.31,111.31,Wellcare,Wellcare,111.31,,,,,,,case rate,111.31,111.31,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
THER ACT DIRECT 15 MIN        ,34210150,CDM,430,RC,97530,CPT,,,GO,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Meritain Health PPO CPD,Meritain Health PPO CPD,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Aetna/Commercial Product,Aetna/Commercial Product,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Meritain Health CPD,Meritain Health CPD,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Starmark CPD,Starmark CPD,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Aetna Medicare,Aetna Medicare,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Ambetter ,Ambetter ,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Blue Access,Anthem Blue Access,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Blue Access Choice,Anthem Blue Access Choice,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Blue Preferred,Anthem Blue Preferred,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Pathway,Anthem Pathway,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Alliance,Anthem Alliance,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Anthem Medicare,Anthem Medicare,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Cigna,Cigna,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Cigna PPO,Cigna PPO,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Cigna Medicare Advantage,Cigna Medicare Advantage,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Essence,Essence,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Healthlink HMO,Healthlink HMO,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Healthlink PPO,Healthlink PPO,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,HomeState Health Plan,HomeState Health Plan,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Humana Gold,Humana Gold,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Medicaid MO,Medicaid MO,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Medica,Medica,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Tricare,Tricare,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,UHC All Payer,UHC All Payer,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,UHC Exchange,UHC Exchange,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,UHC Medicaid,UHC Medicaid,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,UMR CPD,UMR CPD,44.91,,,,,,,per diem,44.91,44.91,"Per diem rate, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,UHC Medicare,UHC Medicare,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM UNATTENDED          ,34210195,CDM,432,RC,97014,CPT,G0281,HCPCS,GO,Inpatient,,,44.91,44.91,Wellcare,Wellcare,44.91,,,,,,,case rate,44.91,44.91,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Meritain Health PPO CPD,Meritain Health PPO CPD,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Aetna/Commercial Product,Aetna/Commercial Product,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Meritain Health CPD,Meritain Health CPD,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Starmark CPD,Starmark CPD,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Aetna Medicare,Aetna Medicare,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Ambetter ,Ambetter ,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Blue Access,Anthem Blue Access,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Blue Access Choice,Anthem Blue Access Choice,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Blue Preferred,Anthem Blue Preferred,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Pathway,Anthem Pathway,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Alliance,Anthem Alliance,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Anthem Medicare,Anthem Medicare,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Cigna,Cigna,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Cigna PPO,Cigna PPO,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Cigna Medicare Advantage,Cigna Medicare Advantage,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Essence,Essence,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Healthlink HMO,Healthlink HMO,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Healthlink PPO,Healthlink PPO,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,HomeState Health Plan,HomeState Health Plan,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Humana Gold,Humana Gold,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Medicaid MO,Medicaid MO,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Medica,Medica,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Tricare,Tricare,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,UHC All Payer,UHC All Payer,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,UHC Exchange,UHC Exchange,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,UHC Medicaid,UHC Medicaid,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,UMR CPD,UMR CPD,124.18,,,,,,,per diem,124.18,124.18,"Per diem rate, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,UHC Medicare,UHC Medicare,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
ELEC STIM ATTENDED 15 MIN     ,34210215,CDM,430,RC,97032,CPT,,,GO,Inpatient,,,124.18,124.18,Wellcare,Wellcare,124.18,,,,,,,case rate,124.18,124.18,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
WHIRLPOOL HUBBARD TANK 15MIN  ,34210260,CDM,430,RC,97036,CPT,,,GO,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Meritain Health PPO CPD,Meritain Health PPO CPD,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Aetna/Commercial Product,Aetna/Commercial Product,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Meritain Health CPD,Meritain Health CPD,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Starmark CPD,Starmark CPD,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Aetna Medicare,Aetna Medicare,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Ambetter ,Ambetter ,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Blue Access,Anthem Blue Access,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Blue Access Choice,Anthem Blue Access Choice,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Blue Preferred,Anthem Blue Preferred,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Pathway,Anthem Pathway,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Alliance,Anthem Alliance,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Anthem Medicare,Anthem Medicare,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Cigna,Cigna,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Cigna PPO,Cigna PPO,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Cigna Medicare Advantage,Cigna Medicare Advantage,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Essence,Essence,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Healthlink HMO,Healthlink HMO,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Healthlink PPO,Healthlink PPO,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,HomeState Health Plan,HomeState Health Plan,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Humana Gold,Humana Gold,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Medicaid MO,Medicaid MO,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Medica,Medica,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Tricare,Tricare,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,UHC All Payer,UHC All Payer,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,UHC Exchange,UHC Exchange,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,UHC Medicaid,UHC Medicaid,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,UMR CPD,UMR CPD,33.05,,,,,,,per diem,33.05,33.05,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,UHC Medicare,UHC Medicare,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM STATIC ,34210265,CDM,430,RC,29125,CPT,,,GO,Inpatient,,,33.05,33.05,Wellcare,Wellcare,33.05,,,,,,,case rate,33.05,33.05,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Meritain Health PPO CPD,Meritain Health PPO CPD,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Aetna/Commercial Product,Aetna/Commercial Product,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Meritain Health CPD,Meritain Health CPD,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Starmark CPD,Starmark CPD,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Aetna Medicare,Aetna Medicare,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Ambetter ,Ambetter ,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Blue Access,Anthem Blue Access,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Blue Access Choice,Anthem Blue Access Choice,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Blue Preferred,Anthem Blue Preferred,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Pathway,Anthem Pathway,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Alliance,Anthem Alliance,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Anthem Medicare,Anthem Medicare,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Cigna,Cigna,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Cigna PPO,Cigna PPO,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Cigna Medicare Advantage,Cigna Medicare Advantage,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Essence,Essence,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Healthlink HMO,Healthlink HMO,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Healthlink PPO,Healthlink PPO,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,HomeState Health Plan,HomeState Health Plan,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Humana Gold,Humana Gold,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Medicaid MO,Medicaid MO,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Medica,Medica,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Tricare,Tricare,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,UHC All Payer,UHC All Payer,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,UHC Exchange,UHC Exchange,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,UHC Medicaid,UHC Medicaid,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,UMR CPD,UMR CPD,153.36,,,,,,,per diem,153.36,153.36,"Per diem rate, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,UHC Medicare,UHC Medicare,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT SHORT ARM DYNAM  ,34210270,CDM,430,RC,29126,CPT,,,GO,Inpatient,,,153.36,153.36,Wellcare,Wellcare,153.36,,,,,,,case rate,153.36,153.36,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Meritain Health PPO CPD,Meritain Health PPO CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Aetna/Commercial Product,Aetna/Commercial Product,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Meritain Health CPD,Meritain Health CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Starmark CPD,Starmark CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Aetna Medicare,Aetna Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Ambetter ,Ambetter ,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Blue Access,Anthem Blue Access,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Blue Access Choice,Anthem Blue Access Choice,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Blue Preferred,Anthem Blue Preferred,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Pathway,Anthem Pathway,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Alliance,Anthem Alliance,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Anthem Medicare,Anthem Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Cigna,Cigna,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Cigna PPO,Cigna PPO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Cigna Medicare Advantage,Cigna Medicare Advantage,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Essence,Essence,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Healthlink HMO,Healthlink HMO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Healthlink PPO,Healthlink PPO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,HomeState Health Plan,HomeState Health Plan,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Humana Gold,Humana Gold,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Medicaid MO,Medicaid MO,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Medica,Medica,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Tricare,Tricare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,UHC All Payer,UHC All Payer,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,UHC Exchange,UHC Exchange,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,UHC Medicaid,UHC Medicaid,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,UMR CPD,UMR CPD,28.41,,,,,,,per diem,28.41,28.41,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,UHC Medicare,UHC Medicare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER STATIC    ,34210275,CDM,430,RC,29130,CPT,,,GO,Inpatient,,,28.41,28.41,Wellcare,Wellcare,28.41,,,,,,,case rate,28.41,28.41,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Meritain Health PPO CPD,Meritain Health PPO CPD,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Aetna/Commercial Product,Aetna/Commercial Product,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Meritain Health CPD,Meritain Health CPD,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Starmark CPD,Starmark CPD,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Aetna Medicare,Aetna Medicare,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Ambetter ,Ambetter ,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Blue Access,Anthem Blue Access,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Blue Access Choice,Anthem Blue Access Choice,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Blue Preferred,Anthem Blue Preferred,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Pathway,Anthem Pathway,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Alliance,Anthem Alliance,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Anthem Medicare,Anthem Medicare,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Cigna,Cigna,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Cigna PPO,Cigna PPO,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Cigna Medicare Advantage,Cigna Medicare Advantage,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Essence,Essence,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Healthlink HMO,Healthlink HMO,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Healthlink PPO,Healthlink PPO,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,HomeState Health Plan,HomeState Health Plan,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Humana Gold,Humana Gold,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Medicaid MO,Medicaid MO,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Medica,Medica,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Tricare,Tricare,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,UHC All Payer,UHC All Payer,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,UHC Exchange,UHC Exchange,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,UHC Medicaid,UHC Medicaid,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,UMR CPD,UMR CPD,118.43,,,,,,,per diem,118.43,118.43,"Per diem rate, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,UHC Medicare,UHC Medicare,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
APPLY SPLINT FINGER DYNAM     ,34210280,CDM,430,RC,29131,CPT,,,GO,Inpatient,,,118.43,118.43,Wellcare,Wellcare,118.43,,,,,,,case rate,118.43,118.43,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Meritain Health PPO CPD,Meritain Health PPO CPD,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Aetna/Commercial Product,Aetna/Commercial Product,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Meritain Health CPD,Meritain Health CPD,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Starmark CPD,Starmark CPD,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Aetna Medicare,Aetna Medicare,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Ambetter ,Ambetter ,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Blue Access,Anthem Blue Access,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Blue Access Choice,Anthem Blue Access Choice,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Blue Preferred,Anthem Blue Preferred,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Pathway,Anthem Pathway,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Alliance,Anthem Alliance,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Anthem Medicare,Anthem Medicare,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Cigna,Cigna,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Cigna PPO,Cigna PPO,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Cigna Medicare Advantage,Cigna Medicare Advantage,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Essence,Essence,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Healthlink HMO,Healthlink HMO,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Healthlink PPO,Healthlink PPO,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,HomeState Health Plan,HomeState Health Plan,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Humana Gold,Humana Gold,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Medicaid MO,Medicaid MO,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Medica,Medica,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Tricare,Tricare,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,UHC All Payer,UHC All Payer,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,UHC Exchange,UHC Exchange,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,UHC Medicaid,UHC Medicaid,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,UMR CPD,UMR CPD,72.93,,,,,,,per diem,72.93,72.93,"Per diem rate, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,UHC Medicare,UHC Medicare,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING SHOULDER            ,34210285,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,72.93,72.93,Wellcare,Wellcare,72.93,,,,,,,case rate,72.93,72.93,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING ELBOW OR WRIST      ,34210290,CDM,430,RC,29260,CPT,,,GO,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Meritain Health PPO CPD,Meritain Health PPO CPD,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Aetna/Commercial Product,Aetna/Commercial Product,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Meritain Health CPD,Meritain Health CPD,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Starmark CPD,Starmark CPD,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Aetna Medicare,Aetna Medicare,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Ambetter ,Ambetter ,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Blue Access,Anthem Blue Access,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Blue Access Choice,Anthem Blue Access Choice,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Blue Preferred,Anthem Blue Preferred,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Pathway,Anthem Pathway,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Alliance,Anthem Alliance,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Anthem Medicare,Anthem Medicare,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Cigna,Cigna,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Cigna PPO,Cigna PPO,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Cigna Medicare Advantage,Cigna Medicare Advantage,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Essence,Essence,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Healthlink HMO,Healthlink HMO,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Healthlink PPO,Healthlink PPO,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,HomeState Health Plan,HomeState Health Plan,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Humana Gold,Humana Gold,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Medicaid MO,Medicaid MO,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Medica,Medica,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Tricare,Tricare,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,UHC All Payer,UHC All Payer,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,UHC Exchange,UHC Exchange,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,UHC Medicaid,UHC Medicaid,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,UMR CPD,UMR CPD,122.45,,,,,,,per diem,122.45,122.45,"Per diem rate, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,UHC Medicare,UHC Medicare,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST EXTREMITY/TRUNK   ,34210300,CDM,430,RC,95831,CPT,,,GO,Inpatient,,,122.45,122.45,Wellcare,Wellcare,122.45,,,,,,,case rate,122.45,122.45,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Meritain Health PPO CPD,Meritain Health PPO CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Aetna/Commercial Product,Aetna/Commercial Product,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Meritain Health CPD,Meritain Health CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Starmark CPD,Starmark CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Aetna Medicare,Aetna Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Ambetter ,Ambetter ,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Blue Access,Anthem Blue Access,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Blue Access Choice,Anthem Blue Access Choice,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Blue Preferred,Anthem Blue Preferred,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Pathway,Anthem Pathway,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Alliance,Anthem Alliance,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Anthem Medicare,Anthem Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Cigna,Cigna,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Cigna PPO,Cigna PPO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Cigna Medicare Advantage,Cigna Medicare Advantage,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Essence,Essence,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Healthlink HMO,Healthlink HMO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Healthlink PPO,Healthlink PPO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,HomeState Health Plan,HomeState Health Plan,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Humana Gold,Humana Gold,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Medicaid MO,Medicaid MO,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Medica,Medica,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Tricare,Tricare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,UHC All Payer,UHC All Payer,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,UHC Exchange,UHC Exchange,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,UHC Medicaid,UHC Medicaid,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,UMR CPD,UMR CPD,138.69,,,,,,,per diem,138.69,138.69,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,UHC Medicare,UHC Medicare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/O HANDS    ,34210305,CDM,430,RC,95833,CPT,,,GO,Inpatient,,,138.69,138.69,Wellcare,Wellcare,138.69,,,,,,,case rate,138.69,138.69,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Meritain Health PPO CPD,Meritain Health PPO CPD,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Aetna/Commercial Product,Aetna/Commercial Product,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Meritain Health CPD,Meritain Health CPD,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Starmark CPD,Starmark CPD,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Aetna Medicare,Aetna Medicare,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Ambetter ,Ambetter ,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Blue Access,Anthem Blue Access,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Blue Access Choice,Anthem Blue Access Choice,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Blue Preferred,Anthem Blue Preferred,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Pathway,Anthem Pathway,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Alliance,Anthem Alliance,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Anthem Medicare,Anthem Medicare,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Cigna,Cigna,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Cigna PPO,Cigna PPO,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Cigna Medicare Advantage,Cigna Medicare Advantage,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Essence,Essence,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Healthlink HMO,Healthlink HMO,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Healthlink PPO,Healthlink PPO,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,HomeState Health Plan,HomeState Health Plan,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Humana Gold,Humana Gold,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Medicaid MO,Medicaid MO,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Medica,Medica,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Tricare,Tricare,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,UHC All Payer,UHC All Payer,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,UHC Exchange,UHC Exchange,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,UHC Medicaid,UHC Medicaid,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,UMR CPD,UMR CPD,150.26,,,,,,,per diem,150.26,150.26,"Per diem rate, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,UHC Medicare,UHC Medicare,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
MUSCLE TEST BODY W/HANDS      ,34210310,CDM,430,RC,95834,CPT,,,GO,Inpatient,,,150.26,150.26,Wellcare,Wellcare,150.26,,,,,,,case rate,150.26,150.26,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Meritain Health PPO CPD,Meritain Health PPO CPD,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Aetna/Commercial Product,Aetna/Commercial Product,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Meritain Health CPD,Meritain Health CPD,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Starmark CPD,Starmark CPD,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Aetna Medicare,Aetna Medicare,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Ambetter ,Ambetter ,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Blue Access,Anthem Blue Access,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Blue Access Choice,Anthem Blue Access Choice,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Blue Preferred,Anthem Blue Preferred,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Pathway,Anthem Pathway,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Alliance,Anthem Alliance,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Anthem Medicare,Anthem Medicare,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Cigna,Cigna,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Cigna PPO,Cigna PPO,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Cigna Medicare Advantage,Cigna Medicare Advantage,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Essence,Essence,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Healthlink HMO,Healthlink HMO,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Healthlink PPO,Healthlink PPO,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,HomeState Health Plan,HomeState Health Plan,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Humana Gold,Humana Gold,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Medicaid MO,Medicaid MO,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Medica,Medica,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Tricare,Tricare,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,UHC All Payer,UHC All Payer,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,UHC Exchange,UHC Exchange,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,UHC Medicaid,UHC Medicaid,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,UMR CPD,UMR CPD,62.01,,,,,,,per diem,62.01,62.01,"Per diem rate, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,UHC Medicare,UHC Medicare,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING EXTREMITY/TRUNK   ,34210315,CDM,430,RC,95851,CPT,,,GO,Inpatient,,,62.01,62.01,Wellcare,Wellcare,62.01,,,,,,,case rate,62.01,62.01,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Meritain Health PPO CPD,Meritain Health PPO CPD,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Aetna/Commercial Product,Aetna/Commercial Product,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Meritain Health CPD,Meritain Health CPD,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Starmark CPD,Starmark CPD,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Aetna Medicare,Aetna Medicare,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Ambetter ,Ambetter ,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Blue Access,Anthem Blue Access,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Blue Access Choice,Anthem Blue Access Choice,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Blue Preferred,Anthem Blue Preferred,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Pathway,Anthem Pathway,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Alliance,Anthem Alliance,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Anthem Medicare,Anthem Medicare,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Cigna,Cigna,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Cigna PPO,Cigna PPO,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Cigna Medicare Advantage,Cigna Medicare Advantage,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Essence,Essence,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Healthlink HMO,Healthlink HMO,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Healthlink PPO,Healthlink PPO,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,HomeState Health Plan,HomeState Health Plan,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Humana Gold,Humana Gold,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Medicaid MO,Medicaid MO,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Medica,Medica,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Tricare,Tricare,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,UHC All Payer,UHC All Payer,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,UHC Exchange,UHC Exchange,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,UHC Medicaid,UHC Medicaid,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,UMR CPD,UMR CPD,56.96,,,,,,,per diem,56.96,56.96,"Per diem rate, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,UHC Medicare,UHC Medicare,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
ROM TESTING HAND              ,34210320,CDM,430,RC,95852,CPT,,,GO,Inpatient,,,56.96,56.96,Wellcare,Wellcare,56.96,,,,,,,case rate,56.96,56.96,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Meritain Health PPO CPD,Meritain Health PPO CPD,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Aetna/Commercial Product,Aetna/Commercial Product,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Meritain Health CPD,Meritain Health CPD,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Starmark CPD,Starmark CPD,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Aetna Medicare,Aetna Medicare,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Ambetter ,Ambetter ,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Blue Access,Anthem Blue Access,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Blue Access Choice,Anthem Blue Access Choice,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Blue Preferred,Anthem Blue Preferred,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Pathway,Anthem Pathway,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Alliance,Anthem Alliance,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Anthem Medicare,Anthem Medicare,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Cigna,Cigna,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Cigna PPO,Cigna PPO,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Cigna Medicare Advantage,Cigna Medicare Advantage,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Essence,Essence,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Healthlink HMO,Healthlink HMO,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Healthlink PPO,Healthlink PPO,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,HomeState Health Plan,HomeState Health Plan,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Humana Gold,Humana Gold,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Medicaid MO,Medicaid MO,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Medica,Medica,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Tricare,Tricare,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,UHC All Payer,UHC All Payer,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,UHC Exchange,UHC Exchange,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,UHC Medicaid,UHC Medicaid,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,UMR CPD,UMR CPD,74.31,,,,,,,per diem,74.31,74.31,"Per diem rate, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,UHC Medicare,UHC Medicare,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
MUSCLE TEST HAND              ,34210325,CDM,430,RC,95832,CPT,,,GO,Inpatient,,,74.31,74.31,Wellcare,Wellcare,74.31,,,,,,,case rate,74.31,74.31,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
INFRARED                      ,34210330,CDM,430,RC,97026,CPT,,,GO,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Meritain Health PPO CPD,Meritain Health PPO CPD,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Aetna/Commercial Product,Aetna/Commercial Product,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Meritain Health CPD,Meritain Health CPD,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Starmark CPD,Starmark CPD,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Aetna Medicare,Aetna Medicare,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Ambetter ,Ambetter ,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Blue Access,Anthem Blue Access,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Blue Access Choice,Anthem Blue Access Choice,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Blue Preferred,Anthem Blue Preferred,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Pathway,Anthem Pathway,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Alliance,Anthem Alliance,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Anthem Medicare,Anthem Medicare,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Cigna,Cigna,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Cigna PPO,Cigna PPO,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Cigna Medicare Advantage,Cigna Medicare Advantage,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Essence,Essence,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Healthlink HMO,Healthlink HMO,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Healthlink PPO,Healthlink PPO,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,HomeState Health Plan,HomeState Health Plan,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Humana Gold,Humana Gold,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Medicaid MO,Medicaid MO,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Medica,Medica,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Tricare,Tricare,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,UHC All Payer,UHC All Payer,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,UHC Exchange,UHC Exchange,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,UHC Medicaid,UHC Medicaid,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,UMR CPD,UMR CPD,69.64,,,,,,,per diem,69.64,69.64,"Per diem rate, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,UHC Medicare,UHC Medicare,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
DIATHERMY                     ,34210335,CDM,430,RC,97024,CPT,,,GO,Inpatient,,,69.64,69.64,Wellcare,Wellcare,69.64,,,,,,,case rate,69.64,69.64,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health PPO CPD,Meritain Health PPO CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/Commercial Product,Aetna/Commercial Product,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health CPD,Meritain Health CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Starmark CPD,Starmark CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna Medicare,Aetna Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Ambetter ,Ambetter ,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access,Anthem Blue Access,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access Choice,Anthem Blue Access Choice,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Preferred,Anthem Blue Preferred,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Pathway,Anthem Pathway,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Alliance,Anthem Alliance,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Medicare,Anthem Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna,Cigna,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna PPO,Cigna PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna Medicare Advantage,Cigna Medicare Advantage,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Essence,Essence,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink HMO,Healthlink HMO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink PPO,Healthlink PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,HomeState Health Plan,HomeState Health Plan,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Humana Gold,Humana Gold,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Medicaid MO,Medicaid MO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Medica,Medica,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Tricare,Tricare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,UHC All Payer,UHC All Payer,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Exchange,UHC Exchange,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicaid,UHC Medicaid,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,UMR CPD,UMR CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicare,UHC Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34210340,CDM,430,RC,96125,CPT,,,GO,Inpatient,,,281.35,281.35,Wellcare,Wellcare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
AQUATIC THERAPY W/EXER 15 MIN ,34210345,CDM,430,RC,97113,CPT,,,GO,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Meritain Health PPO CPD,Meritain Health PPO CPD,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Aetna/Commercial Product,Aetna/Commercial Product,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Meritain Health CPD,Meritain Health CPD,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Starmark CPD,Starmark CPD,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Aetna Medicare,Aetna Medicare,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Ambetter ,Ambetter ,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Blue Access,Anthem Blue Access,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Blue Access Choice,Anthem Blue Access Choice,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Blue Preferred,Anthem Blue Preferred,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Pathway,Anthem Pathway,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Alliance,Anthem Alliance,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Anthem Medicare,Anthem Medicare,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Cigna,Cigna,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Cigna PPO,Cigna PPO,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Cigna Medicare Advantage,Cigna Medicare Advantage,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Essence,Essence,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Healthlink HMO,Healthlink HMO,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Healthlink PPO,Healthlink PPO,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,HomeState Health Plan,HomeState Health Plan,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Humana Gold,Humana Gold,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Medicaid MO,Medicaid MO,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Medica,Medica,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Tricare,Tricare,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,UHC All Payer,UHC All Payer,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,UHC Exchange,UHC Exchange,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,UHC Medicaid,UHC Medicaid,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,UMR CPD,UMR CPD,93.67,,,,,,,per diem,93.67,93.67,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,UHC Medicare,UHC Medicare,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORM TEST 15MIN   ,34210355,CDM,430,RC,97750,CPT,,,GO,Inpatient,,,93.67,93.67,Wellcare,Wellcare,93.67,,,,,,,case rate,93.67,93.67,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Meritain Health PPO CPD,Meritain Health PPO CPD,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Aetna/Commercial Product,Aetna/Commercial Product,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Meritain Health CPD,Meritain Health CPD,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Starmark CPD,Starmark CPD,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Aetna Medicare,Aetna Medicare,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Ambetter ,Ambetter ,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Blue Access,Anthem Blue Access,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Blue Access Choice,Anthem Blue Access Choice,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Blue Preferred,Anthem Blue Preferred,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Pathway,Anthem Pathway,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Alliance,Anthem Alliance,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Anthem Medicare,Anthem Medicare,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Cigna,Cigna,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Cigna PPO,Cigna PPO,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Cigna Medicare Advantage,Cigna Medicare Advantage,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Essence,Essence,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Healthlink HMO,Healthlink HMO,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Healthlink PPO,Healthlink PPO,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,HomeState Health Plan,HomeState Health Plan,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Humana Gold,Humana Gold,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Medicaid MO,Medicaid MO,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Medica,Medica,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Tricare,Tricare,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,UHC All Payer,UHC All Payer,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,UHC Exchange,UHC Exchange,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,UHC Medicaid,UHC Medicaid,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,UMR CPD,UMR CPD,68.01,,,,,,,per diem,68.01,68.01,"Per diem rate, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,UHC Medicare,UHC Medicare,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
PROSTHETIC TRAIN - INITIAL    ,34210360,CDM,430,RC,97761,CPT,,,GO,Inpatient,,,68.01,68.01,Wellcare,Wellcare,68.01,,,,,,,case rate,68.01,68.01,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health PPO CPD,Meritain Health PPO CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/Commercial Product,Aetna/Commercial Product,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health CPD,Meritain Health CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Starmark CPD,Starmark CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna Medicare,Aetna Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Ambetter ,Ambetter ,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access,Anthem Blue Access,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access Choice,Anthem Blue Access Choice,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Preferred,Anthem Blue Preferred,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Pathway,Anthem Pathway,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Alliance,Anthem Alliance,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Medicare,Anthem Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna,Cigna,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna PPO,Cigna PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna Medicare Advantage,Cigna Medicare Advantage,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Essence,Essence,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink HMO,Healthlink HMO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink PPO,Healthlink PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,HomeState Health Plan,HomeState Health Plan,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Humana Gold,Humana Gold,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Medicaid MO,Medicaid MO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Medica,Medica,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Tricare,Tricare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,UHC All Payer,UHC All Payer,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Exchange,UHC Exchange,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicaid,UHC Medicaid,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,UMR CPD,UMR CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicare,UHC Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34210365,CDM,430,RC,92610,CPT,,,GO,Inpatient,,,281.35,281.35,Wellcare,Wellcare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Meritain Health PPO CPD,Meritain Health PPO CPD,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Aetna/Commercial Product,Aetna/Commercial Product,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Meritain Health CPD,Meritain Health CPD,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Starmark CPD,Starmark CPD,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Aetna Medicare,Aetna Medicare,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Ambetter ,Ambetter ,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Blue Access,Anthem Blue Access,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Blue Access Choice,Anthem Blue Access Choice,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Blue Preferred,Anthem Blue Preferred,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Pathway,Anthem Pathway,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Alliance,Anthem Alliance,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Anthem Medicare,Anthem Medicare,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Cigna,Cigna,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Cigna PPO,Cigna PPO,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Cigna Medicare Advantage,Cigna Medicare Advantage,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Essence,Essence,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Healthlink HMO,Healthlink HMO,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Healthlink PPO,Healthlink PPO,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,HomeState Health Plan,HomeState Health Plan,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Humana Gold,Humana Gold,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Medicaid MO,Medicaid MO,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Medica,Medica,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Tricare,Tricare,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,UHC All Payer,UHC All Payer,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,UHC Exchange,UHC Exchange,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,UHC Medicaid,UHC Medicaid,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,UMR CPD,UMR CPD,537.69,,,,,,,per diem,537.69,537.69,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,UHC Medicare,UHC Medicare,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWIN-RADIO-OPA   ,34210370,CDM,430,RC,92611,CPT,,,GO,Inpatient,,,537.69,537.69,Wellcare,Wellcare,537.69,,,,,,,case rate,537.69,537.69,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health PPO CPD,Meritain Health PPO CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna/Commercial Product,Aetna/Commercial Product,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Meritain Health CPD,Meritain Health CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Starmark CPD,Starmark CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Aetna Medicare,Aetna Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Ambetter ,Ambetter ,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access,Anthem Blue Access,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Access Choice,Anthem Blue Access Choice,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Blue Preferred,Anthem Blue Preferred,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Pathway,Anthem Pathway,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Alliance,Anthem Alliance,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Anthem Medicare,Anthem Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna,Cigna,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna PPO,Cigna PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Cigna Medicare Advantage,Cigna Medicare Advantage,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Essence,Essence,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink HMO,Healthlink HMO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Healthlink PPO,Healthlink PPO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,HomeState Health Plan,HomeState Health Plan,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Humana Gold,Humana Gold,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Medicaid MO,Medicaid MO,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Medica,Medica,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Tricare,Tricare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,UHC All Payer,UHC All Payer,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Exchange,UHC Exchange,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicaid,UHC Medicaid,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,UMR CPD,UMR CPD,281.35,,,,,,,per diem,281.35,281.35,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,UHC Medicare,UHC Medicare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34210375,CDM,430,RC,92526,CPT,,,GO,Inpatient,,,281.35,281.35,Wellcare,Wellcare,281.35,,,,,,,case rate,281.35,281.35,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Meritain Health PPO CPD,Meritain Health PPO CPD,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Aetna/Commercial Product,Aetna/Commercial Product,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Meritain Health CPD,Meritain Health CPD,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Starmark CPD,Starmark CPD,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Aetna Medicare,Aetna Medicare,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Ambetter ,Ambetter ,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Blue Access,Anthem Blue Access,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Blue Access Choice,Anthem Blue Access Choice,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Blue Preferred,Anthem Blue Preferred,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Pathway,Anthem Pathway,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Alliance,Anthem Alliance,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Anthem Medicare,Anthem Medicare,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Cigna,Cigna,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Cigna PPO,Cigna PPO,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Cigna Medicare Advantage,Cigna Medicare Advantage,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Essence,Essence,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Healthlink HMO,Healthlink HMO,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Healthlink PPO,Healthlink PPO,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,HomeState Health Plan,HomeState Health Plan,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Humana Gold,Humana Gold,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Medicaid MO,Medicaid MO,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Medica,Medica,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Tricare,Tricare,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,UHC All Payer,UHC All Payer,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,UHC Exchange,UHC Exchange,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,UHC Medicaid,UHC Medicaid,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,UMR CPD,UMR CPD,67.05,,,,,,,per diem,67.05,67.05,"Per diem rate, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,UHC Medicare,UHC Medicare,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
VASOPNEUMATIC DEVICES         ,34210380,CDM,430,RC,97016,CPT,,,GO,Inpatient,,,67.05,67.05,Wellcare,Wellcare,67.05,,,,,,,case rate,67.05,67.05,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Meritain Health PPO CPD,Meritain Health PPO CPD,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Aetna/Commercial Product,Aetna/Commercial Product,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Meritain Health CPD,Meritain Health CPD,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Starmark CPD,Starmark CPD,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Aetna Medicare,Aetna Medicare,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Ambetter ,Ambetter ,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Blue Access,Anthem Blue Access,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Blue Access Choice,Anthem Blue Access Choice,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Blue Preferred,Anthem Blue Preferred,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Pathway,Anthem Pathway,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Alliance,Anthem Alliance,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Anthem Medicare,Anthem Medicare,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Cigna,Cigna,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Cigna PPO,Cigna PPO,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Cigna Medicare Advantage,Cigna Medicare Advantage,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Essence,Essence,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Healthlink HMO,Healthlink HMO,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Healthlink PPO,Healthlink PPO,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,HomeState Health Plan,HomeState Health Plan,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Humana Gold,Humana Gold,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Medicaid MO,Medicaid MO,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Medica,Medica,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Tricare,Tricare,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,UHC All Payer,UHC All Payer,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,UHC Exchange,UHC Exchange,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,UHC Medicaid,UHC Medicaid,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,UMR CPD,UMR CPD,73.31,,,,,,,per diem,73.31,73.31,"Per diem rate, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,UHC Medicare,UHC Medicare,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
CONTRAST BATH 15 MIN          ,34210385,CDM,430,RC,97034,CPT,,,GO,Inpatient,,,73.31,73.31,Wellcare,Wellcare,73.31,,,,,,,case rate,73.31,73.31,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Meritain Health PPO CPD,Meritain Health PPO CPD,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Aetna/Commercial Product,Aetna/Commercial Product,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Meritain Health CPD,Meritain Health CPD,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Starmark CPD,Starmark CPD,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Aetna Medicare,Aetna Medicare,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Ambetter ,Ambetter ,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Blue Access,Anthem Blue Access,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Blue Access Choice,Anthem Blue Access Choice,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Blue Preferred,Anthem Blue Preferred,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Pathway,Anthem Pathway,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Alliance,Anthem Alliance,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Anthem Medicare,Anthem Medicare,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Cigna,Cigna,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Cigna PPO,Cigna PPO,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Cigna Medicare Advantage,Cigna Medicare Advantage,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Essence,Essence,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Healthlink HMO,Healthlink HMO,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Healthlink PPO,Healthlink PPO,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,HomeState Health Plan,HomeState Health Plan,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Humana Gold,Humana Gold,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Medicaid MO,Medicaid MO,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Medica,Medica,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Tricare,Tricare,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,UHC All Payer,UHC All Payer,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,UHC Exchange,UHC Exchange,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,UHC Medicaid,UHC Medicaid,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,UMR CPD,UMR CPD,76.25,,,,,,,per diem,76.25,76.25,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,UHC Medicare,UHC Medicare,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE 1ST 20 SQ CM ,34220001,CDM,430,RC,97597,CPT,,,GO,Inpatient,,,76.25,76.25,Wellcare,Wellcare,76.25,,,,,,,case rate,76.25,76.25,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Meritain Health PPO CPD,Meritain Health PPO CPD,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Aetna/Commercial Product,Aetna/Commercial Product,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Meritain Health CPD,Meritain Health CPD,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Starmark CPD,Starmark CPD,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Aetna Medicare,Aetna Medicare,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Ambetter ,Ambetter ,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Blue Access,Anthem Blue Access,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Blue Access Choice,Anthem Blue Access Choice,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Blue Preferred,Anthem Blue Preferred,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Pathway,Anthem Pathway,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Alliance,Anthem Alliance,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Anthem Medicare,Anthem Medicare,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Cigna,Cigna,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Cigna PPO,Cigna PPO,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Cigna Medicare Advantage,Cigna Medicare Advantage,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Essence,Essence,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Healthlink HMO,Healthlink HMO,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Healthlink PPO,Healthlink PPO,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,HomeState Health Plan,HomeState Health Plan,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Humana Gold,Humana Gold,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Medicaid MO,Medicaid MO,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Medica,Medica,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Tricare,Tricare,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,UHC All Payer,UHC All Payer,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,UHC Exchange,UHC Exchange,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,UHC Medicaid,UHC Medicaid,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,UMR CPD,UMR CPD,193.78,,,,,,,per diem,193.78,193.78,"Per diem rate, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,UHC Medicare,UHC Medicare,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
SELECTIV DEBRIDE EA AD 20SQ CM,34220002,CDM,430,RC,97598,CPT,,,GO,Inpatient,,,193.78,193.78,Wellcare,Wellcare,193.78,,,,,,,case rate,193.78,193.78,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Meritain Health PPO CPD,Meritain Health PPO CPD,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Aetna/Commercial Product,Aetna/Commercial Product,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Meritain Health CPD,Meritain Health CPD,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Starmark CPD,Starmark CPD,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Aetna Medicare,Aetna Medicare,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Ambetter ,Ambetter ,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Blue Access,Anthem Blue Access,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Blue Access Choice,Anthem Blue Access Choice,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Blue Preferred,Anthem Blue Preferred,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Pathway,Anthem Pathway,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Alliance,Anthem Alliance,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Anthem Medicare,Anthem Medicare,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Cigna,Cigna,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Cigna PPO,Cigna PPO,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Cigna Medicare Advantage,Cigna Medicare Advantage,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Essence,Essence,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Healthlink HMO,Healthlink HMO,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Healthlink PPO,Healthlink PPO,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,HomeState Health Plan,HomeState Health Plan,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Humana Gold,Humana Gold,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Medicaid MO,Medicaid MO,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Medica,Medica,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Tricare,Tricare,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,UHC All Payer,UHC All Payer,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,UHC Exchange,UHC Exchange,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,UHC Medicaid,UHC Medicaid,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,UMR CPD,UMR CPD,291.92,,,,,,,per diem,291.92,291.92,"Per diem rate, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,UHC Medicare,UHC Medicare,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
ORTHOTIC FIT/TRAIN -INITIAL   ,34250050,CDM,430,RC,97760,CPT,,,GO,Inpatient,,,291.92,291.92,Wellcare,Wellcare,291.92,,,,,,,case rate,291.92,291.92,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health PPO CPD,Meritain Health PPO CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna/Commercial Product,Aetna/Commercial Product,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Meritain Health CPD,Meritain Health CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Starmark CPD,Starmark CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Aetna Medicare,Aetna Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Ambetter ,Ambetter ,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access,Anthem Blue Access,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Access Choice,Anthem Blue Access Choice,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Blue Preferred,Anthem Blue Preferred,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Pathway,Anthem Pathway,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Alliance,Anthem Alliance,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Anthem Medicare,Anthem Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna,Cigna,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna PPO,Cigna PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Cigna Medicare Advantage,Cigna Medicare Advantage,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Essence,Essence,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink HMO,Healthlink HMO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Healthlink PPO,Healthlink PPO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,HomeState Health Plan,HomeState Health Plan,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Humana Gold,Humana Gold,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Medicaid MO,Medicaid MO,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Medica,Medica,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Tricare,Tricare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,UHC All Payer,UHC All Payer,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Exchange,UHC Exchange,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicaid,UHC Medicaid,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,UMR CPD,UMR CPD,140.68,,,,,,,per diem,140.68,140.68,"Per diem rate, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,UHC Medicare,UHC Medicare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
STRAPPING-SHOULDER            ,34250065,CDM,430,RC,29240,CPT,,,GO,Inpatient,,,140.68,140.68,Wellcare,Wellcare,140.68,,,,,,,case rate,140.68,140.68,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Meritain Health PPO CPD,Meritain Health PPO CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna/Commercial Product,Aetna/Commercial Product,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Meritain Health CPD,Meritain Health CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Starmark CPD,Starmark CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Aetna Medicare,Aetna Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Ambetter ,Ambetter ,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Access,Anthem Blue Access,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Access Choice,Anthem Blue Access Choice,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Blue Preferred,Anthem Blue Preferred,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Pathway,Anthem Pathway,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Alliance,Anthem Alliance,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Anthem Medicare,Anthem Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna,Cigna,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna PPO,Cigna PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Cigna Medicare Advantage,Cigna Medicare Advantage,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Essence,Essence,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Healthlink HMO,Healthlink HMO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Healthlink PPO,Healthlink PPO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,HomeState Health Plan,HomeState Health Plan,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Humana Gold,Humana Gold,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Medicaid MO,Medicaid MO,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Medica,Medica,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Tricare,Tricare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,UHC All Payer,UHC All Payer,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Exchange,UHC Exchange,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Medicaid,UHC Medicaid,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,UMR CPD,UMR CPD,70.34,,,,,,,per diem,70.34,70.34,"Per diem rate, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,UHC Medicare,UHC Medicare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK INCONT TRAINING   ,34250084,CDM,430,RC,90911,CPT,,,GO,Inpatient,,,70.34,70.34,Wellcare,Wellcare,70.34,,,,,,,case rate,70.34,70.34,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Meritain Health PPO CPD,Meritain Health PPO CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Aetna/Commercial Product,Aetna/Commercial Product,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Meritain Health CPD,Meritain Health CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Starmark CPD,Starmark CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Aetna Medicare,Aetna Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Ambetter ,Ambetter ,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Blue Access,Anthem Blue Access,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Blue Access Choice,Anthem Blue Access Choice,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Blue Preferred,Anthem Blue Preferred,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Pathway,Anthem Pathway,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Alliance,Anthem Alliance,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Anthem Medicare,Anthem Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Cigna,Cigna,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Cigna PPO,Cigna PPO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Cigna Medicare Advantage,Cigna Medicare Advantage,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Essence,Essence,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Healthlink HMO,Healthlink HMO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Healthlink PPO,Healthlink PPO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,HomeState Health Plan,HomeState Health Plan,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Humana Gold,Humana Gold,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Medicaid MO,Medicaid MO,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Medica,Medica,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Tricare,Tricare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,UHC All Payer,UHC All Payer,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,UHC Exchange,UHC Exchange,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,UHC Medicaid,UHC Medicaid,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,UMR CPD,UMR CPD,171.83,,,,,,,per diem,171.83,171.83,"Per diem rate, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,UHC Medicare,UHC Medicare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
BIOFEEDBACK TRAINING          ,34250085,CDM,430,RC,90901,CPT,,,GO,Inpatient,,,171.83,171.83,Wellcare,Wellcare,171.83,,,,,,,case rate,171.83,171.83,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health PPO CPD,Meritain Health PPO CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/Commercial Product,Aetna/Commercial Product,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health CPD,Meritain Health CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Starmark CPD,Starmark CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna Medicare,Aetna Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Ambetter ,Ambetter ,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access,Anthem Blue Access,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access Choice,Anthem Blue Access Choice,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Preferred,Anthem Blue Preferred,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Pathway,Anthem Pathway,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Alliance,Anthem Alliance,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Medicare,Anthem Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna,Cigna,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna PPO,Cigna PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna Medicare Advantage,Cigna Medicare Advantage,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Essence,Essence,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink HMO,Healthlink HMO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink PPO,Healthlink PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,HomeState Health Plan,HomeState Health Plan,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Humana Gold,Humana Gold,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Medicaid MO,Medicaid MO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Medica,Medica,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Tricare,Tricare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,UHC All Payer,UHC All Payer,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Exchange,UHC Exchange,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicaid,UHC Medicaid,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,UMR CPD,UMR CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicare,UHC Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION LOW COMPLEXITY  ,34250127,CDM,434,RC,97165,CPT,,,GO,Inpatient,,,399.7,399.7,Wellcare,Wellcare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health PPO CPD,Meritain Health PPO CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/Commercial Product,Aetna/Commercial Product,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health CPD,Meritain Health CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Starmark CPD,Starmark CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna Medicare,Aetna Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Ambetter ,Ambetter ,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access,Anthem Blue Access,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access Choice,Anthem Blue Access Choice,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Preferred,Anthem Blue Preferred,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Pathway,Anthem Pathway,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Alliance,Anthem Alliance,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Medicare,Anthem Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna,Cigna,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna PPO,Cigna PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna Medicare Advantage,Cigna Medicare Advantage,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Essence,Essence,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink HMO,Healthlink HMO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink PPO,Healthlink PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,HomeState Health Plan,HomeState Health Plan,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Humana Gold,Humana Gold,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Medicaid MO,Medicaid MO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Medica,Medica,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Tricare,Tricare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,UHC All Payer,UHC All Payer,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Exchange,UHC Exchange,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicaid,UHC Medicaid,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,UMR CPD,UMR CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicare,UHC Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION MOD COMPLEXITY  ,34250128,CDM,434,RC,97166,CPT,,,GO,Inpatient,,,399.7,399.7,Wellcare,Wellcare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health PPO CPD,Meritain Health PPO CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/Commercial Product,Aetna/Commercial Product,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health CPD,Meritain Health CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Starmark CPD,Starmark CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna Medicare,Aetna Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Ambetter ,Ambetter ,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access,Anthem Blue Access,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access Choice,Anthem Blue Access Choice,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Preferred,Anthem Blue Preferred,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Pathway,Anthem Pathway,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Alliance,Anthem Alliance,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Medicare,Anthem Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna,Cigna,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna PPO,Cigna PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna Medicare Advantage,Cigna Medicare Advantage,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Essence,Essence,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink HMO,Healthlink HMO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink PPO,Healthlink PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,HomeState Health Plan,HomeState Health Plan,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Humana Gold,Humana Gold,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Medicaid MO,Medicaid MO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Medica,Medica,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Tricare,Tricare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,UHC All Payer,UHC All Payer,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Exchange,UHC Exchange,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicaid,UHC Medicaid,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,UMR CPD,UMR CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicare,UHC Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OT EVALUATION HIGH COMPLEXITY ,34250129,CDM,434,RC,97167,CPT,,,GO,Inpatient,,,399.7,399.7,Wellcare,Wellcare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Meritain Health PPO CPD,Meritain Health PPO CPD,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Aetna/Commercial Product,Aetna/Commercial Product,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Meritain Health CPD,Meritain Health CPD,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Starmark CPD,Starmark CPD,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Aetna Medicare,Aetna Medicare,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Ambetter ,Ambetter ,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Blue Access,Anthem Blue Access,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Blue Access Choice,Anthem Blue Access Choice,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Blue Preferred,Anthem Blue Preferred,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Pathway,Anthem Pathway,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Alliance,Anthem Alliance,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Anthem Medicare,Anthem Medicare,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Cigna,Cigna,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Cigna PPO,Cigna PPO,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Cigna Medicare Advantage,Cigna Medicare Advantage,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Essence,Essence,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Healthlink HMO,Healthlink HMO,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Healthlink PPO,Healthlink PPO,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,HomeState Health Plan,HomeState Health Plan,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Humana Gold,Humana Gold,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Medicaid MO,Medicaid MO,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Medica,Medica,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Tricare,Tricare,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,UHC All Payer,UHC All Payer,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,UHC Exchange,UHC Exchange,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,UHC Medicaid,UHC Medicaid,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,UMR CPD,UMR CPD,357.05,,,,,,,per diem,357.05,357.05,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,UHC Medicare,UHC Medicare,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY RE-EVAL       ,34250130,CDM,434,RC,97168,CPT,,,GO,Inpatient,,,357.05,357.05,Wellcare,Wellcare,357.05,,,,,,,case rate,357.05,357.05,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Meritain Health PPO CPD,Meritain Health PPO CPD,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Aetna/Commercial Product,Aetna/Commercial Product,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Meritain Health CPD,Meritain Health CPD,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Starmark CPD,Starmark CPD,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Aetna Medicare,Aetna Medicare,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Ambetter ,Ambetter ,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Blue Access,Anthem Blue Access,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Blue Access Choice,Anthem Blue Access Choice,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Blue Preferred,Anthem Blue Preferred,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Pathway,Anthem Pathway,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Alliance,Anthem Alliance,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Anthem Medicare,Anthem Medicare,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Cigna,Cigna,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Cigna PPO,Cigna PPO,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Cigna Medicare Advantage,Cigna Medicare Advantage,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Essence,Essence,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Healthlink HMO,Healthlink HMO,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Healthlink PPO,Healthlink PPO,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,HomeState Health Plan,HomeState Health Plan,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Humana Gold,Humana Gold,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Medicaid MO,Medicaid MO,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Medica,Medica,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Tricare,Tricare,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,UHC All Payer,UHC All Payer,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,UHC Exchange,UHC Exchange,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,UHC Medicaid,UHC Medicaid,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,UMR CPD,UMR CPD,313.82,,,,,,,per diem,313.82,313.82,"Per diem rate, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,UHC Medicare,UHC Medicare,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OT EVAL HIGH COMPLEXITY 60 MIN,34250131,CDM,430,RC,97167,CPT,,,,Inpatient,,,313.82,313.82,Wellcare,Wellcare,313.82,,,,,,,case rate,313.82,313.82,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Meritain Health PPO CPD,Meritain Health PPO CPD,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Aetna/Commercial Product,Aetna/Commercial Product,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Meritain Health CPD,Meritain Health CPD,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Starmark CPD,Starmark CPD,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Aetna Medicare,Aetna Medicare,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Ambetter ,Ambetter ,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Blue Access,Anthem Blue Access,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Blue Access Choice,Anthem Blue Access Choice,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Blue Preferred,Anthem Blue Preferred,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Pathway,Anthem Pathway,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Alliance,Anthem Alliance,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Anthem Medicare,Anthem Medicare,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Cigna,Cigna,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Cigna PPO,Cigna PPO,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Cigna Medicare Advantage,Cigna Medicare Advantage,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Essence,Essence,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Healthlink HMO,Healthlink HMO,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Healthlink PPO,Healthlink PPO,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,HomeState Health Plan,HomeState Health Plan,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Humana Gold,Humana Gold,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Medicaid MO,Medicaid MO,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Medica,Medica,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Tricare,Tricare,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,UHC All Payer,UHC All Payer,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,UHC Exchange,UHC Exchange,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,UHC Medicaid,UHC Medicaid,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,UMR CPD,UMR CPD,275.97,,,,,,,per diem,275.97,275.97,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,UHC Medicare,UHC Medicare,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 15 MIN   ,34250135,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,275.97,275.97,Wellcare,Wellcare,275.97,,,,,,,case rate,275.97,275.97,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Meritain Health PPO CPD,Meritain Health PPO CPD,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Aetna/Commercial Product,Aetna/Commercial Product,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Meritain Health CPD,Meritain Health CPD,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Starmark CPD,Starmark CPD,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Aetna Medicare,Aetna Medicare,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Ambetter ,Ambetter ,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Blue Access,Anthem Blue Access,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Blue Access Choice,Anthem Blue Access Choice,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Blue Preferred,Anthem Blue Preferred,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Pathway,Anthem Pathway,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Alliance,Anthem Alliance,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Anthem Medicare,Anthem Medicare,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Cigna,Cigna,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Cigna PPO,Cigna PPO,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Cigna Medicare Advantage,Cigna Medicare Advantage,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Essence,Essence,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Healthlink HMO,Healthlink HMO,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Healthlink PPO,Healthlink PPO,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,HomeState Health Plan,HomeState Health Plan,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Humana Gold,Humana Gold,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Medicaid MO,Medicaid MO,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Medica,Medica,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Tricare,Tricare,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,UHC All Payer,UHC All Payer,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,UHC Exchange,UHC Exchange,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,UHC Medicaid,UHC Medicaid,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,UMR CPD,UMR CPD,338.03,,,,,,,per diem,338.03,338.03,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,UHC Medicare,UHC Medicare,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 60 MIN   ,34250136,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,338.03,338.03,Wellcare,Wellcare,338.03,,,,,,,case rate,338.03,338.03,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Meritain Health PPO CPD,Meritain Health PPO CPD,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Aetna/Commercial Product,Aetna/Commercial Product,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Meritain Health CPD,Meritain Health CPD,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Starmark CPD,Starmark CPD,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Aetna Medicare,Aetna Medicare,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Ambetter ,Ambetter ,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Blue Access,Anthem Blue Access,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Blue Access Choice,Anthem Blue Access Choice,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Blue Preferred,Anthem Blue Preferred,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Pathway,Anthem Pathway,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Alliance,Anthem Alliance,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Anthem Medicare,Anthem Medicare,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Cigna,Cigna,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Cigna PPO,Cigna PPO,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Cigna Medicare Advantage,Cigna Medicare Advantage,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Essence,Essence,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Healthlink HMO,Healthlink HMO,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Healthlink PPO,Healthlink PPO,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,HomeState Health Plan,HomeState Health Plan,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Humana Gold,Humana Gold,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Medicaid MO,Medicaid MO,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Medica,Medica,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Tricare,Tricare,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,UHC All Payer,UHC All Payer,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,UHC Exchange,UHC Exchange,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,UHC Medicaid,UHC Medicaid,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,UMR CPD,UMR CPD,322.95,,,,,,,per diem,322.95,322.95,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,UHC Medicare,UHC Medicare,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 30 MIN   ,34250137,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,322.95,322.95,Wellcare,Wellcare,322.95,,,,,,,case rate,322.95,322.95,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Meritain Health PPO CPD,Meritain Health PPO CPD,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Aetna/Commercial Product,Aetna/Commercial Product,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Meritain Health CPD,Meritain Health CPD,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Starmark CPD,Starmark CPD,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Aetna Medicare,Aetna Medicare,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Ambetter ,Ambetter ,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Blue Access,Anthem Blue Access,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Blue Access Choice,Anthem Blue Access Choice,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Blue Preferred,Anthem Blue Preferred,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Pathway,Anthem Pathway,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Alliance,Anthem Alliance,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Anthem Medicare,Anthem Medicare,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Cigna,Cigna,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Cigna PPO,Cigna PPO,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Cigna Medicare Advantage,Cigna Medicare Advantage,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Essence,Essence,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Healthlink HMO,Healthlink HMO,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Healthlink PPO,Healthlink PPO,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,HomeState Health Plan,HomeState Health Plan,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Humana Gold,Humana Gold,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Medicaid MO,Medicaid MO,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Medica,Medica,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Tricare,Tricare,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,UHC All Payer,UHC All Payer,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,UHC Exchange,UHC Exchange,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,UHC Medicaid,UHC Medicaid,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,UMR CPD,UMR CPD,272.75,,,,,,,per diem,272.75,272.75,"Per diem rate, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,UHC Medicare,UHC Medicare,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
OCCUPAT THERAPY EVAL 45 MIN   ,34250138,CDM,434,RC,97003,CPT,,,GO,Inpatient,,,272.75,272.75,Wellcare,Wellcare,272.75,,,,,,,case rate,272.75,272.75,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Meritain Health PPO CPD,Meritain Health PPO CPD,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Aetna/Commercial Product,Aetna/Commercial Product,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Meritain Health CPD,Meritain Health CPD,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Starmark CPD,Starmark CPD,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Aetna Medicare,Aetna Medicare,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Ambetter ,Ambetter ,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Blue Access,Anthem Blue Access,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Blue Access Choice,Anthem Blue Access Choice,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Blue Preferred,Anthem Blue Preferred,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Pathway,Anthem Pathway,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Alliance,Anthem Alliance,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Anthem Medicare,Anthem Medicare,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Cigna,Cigna,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Cigna PPO,Cigna PPO,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Cigna Medicare Advantage,Cigna Medicare Advantage,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Essence,Essence,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Healthlink HMO,Healthlink HMO,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Healthlink PPO,Healthlink PPO,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,HomeState Health Plan,HomeState Health Plan,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Humana Gold,Humana Gold,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Medicaid MO,Medicaid MO,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Medica,Medica,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Tricare,Tricare,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,UHC All Payer,UHC All Payer,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,UHC Exchange,UHC Exchange,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,UHC Medicaid,UHC Medicaid,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,UMR CPD,UMR CPD,103.38,,,,,,,per diem,103.38,103.38,"Per diem rate, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,UHC Medicare,UHC Medicare,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
TENS APPLY/EDUCATE            ,34299980,CDM,430,RC,64550,CPT,,,GO,Inpatient,,,103.38,103.38,Wellcare,Wellcare,103.38,,,,,,,case rate,103.38,103.38,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health PPO CPD,Meritain Health PPO CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna/Commercial Product,Aetna/Commercial Product,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Meritain Health CPD,Meritain Health CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Starmark CPD,Starmark CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Aetna Medicare,Aetna Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Ambetter ,Ambetter ,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access,Anthem Blue Access,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Access Choice,Anthem Blue Access Choice,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Blue Preferred,Anthem Blue Preferred,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Pathway,Anthem Pathway,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Alliance,Anthem Alliance,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Anthem Medicare,Anthem Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna,Cigna,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna PPO,Cigna PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Cigna Medicare Advantage,Cigna Medicare Advantage,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Essence,Essence,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink HMO,Healthlink HMO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Healthlink PPO,Healthlink PPO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,HomeState Health Plan,HomeState Health Plan,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Humana Gold,Humana Gold,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Medicaid MO,Medicaid MO,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Medica,Medica,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Tricare,Tricare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,UHC All Payer,UHC All Payer,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Exchange,UHC Exchange,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicaid,UHC Medicaid,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,UMR CPD,UMR CPD,399.7,,,,,,,per diem,399.7,399.7,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,UHC Medicare,UHC Medicare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34299985,CDM,430,RC,98960,CPT,,,GO,Inpatient,,,399.7,399.7,Wellcare,Wellcare,399.7,,,,,,,case rate,399.7,399.7,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Meritain Health PPO CPD,Meritain Health PPO CPD,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Aetna/Commercial Product,Aetna/Commercial Product,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Meritain Health CPD,Meritain Health CPD,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Starmark CPD,Starmark CPD,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Aetna Medicare,Aetna Medicare,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Ambetter ,Ambetter ,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Blue Access,Anthem Blue Access,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Blue Access Choice,Anthem Blue Access Choice,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Blue Preferred,Anthem Blue Preferred,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Pathway,Anthem Pathway,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Alliance,Anthem Alliance,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Anthem Medicare,Anthem Medicare,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Cigna,Cigna,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Cigna PPO,Cigna PPO,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Cigna Medicare Advantage,Cigna Medicare Advantage,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Essence,Essence,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Healthlink HMO,Healthlink HMO,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Healthlink PPO,Healthlink PPO,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,HomeState Health Plan,HomeState Health Plan,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Humana Gold,Humana Gold,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Medicaid MO,Medicaid MO,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Medica,Medica,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Tricare,Tricare,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,UHC All Payer,UHC All Payer,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,UHC Exchange,UHC Exchange,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,UHC Medicaid,UHC Medicaid,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,UMR CPD,UMR CPD,468.15,,,,,,,per diem,468.15,468.15,"Per diem rate, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,UHC Medicare,UHC Medicare,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING INIT 2 HRS     ,34299986,CDM,430,RC,97545,CPT,,,GO,Inpatient,,,468.15,468.15,Wellcare,Wellcare,468.15,,,,,,,case rate,468.15,468.15,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Meritain Health PPO CPD,Meritain Health PPO CPD,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Aetna/Commercial Product,Aetna/Commercial Product,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Meritain Health CPD,Meritain Health CPD,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Starmark CPD,Starmark CPD,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Aetna Medicare,Aetna Medicare,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Ambetter ,Ambetter ,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Blue Access,Anthem Blue Access,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Blue Access Choice,Anthem Blue Access Choice,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Blue Preferred,Anthem Blue Preferred,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Pathway,Anthem Pathway,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Alliance,Anthem Alliance,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Anthem Medicare,Anthem Medicare,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Cigna,Cigna,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Cigna PPO,Cigna PPO,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Cigna Medicare Advantage,Cigna Medicare Advantage,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Essence,Essence,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Healthlink HMO,Healthlink HMO,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Healthlink PPO,Healthlink PPO,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,HomeState Health Plan,HomeState Health Plan,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Humana Gold,Humana Gold,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Medicaid MO,Medicaid MO,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Medica,Medica,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Tricare,Tricare,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,UHC All Payer,UHC All Payer,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,UHC Exchange,UHC Exchange,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,UHC Medicaid,UHC Medicaid,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,UMR CPD,UMR CPD,140.11,,,,,,,per diem,140.11,140.11,"Per diem rate, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,UHC Medicare,UHC Medicare,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
WORK HARDENING EA AD 30MIN    ,34299987,CDM,430,RC,97546,CPT,,,GO,Inpatient,,,140.11,140.11,Wellcare,Wellcare,140.11,,,,,,,case rate,140.11,140.11,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Meritain Health PPO CPD,Meritain Health PPO CPD,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Aetna/Commercial Product,Aetna/Commercial Product,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Meritain Health CPD,Meritain Health CPD,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Starmark CPD,Starmark CPD,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Aetna Medicare,Aetna Medicare,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Ambetter ,Ambetter ,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Blue Access,Anthem Blue Access,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Blue Access Choice,Anthem Blue Access Choice,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Blue Preferred,Anthem Blue Preferred,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Pathway,Anthem Pathway,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Alliance,Anthem Alliance,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Anthem Medicare,Anthem Medicare,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Cigna,Cigna,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Cigna PPO,Cigna PPO,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Cigna Medicare Advantage,Cigna Medicare Advantage,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Essence,Essence,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Healthlink HMO,Healthlink HMO,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Healthlink PPO,Healthlink PPO,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,HomeState Health Plan,HomeState Health Plan,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Humana Gold,Humana Gold,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Medicaid MO,Medicaid MO,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Medica,Medica,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Tricare,Tricare,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,UHC All Payer,UHC All Payer,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,UHC Exchange,UHC Exchange,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,UHC Medicaid,UHC Medicaid,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,UMR CPD,UMR CPD,74.83,,,,,,,per diem,74.83,74.83,"Per diem rate, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,UHC Medicare,UHC Medicare,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
OCCUP THER UNLISTED 15 MIN    ,34299999,CDM,430,RC,97139,CPT,,,GO,Inpatient,,,74.83,74.83,Wellcare,Wellcare,74.83,,,,,,,case rate,74.83,74.83,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Meritain Health PPO CPD,Meritain Health PPO CPD,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Aetna/Commercial Product,Aetna/Commercial Product,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Meritain Health CPD,Meritain Health CPD,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Starmark CPD,Starmark CPD,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Aetna Medicare,Aetna Medicare,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Ambetter ,Ambetter ,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Blue Access,Anthem Blue Access,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Blue Access Choice,Anthem Blue Access Choice,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Blue Preferred,Anthem Blue Preferred,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Pathway,Anthem Pathway,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Alliance,Anthem Alliance,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Anthem Medicare,Anthem Medicare,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Cigna,Cigna,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Cigna PPO,Cigna PPO,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Cigna Medicare Advantage,Cigna Medicare Advantage,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Essence,Essence,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Healthlink HMO,Healthlink HMO,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Healthlink PPO,Healthlink PPO,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,HomeState Health Plan,HomeState Health Plan,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Humana Gold,Humana Gold,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Medicaid MO,Medicaid MO,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Medica,Medica,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Tricare,Tricare,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,UHC All Payer,UHC All Payer,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,UHC Exchange,UHC Exchange,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,UHC Medicaid,UHC Medicaid,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,UMR CPD,UMR CPD,91.7,,,,,,,per diem,91.7,91.7,"Per diem rate, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,UHC Medicare,UHC Medicare,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
THER INT COG FUNC EAADDL 15MIN,34600014,CDM,440,RC,97130,CPT,,,GN,Inpatient,,,91.7,91.7,Wellcare,Wellcare,91.7,,,,,,,case rate,91.7,91.7,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Meritain Health PPO CPD,Meritain Health PPO CPD,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Aetna/Commercial Product,Aetna/Commercial Product,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Meritain Health CPD,Meritain Health CPD,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Starmark CPD,Starmark CPD,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Aetna Medicare,Aetna Medicare,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Ambetter ,Ambetter ,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Blue Access,Anthem Blue Access,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Blue Access Choice,Anthem Blue Access Choice,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Blue Preferred,Anthem Blue Preferred,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Pathway,Anthem Pathway,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Alliance,Anthem Alliance,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Anthem Medicare,Anthem Medicare,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Cigna,Cigna,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Cigna PPO,Cigna PPO,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Cigna Medicare Advantage,Cigna Medicare Advantage,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Essence,Essence,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Healthlink HMO,Healthlink HMO,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Healthlink PPO,Healthlink PPO,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,HomeState Health Plan,HomeState Health Plan,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Humana Gold,Humana Gold,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Medicaid MO,Medicaid MO,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Medica,Medica,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Tricare,Tricare,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,UHC All Payer,UHC All Payer,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,UHC Exchange,UHC Exchange,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,UHC Medicaid,UHC Medicaid,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,UMR CPD,UMR CPD,75.4,,,,,,,per diem,75.4,75.4,"Per diem rate, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,UHC Medicare,UHC Medicare,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
COGNITIVE TRAINING 15 MIN     ,34600016,CDM,440,RC,97532,CPT,G0515,HCPCS,GNGN,Inpatient,,,75.4,75.4,Wellcare,Wellcare,75.4,,,,,,,case rate,75.4,75.4,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Meritain Health PPO CPD,Meritain Health PPO CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Aetna/Commercial Product,Aetna/Commercial Product,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Meritain Health CPD,Meritain Health CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Starmark CPD,Starmark CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Aetna Medicare,Aetna Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Ambetter ,Ambetter ,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Blue Access,Anthem Blue Access,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Blue Access Choice,Anthem Blue Access Choice,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Blue Preferred,Anthem Blue Preferred,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Pathway,Anthem Pathway,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Alliance,Anthem Alliance,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Anthem Medicare,Anthem Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Cigna,Cigna,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Cigna PPO,Cigna PPO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Cigna Medicare Advantage,Cigna Medicare Advantage,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Essence,Essence,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Healthlink HMO,Healthlink HMO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Healthlink PPO,Healthlink PPO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,HomeState Health Plan,HomeState Health Plan,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Humana Gold,Humana Gold,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Medicaid MO,Medicaid MO,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Medica,Medica,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Tricare,Tricare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,UHC All Payer,UHC All Payer,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,UHC Exchange,UHC Exchange,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,UHC Medicaid,UHC Medicaid,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,UMR CPD,UMR CPD,99.99,,,,,,,per diem,99.99,99.99,"Per diem rate, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,UHC Medicare,UHC Medicare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
SENSORY STIMULATION 15 MIN    ,34600019,CDM,440,RC,97533,CPT,,,GN,Inpatient,,,99.99,99.99,Wellcare,Wellcare,99.99,,,,,,,case rate,99.99,99.99,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Meritain Health PPO CPD,Meritain Health PPO CPD,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Aetna/Commercial Product,Aetna/Commercial Product,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Meritain Health CPD,Meritain Health CPD,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Starmark CPD,Starmark CPD,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Aetna Medicare,Aetna Medicare,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Ambetter ,Ambetter ,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Blue Access,Anthem Blue Access,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Blue Access Choice,Anthem Blue Access Choice,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Blue Preferred,Anthem Blue Preferred,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Pathway,Anthem Pathway,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Alliance,Anthem Alliance,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Anthem Medicare,Anthem Medicare,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Cigna,Cigna,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Cigna PPO,Cigna PPO,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Cigna Medicare Advantage,Cigna Medicare Advantage,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Essence,Essence,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Healthlink HMO,Healthlink HMO,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Healthlink PPO,Healthlink PPO,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,HomeState Health Plan,HomeState Health Plan,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Humana Gold,Humana Gold,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Medicaid MO,Medicaid MO,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Medica,Medica,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Tricare,Tricare,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,UHC All Payer,UHC All Payer,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,UHC Exchange,UHC Exchange,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,UHC Medicaid,UHC Medicaid,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,UMR CPD,UMR CPD,306.95,,,,,,,per diem,306.95,306.95,"Per diem rate, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,UHC Medicare,UHC Medicare,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH FLUENCY           ,34600030,CDM,444,RC,92521,CPT,,,GN,Inpatient,,,306.95,306.95,Wellcare,Wellcare,306.95,,,,,,,case rate,306.95,306.95,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Meritain Health PPO CPD,Meritain Health PPO CPD,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Aetna/Commercial Product,Aetna/Commercial Product,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Meritain Health CPD,Meritain Health CPD,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Starmark CPD,Starmark CPD,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Aetna Medicare,Aetna Medicare,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Ambetter ,Ambetter ,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Blue Access,Anthem Blue Access,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Blue Access Choice,Anthem Blue Access Choice,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Blue Preferred,Anthem Blue Preferred,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Pathway,Anthem Pathway,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Alliance,Anthem Alliance,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Anthem Medicare,Anthem Medicare,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Cigna,Cigna,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Cigna PPO,Cigna PPO,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Cigna Medicare Advantage,Cigna Medicare Advantage,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Essence,Essence,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Healthlink HMO,Healthlink HMO,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Healthlink PPO,Healthlink PPO,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,HomeState Health Plan,HomeState Health Plan,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Humana Gold,Humana Gold,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Medicaid MO,Medicaid MO,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Medica,Medica,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Tricare,Tricare,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,UHC All Payer,UHC All Payer,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,UHC Exchange,UHC Exchange,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,UHC Medicaid,UHC Medicaid,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,UMR CPD,UMR CPD,375.15,,,,,,,per diem,375.15,375.15,"Per diem rate, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,UHC Medicare,UHC Medicare,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SPEECH SOUND PRODUCTION  ,34600031,CDM,440,RC,92522,CPT,,,GN,Inpatient,,,375.15,375.15,Wellcare,Wellcare,375.15,,,,,,,case rate,375.15,375.15,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Meritain Health PPO CPD,Meritain Health PPO CPD,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Aetna/Commercial Product,Aetna/Commercial Product,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Meritain Health CPD,Meritain Health CPD,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Starmark CPD,Starmark CPD,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Aetna Medicare,Aetna Medicare,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Ambetter ,Ambetter ,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Blue Access,Anthem Blue Access,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Blue Access Choice,Anthem Blue Access Choice,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Blue Preferred,Anthem Blue Preferred,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Pathway,Anthem Pathway,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Alliance,Anthem Alliance,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Anthem Medicare,Anthem Medicare,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Cigna,Cigna,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Cigna PPO,Cigna PPO,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Cigna Medicare Advantage,Cigna Medicare Advantage,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Essence,Essence,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Healthlink HMO,Healthlink HMO,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Healthlink PPO,Healthlink PPO,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,HomeState Health Plan,HomeState Health Plan,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Humana Gold,Humana Gold,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Medicaid MO,Medicaid MO,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Medica,Medica,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Tricare,Tricare,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,UHC All Payer,UHC All Payer,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,UHC Exchange,UHC Exchange,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,UHC Medicaid,UHC Medicaid,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,UMR CPD,UMR CPD,351.6,,,,,,,per diem,351.6,351.6,"Per diem rate, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,UHC Medicare,UHC Medicare,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
EVAL SOUND PROD/LANG CMP EXP  ,34600032,CDM,440,RC,92523,CPT,,,GN,Inpatient,,,351.6,351.6,Wellcare,Wellcare,351.6,,,,,,,case rate,351.6,351.6,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Meritain Health PPO CPD,Meritain Health PPO CPD,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Aetna/Commercial Product,Aetna/Commercial Product,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Meritain Health CPD,Meritain Health CPD,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Starmark CPD,Starmark CPD,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Aetna Medicare,Aetna Medicare,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Ambetter ,Ambetter ,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Blue Access,Anthem Blue Access,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Blue Access Choice,Anthem Blue Access Choice,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Blue Preferred,Anthem Blue Preferred,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Pathway,Anthem Pathway,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Alliance,Anthem Alliance,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Anthem Medicare,Anthem Medicare,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Cigna,Cigna,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Cigna PPO,Cigna PPO,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Cigna Medicare Advantage,Cigna Medicare Advantage,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Essence,Essence,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Healthlink HMO,Healthlink HMO,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Healthlink PPO,Healthlink PPO,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,HomeState Health Plan,HomeState Health Plan,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Humana Gold,Humana Gold,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Medicaid MO,Medicaid MO,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Medica,Medica,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Tricare,Tricare,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,UHC All Payer,UHC All Payer,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,UHC Exchange,UHC Exchange,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,UHC Medicaid,UHC Medicaid,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,UMR CPD,UMR CPD,302.52,,,,,,,per diem,302.52,302.52,"Per diem rate, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,UHC Medicare,UHC Medicare,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
BEH QUAL ANALYSIS VOICE/RESON ,34600034,CDM,440,RC,92524,CPT,,,GN,Inpatient,,,302.52,302.52,Wellcare,Wellcare,302.52,,,,,,,case rate,302.52,302.52,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Meritain Health PPO CPD,Meritain Health PPO CPD,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Aetna/Commercial Product,Aetna/Commercial Product,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Meritain Health CPD,Meritain Health CPD,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Starmark CPD,Starmark CPD,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Aetna Medicare,Aetna Medicare,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Ambetter ,Ambetter ,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Blue Access,Anthem Blue Access,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Blue Access Choice,Anthem Blue Access Choice,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Blue Preferred,Anthem Blue Preferred,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Pathway,Anthem Pathway,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Alliance,Anthem Alliance,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Anthem Medicare,Anthem Medicare,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Cigna,Cigna,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Cigna PPO,Cigna PPO,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Cigna Medicare Advantage,Cigna Medicare Advantage,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Essence,Essence,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Healthlink HMO,Healthlink HMO,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Healthlink PPO,Healthlink PPO,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,HomeState Health Plan,HomeState Health Plan,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Humana Gold,Humana Gold,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Medicaid MO,Medicaid MO,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Medica,Medica,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Tricare,Tricare,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,UHC All Payer,UHC All Payer,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,UHC Exchange,UHC Exchange,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,UHC Medicaid,UHC Medicaid,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,UMR CPD,UMR CPD,374.63,,,,,,,per diem,374.63,374.63,"Per diem rate, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,UHC Medicare,UHC Medicare,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
TX SWALLOWING/ORAL DYSFUN     ,34600120,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,374.63,374.63,Wellcare,Wellcare,374.63,,,,,,,case rate,374.63,374.63,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Meritain Health PPO CPD,Meritain Health PPO CPD,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Aetna/Commercial Product,Aetna/Commercial Product,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Meritain Health CPD,Meritain Health CPD,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Starmark CPD,Starmark CPD,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Aetna Medicare,Aetna Medicare,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Ambetter ,Ambetter ,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Blue Access,Anthem Blue Access,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Blue Access Choice,Anthem Blue Access Choice,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Blue Preferred,Anthem Blue Preferred,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Pathway,Anthem Pathway,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Alliance,Anthem Alliance,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Anthem Medicare,Anthem Medicare,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Cigna,Cigna,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Cigna PPO,Cigna PPO,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Cigna Medicare Advantage,Cigna Medicare Advantage,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Essence,Essence,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Healthlink HMO,Healthlink HMO,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Healthlink PPO,Healthlink PPO,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,HomeState Health Plan,HomeState Health Plan,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Humana Gold,Humana Gold,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Medicaid MO,Medicaid MO,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Medica,Medica,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Tricare,Tricare,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,UHC All Payer,UHC All Payer,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,UHC Exchange,UHC Exchange,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,UHC Medicaid,UHC Medicaid,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,UMR CPD,UMR CPD,84.89,,,,,,,per diem,84.89,84.89,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,UHC Medicare,UHC Medicare,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 15 MIN     ,34600134,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,84.89,84.89,Wellcare,Wellcare,84.89,,,,,,,case rate,84.89,84.89,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Meritain Health PPO CPD,Meritain Health PPO CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna/Commercial Product,Aetna/Commercial Product,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Meritain Health CPD,Meritain Health CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Starmark CPD,Starmark CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna Medicare,Aetna Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Ambetter ,Ambetter ,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Access,Anthem Blue Access,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Access Choice,Anthem Blue Access Choice,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Preferred,Anthem Blue Preferred,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Pathway,Anthem Pathway,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Alliance,Anthem Alliance,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Medicare,Anthem Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna,Cigna,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna PPO,Cigna PPO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna Medicare Advantage,Cigna Medicare Advantage,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Essence,Essence,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Healthlink HMO,Healthlink HMO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Healthlink PPO,Healthlink PPO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,HomeState Health Plan,HomeState Health Plan,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Humana Gold,Humana Gold,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Medicaid MO,Medicaid MO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Medica,Medica,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Tricare,Tricare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,UHC All Payer,UHC All Payer,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Exchange,UHC Exchange,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Medicaid,UHC Medicaid,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,UMR CPD,UMR CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Medicare,UHC Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 30 MIN     ,34600135,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,93.59,93.59,Wellcare,Wellcare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Meritain Health PPO CPD,Meritain Health PPO CPD,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Aetna/Commercial Product,Aetna/Commercial Product,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Meritain Health CPD,Meritain Health CPD,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Starmark CPD,Starmark CPD,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Aetna Medicare,Aetna Medicare,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Ambetter ,Ambetter ,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Blue Access,Anthem Blue Access,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Blue Access Choice,Anthem Blue Access Choice,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Blue Preferred,Anthem Blue Preferred,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Pathway,Anthem Pathway,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Alliance,Anthem Alliance,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Anthem Medicare,Anthem Medicare,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Cigna,Cigna,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Cigna PPO,Cigna PPO,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Cigna Medicare Advantage,Cigna Medicare Advantage,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Essence,Essence,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Healthlink HMO,Healthlink HMO,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Healthlink PPO,Healthlink PPO,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,HomeState Health Plan,HomeState Health Plan,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Humana Gold,Humana Gold,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Medicaid MO,Medicaid MO,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Medica,Medica,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Tricare,Tricare,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,UHC All Payer,UHC All Payer,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,UHC Exchange,UHC Exchange,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,UHC Medicaid,UHC Medicaid,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,UMR CPD,UMR CPD,250.78,,,,,,,per diem,250.78,250.78,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,UHC Medicare,UHC Medicare,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 45 MIN     ,34600136,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,250.78,250.78,Wellcare,Wellcare,250.78,,,,,,,case rate,250.78,250.78,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Meritain Health PPO CPD,Meritain Health PPO CPD,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Aetna/Commercial Product,Aetna/Commercial Product,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Meritain Health CPD,Meritain Health CPD,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Starmark CPD,Starmark CPD,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Aetna Medicare,Aetna Medicare,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Ambetter ,Ambetter ,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Blue Access,Anthem Blue Access,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Blue Access Choice,Anthem Blue Access Choice,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Blue Preferred,Anthem Blue Preferred,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Pathway,Anthem Pathway,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Alliance,Anthem Alliance,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Anthem Medicare,Anthem Medicare,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Cigna,Cigna,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Cigna PPO,Cigna PPO,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Cigna Medicare Advantage,Cigna Medicare Advantage,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Essence,Essence,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Healthlink HMO,Healthlink HMO,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Healthlink PPO,Healthlink PPO,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,HomeState Health Plan,HomeState Health Plan,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Humana Gold,Humana Gold,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Medicaid MO,Medicaid MO,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Medica,Medica,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Tricare,Tricare,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,UHC All Payer,UHC All Payer,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,UHC Exchange,UHC Exchange,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,UHC Medicaid,UHC Medicaid,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,UMR CPD,UMR CPD,351.51,,,,,,,per diem,351.51,351.51,"Per diem rate, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,UHC Medicare,UHC Medicare,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SPEECH GROUP TRTMT 60 MIN     ,34600137,CDM,443,RC,92508,CPT,,,GN,Inpatient,,,351.51,351.51,Wellcare,Wellcare,351.51,,,,,,,case rate,351.51,351.51,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Meritain Health PPO CPD,Meritain Health PPO CPD,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Aetna/Commercial Product,Aetna/Commercial Product,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Meritain Health CPD,Meritain Health CPD,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Starmark CPD,Starmark CPD,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Aetna Medicare,Aetna Medicare,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Ambetter ,Ambetter ,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Blue Access,Anthem Blue Access,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Blue Access Choice,Anthem Blue Access Choice,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Blue Preferred,Anthem Blue Preferred,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Pathway,Anthem Pathway,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Alliance,Anthem Alliance,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Anthem Medicare,Anthem Medicare,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Cigna,Cigna,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Cigna PPO,Cigna PPO,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Cigna Medicare Advantage,Cigna Medicare Advantage,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Essence,Essence,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Healthlink HMO,Healthlink HMO,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Healthlink PPO,Healthlink PPO,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,HomeState Health Plan,HomeState Health Plan,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Humana Gold,Humana Gold,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Medicaid MO,Medicaid MO,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Medica,Medica,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Tricare,Tricare,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,UHC All Payer,UHC All Payer,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,UHC Exchange,UHC Exchange,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,UHC Medicaid,UHC Medicaid,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,UMR CPD,UMR CPD,69.53,,,,,,,per diem,69.53,69.53,"Per diem rate, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,UHC Medicare,UHC Medicare,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SELF CARE/HOME MGT 15 MIN     ,34600141,CDM,440,RC,97535,CPT,,,GN,Inpatient,,,69.53,69.53,Wellcare,Wellcare,69.53,,,,,,,case rate,69.53,69.53,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health PPO CPD,Meritain Health PPO CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/Commercial Product,Aetna/Commercial Product,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health CPD,Meritain Health CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Starmark CPD,Starmark CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna Medicare,Aetna Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Ambetter ,Ambetter ,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access,Anthem Blue Access,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access Choice,Anthem Blue Access Choice,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Preferred,Anthem Blue Preferred,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Pathway,Anthem Pathway,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Alliance,Anthem Alliance,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Medicare,Anthem Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna,Cigna,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna PPO,Cigna PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna Medicare Advantage,Cigna Medicare Advantage,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Essence,Essence,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink HMO,Healthlink HMO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink PPO,Healthlink PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,HomeState Health Plan,HomeState Health Plan,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Humana Gold,Humana Gold,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medicaid MO,Medicaid MO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medica,Medica,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Tricare,Tricare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC All Payer,UHC All Payer,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Exchange,UHC Exchange,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicaid,UHC Medicaid,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UMR CPD,UMR CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicare,UHC Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 15 MIN    ,34600145,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Wellcare,Wellcare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Meritain Health PPO CPD,Meritain Health PPO CPD,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Aetna/Commercial Product,Aetna/Commercial Product,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Meritain Health CPD,Meritain Health CPD,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Starmark CPD,Starmark CPD,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Aetna Medicare,Aetna Medicare,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Ambetter ,Ambetter ,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Blue Access,Anthem Blue Access,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Blue Access Choice,Anthem Blue Access Choice,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Blue Preferred,Anthem Blue Preferred,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Pathway,Anthem Pathway,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Alliance,Anthem Alliance,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Anthem Medicare,Anthem Medicare,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Cigna,Cigna,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Cigna PPO,Cigna PPO,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Cigna Medicare Advantage,Cigna Medicare Advantage,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Essence,Essence,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Healthlink HMO,Healthlink HMO,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Healthlink PPO,Healthlink PPO,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,HomeState Health Plan,HomeState Health Plan,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Humana Gold,Humana Gold,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Medicaid MO,Medicaid MO,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Medica,Medica,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Tricare,Tricare,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,UHC All Payer,UHC All Payer,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,UHC Exchange,UHC Exchange,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,UHC Medicaid,UHC Medicaid,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,UMR CPD,UMR CPD,473.4,,,,,,,per diem,473.4,473.4,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,UHC Medicare,UHC Medicare,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 30 MIN    ,34600146,CDM,440,RC,92522,CPT,,,,Inpatient,,,473.4,473.4,Wellcare,Wellcare,473.4,,,,,,,case rate,473.4,473.4,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health PPO CPD,Meritain Health PPO CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/Commercial Product,Aetna/Commercial Product,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health CPD,Meritain Health CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Starmark CPD,Starmark CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna Medicare,Aetna Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Ambetter ,Ambetter ,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access,Anthem Blue Access,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access Choice,Anthem Blue Access Choice,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Preferred,Anthem Blue Preferred,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Pathway,Anthem Pathway,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Alliance,Anthem Alliance,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Medicare,Anthem Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna,Cigna,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna PPO,Cigna PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna Medicare Advantage,Cigna Medicare Advantage,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Essence,Essence,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink HMO,Healthlink HMO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink PPO,Healthlink PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,HomeState Health Plan,HomeState Health Plan,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Humana Gold,Humana Gold,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medicaid MO,Medicaid MO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medica,Medica,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Tricare,Tricare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC All Payer,UHC All Payer,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Exchange,UHC Exchange,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicaid,UHC Medicaid,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UMR CPD,UMR CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicare,UHC Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 45 MIN    ,34600147,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Wellcare,Wellcare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health PPO CPD,Meritain Health PPO CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna/Commercial Product,Aetna/Commercial Product,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Meritain Health CPD,Meritain Health CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Starmark CPD,Starmark CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Aetna Medicare,Aetna Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Ambetter ,Ambetter ,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access,Anthem Blue Access,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Access Choice,Anthem Blue Access Choice,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Blue Preferred,Anthem Blue Preferred,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Pathway,Anthem Pathway,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Alliance,Anthem Alliance,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Anthem Medicare,Anthem Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna,Cigna,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna PPO,Cigna PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Cigna Medicare Advantage,Cigna Medicare Advantage,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Essence,Essence,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink HMO,Healthlink HMO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Healthlink PPO,Healthlink PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,HomeState Health Plan,HomeState Health Plan,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Humana Gold,Humana Gold,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medicaid MO,Medicaid MO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Medica,Medica,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Tricare,Tricare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC All Payer,UHC All Payer,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Exchange,UHC Exchange,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicaid,UHC Medicaid,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UMR CPD,UMR CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,UHC Medicare,UHC Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/HEARING EVAL 60 MIN    ,34600148,CDM,440,RC,92522,CPT,,,,Inpatient,,,540.69,540.69,Wellcare,Wellcare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Meritain Health PPO CPD,Meritain Health PPO CPD,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Aetna/Commercial Product,Aetna/Commercial Product,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Meritain Health CPD,Meritain Health CPD,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Starmark CPD,Starmark CPD,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Aetna Medicare,Aetna Medicare,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Ambetter ,Ambetter ,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Blue Access,Anthem Blue Access,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Blue Access Choice,Anthem Blue Access Choice,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Blue Preferred,Anthem Blue Preferred,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Pathway,Anthem Pathway,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Alliance,Anthem Alliance,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Anthem Medicare,Anthem Medicare,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Cigna,Cigna,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Cigna PPO,Cigna PPO,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Cigna Medicare Advantage,Cigna Medicare Advantage,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Essence,Essence,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Healthlink HMO,Healthlink HMO,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Healthlink PPO,Healthlink PPO,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,HomeState Health Plan,HomeState Health Plan,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Humana Gold,Humana Gold,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Medicaid MO,Medicaid MO,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Medica,Medica,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Tricare,Tricare,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,UHC All Payer,UHC All Payer,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,UHC Exchange,UHC Exchange,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,UHC Medicaid,UHC Medicaid,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,UMR CPD,UMR CPD,210.51,,,,,,,per diem,210.51,210.51,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,UHC Medicare,UHC Medicare,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600149,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,210.51,210.51,Wellcare,Wellcare,210.51,,,,,,,case rate,210.51,210.51,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Meritain Health PPO CPD,Meritain Health PPO CPD,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Aetna/Commercial Product,Aetna/Commercial Product,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Meritain Health CPD,Meritain Health CPD,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Starmark CPD,Starmark CPD,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Aetna Medicare,Aetna Medicare,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Ambetter ,Ambetter ,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Blue Access,Anthem Blue Access,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Blue Access Choice,Anthem Blue Access Choice,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Blue Preferred,Anthem Blue Preferred,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Pathway,Anthem Pathway,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Alliance,Anthem Alliance,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Anthem Medicare,Anthem Medicare,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Cigna,Cigna,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Cigna PPO,Cigna PPO,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Cigna Medicare Advantage,Cigna Medicare Advantage,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Essence,Essence,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Healthlink HMO,Healthlink HMO,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Healthlink PPO,Healthlink PPO,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,HomeState Health Plan,HomeState Health Plan,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Humana Gold,Humana Gold,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Medicaid MO,Medicaid MO,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Medica,Medica,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Tricare,Tricare,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,UHC All Payer,UHC All Payer,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,UHC Exchange,UHC Exchange,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,UHC Medicaid,UHC Medicaid,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,UMR CPD,UMR CPD,65.84,,,,,,,per diem,65.84,65.84,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,UHC Medicare,UHC Medicare,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 30 MIN      ,34600150,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,65.84,65.84,Wellcare,Wellcare,65.84,,,,,,,case rate,65.84,65.84,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Meritain Health PPO CPD,Meritain Health PPO CPD,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Aetna/Commercial Product,Aetna/Commercial Product,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Meritain Health CPD,Meritain Health CPD,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Starmark CPD,Starmark CPD,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Aetna Medicare,Aetna Medicare,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Ambetter ,Ambetter ,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Blue Access,Anthem Blue Access,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Blue Access Choice,Anthem Blue Access Choice,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Blue Preferred,Anthem Blue Preferred,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Pathway,Anthem Pathway,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Alliance,Anthem Alliance,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Anthem Medicare,Anthem Medicare,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Cigna,Cigna,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Cigna PPO,Cigna PPO,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Cigna Medicare Advantage,Cigna Medicare Advantage,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Essence,Essence,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Healthlink HMO,Healthlink HMO,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Healthlink PPO,Healthlink PPO,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,HomeState Health Plan,HomeState Health Plan,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Humana Gold,Humana Gold,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Medicaid MO,Medicaid MO,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Medica,Medica,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Tricare,Tricare,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,UHC All Payer,UHC All Payer,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,UHC Exchange,UHC Exchange,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,UHC Medicaid,UHC Medicaid,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,UMR CPD,UMR CPD,236.02,,,,,,,per diem,236.02,236.02,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,UHC Medicare,UHC Medicare,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 45 MIN      ,34600151,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,236.02,236.02,Wellcare,Wellcare,236.02,,,,,,,case rate,236.02,236.02,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Meritain Health PPO CPD,Meritain Health PPO CPD,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Aetna/Commercial Product,Aetna/Commercial Product,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Meritain Health CPD,Meritain Health CPD,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Starmark CPD,Starmark CPD,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Aetna Medicare,Aetna Medicare,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Ambetter ,Ambetter ,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Blue Access,Anthem Blue Access,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Blue Access Choice,Anthem Blue Access Choice,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Blue Preferred,Anthem Blue Preferred,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Pathway,Anthem Pathway,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Alliance,Anthem Alliance,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Anthem Medicare,Anthem Medicare,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Cigna,Cigna,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Cigna PPO,Cigna PPO,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Cigna Medicare Advantage,Cigna Medicare Advantage,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Essence,Essence,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Healthlink HMO,Healthlink HMO,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Healthlink PPO,Healthlink PPO,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,HomeState Health Plan,HomeState Health Plan,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Humana Gold,Humana Gold,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Medicaid MO,Medicaid MO,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Medica,Medica,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Tricare,Tricare,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,UHC All Payer,UHC All Payer,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,UHC Exchange,UHC Exchange,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,UHC Medicaid,UHC Medicaid,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,UMR CPD,UMR CPD,264.72,,,,,,,per diem,264.72,264.72,"Per diem rate, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,UHC Medicare,UHC Medicare,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
DYSPHAGIA THERAPY 60 MIN      ,34600152,CDM,440,RC,92526,CPT,,,GN,Inpatient,,,264.72,264.72,Wellcare,Wellcare,264.72,,,,,,,case rate,264.72,264.72,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Meritain Health PPO CPD,Meritain Health PPO CPD,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Aetna/Commercial Product,Aetna/Commercial Product,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Meritain Health CPD,Meritain Health CPD,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Starmark CPD,Starmark CPD,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Aetna Medicare,Aetna Medicare,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Ambetter ,Ambetter ,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Blue Access,Anthem Blue Access,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Blue Access Choice,Anthem Blue Access Choice,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Blue Preferred,Anthem Blue Preferred,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Pathway,Anthem Pathway,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Alliance,Anthem Alliance,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Anthem Medicare,Anthem Medicare,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Cigna,Cigna,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Cigna PPO,Cigna PPO,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Cigna Medicare Advantage,Cigna Medicare Advantage,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Essence,Essence,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Healthlink HMO,Healthlink HMO,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Healthlink PPO,Healthlink PPO,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,HomeState Health Plan,HomeState Health Plan,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Humana Gold,Humana Gold,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Medicaid MO,Medicaid MO,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Medica,Medica,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Tricare,Tricare,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,UHC All Payer,UHC All Payer,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,UHC Exchange,UHC Exchange,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,UHC Medicaid,UHC Medicaid,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,UMR CPD,UMR CPD,340.52,,,,,,,per diem,340.52,340.52,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,UHC Medicare,UHC Medicare,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 15 MIN   ,34600153,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,340.52,340.52,Wellcare,Wellcare,340.52,,,,,,,case rate,340.52,340.52,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Meritain Health PPO CPD,Meritain Health PPO CPD,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Aetna/Commercial Product,Aetna/Commercial Product,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Meritain Health CPD,Meritain Health CPD,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Starmark CPD,Starmark CPD,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Aetna Medicare,Aetna Medicare,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Ambetter ,Ambetter ,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Blue Access,Anthem Blue Access,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Blue Access Choice,Anthem Blue Access Choice,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Blue Preferred,Anthem Blue Preferred,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Pathway,Anthem Pathway,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Alliance,Anthem Alliance,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Anthem Medicare,Anthem Medicare,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Cigna,Cigna,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Cigna PPO,Cigna PPO,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Cigna Medicare Advantage,Cigna Medicare Advantage,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Essence,Essence,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Healthlink HMO,Healthlink HMO,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Healthlink PPO,Healthlink PPO,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,HomeState Health Plan,HomeState Health Plan,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Humana Gold,Humana Gold,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Medicaid MO,Medicaid MO,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Medica,Medica,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Tricare,Tricare,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,UHC All Payer,UHC All Payer,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,UHC Exchange,UHC Exchange,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,UHC Medicaid,UHC Medicaid,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,UMR CPD,UMR CPD,273.19,,,,,,,per diem,273.19,273.19,"Per diem rate, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,UHC Medicare,UHC Medicare,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
CLIN SWALL/DYSPH EVAL 15 MIN  ,34600154,CDM,444,RC,92610,CPT,,,,Inpatient,,,273.19,273.19,Wellcare,Wellcare,273.19,,,,,,,case rate,273.19,273.19,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Meritain Health PPO CPD,Meritain Health PPO CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Aetna/Commercial Product,Aetna/Commercial Product,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Meritain Health CPD,Meritain Health CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Starmark CPD,Starmark CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Aetna Medicare,Aetna Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Ambetter ,Ambetter ,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Access,Anthem Blue Access,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Access Choice,Anthem Blue Access Choice,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Preferred,Anthem Blue Preferred,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Pathway,Anthem Pathway,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Alliance,Anthem Alliance,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Anthem Medicare,Anthem Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Cigna,Cigna,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Cigna PPO,Cigna PPO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Cigna Medicare Advantage,Cigna Medicare Advantage,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Essence,Essence,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Healthlink HMO,Healthlink HMO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Healthlink PPO,Healthlink PPO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,HomeState Health Plan,HomeState Health Plan,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Humana Gold,Humana Gold,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Medicaid MO,Medicaid MO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Medica,Medica,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Tricare,Tricare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,UHC All Payer,UHC All Payer,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,UHC Exchange,UHC Exchange,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,UHC Medicaid,UHC Medicaid,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,UMR CPD,UMR CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,UHC Medicare,UHC Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
THERAPEUTIC EXERCISES         ,34600155,CDM,440,RC,97110,CPT,,,,Inpatient,,,125.47,125.47,Wellcare,Wellcare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Meritain Health PPO CPD,Meritain Health PPO CPD,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Aetna/Commercial Product,Aetna/Commercial Product,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Meritain Health CPD,Meritain Health CPD,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Starmark CPD,Starmark CPD,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Aetna Medicare,Aetna Medicare,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Ambetter ,Ambetter ,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Blue Access,Anthem Blue Access,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Blue Access Choice,Anthem Blue Access Choice,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Blue Preferred,Anthem Blue Preferred,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Pathway,Anthem Pathway,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Alliance,Anthem Alliance,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Anthem Medicare,Anthem Medicare,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Cigna,Cigna,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Cigna PPO,Cigna PPO,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Cigna Medicare Advantage,Cigna Medicare Advantage,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Essence,Essence,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Healthlink HMO,Healthlink HMO,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Healthlink PPO,Healthlink PPO,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,HomeState Health Plan,HomeState Health Plan,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Humana Gold,Humana Gold,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Medicaid MO,Medicaid MO,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Medica,Medica,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Tricare,Tricare,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,UHC All Payer,UHC All Payer,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,UHC Exchange,UHC Exchange,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,UHC Medicaid,UHC Medicaid,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,UMR CPD,UMR CPD,123.88,,,,,,,per diem,123.88,123.88,"Per diem rate, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,UHC Medicare,UHC Medicare,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANG THERAPY 30 MIN    ,34600156,CDM,440,RC,92507,CPT,,,,Inpatient,,,123.88,123.88,Wellcare,Wellcare,123.88,,,,,,,case rate,123.88,123.88,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Meritain Health PPO CPD,Meritain Health PPO CPD,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Aetna/Commercial Product,Aetna/Commercial Product,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Meritain Health CPD,Meritain Health CPD,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Starmark CPD,Starmark CPD,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Aetna Medicare,Aetna Medicare,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Ambetter ,Ambetter ,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Blue Access,Anthem Blue Access,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Blue Access Choice,Anthem Blue Access Choice,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Blue Preferred,Anthem Blue Preferred,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Pathway,Anthem Pathway,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Alliance,Anthem Alliance,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Anthem Medicare,Anthem Medicare,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Cigna,Cigna,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Cigna PPO,Cigna PPO,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Cigna Medicare Advantage,Cigna Medicare Advantage,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Essence,Essence,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Healthlink HMO,Healthlink HMO,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Healthlink PPO,Healthlink PPO,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,HomeState Health Plan,HomeState Health Plan,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Humana Gold,Humana Gold,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Medicaid MO,Medicaid MO,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Medica,Medica,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Tricare,Tricare,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,UHC All Payer,UHC All Payer,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,UHC Exchange,UHC Exchange,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,UHC Medicaid,UHC Medicaid,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,UMR CPD,UMR CPD,285.96,,,,,,,per diem,285.96,285.96,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,UHC Medicare,UHC Medicare,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 45 MIN   ,34600157,CDM,440,RC,92507,CPT,,,,Inpatient,,,285.96,285.96,Wellcare,Wellcare,285.96,,,,,,,case rate,285.96,285.96,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Meritain Health PPO CPD,Meritain Health PPO CPD,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Aetna/Commercial Product,Aetna/Commercial Product,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Meritain Health CPD,Meritain Health CPD,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Starmark CPD,Starmark CPD,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Aetna Medicare,Aetna Medicare,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Ambetter ,Ambetter ,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Blue Access,Anthem Blue Access,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Blue Access Choice,Anthem Blue Access Choice,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Blue Preferred,Anthem Blue Preferred,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Pathway,Anthem Pathway,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Alliance,Anthem Alliance,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Anthem Medicare,Anthem Medicare,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Cigna,Cigna,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Cigna PPO,Cigna PPO,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Cigna Medicare Advantage,Cigna Medicare Advantage,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Essence,Essence,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Healthlink HMO,Healthlink HMO,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Healthlink PPO,Healthlink PPO,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,HomeState Health Plan,HomeState Health Plan,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Humana Gold,Humana Gold,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Medicaid MO,Medicaid MO,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Medica,Medica,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Tricare,Tricare,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,UHC All Payer,UHC All Payer,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,UHC Exchange,UHC Exchange,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,UHC Medicaid,UHC Medicaid,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,UMR CPD,UMR CPD,268.2,,,,,,,per diem,268.2,268.2,"Per diem rate, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,UHC Medicare,UHC Medicare,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
SPEECH/LANGUAGE THER 60 MIN   ,34600158,CDM,440,RC,92507,CPT,,,,Inpatient,,,268.2,268.2,Wellcare,Wellcare,268.2,,,,,,,case rate,268.2,268.2,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Meritain Health PPO CPD,Meritain Health PPO CPD,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Aetna/Commercial Product,Aetna/Commercial Product,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Meritain Health CPD,Meritain Health CPD,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Starmark CPD,Starmark CPD,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Aetna Medicare,Aetna Medicare,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Ambetter ,Ambetter ,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Blue Access,Anthem Blue Access,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Blue Access Choice,Anthem Blue Access Choice,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Blue Preferred,Anthem Blue Preferred,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Pathway,Anthem Pathway,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Alliance,Anthem Alliance,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Anthem Medicare,Anthem Medicare,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Cigna,Cigna,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Cigna PPO,Cigna PPO,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Cigna Medicare Advantage,Cigna Medicare Advantage,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Essence,Essence,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Healthlink HMO,Healthlink HMO,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Healthlink PPO,Healthlink PPO,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,HomeState Health Plan,HomeState Health Plan,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Humana Gold,Humana Gold,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Medicaid MO,Medicaid MO,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Medica,Medica,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Tricare,Tricare,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,UHC All Payer,UHC All Payer,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,UHC Exchange,UHC Exchange,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,UHC Medicaid,UHC Medicaid,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,UMR CPD,UMR CPD,423.06,,,,,,,per diem,423.06,423.06,"Per diem rate, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,UHC Medicare,UHC Medicare,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
BEDSIDE SWALLOW/FUNCTION EVAL ,34600159,CDM,444,RC,,,,,,Inpatient,,,423.06,423.06,Wellcare,Wellcare,423.06,,,,,,,case rate,423.06,423.06,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Meritain Health PPO CPD,Meritain Health PPO CPD,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Aetna/Commercial Product,Aetna/Commercial Product,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Meritain Health CPD,Meritain Health CPD,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Starmark CPD,Starmark CPD,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Aetna Medicare,Aetna Medicare,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Ambetter ,Ambetter ,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Blue Access,Anthem Blue Access,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Blue Access Choice,Anthem Blue Access Choice,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Blue Preferred,Anthem Blue Preferred,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Pathway,Anthem Pathway,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Alliance,Anthem Alliance,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Anthem Medicare,Anthem Medicare,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Cigna,Cigna,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Cigna PPO,Cigna PPO,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Cigna Medicare Advantage,Cigna Medicare Advantage,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Essence,Essence,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Healthlink HMO,Healthlink HMO,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Healthlink PPO,Healthlink PPO,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,HomeState Health Plan,HomeState Health Plan,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Humana Gold,Humana Gold,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Medicaid MO,Medicaid MO,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Medica,Medica,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Tricare,Tricare,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,UHC All Payer,UHC All Payer,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,UHC Exchange,UHC Exchange,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,UHC Medicaid,UHC Medicaid,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,UMR CPD,UMR CPD,225.63,,,,,,,per diem,225.63,225.63,"Per diem rate, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,UHC Medicare,UHC Medicare,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
EVAL SPEECH PRODUCTION 60 MIN ,34600160,CDM,444,RC,,,,,,Inpatient,,,225.63,225.63,Wellcare,Wellcare,225.63,,,,,,,case rate,225.63,225.63,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 75 MIN ,34600161,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 60 MIN ,34600162,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 45 MIN ,34600163,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH SOUND LANG COMP 30 MIN ,34600164,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 30 MIN          ,34600165,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 45 MIN          ,34600166,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health PPO CPD,Meritain Health PPO CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna/Commercial Product,Aetna/Commercial Product,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Meritain Health CPD,Meritain Health CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Starmark CPD,Starmark CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Aetna Medicare,Aetna Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Ambetter ,Ambetter ,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access,Anthem Blue Access,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Access Choice,Anthem Blue Access Choice,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Blue Preferred,Anthem Blue Preferred,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Pathway,Anthem Pathway,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Alliance,Anthem Alliance,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Anthem Medicare,Anthem Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna,Cigna,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna PPO,Cigna PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Cigna Medicare Advantage,Cigna Medicare Advantage,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Essence,Essence,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink HMO,Healthlink HMO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Healthlink PPO,Healthlink PPO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,HomeState Health Plan,HomeState Health Plan,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Humana Gold,Humana Gold,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medicaid MO,Medicaid MO,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Medica,Medica,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Tricare,Tricare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC All Payer,UHC All Payer,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Exchange,UHC Exchange,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicaid,UHC Medicaid,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UMR CPD,UMR CPD,466.16,,,,,,,per diem,466.16,466.16,"Per diem rate, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,UHC Medicare,UHC Medicare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
ST EVALUATION 60 MIN          ,34600167,CDM,444,RC,,,,,,Inpatient,,,466.16,466.16,Wellcare,Wellcare,466.16,,,,,,,case rate,466.16,466.16,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Meritain Health PPO CPD,Meritain Health PPO CPD,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Aetna/Commercial Product,Aetna/Commercial Product,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Meritain Health CPD,Meritain Health CPD,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Starmark CPD,Starmark CPD,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Aetna Medicare,Aetna Medicare,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Ambetter ,Ambetter ,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Blue Access,Anthem Blue Access,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Blue Access Choice,Anthem Blue Access Choice,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Blue Preferred,Anthem Blue Preferred,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Pathway,Anthem Pathway,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Alliance,Anthem Alliance,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Anthem Medicare,Anthem Medicare,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Cigna,Cigna,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Cigna PPO,Cigna PPO,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Cigna Medicare Advantage,Cigna Medicare Advantage,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Essence,Essence,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Healthlink HMO,Healthlink HMO,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Healthlink PPO,Healthlink PPO,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,HomeState Health Plan,HomeState Health Plan,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Humana Gold,Humana Gold,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Medicaid MO,Medicaid MO,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Medica,Medica,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Tricare,Tricare,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,UHC All Payer,UHC All Payer,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,UHC Exchange,UHC Exchange,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,UHC Medicaid,UHC Medicaid,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,UMR CPD,UMR CPD,169.35,,,,,,,per diem,169.35,169.35,"Per diem rate, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,UHC Medicare,UHC Medicare,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
SPEECH DEVICE ADAPTATION/TRAIN,34600168,CDM,440,RC,92609,CPT,,,,Inpatient,,,169.35,169.35,Wellcare,Wellcare,169.35,,,,,,,case rate,169.35,169.35,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Meritain Health PPO CPD,Meritain Health PPO CPD,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Aetna/Commercial Product,Aetna/Commercial Product,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Meritain Health CPD,Meritain Health CPD,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Starmark CPD,Starmark CPD,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Aetna Medicare,Aetna Medicare,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Ambetter ,Ambetter ,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Blue Access,Anthem Blue Access,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Blue Access Choice,Anthem Blue Access Choice,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Blue Preferred,Anthem Blue Preferred,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Pathway,Anthem Pathway,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Alliance,Anthem Alliance,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Anthem Medicare,Anthem Medicare,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Cigna,Cigna,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Cigna PPO,Cigna PPO,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Cigna Medicare Advantage,Cigna Medicare Advantage,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Essence,Essence,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Healthlink HMO,Healthlink HMO,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Healthlink PPO,Healthlink PPO,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,HomeState Health Plan,HomeState Health Plan,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Humana Gold,Humana Gold,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Medicaid MO,Medicaid MO,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Medica,Medica,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Tricare,Tricare,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,UHC All Payer,UHC All Payer,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,UHC Exchange,UHC Exchange,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,UHC Medicaid,UHC Medicaid,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,UMR CPD,UMR CPD,153.4,,,,,,,per diem,153.4,153.4,"Per diem rate, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,UHC Medicare,UHC Medicare,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRICAL MUSCLE STIMULATION ,34600169,CDM,440,RC,92609,CPT,,,,Inpatient,,,153.4,153.4,Wellcare,Wellcare,153.4,,,,,,,case rate,153.4,153.4,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Meritain Health PPO CPD,Meritain Health PPO CPD,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Aetna/Commercial Product,Aetna/Commercial Product,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Meritain Health CPD,Meritain Health CPD,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Starmark CPD,Starmark CPD,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Aetna Medicare,Aetna Medicare,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Ambetter ,Ambetter ,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Blue Access,Anthem Blue Access,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Blue Access Choice,Anthem Blue Access Choice,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Blue Preferred,Anthem Blue Preferred,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Pathway,Anthem Pathway,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Alliance,Anthem Alliance,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Anthem Medicare,Anthem Medicare,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Cigna,Cigna,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Cigna PPO,Cigna PPO,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Cigna Medicare Advantage,Cigna Medicare Advantage,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Essence,Essence,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Healthlink HMO,Healthlink HMO,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Healthlink PPO,Healthlink PPO,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,HomeState Health Plan,HomeState Health Plan,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Humana Gold,Humana Gold,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Medicaid MO,Medicaid MO,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Medica,Medica,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Tricare,Tricare,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,UHC All Payer,UHC All Payer,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,UHC Exchange,UHC Exchange,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,UHC Medicaid,UHC Medicaid,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,UMR CPD,UMR CPD,144.74,,,,,,,per diem,144.74,144.74,"Per diem rate, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,UHC Medicare,UHC Medicare,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
ELECTRODES                    ,34600170,CDM,440,RC,A4556,HCPCS,,,,Inpatient,,,144.74,144.74,Wellcare,Wellcare,144.74,,,,,,,case rate,144.74,144.74,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Meritain Health PPO CPD,Meritain Health PPO CPD,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Aetna/Commercial Product,Aetna/Commercial Product,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Meritain Health CPD,Meritain Health CPD,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Starmark CPD,Starmark CPD,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Aetna Medicare,Aetna Medicare,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Ambetter ,Ambetter ,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Blue Access,Anthem Blue Access,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Blue Access Choice,Anthem Blue Access Choice,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Blue Preferred,Anthem Blue Preferred,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Pathway,Anthem Pathway,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Alliance,Anthem Alliance,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Anthem Medicare,Anthem Medicare,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Cigna,Cigna,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Cigna PPO,Cigna PPO,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Cigna Medicare Advantage,Cigna Medicare Advantage,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Essence,Essence,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Healthlink HMO,Healthlink HMO,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Healthlink PPO,Healthlink PPO,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,HomeState Health Plan,HomeState Health Plan,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Humana Gold,Humana Gold,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Medicaid MO,Medicaid MO,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Medica,Medica,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Tricare,Tricare,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,UHC All Payer,UHC All Payer,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,UHC Exchange,UHC Exchange,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,UHC Medicaid,UHC Medicaid,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,UMR CPD,UMR CPD,68.85,,,,,,,per diem,68.85,68.85,"Per diem rate, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,UHC Medicare,UHC Medicare,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPL PATIENT CONFERENCE        ,34600174,CDM,440,RC,,,,,,Inpatient,,,68.85,68.85,Wellcare,Wellcare,68.85,,,,,,,case rate,68.85,68.85,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Meritain Health PPO CPD,Meritain Health PPO CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Aetna/Commercial Product,Aetna/Commercial Product,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Meritain Health CPD,Meritain Health CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Starmark CPD,Starmark CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Aetna Medicare,Aetna Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Ambetter ,Ambetter ,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Blue Access,Anthem Blue Access,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Blue Access Choice,Anthem Blue Access Choice,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Blue Preferred,Anthem Blue Preferred,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Pathway,Anthem Pathway,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Alliance,Anthem Alliance,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Anthem Medicare,Anthem Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Cigna,Cigna,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Cigna PPO,Cigna PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Cigna Medicare Advantage,Cigna Medicare Advantage,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Essence,Essence,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Healthlink HMO,Healthlink HMO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Healthlink PPO,Healthlink PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,HomeState Health Plan,HomeState Health Plan,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Humana Gold,Humana Gold,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Medicaid MO,Medicaid MO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Medica,Medica,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Tricare,Tricare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,UHC All Payer,UHC All Payer,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,UHC Exchange,UHC Exchange,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,UHC Medicaid,UHC Medicaid,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,UMR CPD,UMR CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,UHC Medicare,UHC Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
SPEEH/HEARING THERAPHY 15 MIN ,34600179,CDM,440,RC,,,,,,Inpatient,,,58.35,58.35,Wellcare,Wellcare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE INITIAL 15 MIN      ,34600180,CDM,440,RC,97129,CPT,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Meritain Health PPO CPD,Meritain Health PPO CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna/Commercial Product,Aetna/Commercial Product,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Meritain Health CPD,Meritain Health CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Starmark CPD,Starmark CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna Medicare,Aetna Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Ambetter ,Ambetter ,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Access,Anthem Blue Access,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Access Choice,Anthem Blue Access Choice,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Preferred,Anthem Blue Preferred,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Pathway,Anthem Pathway,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Alliance,Anthem Alliance,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Medicare,Anthem Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna,Cigna,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna PPO,Cigna PPO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna Medicare Advantage,Cigna Medicare Advantage,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Essence,Essence,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Healthlink HMO,Healthlink HMO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Healthlink PPO,Healthlink PPO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,HomeState Health Plan,HomeState Health Plan,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Humana Gold,Humana Gold,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Medicaid MO,Medicaid MO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Medica,Medica,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Tricare,Tricare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,UHC All Payer,UHC All Payer,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Exchange,UHC Exchange,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Medicaid,UHC Medicaid,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,UMR CPD,UMR CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Medicare,UHC Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING-RADIO-OPA  ,34600181,CDM,440,RC,92611,CPT,,,GN,Inpatient,,,165.82,165.82,Wellcare,Wellcare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Meritain Health PPO CPD,Meritain Health PPO CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Aetna/Commercial Product,Aetna/Commercial Product,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Meritain Health CPD,Meritain Health CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Starmark CPD,Starmark CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Aetna Medicare,Aetna Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Ambetter ,Ambetter ,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Blue Access,Anthem Blue Access,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Blue Access Choice,Anthem Blue Access Choice,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Blue Preferred,Anthem Blue Preferred,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Pathway,Anthem Pathway,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Alliance,Anthem Alliance,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Anthem Medicare,Anthem Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Cigna,Cigna,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Cigna PPO,Cigna PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Cigna Medicare Advantage,Cigna Medicare Advantage,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Essence,Essence,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Healthlink HMO,Healthlink HMO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Healthlink PPO,Healthlink PPO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,HomeState Health Plan,HomeState Health Plan,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Humana Gold,Humana Gold,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Medicaid MO,Medicaid MO,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Medica,Medica,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Tricare,Tricare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,UHC All Payer,UHC All Payer,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,UHC Exchange,UHC Exchange,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,UHC Medicaid,UHC Medicaid,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,UMR CPD,UMR CPD,88,,,,,,,per diem,88,88,"Per diem rate, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,UHC Medicare,UHC Medicare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
COGNITIVE ADDITIONAL 15 MIN   ,34600182,CDM,440,RC,97130,CPT,,,,Inpatient,,,88,88,Wellcare,Wellcare,88,,,,,,,case rate,88,88,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Meritain Health PPO CPD,Meritain Health PPO CPD,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Aetna/Commercial Product,Aetna/Commercial Product,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Meritain Health CPD,Meritain Health CPD,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Starmark CPD,Starmark CPD,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Aetna Medicare,Aetna Medicare,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Ambetter ,Ambetter ,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Blue Access,Anthem Blue Access,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Blue Access Choice,Anthem Blue Access Choice,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Blue Preferred,Anthem Blue Preferred,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Pathway,Anthem Pathway,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Alliance,Anthem Alliance,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Anthem Medicare,Anthem Medicare,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Cigna,Cigna,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Cigna PPO,Cigna PPO,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Cigna Medicare Advantage,Cigna Medicare Advantage,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Essence,Essence,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Healthlink HMO,Healthlink HMO,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Healthlink PPO,Healthlink PPO,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,HomeState Health Plan,HomeState Health Plan,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Humana Gold,Humana Gold,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Medicaid MO,Medicaid MO,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Medica,Medica,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Tricare,Tricare,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,UHC All Payer,UHC All Payer,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,UHC Exchange,UHC Exchange,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,UHC Medicaid,UHC Medicaid,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,UMR CPD,UMR CPD,214.44,,,,,,,per diem,214.44,214.44,"Per diem rate, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,UHC Medicare,UHC Medicare,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
MOD OF PROSTH COMMUN DEVICE   ,34600280,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,214.44,214.44,Wellcare,Wellcare,214.44,,,,,,,case rate,214.44,214.44,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Meritain Health PPO CPD,Meritain Health PPO CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna/Commercial Product,Aetna/Commercial Product,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Meritain Health CPD,Meritain Health CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Starmark CPD,Starmark CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Aetna Medicare,Aetna Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Ambetter ,Ambetter ,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Access,Anthem Blue Access,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Access Choice,Anthem Blue Access Choice,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Blue Preferred,Anthem Blue Preferred,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Pathway,Anthem Pathway,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Alliance,Anthem Alliance,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Anthem Medicare,Anthem Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna,Cigna,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna PPO,Cigna PPO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Cigna Medicare Advantage,Cigna Medicare Advantage,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Essence,Essence,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Healthlink HMO,Healthlink HMO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Healthlink PPO,Healthlink PPO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,HomeState Health Plan,HomeState Health Plan,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Humana Gold,Humana Gold,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Medicaid MO,Medicaid MO,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Medica,Medica,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Tricare,Tricare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,UHC All Payer,UHC All Payer,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Exchange,UHC Exchange,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Medicaid,UHC Medicaid,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,UMR CPD,UMR CPD,93.59,,,,,,,per diem,93.59,93.59,"Per diem rate, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,UHC Medicare,UHC Medicare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
SPEECH LANGUAGE TREATMENT     ,34600290,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,93.59,93.59,Wellcare,Wellcare,93.59,,,,,,,case rate,93.59,93.59,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Meritain Health PPO CPD,Meritain Health PPO CPD,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Aetna/Commercial Product,Aetna/Commercial Product,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Meritain Health CPD,Meritain Health CPD,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Starmark CPD,Starmark CPD,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Aetna Medicare,Aetna Medicare,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Ambetter ,Ambetter ,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Blue Access,Anthem Blue Access,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Blue Access Choice,Anthem Blue Access Choice,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Blue Preferred,Anthem Blue Preferred,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Pathway,Anthem Pathway,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Alliance,Anthem Alliance,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Anthem Medicare,Anthem Medicare,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Cigna,Cigna,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Cigna PPO,Cigna PPO,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Cigna Medicare Advantage,Cigna Medicare Advantage,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Essence,Essence,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Healthlink HMO,Healthlink HMO,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Healthlink PPO,Healthlink PPO,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,HomeState Health Plan,HomeState Health Plan,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Humana Gold,Humana Gold,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Medicaid MO,Medicaid MO,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Medica,Medica,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Tricare,Tricare,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,UHC All Payer,UHC All Payer,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,UHC Exchange,UHC Exchange,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,UHC Medicaid,UHC Medicaid,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,UMR CPD,UMR CPD,678.55,,,,,,,per diem,678.55,678.55,"Per diem rate, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,UHC Medicare,UHC Medicare,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC EVAL SWALLOWING    ,34600400,CDM,440,RC,92612,CPT,,,GN,Inpatient,,,678.55,678.55,Wellcare,Wellcare,678.55,,,,,,,case rate,678.55,678.55,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Meritain Health PPO CPD,Meritain Health PPO CPD,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Aetna/Commercial Product,Aetna/Commercial Product,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Meritain Health CPD,Meritain Health CPD,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Starmark CPD,Starmark CPD,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Aetna Medicare,Aetna Medicare,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Ambetter ,Ambetter ,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Blue Access,Anthem Blue Access,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Blue Access Choice,Anthem Blue Access Choice,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Blue Preferred,Anthem Blue Preferred,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Pathway,Anthem Pathway,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Alliance,Anthem Alliance,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Anthem Medicare,Anthem Medicare,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Cigna,Cigna,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Cigna PPO,Cigna PPO,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Cigna Medicare Advantage,Cigna Medicare Advantage,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Essence,Essence,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Healthlink HMO,Healthlink HMO,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Healthlink PPO,Healthlink PPO,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,HomeState Health Plan,HomeState Health Plan,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Humana Gold,Humana Gold,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Medicaid MO,Medicaid MO,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Medica,Medica,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Tricare,Tricare,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,UHC All Payer,UHC All Payer,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,UHC Exchange,UHC Exchange,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,UHC Medicaid,UHC Medicaid,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,UMR CPD,UMR CPD,252.97,,,,,,,per diem,252.97,252.97,"Per diem rate, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,UHC Medicare,UHC Medicare,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
FIBEROPTIC LARYNG SENSORY TEST,34600410,CDM,440,RC,92614,CPT,,,GN,Inpatient,,,252.97,252.97,Wellcare,Wellcare,252.97,,,,,,,case rate,252.97,252.97,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Meritain Health PPO CPD,Meritain Health PPO CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Aetna/Commercial Product,Aetna/Commercial Product,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Meritain Health CPD,Meritain Health CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Starmark CPD,Starmark CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Aetna Medicare,Aetna Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Ambetter ,Ambetter ,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Blue Access,Anthem Blue Access,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Blue Access Choice,Anthem Blue Access Choice,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Blue Preferred,Anthem Blue Preferred,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Pathway,Anthem Pathway,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Alliance,Anthem Alliance,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Anthem Medicare,Anthem Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Cigna,Cigna,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Cigna PPO,Cigna PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Cigna Medicare Advantage,Cigna Medicare Advantage,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Essence,Essence,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Healthlink HMO,Healthlink HMO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Healthlink PPO,Healthlink PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,HomeState Health Plan,HomeState Health Plan,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Humana Gold,Humana Gold,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Medicaid MO,Medicaid MO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Medica,Medica,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Tricare,Tricare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,UHC All Payer,UHC All Payer,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,UHC Exchange,UHC Exchange,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,UHC Medicaid,UHC Medicaid,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,UMR CPD,UMR CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,UHC Medicare,UHC Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 15 MIN ,34600420,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,540.69,540.69,Wellcare,Wellcare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Meritain Health PPO CPD,Meritain Health PPO CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna/Commercial Product,Aetna/Commercial Product,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Meritain Health CPD,Meritain Health CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Starmark CPD,Starmark CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Aetna Medicare,Aetna Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Ambetter ,Ambetter ,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Access,Anthem Blue Access,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Access Choice,Anthem Blue Access Choice,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Blue Preferred,Anthem Blue Preferred,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Pathway,Anthem Pathway,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Alliance,Anthem Alliance,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Anthem Medicare,Anthem Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna,Cigna,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna PPO,Cigna PPO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Cigna Medicare Advantage,Cigna Medicare Advantage,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Essence,Essence,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Healthlink HMO,Healthlink HMO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Healthlink PPO,Healthlink PPO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,HomeState Health Plan,HomeState Health Plan,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Humana Gold,Humana Gold,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Medicaid MO,Medicaid MO,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Medica,Medica,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Tricare,Tricare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,UHC All Payer,UHC All Payer,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Exchange,UHC Exchange,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Medicaid,UHC Medicaid,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,UMR CPD,UMR CPD,165.82,,,,,,,per diem,165.82,165.82,"Per diem rate, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,UHC Medicare,UHC Medicare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL OF SWALLOWING BLUE DYE   ,34600421,CDM,440,RC,92610,CPT,,,GN,Inpatient,,,165.82,165.82,Wellcare,Wellcare,165.82,,,,,,,case rate,165.82,165.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Meritain Health PPO CPD,Meritain Health PPO CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna/Commercial Product,Aetna/Commercial Product,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Meritain Health CPD,Meritain Health CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Starmark CPD,Starmark CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna Medicare,Aetna Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Ambetter ,Ambetter ,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Access,Anthem Blue Access,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Access Choice,Anthem Blue Access Choice,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Preferred,Anthem Blue Preferred,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Pathway,Anthem Pathway,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Alliance,Anthem Alliance,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Medicare,Anthem Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna,Cigna,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna PPO,Cigna PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna Medicare Advantage,Cigna Medicare Advantage,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Essence,Essence,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthlink HMO,Healthlink HMO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthlink PPO,Healthlink PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,HomeState Health Plan,HomeState Health Plan,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Humana Gold,Humana Gold,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Medicaid MO,Medicaid MO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Medica,Medica,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Tricare,Tricare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC All Payer,UHC All Payer,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Exchange,UHC Exchange,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Medicaid,UHC Medicaid,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UMR CPD,UMR CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Medicare,UHC Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 30 MIN ,34600422,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Wellcare,Wellcare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Meritain Health PPO CPD,Meritain Health PPO CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna/Commercial Product,Aetna/Commercial Product,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Meritain Health CPD,Meritain Health CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Starmark CPD,Starmark CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Aetna Medicare,Aetna Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Ambetter ,Ambetter ,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Access,Anthem Blue Access,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Access Choice,Anthem Blue Access Choice,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Blue Preferred,Anthem Blue Preferred,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Pathway,Anthem Pathway,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Alliance,Anthem Alliance,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Anthem Medicare,Anthem Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna,Cigna,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna PPO,Cigna PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Cigna Medicare Advantage,Cigna Medicare Advantage,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Essence,Essence,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthlink HMO,Healthlink HMO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Healthlink PPO,Healthlink PPO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,HomeState Health Plan,HomeState Health Plan,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Humana Gold,Humana Gold,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Medicaid MO,Medicaid MO,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Medica,Medica,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Tricare,Tricare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC All Payer,UHC All Payer,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Exchange,UHC Exchange,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Medicaid,UHC Medicaid,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UMR CPD,UMR CPD,305.82,,,,,,,per diem,305.82,305.82,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,UHC Medicare,UHC Medicare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 45 MIN ,34600423,CDM,440,RC,92610,CPT,,,,Inpatient,,,305.82,305.82,Wellcare,Wellcare,305.82,,,,,,,case rate,305.82,305.82,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Meritain Health PPO CPD,Meritain Health PPO CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Aetna/Commercial Product,Aetna/Commercial Product,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Meritain Health CPD,Meritain Health CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Starmark CPD,Starmark CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Aetna Medicare,Aetna Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Ambetter ,Ambetter ,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Blue Access,Anthem Blue Access,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Blue Access Choice,Anthem Blue Access Choice,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Blue Preferred,Anthem Blue Preferred,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Pathway,Anthem Pathway,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Alliance,Anthem Alliance,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Anthem Medicare,Anthem Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Cigna,Cigna,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Cigna PPO,Cigna PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Cigna Medicare Advantage,Cigna Medicare Advantage,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Essence,Essence,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Healthlink HMO,Healthlink HMO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Healthlink PPO,Healthlink PPO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,HomeState Health Plan,HomeState Health Plan,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Humana Gold,Humana Gold,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Medicaid MO,Medicaid MO,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Medica,Medica,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Tricare,Tricare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,UHC All Payer,UHC All Payer,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,UHC Exchange,UHC Exchange,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,UHC Medicaid,UHC Medicaid,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,UMR CPD,UMR CPD,540.69,,,,,,,per diem,540.69,540.69,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,UHC Medicare,UHC Medicare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/ORAL FUNC 60 MIN ,34600424,CDM,440,RC,,,,,,Inpatient,,,540.69,540.69,Wellcare,Wellcare,540.69,,,,,,,case rate,540.69,540.69,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Meritain Health PPO CPD,Meritain Health PPO CPD,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Aetna/Commercial Product,Aetna/Commercial Product,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Meritain Health CPD,Meritain Health CPD,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Starmark CPD,Starmark CPD,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Aetna Medicare,Aetna Medicare,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Ambetter ,Ambetter ,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Blue Access,Anthem Blue Access,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Blue Access Choice,Anthem Blue Access Choice,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Blue Preferred,Anthem Blue Preferred,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Pathway,Anthem Pathway,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Alliance,Anthem Alliance,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Anthem Medicare,Anthem Medicare,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Cigna,Cigna,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Cigna PPO,Cigna PPO,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Cigna Medicare Advantage,Cigna Medicare Advantage,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Essence,Essence,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Healthlink HMO,Healthlink HMO,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Healthlink PPO,Healthlink PPO,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,HomeState Health Plan,HomeState Health Plan,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Humana Gold,Humana Gold,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Medicaid MO,Medicaid MO,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Medica,Medica,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Tricare,Tricare,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,UHC All Payer,UHC All Payer,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,UHC Exchange,UHC Exchange,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,UHC Medicaid,UHC Medicaid,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,UMR CPD,UMR CPD,334.81,,,,,,,per diem,334.81,334.81,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,UHC Medicare,UHC Medicare,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE 1ST HR     ,34600440,CDM,444,RC,92607,CPT,,,GN,Inpatient,,,334.81,334.81,Wellcare,Wellcare,334.81,,,,,,,case rate,334.81,334.81,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Meritain Health PPO CPD,Meritain Health PPO CPD,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Aetna/Commercial Product,Aetna/Commercial Product,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Meritain Health CPD,Meritain Health CPD,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Starmark CPD,Starmark CPD,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Aetna Medicare,Aetna Medicare,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Ambetter ,Ambetter ,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Blue Access,Anthem Blue Access,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Blue Access Choice,Anthem Blue Access Choice,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Blue Preferred,Anthem Blue Preferred,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Pathway,Anthem Pathway,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Alliance,Anthem Alliance,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Anthem Medicare,Anthem Medicare,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Cigna,Cigna,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Cigna PPO,Cigna PPO,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Cigna Medicare Advantage,Cigna Medicare Advantage,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Essence,Essence,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Healthlink HMO,Healthlink HMO,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Healthlink PPO,Healthlink PPO,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,HomeState Health Plan,HomeState Health Plan,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Humana Gold,Humana Gold,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Medicaid MO,Medicaid MO,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Medica,Medica,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Tricare,Tricare,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,UHC All Payer,UHC All Payer,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,UHC Exchange,UHC Exchange,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,UHC Medicaid,UHC Medicaid,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,UMR CPD,UMR CPD,135.7,,,,,,,per diem,135.7,135.7,"Per diem rate, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,UHC Medicare,UHC Medicare,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
EVAL SPEECH DEVICE ADDL 30 MIN,34600445,CDM,444,RC,92608,CPT,,,GN,Inpatient,,,135.7,135.7,Wellcare,Wellcare,135.7,,,,,,,case rate,135.7,135.7,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Meritain Health PPO CPD,Meritain Health PPO CPD,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Aetna/Commercial Product,Aetna/Commercial Product,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Meritain Health CPD,Meritain Health CPD,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Starmark CPD,Starmark CPD,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Aetna Medicare,Aetna Medicare,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Ambetter ,Ambetter ,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Blue Access,Anthem Blue Access,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Blue Access Choice,Anthem Blue Access Choice,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Blue Preferred,Anthem Blue Preferred,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Pathway,Anthem Pathway,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Alliance,Anthem Alliance,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Anthem Medicare,Anthem Medicare,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Cigna,Cigna,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Cigna PPO,Cigna PPO,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Cigna Medicare Advantage,Cigna Medicare Advantage,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Essence,Essence,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Healthlink HMO,Healthlink HMO,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Healthlink PPO,Healthlink PPO,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,HomeState Health Plan,HomeState Health Plan,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Humana Gold,Humana Gold,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Medicaid MO,Medicaid MO,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Medica,Medica,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Tricare,Tricare,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,UHC All Payer,UHC All Payer,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,UHC Exchange,UHC Exchange,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,UHC Medicaid,UHC Medicaid,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,UMR CPD,UMR CPD,171.53,,,,,,,per diem,171.53,171.53,"Per diem rate, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,UHC Medicare,UHC Medicare,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
THERAPY SPEECH GEN DEVICE     ,34600450,CDM,440,RC,92609,CPT,,,GN,Inpatient,,,171.53,171.53,Wellcare,Wellcare,171.53,,,,,,,case rate,171.53,171.53,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Meritain Health PPO CPD,Meritain Health PPO CPD,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Aetna/Commercial Product,Aetna/Commercial Product,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Meritain Health CPD,Meritain Health CPD,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Starmark CPD,Starmark CPD,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Aetna Medicare,Aetna Medicare,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Ambetter ,Ambetter ,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Blue Access,Anthem Blue Access,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Blue Access Choice,Anthem Blue Access Choice,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Blue Preferred,Anthem Blue Preferred,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Pathway,Anthem Pathway,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Alliance,Anthem Alliance,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Anthem Medicare,Anthem Medicare,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Cigna,Cigna,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Cigna PPO,Cigna PPO,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Cigna Medicare Advantage,Cigna Medicare Advantage,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Essence,Essence,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Healthlink HMO,Healthlink HMO,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Healthlink PPO,Healthlink PPO,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,HomeState Health Plan,HomeState Health Plan,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Humana Gold,Humana Gold,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Medicaid MO,Medicaid MO,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Medica,Medica,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Tricare,Tricare,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,UHC All Payer,UHC All Payer,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,UHC Exchange,UHC Exchange,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,UHC Medicaid,UHC Medicaid,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,UMR CPD,UMR CPD,92.51,,,,,,,per diem,92.51,92.51,"Per diem rate, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,UHC Medicare,UHC Medicare,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
ASSISTIVE TECH ASSESS 15 MIN  ,34600500,CDM,440,RC,97755,CPT,,,GN,Inpatient,,,92.51,92.51,Wellcare,Wellcare,92.51,,,,,,,case rate,92.51,92.51,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Meritain Health PPO CPD,Meritain Health PPO CPD,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Aetna/Commercial Product,Aetna/Commercial Product,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Meritain Health CPD,Meritain Health CPD,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Starmark CPD,Starmark CPD,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Aetna Medicare,Aetna Medicare,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Ambetter ,Ambetter ,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Blue Access,Anthem Blue Access,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Blue Access Choice,Anthem Blue Access Choice,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Blue Preferred,Anthem Blue Preferred,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Pathway,Anthem Pathway,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Alliance,Anthem Alliance,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Anthem Medicare,Anthem Medicare,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Cigna,Cigna,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Cigna PPO,Cigna PPO,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Cigna Medicare Advantage,Cigna Medicare Advantage,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Essence,Essence,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Healthlink HMO,Healthlink HMO,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Healthlink PPO,Healthlink PPO,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,HomeState Health Plan,HomeState Health Plan,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Humana Gold,Humana Gold,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Medicaid MO,Medicaid MO,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Medica,Medica,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Tricare,Tricare,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,UHC All Payer,UHC All Payer,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,UHC Exchange,UHC Exchange,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,UHC Medicaid,UHC Medicaid,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,UMR CPD,UMR CPD,290.21,,,,,,,per diem,290.21,290.21,"Per diem rate, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,UHC Medicare,UHC Medicare,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
EVAL SWALLOW/LARYN SENSORY    ,34600505,CDM,440,RC,92616,CPT,,,GN,Inpatient,,,290.21,290.21,Wellcare,Wellcare,290.21,,,,,,,case rate,290.21,290.21,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Meritain Health PPO CPD,Meritain Health PPO CPD,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Aetna/Commercial Product,Aetna/Commercial Product,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Meritain Health CPD,Meritain Health CPD,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Starmark CPD,Starmark CPD,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Aetna Medicare,Aetna Medicare,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Ambetter ,Ambetter ,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Blue Access,Anthem Blue Access,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Blue Access Choice,Anthem Blue Access Choice,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Blue Preferred,Anthem Blue Preferred,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Pathway,Anthem Pathway,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Alliance,Anthem Alliance,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Anthem Medicare,Anthem Medicare,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Cigna,Cigna,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Cigna PPO,Cigna PPO,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Cigna Medicare Advantage,Cigna Medicare Advantage,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Essence,Essence,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Healthlink HMO,Healthlink HMO,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Healthlink PPO,Healthlink PPO,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,HomeState Health Plan,HomeState Health Plan,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Humana Gold,Humana Gold,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Medicaid MO,Medicaid MO,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Medica,Medica,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Tricare,Tricare,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,UHC All Payer,UHC All Payer,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,UHC Exchange,UHC Exchange,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,UHC Medicaid,UHC Medicaid,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,UMR CPD,UMR CPD,150.34,,,,,,,per diem,150.34,150.34,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,UHC Medicare,UHC Medicare,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING LIMITED   ,34600510,CDM,440,RC,96110,CPT,,,GN,Inpatient,,,150.34,150.34,Wellcare,Wellcare,150.34,,,,,,,case rate,150.34,150.34,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Meritain Health PPO CPD,Meritain Health PPO CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Aetna/Commercial Product,Aetna/Commercial Product,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Meritain Health CPD,Meritain Health CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Starmark CPD,Starmark CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Aetna Medicare,Aetna Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Ambetter ,Ambetter ,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Blue Access,Anthem Blue Access,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Blue Access Choice,Anthem Blue Access Choice,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Blue Preferred,Anthem Blue Preferred,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Pathway,Anthem Pathway,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Alliance,Anthem Alliance,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Anthem Medicare,Anthem Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Cigna,Cigna,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Cigna PPO,Cigna PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Cigna Medicare Advantage,Cigna Medicare Advantage,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Essence,Essence,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Healthlink HMO,Healthlink HMO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Healthlink PPO,Healthlink PPO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,HomeState Health Plan,HomeState Health Plan,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Humana Gold,Humana Gold,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Medicaid MO,Medicaid MO,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Medica,Medica,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Tricare,Tricare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,UHC All Payer,UHC All Payer,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,UHC Exchange,UHC Exchange,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,UHC Medicaid,UHC Medicaid,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,UMR CPD,UMR CPD,73.77,,,,,,,per diem,73.77,73.77,"Per diem rate, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,UHC Medicare,UHC Medicare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
DEVELOPMENT TESTING EXTEND    ,34600515,CDM,440,RC,96111,CPT,,,GN,Inpatient,,,73.77,73.77,Wellcare,Wellcare,73.77,,,,,,,case rate,73.77,73.77,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Meritain Health PPO CPD,Meritain Health PPO CPD,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Aetna/Commercial Product,Aetna/Commercial Product,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Meritain Health CPD,Meritain Health CPD,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Starmark CPD,Starmark CPD,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Aetna Medicare,Aetna Medicare,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Ambetter ,Ambetter ,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Blue Access,Anthem Blue Access,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Blue Access Choice,Anthem Blue Access Choice,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Blue Preferred,Anthem Blue Preferred,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Pathway,Anthem Pathway,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Alliance,Anthem Alliance,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Anthem Medicare,Anthem Medicare,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Cigna,Cigna,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Cigna PPO,Cigna PPO,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Cigna Medicare Advantage,Cigna Medicare Advantage,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Essence,Essence,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Healthlink HMO,Healthlink HMO,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Healthlink PPO,Healthlink PPO,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,HomeState Health Plan,HomeState Health Plan,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Humana Gold,Humana Gold,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Medicaid MO,Medicaid MO,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Medica,Medica,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Tricare,Tricare,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,UHC All Payer,UHC All Payer,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,UHC Exchange,UHC Exchange,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,UHC Medicaid,UHC Medicaid,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,UMR CPD,UMR CPD,78.95,,,,,,,per diem,78.95,78.95,"Per diem rate, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,UHC Medicare,UHC Medicare,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
COMM/WORK REINTEG 15 MIN      ,34600525,CDM,440,RC,97537,CPT,,,GN,Inpatient,,,78.95,78.95,Wellcare,Wellcare,78.95,,,,,,,case rate,78.95,78.95,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Meritain Health PPO CPD,Meritain Health PPO CPD,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Aetna/Commercial Product,Aetna/Commercial Product,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Meritain Health CPD,Meritain Health CPD,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Starmark CPD,Starmark CPD,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Aetna Medicare,Aetna Medicare,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Ambetter ,Ambetter ,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Blue Access,Anthem Blue Access,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Blue Access Choice,Anthem Blue Access Choice,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Blue Preferred,Anthem Blue Preferred,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Pathway,Anthem Pathway,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Alliance,Anthem Alliance,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Anthem Medicare,Anthem Medicare,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Cigna,Cigna,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Cigna PPO,Cigna PPO,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Cigna Medicare Advantage,Cigna Medicare Advantage,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Essence,Essence,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Healthlink HMO,Healthlink HMO,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Healthlink PPO,Healthlink PPO,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,HomeState Health Plan,HomeState Health Plan,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Humana Gold,Humana Gold,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Medicaid MO,Medicaid MO,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Medica,Medica,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Tricare,Tricare,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,UHC All Payer,UHC All Payer,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,UHC Exchange,UHC Exchange,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,UHC Medicaid,UHC Medicaid,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,UMR CPD,UMR CPD,396.23,,,,,,,per diem,396.23,396.23,"Per diem rate, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,UHC Medicare,UHC Medicare,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
STANDARD COGNITIVE TEST PER HR,34600530,CDM,440,RC,96125,CPT,,,GN,Inpatient,,,396.23,396.23,Wellcare,Wellcare,396.23,,,,,,,case rate,396.23,396.23,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Meritain Health PPO CPD,Meritain Health PPO CPD,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Aetna/Commercial Product,Aetna/Commercial Product,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Meritain Health CPD,Meritain Health CPD,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Starmark CPD,Starmark CPD,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Aetna Medicare,Aetna Medicare,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Ambetter ,Ambetter ,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Blue Access,Anthem Blue Access,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Blue Access Choice,Anthem Blue Access Choice,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Blue Preferred,Anthem Blue Preferred,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Pathway,Anthem Pathway,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Alliance,Anthem Alliance,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Anthem Medicare,Anthem Medicare,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Cigna,Cigna,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Cigna PPO,Cigna PPO,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Cigna Medicare Advantage,Cigna Medicare Advantage,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Essence,Essence,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Healthlink HMO,Healthlink HMO,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Healthlink PPO,Healthlink PPO,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,HomeState Health Plan,HomeState Health Plan,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Humana Gold,Humana Gold,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Medicaid MO,Medicaid MO,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Medica,Medica,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Tricare,Tricare,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,UHC All Payer,UHC All Payer,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,UHC Exchange,UHC Exchange,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,UHC Medicaid,UHC Medicaid,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,UMR CPD,UMR CPD,356.17,,,,,,,per diem,356.17,356.17,"Per diem rate, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,UHC Medicare,UHC Medicare,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL OF PROSTH COMM DEVICE    ,34610010,CDM,440,RC,92597,CPT,,,GN,Inpatient,,,356.17,356.17,Wellcare,Wellcare,356.17,,,,,,,case rate,356.17,356.17,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Meritain Health PPO CPD,Meritain Health PPO CPD,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Aetna/Commercial Product,Aetna/Commercial Product,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Meritain Health CPD,Meritain Health CPD,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Starmark CPD,Starmark CPD,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Aetna Medicare,Aetna Medicare,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Ambetter ,Ambetter ,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Blue Access,Anthem Blue Access,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Blue Access Choice,Anthem Blue Access Choice,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Blue Preferred,Anthem Blue Preferred,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Pathway,Anthem Pathway,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Alliance,Anthem Alliance,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Anthem Medicare,Anthem Medicare,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Cigna,Cigna,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Cigna PPO,Cigna PPO,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Cigna Medicare Advantage,Cigna Medicare Advantage,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Essence,Essence,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Healthlink HMO,Healthlink HMO,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Healthlink PPO,Healthlink PPO,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,HomeState Health Plan,HomeState Health Plan,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Humana Gold,Humana Gold,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Medicaid MO,Medicaid MO,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Medica,Medica,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Tricare,Tricare,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,UHC All Payer,UHC All Payer,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,UHC Exchange,UHC Exchange,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,UHC Medicaid,UHC Medicaid,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,UMR CPD,UMR CPD,316.87,,,,,,,per diem,316.87,316.87,"Per diem rate, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,UHC Medicare,UHC Medicare,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
EVAL APHASIA PER HR           ,34650005,CDM,440,RC,96105,CPT,,,GN,Inpatient,,,316.87,316.87,Wellcare,Wellcare,316.87,,,,,,,case rate,316.87,316.87,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Meritain Health PPO CPD,Meritain Health PPO CPD,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Aetna/Commercial Product,Aetna/Commercial Product,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Meritain Health CPD,Meritain Health CPD,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Starmark CPD,Starmark CPD,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Aetna Medicare,Aetna Medicare,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Ambetter ,Ambetter ,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Blue Access,Anthem Blue Access,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Blue Access Choice,Anthem Blue Access Choice,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Blue Preferred,Anthem Blue Preferred,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Pathway,Anthem Pathway,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Alliance,Anthem Alliance,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Anthem Medicare,Anthem Medicare,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Cigna,Cigna,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Cigna PPO,Cigna PPO,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Cigna Medicare Advantage,Cigna Medicare Advantage,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Essence,Essence,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Healthlink HMO,Healthlink HMO,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Healthlink PPO,Healthlink PPO,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,HomeState Health Plan,HomeState Health Plan,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Humana Gold,Humana Gold,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Medicaid MO,Medicaid MO,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Medica,Medica,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Tricare,Tricare,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,UHC All Payer,UHC All Payer,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,UHC Exchange,UHC Exchange,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,UHC Medicaid,UHC Medicaid,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,UMR CPD,UMR CPD,221.94,,,,,,,per diem,221.94,221.94,"Per diem rate, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,UHC Medicare,UHC Medicare,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
AURAL REHAB INDIVIDUAL        ,34650015,CDM,440,RC,92507,CPT,,,GN,Inpatient,,,221.94,221.94,Wellcare,Wellcare,221.94,,,,,,,case rate,221.94,221.94,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Meritain Health PPO CPD,Meritain Health PPO CPD,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Aetna/Commercial Product,Aetna/Commercial Product,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Meritain Health CPD,Meritain Health CPD,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Starmark CPD,Starmark CPD,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Aetna Medicare,Aetna Medicare,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Ambetter ,Ambetter ,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Blue Access,Anthem Blue Access,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Blue Access Choice,Anthem Blue Access Choice,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Blue Preferred,Anthem Blue Preferred,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Pathway,Anthem Pathway,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Alliance,Anthem Alliance,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Anthem Medicare,Anthem Medicare,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Cigna,Cigna,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Cigna PPO,Cigna PPO,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Cigna Medicare Advantage,Cigna Medicare Advantage,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Essence,Essence,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Healthlink HMO,Healthlink HMO,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Healthlink PPO,Healthlink PPO,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,HomeState Health Plan,HomeState Health Plan,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Humana Gold,Humana Gold,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Medicaid MO,Medicaid MO,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Medica,Medica,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Tricare,Tricare,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,UHC All Payer,UHC All Payer,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,UHC Exchange,UHC Exchange,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,UHC Medicaid,UHC Medicaid,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,UMR CPD,UMR CPD,674.5,,,,,,,per diem,674.5,674.5,"Per diem rate, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,UHC Medicare,UHC Medicare,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
MBS EVAL                      ,34650016,CDM,440,RC,,,,,,Inpatient,,,674.5,674.5,Wellcare,Wellcare,674.5,,,,,,,case rate,674.5,674.5,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Meritain Health PPO CPD,Meritain Health PPO CPD,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Aetna/Commercial Product,Aetna/Commercial Product,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Meritain Health CPD,Meritain Health CPD,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Starmark CPD,Starmark CPD,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Aetna Medicare,Aetna Medicare,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Ambetter ,Ambetter ,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Blue Access,Anthem Blue Access,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Blue Access Choice,Anthem Blue Access Choice,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Blue Preferred,Anthem Blue Preferred,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Pathway,Anthem Pathway,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Alliance,Anthem Alliance,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Anthem Medicare,Anthem Medicare,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Cigna,Cigna,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Cigna PPO,Cigna PPO,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Cigna Medicare Advantage,Cigna Medicare Advantage,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Essence,Essence,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Healthlink HMO,Healthlink HMO,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Healthlink PPO,Healthlink PPO,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,HomeState Health Plan,HomeState Health Plan,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Humana Gold,Humana Gold,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Medicaid MO,Medicaid MO,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Medica,Medica,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Tricare,Tricare,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,UHC All Payer,UHC All Payer,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,UHC Exchange,UHC Exchange,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,UHC Medicaid,UHC Medicaid,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,UMR CPD,UMR CPD,331.57,,,,,,,per diem,331.57,331.57,"Per diem rate, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,UHC Medicare,UHC Medicare,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
SWALLOWING TREATMENT          ,34650017,CDM,440,RC,,,,,,Inpatient,,,331.57,331.57,Wellcare,Wellcare,331.57,,,,,,,case rate,331.57,331.57,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Meritain Health PPO CPD,Meritain Health PPO CPD,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Aetna/Commercial Product,Aetna/Commercial Product,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Meritain Health CPD,Meritain Health CPD,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Starmark CPD,Starmark CPD,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Aetna Medicare,Aetna Medicare,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Ambetter ,Ambetter ,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Blue Access,Anthem Blue Access,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Blue Access Choice,Anthem Blue Access Choice,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Blue Preferred,Anthem Blue Preferred,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Pathway,Anthem Pathway,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Alliance,Anthem Alliance,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Anthem Medicare,Anthem Medicare,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Cigna,Cigna,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Cigna PPO,Cigna PPO,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Cigna Medicare Advantage,Cigna Medicare Advantage,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Essence,Essence,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Healthlink HMO,Healthlink HMO,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Healthlink PPO,Healthlink PPO,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,HomeState Health Plan,HomeState Health Plan,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Humana Gold,Humana Gold,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Medicaid MO,Medicaid MO,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Medica,Medica,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Tricare,Tricare,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,UHC All Payer,UHC All Payer,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,UHC Exchange,UHC Exchange,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,UHC Medicaid,UHC Medicaid,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,UMR CPD,UMR CPD,68.47,,,,,,,per diem,68.47,68.47,"Per diem rate, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,UHC Medicare,UHC Medicare,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
DYS TXT W/E-STIM ATTEND 15MIN ,34699980,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,68.47,68.47,Wellcare,Wellcare,68.47,,,,,,,case rate,68.47,68.47,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Meritain Health PPO CPD,Meritain Health PPO CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Aetna/Commercial Product,Aetna/Commercial Product,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Meritain Health CPD,Meritain Health CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Starmark CPD,Starmark CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Aetna Medicare,Aetna Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Ambetter ,Ambetter ,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Blue Access,Anthem Blue Access,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Blue Access Choice,Anthem Blue Access Choice,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Blue Preferred,Anthem Blue Preferred,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Pathway,Anthem Pathway,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Alliance,Anthem Alliance,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Anthem Medicare,Anthem Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Cigna,Cigna,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Cigna PPO,Cigna PPO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Cigna Medicare Advantage,Cigna Medicare Advantage,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Essence,Essence,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Healthlink HMO,Healthlink HMO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Healthlink PPO,Healthlink PPO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,HomeState Health Plan,HomeState Health Plan,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Humana Gold,Humana Gold,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Medicaid MO,Medicaid MO,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Medica,Medica,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Tricare,Tricare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,UHC All Payer,UHC All Payer,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,UHC Exchange,UHC Exchange,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,UHC Medicaid,UHC Medicaid,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,UMR CPD,UMR CPD,127.22,,,,,,,per diem,127.22,127.22,"Per diem rate, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,UHC Medicare,UHC Medicare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
E-STIM ATTENDED 15MIN         ,34699981,CDM,440,RC,97032,CPT,,,GN,Inpatient,,,127.22,127.22,Wellcare,Wellcare,127.22,,,,,,,case rate,127.22,127.22,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Meritain Health PPO CPD,Meritain Health PPO CPD,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Aetna/Commercial Product,Aetna/Commercial Product,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Meritain Health CPD,Meritain Health CPD,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Starmark CPD,Starmark CPD,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Aetna Medicare,Aetna Medicare,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Ambetter ,Ambetter ,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Blue Access,Anthem Blue Access,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Blue Access Choice,Anthem Blue Access Choice,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Blue Preferred,Anthem Blue Preferred,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Pathway,Anthem Pathway,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Alliance,Anthem Alliance,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Anthem Medicare,Anthem Medicare,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Cigna,Cigna,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Cigna PPO,Cigna PPO,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Cigna Medicare Advantage,Cigna Medicare Advantage,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Essence,Essence,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Healthlink HMO,Healthlink HMO,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Healthlink PPO,Healthlink PPO,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,HomeState Health Plan,HomeState Health Plan,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Humana Gold,Humana Gold,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Medicaid MO,Medicaid MO,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Medica,Medica,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Tricare,Tricare,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,UHC All Payer,UHC All Payer,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,UHC Exchange,UHC Exchange,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,UHC Medicaid,UHC Medicaid,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,UMR CPD,UMR CPD,159.03,,,,,,,per diem,159.03,159.03,"Per diem rate, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,UHC Medicare,UHC Medicare,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
PT/FAMILY TRAINING EA 30 MIN  ,34699985,CDM,440,RC,98960,CPT,,,GN,Inpatient,,,159.03,159.03,Wellcare,Wellcare,159.03,,,,,,,case rate,159.03,159.03,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Meritain Health PPO CPD,Meritain Health PPO CPD,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Aetna/Commercial Product,Aetna/Commercial Product,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Meritain Health CPD,Meritain Health CPD,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Starmark CPD,Starmark CPD,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Aetna Medicare,Aetna Medicare,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Ambetter ,Ambetter ,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Blue Access,Anthem Blue Access,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Blue Access Choice,Anthem Blue Access Choice,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Blue Preferred,Anthem Blue Preferred,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Pathway,Anthem Pathway,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Alliance,Anthem Alliance,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Anthem Medicare,Anthem Medicare,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Cigna,Cigna,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Cigna PPO,Cigna PPO,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Cigna Medicare Advantage,Cigna Medicare Advantage,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Essence,Essence,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Healthlink HMO,Healthlink HMO,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Healthlink PPO,Healthlink PPO,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,HomeState Health Plan,HomeState Health Plan,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Humana Gold,Humana Gold,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Medicaid MO,Medicaid MO,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Medica,Medica,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Tricare,Tricare,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,UHC All Payer,UHC All Payer,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,UHC Exchange,UHC Exchange,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,UHC Medicaid,UHC Medicaid,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,UMR CPD,UMR CPD,665.54,,,,,,,per diem,665.54,665.54,"Per diem rate, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,UHC Medicare,UHC Medicare,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
ART LINE INSERTION            ,36000016,CDM,300,RC,36600,CPT,,,,Inpatient,,,665.54,665.54,Wellcare,Wellcare,665.54,,,,,,,case rate,665.54,665.54,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Meritain Health PPO CPD,Meritain Health PPO CPD,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Aetna/Commercial Product,Aetna/Commercial Product,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Meritain Health CPD,Meritain Health CPD,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Starmark CPD,Starmark CPD,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Aetna Medicare,Aetna Medicare,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Ambetter ,Ambetter ,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Blue Access,Anthem Blue Access,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Blue Access Choice,Anthem Blue Access Choice,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Blue Preferred,Anthem Blue Preferred,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Pathway,Anthem Pathway,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Alliance,Anthem Alliance,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Anthem Medicare,Anthem Medicare,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Cigna,Cigna,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Cigna PPO,Cigna PPO,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Cigna Medicare Advantage,Cigna Medicare Advantage,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Essence,Essence,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Healthlink HMO,Healthlink HMO,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Healthlink PPO,Healthlink PPO,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,HomeState Health Plan,HomeState Health Plan,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Humana Gold,Humana Gold,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Medicaid MO,Medicaid MO,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Medica,Medica,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Tricare,Tricare,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,UHC All Payer,UHC All Payer,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,UHC Exchange,UHC Exchange,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,UHC Medicaid,UHC Medicaid,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,UMR CPD,UMR CPD,144.4,,,,,,,per diem,144.4,144.4,"Per diem rate, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,UHC Medicare,UHC Medicare,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
CONT INHAL TRTMT FIRST HR     ,36000070,CDM,410,RC,94644,CPT,,,,Inpatient,,,144.4,144.4,Wellcare,Wellcare,144.4,,,,,,,case rate,144.4,144.4,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health PPO CPD,Meritain Health PPO CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/Commercial Product,Aetna/Commercial Product,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health CPD,Meritain Health CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Starmark CPD,Starmark CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna Medicare,Aetna Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Ambetter ,Ambetter ,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access,Anthem Blue Access,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access Choice,Anthem Blue Access Choice,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Preferred,Anthem Blue Preferred,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Pathway,Anthem Pathway,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Alliance,Anthem Alliance,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Medicare,Anthem Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna,Cigna,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna PPO,Cigna PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna Medicare Advantage,Cigna Medicare Advantage,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Essence,Essence,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink HMO,Healthlink HMO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink PPO,Healthlink PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,HomeState Health Plan,HomeState Health Plan,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Humana Gold,Humana Gold,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medicaid MO,Medicaid MO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medica,Medica,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Tricare,Tricare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC All Payer,UHC All Payer,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Exchange,UHC Exchange,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicaid,UHC Medicaid,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UMR CPD,UMR CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicare,UHC Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
IPPB-INITIAL/EZPAP            ,36000090,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Wellcare,Wellcare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health PPO CPD,Meritain Health PPO CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/Commercial Product,Aetna/Commercial Product,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health CPD,Meritain Health CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Starmark CPD,Starmark CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna Medicare,Aetna Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Ambetter ,Ambetter ,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access,Anthem Blue Access,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access Choice,Anthem Blue Access Choice,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Preferred,Anthem Blue Preferred,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Pathway,Anthem Pathway,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Alliance,Anthem Alliance,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Medicare,Anthem Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna,Cigna,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna PPO,Cigna PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna Medicare Advantage,Cigna Medicare Advantage,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Essence,Essence,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink HMO,Healthlink HMO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink PPO,Healthlink PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,HomeState Health Plan,HomeState Health Plan,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Humana Gold,Humana Gold,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medicaid MO,Medicaid MO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medica,Medica,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Tricare,Tricare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC All Payer,UHC All Payer,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Exchange,UHC Exchange,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicaid,UHC Medicaid,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UMR CPD,UMR CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicare,UHC Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
MDI                           ,36000091,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Wellcare,Wellcare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Meritain Health PPO CPD,Meritain Health PPO CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Aetna/Commercial Product,Aetna/Commercial Product,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Meritain Health CPD,Meritain Health CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Starmark CPD,Starmark CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Aetna Medicare,Aetna Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Ambetter ,Ambetter ,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Blue Access,Anthem Blue Access,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Blue Access Choice,Anthem Blue Access Choice,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Blue Preferred,Anthem Blue Preferred,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Pathway,Anthem Pathway,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Alliance,Anthem Alliance,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Anthem Medicare,Anthem Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Cigna,Cigna,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Cigna PPO,Cigna PPO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Cigna Medicare Advantage,Cigna Medicare Advantage,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Essence,Essence,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Healthlink HMO,Healthlink HMO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Healthlink PPO,Healthlink PPO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,HomeState Health Plan,HomeState Health Plan,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Humana Gold,Humana Gold,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Medicaid MO,Medicaid MO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Medica,Medica,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Tricare,Tricare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,UHC All Payer,UHC All Payer,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,UHC Exchange,UHC Exchange,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,UHC Medicaid,UHC Medicaid,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,UMR CPD,UMR CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,UHC Medicare,UHC Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEBULIZER                     ,36000092,CDM,410,RC,,,,,,Inpatient,,,8.49,8.49,Wellcare,Wellcare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Meritain Health PPO CPD,Meritain Health PPO CPD,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Aetna/Commercial Product,Aetna/Commercial Product,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Meritain Health CPD,Meritain Health CPD,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Starmark CPD,Starmark CPD,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Aetna Medicare,Aetna Medicare,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Ambetter ,Ambetter ,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Blue Access,Anthem Blue Access,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Blue Access Choice,Anthem Blue Access Choice,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Blue Preferred,Anthem Blue Preferred,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Pathway,Anthem Pathway,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Alliance,Anthem Alliance,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Anthem Medicare,Anthem Medicare,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Cigna,Cigna,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Cigna PPO,Cigna PPO,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Cigna Medicare Advantage,Cigna Medicare Advantage,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Essence,Essence,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Healthlink HMO,Healthlink HMO,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Healthlink PPO,Healthlink PPO,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,HomeState Health Plan,HomeState Health Plan,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Humana Gold,Humana Gold,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Medicaid MO,Medicaid MO,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Medica,Medica,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Tricare,Tricare,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,UHC All Payer,UHC All Payer,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,UHC Exchange,UHC Exchange,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,UHC Medicaid,UHC Medicaid,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,UMR CPD,UMR CPD,83.36,,,,,,,per diem,83.36,83.36,"Per diem rate, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,UHC Medicare,UHC Medicare,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
NEW INSTRUCT NEB/MDI          ,36000100,CDM,410,RC,,,,,,Inpatient,,,83.36,83.36,Wellcare,Wellcare,83.36,,,,,,,case rate,83.36,83.36,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Meritain Health PPO CPD,Meritain Health PPO CPD,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Aetna/Commercial Product,Aetna/Commercial Product,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Meritain Health CPD,Meritain Health CPD,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Starmark CPD,Starmark CPD,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Aetna Medicare,Aetna Medicare,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Ambetter ,Ambetter ,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Blue Access,Anthem Blue Access,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Blue Access Choice,Anthem Blue Access Choice,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Blue Preferred,Anthem Blue Preferred,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Pathway,Anthem Pathway,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Alliance,Anthem Alliance,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Anthem Medicare,Anthem Medicare,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Cigna,Cigna,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Cigna PPO,Cigna PPO,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Cigna Medicare Advantage,Cigna Medicare Advantage,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Essence,Essence,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Healthlink HMO,Healthlink HMO,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Healthlink PPO,Healthlink PPO,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,HomeState Health Plan,HomeState Health Plan,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Humana Gold,Humana Gold,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Medicaid MO,Medicaid MO,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Medica,Medica,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Tricare,Tricare,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,UHC All Payer,UHC All Payer,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,UHC Exchange,UHC Exchange,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,UHC Medicaid,UHC Medicaid,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,UMR CPD,UMR CPD,41.17,,,,,,,per diem,41.17,41.17,"Per diem rate, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,UHC Medicare,UHC Medicare,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
SMOKING CESSATION > 10 MIN    ,36000101,CDM,410,RC,,,,,,Inpatient,,,41.17,41.17,Wellcare,Wellcare,41.17,,,,,,,case rate,41.17,41.17,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Meritain Health PPO CPD,Meritain Health PPO CPD,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Aetna/Commercial Product,Aetna/Commercial Product,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Meritain Health CPD,Meritain Health CPD,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Starmark CPD,Starmark CPD,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Aetna Medicare,Aetna Medicare,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Ambetter ,Ambetter ,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Blue Access,Anthem Blue Access,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Blue Access Choice,Anthem Blue Access Choice,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Blue Preferred,Anthem Blue Preferred,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Pathway,Anthem Pathway,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Alliance,Anthem Alliance,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Anthem Medicare,Anthem Medicare,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Cigna,Cigna,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Cigna PPO,Cigna PPO,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Cigna Medicare Advantage,Cigna Medicare Advantage,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Essence,Essence,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Healthlink HMO,Healthlink HMO,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Healthlink PPO,Healthlink PPO,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,HomeState Health Plan,HomeState Health Plan,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Humana Gold,Humana Gold,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Medicaid MO,Medicaid MO,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Medica,Medica,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Tricare,Tricare,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,UHC All Payer,UHC All Payer,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,UHC Exchange,UHC Exchange,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,UHC Medicaid,UHC Medicaid,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,UMR CPD,UMR CPD,474.51,,,,,,,per diem,474.51,474.51,"Per diem rate, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,UHC Medicare,UHC Medicare,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
CPAP INITIAL SETUP            ,36000105,CDM,410,RC,,,,,,Inpatient,,,474.51,474.51,Wellcare,Wellcare,474.51,,,,,,,case rate,474.51,474.51,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Meritain Health PPO CPD,Meritain Health PPO CPD,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Aetna/Commercial Product,Aetna/Commercial Product,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Meritain Health CPD,Meritain Health CPD,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Starmark CPD,Starmark CPD,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Aetna Medicare,Aetna Medicare,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Ambetter ,Ambetter ,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Blue Access,Anthem Blue Access,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Blue Access Choice,Anthem Blue Access Choice,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Blue Preferred,Anthem Blue Preferred,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Pathway,Anthem Pathway,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Alliance,Anthem Alliance,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Anthem Medicare,Anthem Medicare,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Cigna,Cigna,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Cigna PPO,Cigna PPO,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Cigna Medicare Advantage,Cigna Medicare Advantage,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Essence,Essence,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Healthlink HMO,Healthlink HMO,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Healthlink PPO,Healthlink PPO,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,HomeState Health Plan,HomeState Health Plan,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Humana Gold,Humana Gold,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Medicaid MO,Medicaid MO,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Medica,Medica,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Tricare,Tricare,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,UHC All Payer,UHC All Payer,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,UHC Exchange,UHC Exchange,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,UHC Medicaid,UHC Medicaid,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,UMR CPD,UMR CPD,469.74,,,,,,,per diem,469.74,469.74,"Per diem rate, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,UHC Medicare,UHC Medicare,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
OXYGEN DAILY                  ,36000106,CDM,410,RC,,,,,,Inpatient,,,469.74,469.74,Wellcare,Wellcare,469.74,,,,,,,case rate,469.74,469.74,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Meritain Health PPO CPD,Meritain Health PPO CPD,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Aetna/Commercial Product,Aetna/Commercial Product,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Meritain Health CPD,Meritain Health CPD,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Starmark CPD,Starmark CPD,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Aetna Medicare,Aetna Medicare,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Ambetter ,Ambetter ,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Blue Access,Anthem Blue Access,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Blue Access Choice,Anthem Blue Access Choice,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Blue Preferred,Anthem Blue Preferred,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Pathway,Anthem Pathway,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Alliance,Anthem Alliance,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Anthem Medicare,Anthem Medicare,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Cigna,Cigna,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Cigna PPO,Cigna PPO,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Cigna Medicare Advantage,Cigna Medicare Advantage,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Essence,Essence,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Healthlink HMO,Healthlink HMO,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Healthlink PPO,Healthlink PPO,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,HomeState Health Plan,HomeState Health Plan,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Humana Gold,Humana Gold,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Medicaid MO,Medicaid MO,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Medica,Medica,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Tricare,Tricare,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,UHC All Payer,UHC All Payer,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,UHC Exchange,UHC Exchange,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,UHC Medicaid,UHC Medicaid,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,UMR CPD,UMR CPD,710.22,,,,,,,per diem,710.22,710.22,"Per diem rate, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,UHC Medicare,UHC Medicare,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ECH0CARDIOLOGY                ,36000107,CDM,480,RC,,,,,,Inpatient,,,710.22,710.22,Wellcare,Wellcare,710.22,,,,,,,case rate,710.22,710.22,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Meritain Health PPO CPD,Meritain Health PPO CPD,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Aetna/Commercial Product,Aetna/Commercial Product,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Meritain Health CPD,Meritain Health CPD,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Starmark CPD,Starmark CPD,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Aetna Medicare,Aetna Medicare,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Ambetter ,Ambetter ,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Blue Access,Anthem Blue Access,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Blue Access Choice,Anthem Blue Access Choice,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Blue Preferred,Anthem Blue Preferred,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Pathway,Anthem Pathway,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Alliance,Anthem Alliance,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Anthem Medicare,Anthem Medicare,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Cigna,Cigna,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Cigna PPO,Cigna PPO,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Cigna Medicare Advantage,Cigna Medicare Advantage,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Essence,Essence,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Healthlink HMO,Healthlink HMO,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Healthlink PPO,Healthlink PPO,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,HomeState Health Plan,HomeState Health Plan,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Humana Gold,Humana Gold,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Medicaid MO,Medicaid MO,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Medica,Medica,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Tricare,Tricare,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,UHC All Payer,UHC All Payer,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,UHC Exchange,UHC Exchange,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,UHC Medicaid,UHC Medicaid,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,UMR CPD,UMR CPD,416.48,,,,,,,per diem,416.48,416.48,"Per diem rate, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,UHC Medicare,UHC Medicare,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
ARTERIAL BLOOD GAS            ,36000121,CDM,301,RC,82803,CPT,,,,Inpatient,,,416.48,416.48,Wellcare,Wellcare,416.48,,,,,,,case rate,416.48,416.48,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Meritain Health PPO CPD,Meritain Health PPO CPD,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Aetna/Commercial Product,Aetna/Commercial Product,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Meritain Health CPD,Meritain Health CPD,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Starmark CPD,Starmark CPD,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Aetna Medicare,Aetna Medicare,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Ambetter ,Ambetter ,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Blue Access,Anthem Blue Access,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Blue Access Choice,Anthem Blue Access Choice,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Blue Preferred,Anthem Blue Preferred,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Pathway,Anthem Pathway,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Alliance,Anthem Alliance,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Anthem Medicare,Anthem Medicare,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Cigna,Cigna,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Cigna PPO,Cigna PPO,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Cigna Medicare Advantage,Cigna Medicare Advantage,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Essence,Essence,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Healthlink HMO,Healthlink HMO,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Healthlink PPO,Healthlink PPO,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,HomeState Health Plan,HomeState Health Plan,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Humana Gold,Humana Gold,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Medicaid MO,Medicaid MO,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Medica,Medica,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Tricare,Tricare,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,UHC All Payer,UHC All Payer,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,UHC Exchange,UHC Exchange,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,UHC Medicaid,UHC Medicaid,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,UMR CPD,UMR CPD,169.91,,,,,,,per diem,169.91,169.91,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,UHC Medicare,UHC Medicare,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51701     ,36000123,CDM,410,RC,51701,CPT,,,,Inpatient,,,169.91,169.91,Wellcare,Wellcare,169.91,,,,,,,case rate,169.91,169.91,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Meritain Health PPO CPD,Meritain Health PPO CPD,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Aetna/Commercial Product,Aetna/Commercial Product,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Meritain Health CPD,Meritain Health CPD,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Starmark CPD,Starmark CPD,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Aetna Medicare,Aetna Medicare,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Ambetter ,Ambetter ,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Blue Access,Anthem Blue Access,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Blue Access Choice,Anthem Blue Access Choice,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Blue Preferred,Anthem Blue Preferred,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Pathway,Anthem Pathway,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Alliance,Anthem Alliance,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Anthem Medicare,Anthem Medicare,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Cigna,Cigna,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Cigna PPO,Cigna PPO,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Cigna Medicare Advantage,Cigna Medicare Advantage,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Essence,Essence,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Healthlink HMO,Healthlink HMO,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Healthlink PPO,Healthlink PPO,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,HomeState Health Plan,HomeState Health Plan,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Humana Gold,Humana Gold,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Medicaid MO,Medicaid MO,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Medica,Medica,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Tricare,Tricare,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,UHC All Payer,UHC All Payer,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,UHC Exchange,UHC Exchange,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,UHC Medicaid,UHC Medicaid,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,UMR CPD,UMR CPD,79.86,,,,,,,per diem,79.86,79.86,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,UHC Medicare,UHC Medicare,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51702     ,36000124,CDM,410,RC,51702,CPT,,,,Inpatient,,,79.86,79.86,Wellcare,Wellcare,79.86,,,,,,,case rate,79.86,79.86,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Meritain Health PPO CPD,Meritain Health PPO CPD,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Aetna/Commercial Product,Aetna/Commercial Product,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Meritain Health CPD,Meritain Health CPD,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Starmark CPD,Starmark CPD,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Aetna Medicare,Aetna Medicare,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Ambetter ,Ambetter ,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Blue Access,Anthem Blue Access,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Blue Access Choice,Anthem Blue Access Choice,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Blue Preferred,Anthem Blue Preferred,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Pathway,Anthem Pathway,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Alliance,Anthem Alliance,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Anthem Medicare,Anthem Medicare,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Cigna,Cigna,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Cigna PPO,Cigna PPO,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Cigna Medicare Advantage,Cigna Medicare Advantage,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Essence,Essence,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Healthlink HMO,Healthlink HMO,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Healthlink PPO,Healthlink PPO,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,HomeState Health Plan,HomeState Health Plan,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Humana Gold,Humana Gold,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Medicaid MO,Medicaid MO,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Medica,Medica,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Tricare,Tricare,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,UHC All Payer,UHC All Payer,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,UHC Exchange,UHC Exchange,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,UHC Medicaid,UHC Medicaid,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,UMR CPD,UMR CPD,378.7,,,,,,,per diem,378.7,378.7,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,UHC Medicare,UHC Medicare,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 51798     ,36000125,CDM,410,RC,,,,,,Inpatient,,,378.7,378.7,Wellcare,Wellcare,378.7,,,,,,,case rate,378.7,378.7,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Meritain Health PPO CPD,Meritain Health PPO CPD,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Aetna/Commercial Product,Aetna/Commercial Product,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Meritain Health CPD,Meritain Health CPD,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Starmark CPD,Starmark CPD,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Aetna Medicare,Aetna Medicare,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Ambetter ,Ambetter ,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Blue Access,Anthem Blue Access,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Blue Access Choice,Anthem Blue Access Choice,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Blue Preferred,Anthem Blue Preferred,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Pathway,Anthem Pathway,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Alliance,Anthem Alliance,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Anthem Medicare,Anthem Medicare,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Cigna,Cigna,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Cigna PPO,Cigna PPO,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Cigna Medicare Advantage,Cigna Medicare Advantage,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Essence,Essence,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Healthlink HMO,Healthlink HMO,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Healthlink PPO,Healthlink PPO,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,HomeState Health Plan,HomeState Health Plan,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Humana Gold,Humana Gold,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Medicaid MO,Medicaid MO,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Medica,Medica,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Tricare,Tricare,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,UHC All Payer,UHC All Payer,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,UHC Exchange,UHC Exchange,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,UHC Medicaid,UHC Medicaid,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,UMR CPD,UMR CPD,53.54,,,,,,,per diem,53.54,53.54,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,UHC Medicare,UHC Medicare,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82270     ,36000126,CDM,410,RC,82270,CPT,,,,Inpatient,,,53.54,53.54,Wellcare,Wellcare,53.54,,,,,,,case rate,53.54,53.54,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Meritain Health PPO CPD,Meritain Health PPO CPD,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Aetna/Commercial Product,Aetna/Commercial Product,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Meritain Health CPD,Meritain Health CPD,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Starmark CPD,Starmark CPD,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Aetna Medicare,Aetna Medicare,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Ambetter ,Ambetter ,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Blue Access,Anthem Blue Access,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Blue Access Choice,Anthem Blue Access Choice,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Blue Preferred,Anthem Blue Preferred,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Pathway,Anthem Pathway,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Alliance,Anthem Alliance,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Anthem Medicare,Anthem Medicare,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Cigna,Cigna,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Cigna PPO,Cigna PPO,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Cigna Medicare Advantage,Cigna Medicare Advantage,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Essence,Essence,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Healthlink HMO,Healthlink HMO,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Healthlink PPO,Healthlink PPO,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,HomeState Health Plan,HomeState Health Plan,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Humana Gold,Humana Gold,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Medicaid MO,Medicaid MO,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Medica,Medica,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Tricare,Tricare,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,UHC All Payer,UHC All Payer,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,UHC Exchange,UHC Exchange,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,UHC Medicaid,UHC Medicaid,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,UMR CPD,UMR CPD,99.44,,,,,,,per diem,99.44,99.44,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,UHC Medicare,UHC Medicare,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 82565     ,36000127,CDM,410,RC,82565,CPT,,,,Inpatient,,,99.44,99.44,Wellcare,Wellcare,99.44,,,,,,,case rate,99.44,99.44,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health PPO CPD,Meritain Health PPO CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/Commercial Product,Aetna/Commercial Product,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health CPD,Meritain Health CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Starmark CPD,Starmark CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna Medicare,Aetna Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Ambetter ,Ambetter ,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access,Anthem Blue Access,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access Choice,Anthem Blue Access Choice,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Preferred,Anthem Blue Preferred,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Pathway,Anthem Pathway,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Alliance,Anthem Alliance,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Medicare,Anthem Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna,Cigna,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna PPO,Cigna PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna Medicare Advantage,Cigna Medicare Advantage,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Essence,Essence,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink HMO,Healthlink HMO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink PPO,Healthlink PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,HomeState Health Plan,HomeState Health Plan,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Humana Gold,Humana Gold,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medicaid MO,Medicaid MO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medica,Medica,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Tricare,Tricare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC All Payer,UHC All Payer,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Exchange,UHC Exchange,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicaid,UHC Medicaid,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UMR CPD,UMR CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicare,UHC Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94640     ,36000128,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Wellcare,Wellcare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Meritain Health PPO CPD,Meritain Health PPO CPD,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Aetna/Commercial Product,Aetna/Commercial Product,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Meritain Health CPD,Meritain Health CPD,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Starmark CPD,Starmark CPD,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Aetna Medicare,Aetna Medicare,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Ambetter ,Ambetter ,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Blue Access,Anthem Blue Access,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Blue Access Choice,Anthem Blue Access Choice,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Blue Preferred,Anthem Blue Preferred,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Pathway,Anthem Pathway,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Alliance,Anthem Alliance,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Anthem Medicare,Anthem Medicare,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Cigna,Cigna,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Cigna PPO,Cigna PPO,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Cigna Medicare Advantage,Cigna Medicare Advantage,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Essence,Essence,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Healthlink HMO,Healthlink HMO,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Healthlink PPO,Healthlink PPO,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,HomeState Health Plan,HomeState Health Plan,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Humana Gold,Humana Gold,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Medicaid MO,Medicaid MO,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Medica,Medica,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Tricare,Tricare,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,UHC All Payer,UHC All Payer,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,UHC Exchange,UHC Exchange,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,UHC Medicaid,UHC Medicaid,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,UMR CPD,UMR CPD,67.75,,,,,,,per diem,67.75,67.75,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,UHC Medicare,UHC Medicare,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 94799     ,36000129,CDM,410,RC,94799,CPT,,,,Inpatient,,,67.75,67.75,Wellcare,Wellcare,67.75,,,,,,,case rate,67.75,67.75,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Meritain Health PPO CPD,Meritain Health PPO CPD,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Aetna/Commercial Product,Aetna/Commercial Product,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Meritain Health CPD,Meritain Health CPD,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Starmark CPD,Starmark CPD,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Aetna Medicare,Aetna Medicare,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Ambetter ,Ambetter ,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Blue Access,Anthem Blue Access,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Blue Access Choice,Anthem Blue Access Choice,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Blue Preferred,Anthem Blue Preferred,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Pathway,Anthem Pathway,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Alliance,Anthem Alliance,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Anthem Medicare,Anthem Medicare,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Cigna,Cigna,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Cigna PPO,Cigna PPO,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Cigna Medicare Advantage,Cigna Medicare Advantage,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Essence,Essence,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Healthlink HMO,Healthlink HMO,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Healthlink PPO,Healthlink PPO,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,HomeState Health Plan,HomeState Health Plan,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Humana Gold,Humana Gold,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Medicaid MO,Medicaid MO,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Medica,Medica,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Tricare,Tricare,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,UHC All Payer,UHC All Payer,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,UHC Exchange,UHC Exchange,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,UHC Medicaid,UHC Medicaid,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,UMR CPD,UMR CPD,101.53,,,,,,,per diem,101.53,101.53,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,UHC Medicare,UHC Medicare,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97116     ,36000131,CDM,410,RC,97116,CPT,,,,Inpatient,,,101.53,101.53,Wellcare,Wellcare,101.53,,,,,,,case rate,101.53,101.53,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Meritain Health PPO CPD,Meritain Health PPO CPD,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Aetna/Commercial Product,Aetna/Commercial Product,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Meritain Health CPD,Meritain Health CPD,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Starmark CPD,Starmark CPD,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Aetna Medicare,Aetna Medicare,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Ambetter ,Ambetter ,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Blue Access,Anthem Blue Access,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Blue Access Choice,Anthem Blue Access Choice,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Blue Preferred,Anthem Blue Preferred,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Pathway,Anthem Pathway,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Alliance,Anthem Alliance,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Anthem Medicare,Anthem Medicare,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Cigna,Cigna,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Cigna PPO,Cigna PPO,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Cigna Medicare Advantage,Cigna Medicare Advantage,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Essence,Essence,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Healthlink HMO,Healthlink HMO,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Healthlink PPO,Healthlink PPO,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,HomeState Health Plan,HomeState Health Plan,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Humana Gold,Humana Gold,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Medicaid MO,Medicaid MO,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Medica,Medica,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Tricare,Tricare,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,UHC All Payer,UHC All Payer,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,UHC Exchange,UHC Exchange,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,UHC Medicaid,UHC Medicaid,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,UMR CPD,UMR CPD,289.76,,,,,,,per diem,289.76,289.76,"Per diem rate, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,UHC Medicare,UHC Medicare,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
BIPAP DAILY                   ,36000132,CDM,410,RC,94660,CPT,,,,Inpatient,,,289.76,289.76,Wellcare,Wellcare,289.76,,,,,,,case rate,289.76,289.76,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Meritain Health PPO CPD,Meritain Health PPO CPD,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Aetna/Commercial Product,Aetna/Commercial Product,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Meritain Health CPD,Meritain Health CPD,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Starmark CPD,Starmark CPD,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Aetna Medicare,Aetna Medicare,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Ambetter ,Ambetter ,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Blue Access,Anthem Blue Access,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Blue Access Choice,Anthem Blue Access Choice,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Blue Preferred,Anthem Blue Preferred,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Pathway,Anthem Pathway,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Alliance,Anthem Alliance,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Anthem Medicare,Anthem Medicare,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Cigna,Cigna,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Cigna PPO,Cigna PPO,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Cigna Medicare Advantage,Cigna Medicare Advantage,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Essence,Essence,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Healthlink HMO,Healthlink HMO,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Healthlink PPO,Healthlink PPO,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,HomeState Health Plan,HomeState Health Plan,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Humana Gold,Humana Gold,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Medicaid MO,Medicaid MO,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Medica,Medica,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Tricare,Tricare,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,UHC All Payer,UHC All Payer,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,UHC Exchange,UHC Exchange,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,UHC Medicaid,UHC Medicaid,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,UMR CPD,UMR CPD,242.18,,,,,,,per diem,242.18,242.18,"Per diem rate, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,UHC Medicare,UHC Medicare,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
RESPIRATORY THERAPY 97602     ,36000134,CDM,410,RC,97602,CPT,,,,Inpatient,,,242.18,242.18,Wellcare,Wellcare,242.18,,,,,,,case rate,242.18,242.18,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Meritain Health PPO CPD,Meritain Health PPO CPD,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Aetna/Commercial Product,Aetna/Commercial Product,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Meritain Health CPD,Meritain Health CPD,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Starmark CPD,Starmark CPD,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Aetna Medicare,Aetna Medicare,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Ambetter ,Ambetter ,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Blue Access,Anthem Blue Access,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Blue Access Choice,Anthem Blue Access Choice,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Blue Preferred,Anthem Blue Preferred,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Pathway,Anthem Pathway,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Alliance,Anthem Alliance,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Anthem Medicare,Anthem Medicare,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Cigna,Cigna,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Cigna PPO,Cigna PPO,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Cigna Medicare Advantage,Cigna Medicare Advantage,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Essence,Essence,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Healthlink HMO,Healthlink HMO,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Healthlink PPO,Healthlink PPO,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,HomeState Health Plan,HomeState Health Plan,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Humana Gold,Humana Gold,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Medicaid MO,Medicaid MO,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Medica,Medica,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Tricare,Tricare,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,UHC All Payer,UHC All Payer,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,UHC Exchange,UHC Exchange,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,UHC Medicaid,UHC Medicaid,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,UMR CPD,UMR CPD,38.55,,,,,,,per diem,38.55,38.55,"Per diem rate, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,UHC Medicare,UHC Medicare,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CPAP DAILY                    ,36000136,CDM,410,RC,94660,CPT,,,,Inpatient,,,38.55,38.55,Wellcare,Wellcare,38.55,,,,,,,case rate,38.55,38.55,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Meritain Health PPO CPD,Meritain Health PPO CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Aetna/Commercial Product,Aetna/Commercial Product,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Meritain Health CPD,Meritain Health CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Starmark CPD,Starmark CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Aetna Medicare,Aetna Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Ambetter ,Ambetter ,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Access,Anthem Blue Access,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Access Choice,Anthem Blue Access Choice,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Preferred,Anthem Blue Preferred,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Pathway,Anthem Pathway,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Alliance,Anthem Alliance,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Anthem Medicare,Anthem Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Cigna,Cigna,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Cigna PPO,Cigna PPO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Cigna Medicare Advantage,Cigna Medicare Advantage,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Essence,Essence,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Healthlink HMO,Healthlink HMO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Healthlink PPO,Healthlink PPO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,HomeState Health Plan,HomeState Health Plan,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Humana Gold,Humana Gold,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Medicaid MO,Medicaid MO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Medica,Medica,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Tricare,Tricare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,UHC All Payer,UHC All Payer,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,UHC Exchange,UHC Exchange,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,UHC Medicaid,UHC Medicaid,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,UMR CPD,UMR CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,UHC Medicare,UHC Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION INIT  ,36000140,CDM,410,RC,94667,CPT,,,,Inpatient,,,81.67,81.67,Wellcare,Wellcare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Meritain Health PPO CPD,Meritain Health PPO CPD,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Aetna/Commercial Product,Aetna/Commercial Product,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Meritain Health CPD,Meritain Health CPD,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Starmark CPD,Starmark CPD,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Aetna Medicare,Aetna Medicare,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Ambetter ,Ambetter ,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Blue Access,Anthem Blue Access,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Blue Access Choice,Anthem Blue Access Choice,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Blue Preferred,Anthem Blue Preferred,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Pathway,Anthem Pathway,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Alliance,Anthem Alliance,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Anthem Medicare,Anthem Medicare,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Cigna,Cigna,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Cigna PPO,Cigna PPO,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Cigna Medicare Advantage,Cigna Medicare Advantage,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Essence,Essence,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Healthlink HMO,Healthlink HMO,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Healthlink PPO,Healthlink PPO,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,HomeState Health Plan,HomeState Health Plan,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Humana Gold,Humana Gold,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Medicaid MO,Medicaid MO,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Medica,Medica,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Tricare,Tricare,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,UHC All Payer,UHC All Payer,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,UHC Exchange,UHC Exchange,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,UHC Medicaid,UHC Medicaid,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,UMR CPD,UMR CPD,285.41,,,,,,,per diem,285.41,285.41,"Per diem rate, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,UHC Medicare,UHC Medicare,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
HC RT HEATED HIGH FLOW TH     ,36000141,CDM,410,RC,,,,,,Inpatient,,,285.41,285.41,Wellcare,Wellcare,285.41,,,,,,,case rate,285.41,285.41,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Meritain Health PPO CPD,Meritain Health PPO CPD,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Aetna/Commercial Product,Aetna/Commercial Product,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Meritain Health CPD,Meritain Health CPD,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Starmark CPD,Starmark CPD,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Aetna Medicare,Aetna Medicare,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Ambetter ,Ambetter ,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Blue Access,Anthem Blue Access,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Blue Access Choice,Anthem Blue Access Choice,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Blue Preferred,Anthem Blue Preferred,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Pathway,Anthem Pathway,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Alliance,Anthem Alliance,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Anthem Medicare,Anthem Medicare,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Cigna,Cigna,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Cigna PPO,Cigna PPO,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Cigna Medicare Advantage,Cigna Medicare Advantage,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Essence,Essence,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Healthlink HMO,Healthlink HMO,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Healthlink PPO,Healthlink PPO,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,HomeState Health Plan,HomeState Health Plan,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Humana Gold,Humana Gold,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Medicaid MO,Medicaid MO,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Medica,Medica,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Tricare,Tricare,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,UHC All Payer,UHC All Payer,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,UHC Exchange,UHC Exchange,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,UHC Medicaid,UHC Medicaid,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,UMR CPD,UMR CPD,238.7,,,,,,,per diem,238.7,238.7,"Per diem rate, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,UHC Medicare,UHC Medicare,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
VENT CIRCUIT                  ,36000149,CDM,410,RC,,,,,,Inpatient,,,238.7,238.7,Wellcare,Wellcare,238.7,,,,,,,case rate,238.7,238.7,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Meritain Health PPO CPD,Meritain Health PPO CPD,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Aetna/Commercial Product,Aetna/Commercial Product,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Meritain Health CPD,Meritain Health CPD,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Starmark CPD,Starmark CPD,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Aetna Medicare,Aetna Medicare,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Ambetter ,Ambetter ,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Blue Access,Anthem Blue Access,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Blue Access Choice,Anthem Blue Access Choice,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Blue Preferred,Anthem Blue Preferred,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Pathway,Anthem Pathway,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Alliance,Anthem Alliance,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Anthem Medicare,Anthem Medicare,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Cigna,Cigna,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Cigna PPO,Cigna PPO,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Cigna Medicare Advantage,Cigna Medicare Advantage,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Essence,Essence,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Healthlink HMO,Healthlink HMO,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Healthlink PPO,Healthlink PPO,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,HomeState Health Plan,HomeState Health Plan,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Humana Gold,Humana Gold,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Medicaid MO,Medicaid MO,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Medica,Medica,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Tricare,Tricare,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,UHC All Payer,UHC All Payer,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,UHC Exchange,UHC Exchange,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,UHC Medicaid,UHC Medicaid,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,UMR CPD,UMR CPD,21.22,,,,,,,per diem,21.22,21.22,"Per diem rate, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,UHC Medicare,UHC Medicare,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX EA SUBSEQ TX/DAY       ,36000154,CDM,410,RC,,,,,,Inpatient,,,21.22,21.22,Wellcare,Wellcare,21.22,,,,,,,case rate,21.22,21.22,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
INH TX INITIAL EA DAY         ,36000155,CDM,410,RC,,,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Meritain Health PPO CPD,Meritain Health PPO CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Aetna/Commercial Product,Aetna/Commercial Product,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Meritain Health CPD,Meritain Health CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Starmark CPD,Starmark CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Aetna Medicare,Aetna Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Ambetter ,Ambetter ,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Blue Access,Anthem Blue Access,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Blue Access Choice,Anthem Blue Access Choice,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Blue Preferred,Anthem Blue Preferred,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Pathway,Anthem Pathway,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Alliance,Anthem Alliance,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Anthem Medicare,Anthem Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Cigna,Cigna,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Cigna PPO,Cigna PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Cigna Medicare Advantage,Cigna Medicare Advantage,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Essence,Essence,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Healthlink HMO,Healthlink HMO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Healthlink PPO,Healthlink PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,HomeState Health Plan,HomeState Health Plan,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Humana Gold,Humana Gold,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Medicaid MO,Medicaid MO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Medica,Medica,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Tricare,Tricare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,UHC All Payer,UHC All Payer,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,UHC Exchange,UHC Exchange,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,UHC Medicaid,UHC Medicaid,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,UMR CPD,UMR CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,UHC Medicare,UHC Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
RT ASSESSMENT COMPLETE        ,36000156,CDM,410,RC,,,,,,Inpatient,,,79.57,79.57,Wellcare,Wellcare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Meritain Health PPO CPD,Meritain Health PPO CPD,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Aetna/Commercial Product,Aetna/Commercial Product,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Meritain Health CPD,Meritain Health CPD,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Starmark CPD,Starmark CPD,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Aetna Medicare,Aetna Medicare,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Ambetter ,Ambetter ,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Blue Access,Anthem Blue Access,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Blue Access Choice,Anthem Blue Access Choice,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Blue Preferred,Anthem Blue Preferred,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Pathway,Anthem Pathway,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Alliance,Anthem Alliance,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Anthem Medicare,Anthem Medicare,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Cigna,Cigna,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Cigna PPO,Cigna PPO,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Cigna Medicare Advantage,Cigna Medicare Advantage,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Essence,Essence,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Healthlink HMO,Healthlink HMO,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Healthlink PPO,Healthlink PPO,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,HomeState Health Plan,HomeState Health Plan,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Humana Gold,Humana Gold,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Medicaid MO,Medicaid MO,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Medica,Medica,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Tricare,Tricare,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,UHC All Payer,UHC All Payer,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,UHC Exchange,UHC Exchange,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,UHC Medicaid,UHC Medicaid,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,UMR CPD,UMR CPD,52.2,,,,,,,per diem,52.2,52.2,"Per diem rate, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,UHC Medicare,UHC Medicare,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
NUTRITIONAL CONS PER 15 MIN   ,36000157,CDM,410,RC,97802,CPT,,,,Inpatient,,,52.2,52.2,Wellcare,Wellcare,52.2,,,,,,,case rate,52.2,52.2,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Meritain Health PPO CPD,Meritain Health PPO CPD,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Aetna/Commercial Product,Aetna/Commercial Product,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Meritain Health CPD,Meritain Health CPD,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Starmark CPD,Starmark CPD,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Aetna Medicare,Aetna Medicare,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Ambetter ,Ambetter ,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Blue Access,Anthem Blue Access,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Blue Access Choice,Anthem Blue Access Choice,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Blue Preferred,Anthem Blue Preferred,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Pathway,Anthem Pathway,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Alliance,Anthem Alliance,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Anthem Medicare,Anthem Medicare,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Cigna,Cigna,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Cigna PPO,Cigna PPO,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Cigna Medicare Advantage,Cigna Medicare Advantage,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Essence,Essence,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Healthlink HMO,Healthlink HMO,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Healthlink PPO,Healthlink PPO,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,HomeState Health Plan,HomeState Health Plan,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Humana Gold,Humana Gold,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Medicaid MO,Medicaid MO,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Medica,Medica,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Tricare,Tricare,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,UHC All Payer,UHC All Payer,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,UHC Exchange,UHC Exchange,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,UHC Medicaid,UHC Medicaid,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,UMR CPD,UMR CPD,454.07,,,,,,,per diem,454.07,454.07,"Per diem rate, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,UHC Medicare,UHC Medicare,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CARDIAC OUTPUT                ,36000165,CDM,410,RC,93562,CPT,,,,Inpatient,,,454.07,454.07,Wellcare,Wellcare,454.07,,,,,,,case rate,454.07,454.07,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Meritain Health PPO CPD,Meritain Health PPO CPD,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Aetna/Commercial Product,Aetna/Commercial Product,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Meritain Health CPD,Meritain Health CPD,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Starmark CPD,Starmark CPD,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Aetna Medicare,Aetna Medicare,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Ambetter ,Ambetter ,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Blue Access,Anthem Blue Access,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Blue Access Choice,Anthem Blue Access Choice,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Blue Preferred,Anthem Blue Preferred,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Pathway,Anthem Pathway,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Alliance,Anthem Alliance,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Anthem Medicare,Anthem Medicare,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Cigna,Cigna,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Cigna PPO,Cigna PPO,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Cigna Medicare Advantage,Cigna Medicare Advantage,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Essence,Essence,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Healthlink HMO,Healthlink HMO,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Healthlink PPO,Healthlink PPO,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,HomeState Health Plan,HomeState Health Plan,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Humana Gold,Humana Gold,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Medicaid MO,Medicaid MO,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Medica,Medica,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Tricare,Tricare,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,UHC All Payer,UHC All Payer,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,UHC Exchange,UHC Exchange,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,UHC Medicaid,UHC Medicaid,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,UMR CPD,UMR CPD,125.66,,,,,,,per diem,125.66,125.66,"Per diem rate, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,UHC Medicare,UHC Medicare,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CHEST WALL MANIPULATION SUBSEQ,36000180,CDM,410,RC,94668,CPT,,,,Inpatient,,,125.66,125.66,Wellcare,Wellcare,125.66,,,,,,,case rate,125.66,125.66,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Meritain Health PPO CPD,Meritain Health PPO CPD,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Aetna/Commercial Product,Aetna/Commercial Product,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Meritain Health CPD,Meritain Health CPD,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Starmark CPD,Starmark CPD,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Aetna Medicare,Aetna Medicare,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Ambetter ,Ambetter ,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Blue Access,Anthem Blue Access,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Blue Access Choice,Anthem Blue Access Choice,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Blue Preferred,Anthem Blue Preferred,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Pathway,Anthem Pathway,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Alliance,Anthem Alliance,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Anthem Medicare,Anthem Medicare,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Cigna,Cigna,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Cigna PPO,Cigna PPO,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Cigna Medicare Advantage,Cigna Medicare Advantage,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Essence,Essence,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Healthlink HMO,Healthlink HMO,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Healthlink PPO,Healthlink PPO,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,HomeState Health Plan,HomeState Health Plan,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Humana Gold,Humana Gold,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Medicaid MO,Medicaid MO,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Medica,Medica,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Tricare,Tricare,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,UHC All Payer,UHC All Payer,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,UHC Exchange,UHC Exchange,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,UHC Medicaid,UHC Medicaid,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,UMR CPD,UMR CPD,446.92,,,,,,,per diem,446.92,446.92,"Per diem rate, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,UHC Medicare,UHC Medicare,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
CARBON DIOXIDE-EXPIRED GAS    ,36000191,CDM,460,RC,94770,CPT,,,,Inpatient,,,446.92,446.92,Wellcare,Wellcare,446.92,,,,,,,case rate,446.92,446.92,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Meritain Health PPO CPD,Meritain Health PPO CPD,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Aetna/Commercial Product,Aetna/Commercial Product,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Meritain Health CPD,Meritain Health CPD,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Starmark CPD,Starmark CPD,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Aetna Medicare,Aetna Medicare,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Ambetter ,Ambetter ,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Blue Access,Anthem Blue Access,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Blue Access Choice,Anthem Blue Access Choice,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Blue Preferred,Anthem Blue Preferred,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Pathway,Anthem Pathway,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Alliance,Anthem Alliance,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Anthem Medicare,Anthem Medicare,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Cigna,Cigna,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Cigna PPO,Cigna PPO,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Cigna Medicare Advantage,Cigna Medicare Advantage,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Essence,Essence,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Healthlink HMO,Healthlink HMO,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Healthlink PPO,Healthlink PPO,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,HomeState Health Plan,HomeState Health Plan,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Humana Gold,Humana Gold,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Medicaid MO,Medicaid MO,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Medica,Medica,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Tricare,Tricare,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,UHC All Payer,UHC All Payer,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,UHC Exchange,UHC Exchange,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,UHC Medicaid,UHC Medicaid,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,UMR CPD,UMR CPD,357.39,,,,,,,per diem,357.39,357.39,"Per diem rate, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,UHC Medicare,UHC Medicare,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 SINGLE LEVEL            ,36000200,CDM,410,RC,93922,CPT,,,,Inpatient,,,357.39,357.39,Wellcare,Wellcare,357.39,,,,,,,case rate,357.39,357.39,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Meritain Health PPO CPD,Meritain Health PPO CPD,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Aetna/Commercial Product,Aetna/Commercial Product,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Meritain Health CPD,Meritain Health CPD,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Starmark CPD,Starmark CPD,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Aetna Medicare,Aetna Medicare,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Ambetter ,Ambetter ,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Blue Access,Anthem Blue Access,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Blue Access Choice,Anthem Blue Access Choice,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Blue Preferred,Anthem Blue Preferred,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Pathway,Anthem Pathway,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Alliance,Anthem Alliance,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Anthem Medicare,Anthem Medicare,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Cigna,Cigna,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Cigna PPO,Cigna PPO,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Cigna Medicare Advantage,Cigna Medicare Advantage,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Essence,Essence,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Healthlink HMO,Healthlink HMO,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Healthlink PPO,Healthlink PPO,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,HomeState Health Plan,HomeState Health Plan,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Humana Gold,Humana Gold,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Medicaid MO,Medicaid MO,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Medica,Medica,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Tricare,Tricare,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,UHC All Payer,UHC All Payer,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,UHC Exchange,UHC Exchange,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,UHC Medicaid,UHC Medicaid,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,UMR CPD,UMR CPD,1046.41,,,,,,,per diem,1046.41,1046.41,"Per diem rate, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,UHC Medicare,UHC Medicare,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
TCPO2 MULTIPLE LEVELS         ,36000205,CDM,410,RC,93923,CPT,,,,Inpatient,,,1046.41,1046.41,Wellcare,Wellcare,1046.41,,,,,,,case rate,1046.41,1046.41,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Meritain Health PPO CPD,Meritain Health PPO CPD,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Aetna/Commercial Product,Aetna/Commercial Product,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Meritain Health CPD,Meritain Health CPD,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Starmark CPD,Starmark CPD,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Aetna Medicare,Aetna Medicare,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Ambetter ,Ambetter ,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Blue Access,Anthem Blue Access,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Blue Access Choice,Anthem Blue Access Choice,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Blue Preferred,Anthem Blue Preferred,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Pathway,Anthem Pathway,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Alliance,Anthem Alliance,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Anthem Medicare,Anthem Medicare,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Cigna,Cigna,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Cigna PPO,Cigna PPO,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Cigna Medicare Advantage,Cigna Medicare Advantage,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Essence,Essence,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Healthlink HMO,Healthlink HMO,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Healthlink PPO,Healthlink PPO,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,HomeState Health Plan,HomeState Health Plan,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Humana Gold,Humana Gold,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Medicaid MO,Medicaid MO,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Medica,Medica,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Tricare,Tricare,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,UHC All Payer,UHC All Payer,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,UHC Exchange,UHC Exchange,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,UHC Medicaid,UHC Medicaid,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,UMR CPD,UMR CPD,11.03,,,,,,,per diem,11.03,11.03,"Per diem rate, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,UHC Medicare,UHC Medicare,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
PREFILL NEBULIZER KIT         ,36000206,CDM,410,RC,,,,,,Inpatient,,,11.03,11.03,Wellcare,Wellcare,11.03,,,,,,,case rate,11.03,11.03,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Meritain Health PPO CPD,Meritain Health PPO CPD,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Aetna/Commercial Product,Aetna/Commercial Product,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Meritain Health CPD,Meritain Health CPD,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Starmark CPD,Starmark CPD,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Aetna Medicare,Aetna Medicare,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Ambetter ,Ambetter ,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Blue Access,Anthem Blue Access,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Blue Access Choice,Anthem Blue Access Choice,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Blue Preferred,Anthem Blue Preferred,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Pathway,Anthem Pathway,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Alliance,Anthem Alliance,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Anthem Medicare,Anthem Medicare,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Cigna,Cigna,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Cigna PPO,Cigna PPO,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Cigna Medicare Advantage,Cigna Medicare Advantage,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Essence,Essence,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Healthlink HMO,Healthlink HMO,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Healthlink PPO,Healthlink PPO,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,HomeState Health Plan,HomeState Health Plan,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Humana Gold,Humana Gold,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Medicaid MO,Medicaid MO,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Medica,Medica,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Tricare,Tricare,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,UHC All Payer,UHC All Payer,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,UHC Exchange,UHC Exchange,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,UHC Medicaid,UHC Medicaid,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,UMR CPD,UMR CPD,12.38,,,,,,,per diem,12.38,12.38,"Per diem rate, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,UHC Medicare,UHC Medicare,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
HIGH EFFECIENCY NEBULIZER     ,36000207,CDM,410,RC,,,,,,Inpatient,,,12.38,12.38,Wellcare,Wellcare,12.38,,,,,,,case rate,12.38,12.38,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Meritain Health PPO CPD,Meritain Health PPO CPD,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Aetna/Commercial Product,Aetna/Commercial Product,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Meritain Health CPD,Meritain Health CPD,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Starmark CPD,Starmark CPD,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Aetna Medicare,Aetna Medicare,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Ambetter ,Ambetter ,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Blue Access,Anthem Blue Access,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Blue Access Choice,Anthem Blue Access Choice,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Blue Preferred,Anthem Blue Preferred,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Pathway,Anthem Pathway,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Alliance,Anthem Alliance,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Anthem Medicare,Anthem Medicare,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Cigna,Cigna,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Cigna PPO,Cigna PPO,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Cigna Medicare Advantage,Cigna Medicare Advantage,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Essence,Essence,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Healthlink HMO,Healthlink HMO,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Healthlink PPO,Healthlink PPO,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,HomeState Health Plan,HomeState Health Plan,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Humana Gold,Humana Gold,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Medicaid MO,Medicaid MO,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Medica,Medica,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Tricare,Tricare,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,UHC All Payer,UHC All Payer,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,UHC Exchange,UHC Exchange,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,UHC Medicaid,UHC Medicaid,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,UMR CPD,UMR CPD,7.34,,,,,,,per diem,7.34,7.34,"Per diem rate, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,UHC Medicare,UHC Medicare,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
PREFILL HUMID FOR INHALA      ,36000209,CDM,410,RC,,,,,,Inpatient,,,7.34,7.34,Wellcare,Wellcare,7.34,,,,,,,case rate,7.34,7.34,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Meritain Health PPO CPD,Meritain Health PPO CPD,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Aetna/Commercial Product,Aetna/Commercial Product,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Meritain Health CPD,Meritain Health CPD,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Starmark CPD,Starmark CPD,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Aetna Medicare,Aetna Medicare,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Ambetter ,Ambetter ,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Blue Access,Anthem Blue Access,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Blue Access Choice,Anthem Blue Access Choice,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Blue Preferred,Anthem Blue Preferred,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Pathway,Anthem Pathway,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Alliance,Anthem Alliance,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Anthem Medicare,Anthem Medicare,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Cigna,Cigna,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Cigna PPO,Cigna PPO,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Cigna Medicare Advantage,Cigna Medicare Advantage,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Essence,Essence,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Healthlink HMO,Healthlink HMO,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Healthlink PPO,Healthlink PPO,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,HomeState Health Plan,HomeState Health Plan,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Humana Gold,Humana Gold,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Medicaid MO,Medicaid MO,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Medica,Medica,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Tricare,Tricare,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,UHC All Payer,UHC All Payer,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,UHC Exchange,UHC Exchange,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,UHC Medicaid,UHC Medicaid,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,UMR CPD,UMR CPD,5.85,,,,,,,per diem,5.85,5.85,"Per diem rate, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,UHC Medicare,UHC Medicare,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
STER H2O INHALATION 500ML     ,36000210,CDM,410,RC,,,,,,Inpatient,,,5.85,5.85,Wellcare,Wellcare,5.85,,,,,,,case rate,5.85,5.85,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Meritain Health PPO CPD,Meritain Health PPO CPD,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Aetna/Commercial Product,Aetna/Commercial Product,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Meritain Health CPD,Meritain Health CPD,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Starmark CPD,Starmark CPD,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Aetna Medicare,Aetna Medicare,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Ambetter ,Ambetter ,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Blue Access,Anthem Blue Access,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Blue Access Choice,Anthem Blue Access Choice,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Blue Preferred,Anthem Blue Preferred,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Pathway,Anthem Pathway,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Alliance,Anthem Alliance,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Anthem Medicare,Anthem Medicare,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Cigna,Cigna,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Cigna PPO,Cigna PPO,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Cigna Medicare Advantage,Cigna Medicare Advantage,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Essence,Essence,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Healthlink HMO,Healthlink HMO,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Healthlink PPO,Healthlink PPO,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,HomeState Health Plan,HomeState Health Plan,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Humana Gold,Humana Gold,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Medicaid MO,Medicaid MO,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Medica,Medica,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Tricare,Tricare,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,UHC All Payer,UHC All Payer,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,UHC Exchange,UHC Exchange,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,UHC Medicaid,UHC Medicaid,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,UMR CPD,UMR CPD,14.17,,,,,,,per diem,14.17,14.17,"Per diem rate, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,UHC Medicare,UHC Medicare,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
INLINE NEB T W/VLV 22MM       ,36000211,CDM,410,RC,,,,,,Inpatient,,,14.17,14.17,Wellcare,Wellcare,14.17,,,,,,,case rate,14.17,14.17,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Meritain Health PPO CPD,Meritain Health PPO CPD,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Aetna/Commercial Product,Aetna/Commercial Product,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Meritain Health CPD,Meritain Health CPD,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Starmark CPD,Starmark CPD,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Aetna Medicare,Aetna Medicare,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Ambetter ,Ambetter ,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Blue Access,Anthem Blue Access,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Blue Access Choice,Anthem Blue Access Choice,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Blue Preferred,Anthem Blue Preferred,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Pathway,Anthem Pathway,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Alliance,Anthem Alliance,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Anthem Medicare,Anthem Medicare,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Cigna,Cigna,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Cigna PPO,Cigna PPO,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Cigna Medicare Advantage,Cigna Medicare Advantage,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Essence,Essence,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Healthlink HMO,Healthlink HMO,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Healthlink PPO,Healthlink PPO,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,HomeState Health Plan,HomeState Health Plan,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Humana Gold,Humana Gold,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Medicaid MO,Medicaid MO,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Medica,Medica,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Tricare,Tricare,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,UHC All Payer,UHC All Payer,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,UHC Exchange,UHC Exchange,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,UHC Medicaid,UHC Medicaid,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,UMR CPD,UMR CPD,401.02,,,,,,,per diem,401.02,401.02,"Per diem rate, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,UHC Medicare,UHC Medicare,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
DECANULATE                    ,36000212,CDM,410,RC,,,,,,Inpatient,,,401.02,401.02,Wellcare,Wellcare,401.02,,,,,,,case rate,401.02,401.02,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Meritain Health PPO CPD,Meritain Health PPO CPD,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Aetna/Commercial Product,Aetna/Commercial Product,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Meritain Health CPD,Meritain Health CPD,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Starmark CPD,Starmark CPD,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Aetna Medicare,Aetna Medicare,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Ambetter ,Ambetter ,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Blue Access,Anthem Blue Access,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Blue Access Choice,Anthem Blue Access Choice,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Blue Preferred,Anthem Blue Preferred,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Pathway,Anthem Pathway,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Alliance,Anthem Alliance,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Anthem Medicare,Anthem Medicare,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Cigna,Cigna,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Cigna PPO,Cigna PPO,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Cigna Medicare Advantage,Cigna Medicare Advantage,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Essence,Essence,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Healthlink HMO,Healthlink HMO,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Healthlink PPO,Healthlink PPO,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,HomeState Health Plan,HomeState Health Plan,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Humana Gold,Humana Gold,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Medicaid MO,Medicaid MO,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Medica,Medica,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Tricare,Tricare,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,UHC All Payer,UHC All Payer,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,UHC Exchange,UHC Exchange,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,UHC Medicaid,UHC Medicaid,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,UMR CPD,UMR CPD,56.83,,,,,,,per diem,56.83,56.83,"Per diem rate, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,UHC Medicare,UHC Medicare,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
SUCTIONING                    ,36000214,CDM,410,RC,,,,,,Inpatient,,,56.83,56.83,Wellcare,Wellcare,56.83,,,,,,,case rate,56.83,56.83,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Meritain Health PPO CPD,Meritain Health PPO CPD,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Aetna/Commercial Product,Aetna/Commercial Product,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Meritain Health CPD,Meritain Health CPD,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Starmark CPD,Starmark CPD,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Aetna Medicare,Aetna Medicare,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Ambetter ,Ambetter ,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Blue Access,Anthem Blue Access,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Blue Access Choice,Anthem Blue Access Choice,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Blue Preferred,Anthem Blue Preferred,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Pathway,Anthem Pathway,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Alliance,Anthem Alliance,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Anthem Medicare,Anthem Medicare,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Cigna,Cigna,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Cigna PPO,Cigna PPO,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Cigna Medicare Advantage,Cigna Medicare Advantage,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Essence,Essence,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Healthlink HMO,Healthlink HMO,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Healthlink PPO,Healthlink PPO,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,HomeState Health Plan,HomeState Health Plan,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Humana Gold,Humana Gold,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Medicaid MO,Medicaid MO,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Medica,Medica,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Tricare,Tricare,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,UHC All Payer,UHC All Payer,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,UHC Exchange,UHC Exchange,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,UHC Medicaid,UHC Medicaid,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,UMR CPD,UMR CPD,114.79,,,,,,,per diem,114.79,114.79,"Per diem rate, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,UHC Medicare,UHC Medicare,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
"TEACHING BREATHING 15""        ",36000215,CDM,410,RC,,,,,,Inpatient,,,114.79,114.79,Wellcare,Wellcare,114.79,,,,,,,case rate,114.79,114.79,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Meritain Health PPO CPD,Meritain Health PPO CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Aetna/Commercial Product,Aetna/Commercial Product,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Meritain Health CPD,Meritain Health CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Starmark CPD,Starmark CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Aetna Medicare,Aetna Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Ambetter ,Ambetter ,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Blue Access,Anthem Blue Access,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Blue Access Choice,Anthem Blue Access Choice,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Blue Preferred,Anthem Blue Preferred,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Pathway,Anthem Pathway,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Alliance,Anthem Alliance,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Anthem Medicare,Anthem Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Cigna,Cigna,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Cigna PPO,Cigna PPO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Cigna Medicare Advantage,Cigna Medicare Advantage,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Essence,Essence,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Healthlink HMO,Healthlink HMO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Healthlink PPO,Healthlink PPO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,HomeState Health Plan,HomeState Health Plan,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Humana Gold,Humana Gold,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Medicaid MO,Medicaid MO,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Medica,Medica,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Tricare,Tricare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,UHC All Payer,UHC All Payer,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,UHC Exchange,UHC Exchange,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,UHC Medicaid,UHC Medicaid,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,UMR CPD,UMR CPD,79.07,,,,,,,per diem,79.07,79.07,"Per diem rate, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,UHC Medicare,UHC Medicare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
THER PROC INPT 30 MIN         ,36000217,CDM,410,RC,,,,,,Inpatient,,,79.07,79.07,Wellcare,Wellcare,79.07,,,,,,,case rate,79.07,79.07,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Meritain Health PPO CPD,Meritain Health PPO CPD,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Aetna/Commercial Product,Aetna/Commercial Product,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Meritain Health CPD,Meritain Health CPD,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Starmark CPD,Starmark CPD,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Aetna Medicare,Aetna Medicare,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Ambetter ,Ambetter ,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Blue Access,Anthem Blue Access,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Blue Access Choice,Anthem Blue Access Choice,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Blue Preferred,Anthem Blue Preferred,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Pathway,Anthem Pathway,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Alliance,Anthem Alliance,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Anthem Medicare,Anthem Medicare,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Cigna,Cigna,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Cigna PPO,Cigna PPO,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Cigna Medicare Advantage,Cigna Medicare Advantage,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Essence,Essence,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Healthlink HMO,Healthlink HMO,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Healthlink PPO,Healthlink PPO,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,HomeState Health Plan,HomeState Health Plan,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Humana Gold,Humana Gold,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Medicaid MO,Medicaid MO,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Medica,Medica,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Tricare,Tricare,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,UHC All Payer,UHC All Payer,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,UHC Exchange,UHC Exchange,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,UHC Medicaid,UHC Medicaid,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,UMR CPD,UMR CPD,460.09,,,,,,,per diem,460.09,460.09,"Per diem rate, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,UHC Medicare,UHC Medicare,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
CPAP/BIPAP CONTINUOUS         ,36000219,CDM,410,RC,,,,,,Inpatient,,,460.09,460.09,Wellcare,Wellcare,460.09,,,,,,,case rate,460.09,460.09,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Meritain Health PPO CPD,Meritain Health PPO CPD,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Aetna/Commercial Product,Aetna/Commercial Product,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Meritain Health CPD,Meritain Health CPD,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Starmark CPD,Starmark CPD,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Aetna Medicare,Aetna Medicare,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Ambetter ,Ambetter ,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Blue Access,Anthem Blue Access,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Blue Access Choice,Anthem Blue Access Choice,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Blue Preferred,Anthem Blue Preferred,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Pathway,Anthem Pathway,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Alliance,Anthem Alliance,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Anthem Medicare,Anthem Medicare,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Cigna,Cigna,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Cigna PPO,Cigna PPO,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Cigna Medicare Advantage,Cigna Medicare Advantage,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Essence,Essence,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Healthlink HMO,Healthlink HMO,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Healthlink PPO,Healthlink PPO,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,HomeState Health Plan,HomeState Health Plan,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Humana Gold,Humana Gold,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Medicaid MO,Medicaid MO,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Medica,Medica,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Tricare,Tricare,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,UHC All Payer,UHC All Payer,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,UHC Exchange,UHC Exchange,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,UHC Medicaid,UHC Medicaid,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,UMR CPD,UMR CPD,107.15,,,,,,,per diem,107.15,107.15,"Per diem rate, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,UHC Medicare,UHC Medicare,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
G0238 THER PROC INCR RESP FUNC,36000295,CDM,410,RC,,,,,,Inpatient,,,107.15,107.15,Wellcare,Wellcare,107.15,,,,,,,case rate,107.15,107.15,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Meritain Health PPO CPD,Meritain Health PPO CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Aetna/Commercial Product,Aetna/Commercial Product,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Meritain Health CPD,Meritain Health CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Starmark CPD,Starmark CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Aetna Medicare,Aetna Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Ambetter ,Ambetter ,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Blue Access,Anthem Blue Access,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Blue Access Choice,Anthem Blue Access Choice,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Blue Preferred,Anthem Blue Preferred,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Pathway,Anthem Pathway,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Alliance,Anthem Alliance,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Anthem Medicare,Anthem Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Cigna,Cigna,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Cigna PPO,Cigna PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Cigna Medicare Advantage,Cigna Medicare Advantage,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Essence,Essence,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Healthlink HMO,Healthlink HMO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Healthlink PPO,Healthlink PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,HomeState Health Plan,HomeState Health Plan,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Humana Gold,Humana Gold,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Medicaid MO,Medicaid MO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Medica,Medica,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Tricare,Tricare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,UHC All Payer,UHC All Payer,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,UHC Exchange,UHC Exchange,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,UHC Medicaid,UHC Medicaid,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,UMR CPD,UMR CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,UHC Medicare,UHC Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
ADDITIONAL TIME INCREMENT     ,36000304,CDM,410,RC,,,,,,Inpatient,,,74.26,74.26,Wellcare,Wellcare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health PPO CPD,Meritain Health PPO CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Aetna/Commercial Product,Aetna/Commercial Product,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health CPD,Meritain Health CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Starmark CPD,Starmark CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Aetna Medicare,Aetna Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Ambetter ,Ambetter ,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access,Anthem Blue Access,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access Choice,Anthem Blue Access Choice,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Preferred,Anthem Blue Preferred,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Pathway,Anthem Pathway,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Alliance,Anthem Alliance,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Anthem Medicare,Anthem Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Cigna,Cigna,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Cigna PPO,Cigna PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Cigna Medicare Advantage,Cigna Medicare Advantage,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Essence,Essence,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Healthlink HMO,Healthlink HMO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Healthlink PPO,Healthlink PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,HomeState Health Plan,HomeState Health Plan,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Humana Gold,Humana Gold,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Medicaid MO,Medicaid MO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Medica,Medica,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Tricare,Tricare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,UHC All Payer,UHC All Payer,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,UHC Exchange,UHC Exchange,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicaid,UHC Medicaid,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,UMR CPD,UMR CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicare,UHC Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
SELF CARE HOME MANAGEMENT     ,36000340,CDM,410,RC,97535,CPT,,,,Inpatient,,,80.63,80.63,Wellcare,Wellcare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Meritain Health PPO CPD,Meritain Health PPO CPD,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Aetna/Commercial Product,Aetna/Commercial Product,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Meritain Health CPD,Meritain Health CPD,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Starmark CPD,Starmark CPD,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Aetna Medicare,Aetna Medicare,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Ambetter ,Ambetter ,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Blue Access,Anthem Blue Access,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Blue Access Choice,Anthem Blue Access Choice,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Blue Preferred,Anthem Blue Preferred,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Pathway,Anthem Pathway,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Alliance,Anthem Alliance,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Anthem Medicare,Anthem Medicare,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Cigna,Cigna,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Cigna PPO,Cigna PPO,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Cigna Medicare Advantage,Cigna Medicare Advantage,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Essence,Essence,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Healthlink HMO,Healthlink HMO,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Healthlink PPO,Healthlink PPO,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,HomeState Health Plan,HomeState Health Plan,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Humana Gold,Humana Gold,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Medicaid MO,Medicaid MO,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Medica,Medica,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Tricare,Tricare,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,UHC All Payer,UHC All Payer,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,UHC Exchange,UHC Exchange,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,UHC Medicaid,UHC Medicaid,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,UMR CPD,UMR CPD,168.12,,,,,,,per diem,168.12,168.12,"Per diem rate, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,UHC Medicare,UHC Medicare,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
INCENTIVE SPIRO TX            ,36000366,CDM,410,RC,94010,CPT,,,,Inpatient,,,168.12,168.12,Wellcare,Wellcare,168.12,,,,,,,case rate,168.12,168.12,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Meritain Health PPO CPD,Meritain Health PPO CPD,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Aetna/Commercial Product,Aetna/Commercial Product,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Meritain Health CPD,Meritain Health CPD,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Starmark CPD,Starmark CPD,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Aetna Medicare,Aetna Medicare,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Ambetter ,Ambetter ,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Blue Access,Anthem Blue Access,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Blue Access Choice,Anthem Blue Access Choice,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Blue Preferred,Anthem Blue Preferred,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Pathway,Anthem Pathway,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Alliance,Anthem Alliance,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Anthem Medicare,Anthem Medicare,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Cigna,Cigna,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Cigna PPO,Cigna PPO,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Cigna Medicare Advantage,Cigna Medicare Advantage,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Essence,Essence,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Healthlink HMO,Healthlink HMO,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Healthlink PPO,Healthlink PPO,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,HomeState Health Plan,HomeState Health Plan,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Humana Gold,Humana Gold,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Medicaid MO,Medicaid MO,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Medica,Medica,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Tricare,Tricare,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,UHC All Payer,UHC All Payer,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,UHC Exchange,UHC Exchange,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,UHC Medicaid,UHC Medicaid,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,UMR CPD,UMR CPD,175.58,,,,,,,per diem,175.58,175.58,"Per diem rate, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,UHC Medicare,UHC Medicare,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
IPPB-SUBSEQ/EZPAP             ,36000380,CDM,410,RC,94640,CPT,,,76,Inpatient,,,175.58,175.58,Wellcare,Wellcare,175.58,,,,,,,case rate,175.58,175.58,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health PPO CPD,Meritain Health PPO CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna/Commercial Product,Aetna/Commercial Product,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Meritain Health CPD,Meritain Health CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Starmark CPD,Starmark CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Aetna Medicare,Aetna Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Ambetter ,Ambetter ,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access,Anthem Blue Access,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Access Choice,Anthem Blue Access Choice,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Blue Preferred,Anthem Blue Preferred,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Pathway,Anthem Pathway,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Alliance,Anthem Alliance,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Anthem Medicare,Anthem Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna,Cigna,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna PPO,Cigna PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Cigna Medicare Advantage,Cigna Medicare Advantage,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Essence,Essence,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink HMO,Healthlink HMO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Healthlink PPO,Healthlink PPO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,HomeState Health Plan,HomeState Health Plan,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Humana Gold,Humana Gold,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medicaid MO,Medicaid MO,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Medica,Medica,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Tricare,Tricare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC All Payer,UHC All Payer,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Exchange,UHC Exchange,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicaid,UHC Medicaid,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UMR CPD,UMR CPD,124.57,,,,,,,per diem,124.57,124.57,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,UHC Medicare,UHC Medicare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE INITIAL  ,36000400,CDM,410,RC,94640,CPT,,,,Inpatient,,,124.57,124.57,Wellcare,Wellcare,124.57,,,,,,,case rate,124.57,124.57,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Meritain Health PPO CPD,Meritain Health PPO CPD,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Aetna/Commercial Product,Aetna/Commercial Product,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Meritain Health CPD,Meritain Health CPD,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Starmark CPD,Starmark CPD,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Aetna Medicare,Aetna Medicare,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Ambetter ,Ambetter ,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Blue Access,Anthem Blue Access,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Blue Access Choice,Anthem Blue Access Choice,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Blue Preferred,Anthem Blue Preferred,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Pathway,Anthem Pathway,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Alliance,Anthem Alliance,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Anthem Medicare,Anthem Medicare,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Cigna,Cigna,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Cigna PPO,Cigna PPO,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Cigna Medicare Advantage,Cigna Medicare Advantage,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Essence,Essence,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Healthlink HMO,Healthlink HMO,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Healthlink PPO,Healthlink PPO,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,HomeState Health Plan,HomeState Health Plan,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Humana Gold,Humana Gold,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Medicaid MO,Medicaid MO,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Medica,Medica,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Tricare,Tricare,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,UHC All Payer,UHC All Payer,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,UHC Exchange,UHC Exchange,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,UHC Medicaid,UHC Medicaid,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,UMR CPD,UMR CPD,54.11,,,,,,,per diem,54.11,54.11,"Per diem rate, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,UHC Medicare,UHC Medicare,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
OXYGEN PER HR                 ,36000510,CDM,270,RC,,,,,,Inpatient,,,54.11,54.11,Wellcare,Wellcare,54.11,,,,,,,case rate,54.11,54.11,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Meritain Health PPO CPD,Meritain Health PPO CPD,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Aetna/Commercial Product,Aetna/Commercial Product,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Meritain Health CPD,Meritain Health CPD,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Starmark CPD,Starmark CPD,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Aetna Medicare,Aetna Medicare,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Ambetter ,Ambetter ,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Blue Access,Anthem Blue Access,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Blue Access Choice,Anthem Blue Access Choice,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Blue Preferred,Anthem Blue Preferred,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Pathway,Anthem Pathway,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Alliance,Anthem Alliance,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Anthem Medicare,Anthem Medicare,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Cigna,Cigna,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Cigna PPO,Cigna PPO,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Cigna Medicare Advantage,Cigna Medicare Advantage,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Essence,Essence,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Healthlink HMO,Healthlink HMO,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Healthlink PPO,Healthlink PPO,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,HomeState Health Plan,HomeState Health Plan,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Humana Gold,Humana Gold,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Medicaid MO,Medicaid MO,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Medica,Medica,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Tricare,Tricare,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,UHC All Payer,UHC All Payer,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,UHC Exchange,UHC Exchange,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,UHC Medicaid,UHC Medicaid,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,UMR CPD,UMR CPD,251.42,,,,,,,per diem,251.42,251.42,"Per diem rate, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,UHC Medicare,UHC Medicare,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PASSY MUIR VALVE ASSIST       ,36000530,CDM,410,RC,92507,CPT,,,,Inpatient,,,251.42,251.42,Wellcare,Wellcare,251.42,,,,,,,case rate,251.42,251.42,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Meritain Health PPO CPD,Meritain Health PPO CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Aetna/Commercial Product,Aetna/Commercial Product,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Meritain Health CPD,Meritain Health CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Starmark CPD,Starmark CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Aetna Medicare,Aetna Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Ambetter ,Ambetter ,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Access,Anthem Blue Access,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Access Choice,Anthem Blue Access Choice,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Preferred,Anthem Blue Preferred,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Pathway,Anthem Pathway,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Alliance,Anthem Alliance,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Anthem Medicare,Anthem Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Cigna,Cigna,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Cigna PPO,Cigna PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Cigna Medicare Advantage,Cigna Medicare Advantage,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Essence,Essence,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Healthlink HMO,Healthlink HMO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Healthlink PPO,Healthlink PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,HomeState Health Plan,HomeState Health Plan,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Humana Gold,Humana Gold,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Medicaid MO,Medicaid MO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Medica,Medica,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Tricare,Tricare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,UHC All Payer,UHC All Payer,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,UHC Exchange,UHC Exchange,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,UHC Medicaid,UHC Medicaid,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,UMR CPD,UMR CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,UHC Medicare,UHC Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULM COMPLIANCE STUDY         ,36000560,CDM,460,RC,94750,CPT,,,,Inpatient,,,79.57,79.57,Wellcare,Wellcare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Meritain Health PPO CPD,Meritain Health PPO CPD,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Aetna/Commercial Product,Aetna/Commercial Product,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Meritain Health CPD,Meritain Health CPD,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Starmark CPD,Starmark CPD,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Aetna Medicare,Aetna Medicare,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Ambetter ,Ambetter ,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Blue Access,Anthem Blue Access,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Blue Access Choice,Anthem Blue Access Choice,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Blue Preferred,Anthem Blue Preferred,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Pathway,Anthem Pathway,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Alliance,Anthem Alliance,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Anthem Medicare,Anthem Medicare,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Cigna,Cigna,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Cigna PPO,Cigna PPO,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Cigna Medicare Advantage,Cigna Medicare Advantage,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Essence,Essence,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Healthlink HMO,Healthlink HMO,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Healthlink PPO,Healthlink PPO,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,HomeState Health Plan,HomeState Health Plan,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Humana Gold,Humana Gold,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Medicaid MO,Medicaid MO,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Medica,Medica,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Tricare,Tricare,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,UHC All Payer,UHC All Payer,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,UHC Exchange,UHC Exchange,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,UHC Medicaid,UHC Medicaid,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,UMR CPD,UMR CPD,113.53,,,,,,,per diem,113.53,113.53,"Per diem rate, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,UHC Medicare,UHC Medicare,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
"MONITOR/EVAL IPPB, MDI, AERO  ",36000570,CDM,410,RC,94664,CPT,,,,Inpatient,,,113.53,113.53,Wellcare,Wellcare,113.53,,,,,,,case rate,113.53,113.53,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Meritain Health PPO CPD,Meritain Health PPO CPD,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Aetna/Commercial Product,Aetna/Commercial Product,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Meritain Health CPD,Meritain Health CPD,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Starmark CPD,Starmark CPD,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Aetna Medicare,Aetna Medicare,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Ambetter ,Ambetter ,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Blue Access,Anthem Blue Access,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Blue Access Choice,Anthem Blue Access Choice,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Blue Preferred,Anthem Blue Preferred,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Pathway,Anthem Pathway,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Alliance,Anthem Alliance,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Anthem Medicare,Anthem Medicare,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Cigna,Cigna,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Cigna PPO,Cigna PPO,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Cigna Medicare Advantage,Cigna Medicare Advantage,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Essence,Essence,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Healthlink HMO,Healthlink HMO,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Healthlink PPO,Healthlink PPO,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,HomeState Health Plan,HomeState Health Plan,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Humana Gold,Humana Gold,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Medicaid MO,Medicaid MO,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Medica,Medica,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Tricare,Tricare,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,UHC All Payer,UHC All Payer,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,UHC Exchange,UHC Exchange,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,UHC Medicaid,UHC Medicaid,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,UMR CPD,UMR CPD,275.59,,,,,,,per diem,275.59,275.59,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,UHC Medicare,UHC Medicare,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-CONTINUOUS     ,36000610,CDM,460,RC,94762,CPT,,,,Inpatient,,,275.59,275.59,Wellcare,Wellcare,275.59,,,,,,,case rate,275.59,275.59,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Meritain Health PPO CPD,Meritain Health PPO CPD,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Aetna/Commercial Product,Aetna/Commercial Product,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Meritain Health CPD,Meritain Health CPD,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Starmark CPD,Starmark CPD,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Aetna Medicare,Aetna Medicare,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Ambetter ,Ambetter ,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Blue Access,Anthem Blue Access,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Blue Access Choice,Anthem Blue Access Choice,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Blue Preferred,Anthem Blue Preferred,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Pathway,Anthem Pathway,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Alliance,Anthem Alliance,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Anthem Medicare,Anthem Medicare,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Cigna,Cigna,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Cigna PPO,Cigna PPO,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Cigna Medicare Advantage,Cigna Medicare Advantage,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Essence,Essence,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Healthlink HMO,Healthlink HMO,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Healthlink PPO,Healthlink PPO,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,HomeState Health Plan,HomeState Health Plan,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Humana Gold,Humana Gold,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Medicaid MO,Medicaid MO,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Medica,Medica,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Tricare,Tricare,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,UHC All Payer,UHC All Payer,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,UHC Exchange,UHC Exchange,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,UHC Medicaid,UHC Medicaid,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,UMR CPD,UMR CPD,76.49,,,,,,,per diem,76.49,76.49,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,UHC Medicare,UHC Medicare,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36000620,CDM,460,RC,94760,CPT,,,,Inpatient,,,76.49,76.49,Wellcare,Wellcare,76.49,,,,,,,case rate,76.49,76.49,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURE INDIV   ,36000672,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Meritain Health PPO CPD,Meritain Health PPO CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Aetna/Commercial Product,Aetna/Commercial Product,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Meritain Health CPD,Meritain Health CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Starmark CPD,Starmark CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Aetna Medicare,Aetna Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Ambetter ,Ambetter ,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Access,Anthem Blue Access,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Access Choice,Anthem Blue Access Choice,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Preferred,Anthem Blue Preferred,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Pathway,Anthem Pathway,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Alliance,Anthem Alliance,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Anthem Medicare,Anthem Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Cigna,Cigna,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Cigna PPO,Cigna PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Cigna Medicare Advantage,Cigna Medicare Advantage,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Essence,Essence,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Healthlink HMO,Healthlink HMO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Healthlink PPO,Healthlink PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,HomeState Health Plan,HomeState Health Plan,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Humana Gold,Humana Gold,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Medicaid MO,Medicaid MO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Medica,Medica,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Tricare,Tricare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,UHC All Payer,UHC All Payer,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,UHC Exchange,UHC Exchange,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,UHC Medicaid,UHC Medicaid,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,UMR CPD,UMR CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,UHC Medicare,UHC Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
INTUBATION                    ,36000675,CDM,410,RC,31500,CPT,,,,Inpatient,,,75.32,75.32,Wellcare,Wellcare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Meritain Health PPO CPD,Meritain Health PPO CPD,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Aetna/Commercial Product,Aetna/Commercial Product,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Meritain Health CPD,Meritain Health CPD,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Starmark CPD,Starmark CPD,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Aetna Medicare,Aetna Medicare,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Ambetter ,Ambetter ,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Blue Access,Anthem Blue Access,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Blue Access Choice,Anthem Blue Access Choice,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Blue Preferred,Anthem Blue Preferred,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Pathway,Anthem Pathway,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Alliance,Anthem Alliance,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Anthem Medicare,Anthem Medicare,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Cigna,Cigna,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Cigna PPO,Cigna PPO,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Cigna Medicare Advantage,Cigna Medicare Advantage,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Essence,Essence,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Healthlink HMO,Healthlink HMO,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Healthlink PPO,Healthlink PPO,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,HomeState Health Plan,HomeState Health Plan,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Humana Gold,Humana Gold,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Medicaid MO,Medicaid MO,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Medica,Medica,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Tricare,Tricare,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,UHC All Payer,UHC All Payer,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,UHC Exchange,UHC Exchange,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,UHC Medicaid,UHC Medicaid,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,UMR CPD,UMR CPD,666.54,,,,,,,per diem,666.54,666.54,"Per diem rate, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,UHC Medicare,UHC Medicare,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
CARDIOPULMONARY RESUSCITATION ,36000676,CDM,480,RC,92950,CPT,,,,Inpatient,,,666.54,666.54,Wellcare,Wellcare,666.54,,,,,,,case rate,666.54,666.54,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Meritain Health PPO CPD,Meritain Health PPO CPD,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Aetna/Commercial Product,Aetna/Commercial Product,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Meritain Health CPD,Meritain Health CPD,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Starmark CPD,Starmark CPD,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Aetna Medicare,Aetna Medicare,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Ambetter ,Ambetter ,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Blue Access,Anthem Blue Access,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Blue Access Choice,Anthem Blue Access Choice,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Blue Preferred,Anthem Blue Preferred,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Pathway,Anthem Pathway,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Alliance,Anthem Alliance,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Anthem Medicare,Anthem Medicare,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Cigna,Cigna,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Cigna PPO,Cigna PPO,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Cigna Medicare Advantage,Cigna Medicare Advantage,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Essence,Essence,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Healthlink HMO,Healthlink HMO,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Healthlink PPO,Healthlink PPO,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,HomeState Health Plan,HomeState Health Plan,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Humana Gold,Humana Gold,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Medicaid MO,Medicaid MO,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Medica,Medica,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Tricare,Tricare,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,UHC All Payer,UHC All Payer,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,UHC Exchange,UHC Exchange,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,UHC Medicaid,UHC Medicaid,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,UMR CPD,UMR CPD,37.13,,,,,,,per diem,37.13,37.13,"Per diem rate, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,UHC Medicare,UHC Medicare,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
SPUTUM COLLECTION             ,36000739,CDM,300,RC,89220,CPT,,,,Inpatient,,,37.13,37.13,Wellcare,Wellcare,37.13,,,,,,,case rate,37.13,37.13,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Meritain Health PPO CPD,Meritain Health PPO CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Aetna/Commercial Product,Aetna/Commercial Product,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Meritain Health CPD,Meritain Health CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Starmark CPD,Starmark CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Aetna Medicare,Aetna Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Ambetter ,Ambetter ,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Access,Anthem Blue Access,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Access Choice,Anthem Blue Access Choice,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Blue Preferred,Anthem Blue Preferred,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Pathway,Anthem Pathway,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Alliance,Anthem Alliance,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Anthem Medicare,Anthem Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Cigna,Cigna,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Cigna PPO,Cigna PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Cigna Medicare Advantage,Cigna Medicare Advantage,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Essence,Essence,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Healthlink HMO,Healthlink HMO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Healthlink PPO,Healthlink PPO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,HomeState Health Plan,HomeState Health Plan,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Humana Gold,Humana Gold,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Medicaid MO,Medicaid MO,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Medica,Medica,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Tricare,Tricare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,UHC All Payer,UHC All Payer,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,UHC Exchange,UHC Exchange,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,UHC Medicaid,UHC Medicaid,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,UMR CPD,UMR CPD,79.57,,,,,,,per diem,79.57,79.57,"Per diem rate, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,UHC Medicare,UHC Medicare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
TRACH CHANGE                  ,36000840,CDM,410,RC,31502,CPT,,,,Inpatient,,,79.57,79.57,Wellcare,Wellcare,79.57,,,,,,,case rate,79.57,79.57,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Meritain Health PPO CPD,Meritain Health PPO CPD,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Aetna/Commercial Product,Aetna/Commercial Product,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Meritain Health CPD,Meritain Health CPD,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Starmark CPD,Starmark CPD,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Aetna Medicare,Aetna Medicare,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Ambetter ,Ambetter ,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Blue Access,Anthem Blue Access,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Blue Access Choice,Anthem Blue Access Choice,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Blue Preferred,Anthem Blue Preferred,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Pathway,Anthem Pathway,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Alliance,Anthem Alliance,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Anthem Medicare,Anthem Medicare,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Cigna,Cigna,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Cigna PPO,Cigna PPO,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Cigna Medicare Advantage,Cigna Medicare Advantage,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Essence,Essence,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Healthlink HMO,Healthlink HMO,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Healthlink PPO,Healthlink PPO,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,HomeState Health Plan,HomeState Health Plan,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Humana Gold,Humana Gold,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Medicaid MO,Medicaid MO,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Medica,Medica,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Tricare,Tricare,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,UHC All Payer,UHC All Payer,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,UHC Exchange,UHC Exchange,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,UHC Medicaid,UHC Medicaid,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,UMR CPD,UMR CPD,213.05,,,,,,,per diem,213.05,213.05,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,UHC Medicare,UHC Medicare,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-MULTI CHECKS   ,36000845,CDM,460,RC,94761,CPT,,,,Inpatient,,,213.05,213.05,Wellcare,Wellcare,213.05,,,,,,,case rate,213.05,213.05,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Meritain Health PPO CPD,Meritain Health PPO CPD,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Aetna/Commercial Product,Aetna/Commercial Product,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Meritain Health CPD,Meritain Health CPD,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Starmark CPD,Starmark CPD,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Aetna Medicare,Aetna Medicare,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Ambetter ,Ambetter ,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Blue Access,Anthem Blue Access,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Blue Access Choice,Anthem Blue Access Choice,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Blue Preferred,Anthem Blue Preferred,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Pathway,Anthem Pathway,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Alliance,Anthem Alliance,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Anthem Medicare,Anthem Medicare,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Cigna,Cigna,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Cigna PPO,Cigna PPO,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Cigna Medicare Advantage,Cigna Medicare Advantage,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Essence,Essence,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Healthlink HMO,Healthlink HMO,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Healthlink PPO,Healthlink PPO,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,HomeState Health Plan,HomeState Health Plan,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Humana Gold,Humana Gold,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Medicaid MO,Medicaid MO,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Medica,Medica,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Tricare,Tricare,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,UHC All Payer,UHC All Payer,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,UHC Exchange,UHC Exchange,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,UHC Medicaid,UHC Medicaid,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,UMR CPD,UMR CPD,81.61,,,,,,,per diem,81.61,81.61,"Per diem rate, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,UHC Medicare,UHC Medicare,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
AEROSOL/VAPOR INHALE SUBSEQ   ,36000880,CDM,410,RC,94640,CPT,,,76,Inpatient,,,81.61,81.61,Wellcare,Wellcare,81.61,,,,,,,case rate,81.61,81.61,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Meritain Health PPO CPD,Meritain Health PPO CPD,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Aetna/Commercial Product,Aetna/Commercial Product,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Meritain Health CPD,Meritain Health CPD,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Starmark CPD,Starmark CPD,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Aetna Medicare,Aetna Medicare,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Ambetter ,Ambetter ,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Blue Access,Anthem Blue Access,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Blue Access Choice,Anthem Blue Access Choice,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Blue Preferred,Anthem Blue Preferred,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Pathway,Anthem Pathway,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Alliance,Anthem Alliance,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Anthem Medicare,Anthem Medicare,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Cigna,Cigna,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Cigna PPO,Cigna PPO,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Cigna Medicare Advantage,Cigna Medicare Advantage,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Essence,Essence,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Healthlink HMO,Healthlink HMO,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Healthlink PPO,Healthlink PPO,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,HomeState Health Plan,HomeState Health Plan,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Humana Gold,Humana Gold,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Medicaid MO,Medicaid MO,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Medica,Medica,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Tricare,Tricare,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,UHC All Payer,UHC All Payer,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,UHC Exchange,UHC Exchange,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,UHC Medicaid,UHC Medicaid,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,UMR CPD,UMR CPD,110.33,,,,,,,per diem,110.33,110.33,"Per diem rate, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,UHC Medicare,UHC Medicare,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR INITIAL DAILY      ,36000940,CDM,419,RC,94002,CPT,,,,Inpatient,,,110.33,110.33,Wellcare,Wellcare,110.33,,,,,,,case rate,110.33,110.33,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Meritain Health PPO CPD,Meritain Health PPO CPD,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Aetna/Commercial Product,Aetna/Commercial Product,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Meritain Health CPD,Meritain Health CPD,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Starmark CPD,Starmark CPD,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Aetna Medicare,Aetna Medicare,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Ambetter ,Ambetter ,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Blue Access,Anthem Blue Access,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Blue Access Choice,Anthem Blue Access Choice,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Blue Preferred,Anthem Blue Preferred,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Pathway,Anthem Pathway,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Alliance,Anthem Alliance,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Anthem Medicare,Anthem Medicare,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Cigna,Cigna,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Cigna PPO,Cigna PPO,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Cigna Medicare Advantage,Cigna Medicare Advantage,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Essence,Essence,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Healthlink HMO,Healthlink HMO,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Healthlink PPO,Healthlink PPO,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,HomeState Health Plan,HomeState Health Plan,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Humana Gold,Humana Gold,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Medicaid MO,Medicaid MO,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Medica,Medica,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Tricare,Tricare,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,UHC All Payer,UHC All Payer,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,UHC Exchange,UHC Exchange,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,UHC Medicaid,UHC Medicaid,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,UMR CPD,UMR CPD,96.02,,,,,,,per diem,96.02,96.02,"Per diem rate, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,UHC Medicare,UHC Medicare,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
VENTILATOR SUBSEQUENT DAILY   ,36000945,CDM,419,RC,94003,CPT,,,,Inpatient,,,96.02,96.02,Wellcare,Wellcare,96.02,,,,,,,case rate,96.02,96.02,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health PPO CPD,Meritain Health PPO CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Aetna/Commercial Product,Aetna/Commercial Product,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health CPD,Meritain Health CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Starmark CPD,Starmark CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Aetna Medicare,Aetna Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Ambetter ,Ambetter ,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access,Anthem Blue Access,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access Choice,Anthem Blue Access Choice,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Preferred,Anthem Blue Preferred,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Pathway,Anthem Pathway,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Alliance,Anthem Alliance,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Anthem Medicare,Anthem Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Cigna,Cigna,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Cigna PPO,Cigna PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Cigna Medicare Advantage,Cigna Medicare Advantage,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Essence,Essence,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Healthlink HMO,Healthlink HMO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Healthlink PPO,Healthlink PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,HomeState Health Plan,HomeState Health Plan,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Humana Gold,Humana Gold,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Medicaid MO,Medicaid MO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Medica,Medica,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Tricare,Tricare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,UHC All Payer,UHC All Payer,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,UHC Exchange,UHC Exchange,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicaid,UHC Medicaid,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,UMR CPD,UMR CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicare,UHC Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
MAX BREATHING CAPACITY        ,36000980,CDM,410,RC,94200,CPT,,,,Inpatient,,,80.63,80.63,Wellcare,Wellcare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health PPO CPD,Meritain Health PPO CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna/Commercial Product,Aetna/Commercial Product,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health CPD,Meritain Health CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Starmark CPD,Starmark CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna Medicare,Aetna Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Ambetter ,Ambetter ,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access,Anthem Blue Access,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access Choice,Anthem Blue Access Choice,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Preferred,Anthem Blue Preferred,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Pathway,Anthem Pathway,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Alliance,Anthem Alliance,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Medicare,Anthem Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna,Cigna,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna PPO,Cigna PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna Medicare Advantage,Cigna Medicare Advantage,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Essence,Essence,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthlink HMO,Healthlink HMO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthlink PPO,Healthlink PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,HomeState Health Plan,HomeState Health Plan,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Humana Gold,Humana Gold,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Medicaid MO,Medicaid MO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Medica,Medica,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Tricare,Tricare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC All Payer,UHC All Payer,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Exchange,UHC Exchange,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicaid,UHC Medicaid,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UMR CPD,UMR CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicare,UHC Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHOSPASM EVALUATION       ,36001045,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Wellcare,Wellcare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health PPO CPD,Meritain Health PPO CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna/Commercial Product,Aetna/Commercial Product,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health CPD,Meritain Health CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Starmark CPD,Starmark CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Aetna Medicare,Aetna Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Ambetter ,Ambetter ,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access,Anthem Blue Access,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access Choice,Anthem Blue Access Choice,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Preferred,Anthem Blue Preferred,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Pathway,Anthem Pathway,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Alliance,Anthem Alliance,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Anthem Medicare,Anthem Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna,Cigna,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna PPO,Cigna PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Cigna Medicare Advantage,Cigna Medicare Advantage,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Essence,Essence,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthlink HMO,Healthlink HMO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Healthlink PPO,Healthlink PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,HomeState Health Plan,HomeState Health Plan,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Humana Gold,Humana Gold,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Medicaid MO,Medicaid MO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Medica,Medica,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Tricare,Tricare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC All Payer,UHC All Payer,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Exchange,UHC Exchange,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicaid,UHC Medicaid,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UMR CPD,UMR CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicare,UHC Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
BRONCHODIL RESPONSE-PRE & POST,36001050,CDM,460,RC,94060,CPT,,,,Inpatient,,,80.63,80.63,Wellcare,Wellcare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Meritain Health PPO CPD,Meritain Health PPO CPD,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Aetna/Commercial Product,Aetna/Commercial Product,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Meritain Health CPD,Meritain Health CPD,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Starmark CPD,Starmark CPD,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Aetna Medicare,Aetna Medicare,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Ambetter ,Ambetter ,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Blue Access,Anthem Blue Access,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Blue Access Choice,Anthem Blue Access Choice,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Blue Preferred,Anthem Blue Preferred,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Pathway,Anthem Pathway,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Alliance,Anthem Alliance,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Anthem Medicare,Anthem Medicare,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Cigna,Cigna,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Cigna PPO,Cigna PPO,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Cigna Medicare Advantage,Cigna Medicare Advantage,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Essence,Essence,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Healthlink HMO,Healthlink HMO,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Healthlink PPO,Healthlink PPO,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,HomeState Health Plan,HomeState Health Plan,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Humana Gold,Humana Gold,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Medicaid MO,Medicaid MO,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Medica,Medica,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Tricare,Tricare,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,UHC All Payer,UHC All Payer,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,UHC Exchange,UHC Exchange,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,UHC Medicaid,UHC Medicaid,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,UMR CPD,UMR CPD,233.89,,,,,,,per diem,233.89,233.89,"Per diem rate, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,UHC Medicare,UHC Medicare,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
WORK HARDENING EA ADDL HR     ,36050065,CDM,420,RC,97546,CPT,,,GP,Inpatient,,,233.89,233.89,Wellcare,Wellcare,233.89,,,,,,,case rate,233.89,233.89,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Meritain Health PPO CPD,Meritain Health PPO CPD,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Aetna/Commercial Product,Aetna/Commercial Product,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Meritain Health CPD,Meritain Health CPD,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Starmark CPD,Starmark CPD,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Aetna Medicare,Aetna Medicare,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Ambetter ,Ambetter ,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Blue Access,Anthem Blue Access,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Blue Access Choice,Anthem Blue Access Choice,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Blue Preferred,Anthem Blue Preferred,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Pathway,Anthem Pathway,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Alliance,Anthem Alliance,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Anthem Medicare,Anthem Medicare,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Cigna,Cigna,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Cigna PPO,Cigna PPO,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Cigna Medicare Advantage,Cigna Medicare Advantage,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Essence,Essence,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Healthlink HMO,Healthlink HMO,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Healthlink PPO,Healthlink PPO,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,HomeState Health Plan,HomeState Health Plan,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Humana Gold,Humana Gold,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Medicaid MO,Medicaid MO,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Medica,Medica,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Tricare,Tricare,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,UHC All Payer,UHC All Payer,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,UHC Exchange,UHC Exchange,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,UHC Medicaid,UHC Medicaid,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,UMR CPD,UMR CPD,397.33,,,,,,,per diem,397.33,397.33,"Per diem rate, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,UHC Medicare,UHC Medicare,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
TRANSTRACHIAL FOLLOW UP       ,36099215,CDM,510,RC,99215,CPT,,,,Inpatient,,,397.33,397.33,Wellcare,Wellcare,397.33,,,,,,,case rate,397.33,397.33,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Meritain Health PPO CPD,Meritain Health PPO CPD,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Aetna/Commercial Product,Aetna/Commercial Product,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Meritain Health CPD,Meritain Health CPD,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Starmark CPD,Starmark CPD,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Aetna Medicare,Aetna Medicare,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Ambetter ,Ambetter ,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Blue Access,Anthem Blue Access,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Blue Access Choice,Anthem Blue Access Choice,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Blue Preferred,Anthem Blue Preferred,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Pathway,Anthem Pathway,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Alliance,Anthem Alliance,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Anthem Medicare,Anthem Medicare,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Cigna,Cigna,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Cigna PPO,Cigna PPO,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Cigna Medicare Advantage,Cigna Medicare Advantage,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Essence,Essence,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Healthlink HMO,Healthlink HMO,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Healthlink PPO,Healthlink PPO,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,HomeState Health Plan,HomeState Health Plan,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Humana Gold,Humana Gold,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Medicaid MO,Medicaid MO,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Medica,Medica,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Tricare,Tricare,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,UHC All Payer,UHC All Payer,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,UHC Exchange,UHC Exchange,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,UHC Medicaid,UHC Medicaid,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,UMR CPD,UMR CPD,112.46,,,,,,,per diem,112.46,112.46,"Per diem rate, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,UHC Medicare,UHC Medicare,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
PHYSICAL PERFORMANCE TEST     ,36200145,CDM,419,RC,97750,CPT,,,,Inpatient,,,112.46,112.46,Wellcare,Wellcare,112.46,,,,,,,case rate,112.46,112.46,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Meritain Health PPO CPD,Meritain Health PPO CPD,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Aetna/Commercial Product,Aetna/Commercial Product,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Meritain Health CPD,Meritain Health CPD,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Starmark CPD,Starmark CPD,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Aetna Medicare,Aetna Medicare,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Ambetter ,Ambetter ,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Blue Access,Anthem Blue Access,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Blue Access Choice,Anthem Blue Access Choice,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Blue Preferred,Anthem Blue Preferred,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Pathway,Anthem Pathway,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Alliance,Anthem Alliance,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Anthem Medicare,Anthem Medicare,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Cigna,Cigna,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Cigna PPO,Cigna PPO,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Cigna Medicare Advantage,Cigna Medicare Advantage,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Essence,Essence,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Healthlink HMO,Healthlink HMO,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Healthlink PPO,Healthlink PPO,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,HomeState Health Plan,HomeState Health Plan,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Humana Gold,Humana Gold,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Medicaid MO,Medicaid MO,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Medica,Medica,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Tricare,Tricare,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,UHC All Payer,UHC All Payer,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,UHC Exchange,UHC Exchange,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,UHC Medicaid,UHC Medicaid,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,UMR CPD,UMR CPD,798.25,,,,,,,per diem,798.25,798.25,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,UHC Medicare,UHC Medicare,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-SUBSEQ       ,36200171,CDM,410,RC,94668,CPT,,,,Inpatient,,,798.25,798.25,Wellcare,Wellcare,798.25,,,,,,,case rate,798.25,798.25,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Meritain Health PPO CPD,Meritain Health PPO CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Aetna/Commercial Product,Aetna/Commercial Product,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Meritain Health CPD,Meritain Health CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Starmark CPD,Starmark CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Aetna Medicare,Aetna Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Ambetter ,Ambetter ,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Blue Access,Anthem Blue Access,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Blue Access Choice,Anthem Blue Access Choice,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Blue Preferred,Anthem Blue Preferred,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Pathway,Anthem Pathway,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Alliance,Anthem Alliance,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Anthem Medicare,Anthem Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Cigna,Cigna,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Cigna PPO,Cigna PPO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Cigna Medicare Advantage,Cigna Medicare Advantage,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Essence,Essence,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Healthlink HMO,Healthlink HMO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Healthlink PPO,Healthlink PPO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,HomeState Health Plan,HomeState Health Plan,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Humana Gold,Humana Gold,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Medicaid MO,Medicaid MO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Medica,Medica,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Tricare,Tricare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,UHC All Payer,UHC All Payer,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,UHC Exchange,UHC Exchange,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,UHC Medicaid,UHC Medicaid,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,UMR CPD,UMR CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,UHC Medicare,UHC Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
CHEST WALL MANIP-INITIAL      ,36200180,CDM,410,RC,94667,CPT,,,,Inpatient,,,108.15,108.15,Wellcare,Wellcare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Meritain Health PPO CPD,Meritain Health PPO CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Aetna/Commercial Product,Aetna/Commercial Product,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Meritain Health CPD,Meritain Health CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Starmark CPD,Starmark CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Aetna Medicare,Aetna Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Ambetter ,Ambetter ,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Blue Access,Anthem Blue Access,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Blue Access Choice,Anthem Blue Access Choice,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Blue Preferred,Anthem Blue Preferred,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Pathway,Anthem Pathway,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Alliance,Anthem Alliance,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Anthem Medicare,Anthem Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Cigna,Cigna,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Cigna PPO,Cigna PPO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Cigna Medicare Advantage,Cigna Medicare Advantage,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Essence,Essence,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Healthlink HMO,Healthlink HMO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Healthlink PPO,Healthlink PPO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,HomeState Health Plan,HomeState Health Plan,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Humana Gold,Humana Gold,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Medicaid MO,Medicaid MO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Medica,Medica,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Tricare,Tricare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,UHC All Payer,UHC All Payer,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,UHC Exchange,UHC Exchange,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,UHC Medicaid,UHC Medicaid,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,UMR CPD,UMR CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,UHC Medicare,UHC Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
THERAPEUTIC PROCEDURES INDIV  ,36200790,CDM,410,RC,G0238,HCPCS,,,,Inpatient,,,128.75,128.75,Wellcare,Wellcare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Meritain Health PPO CPD,Meritain Health PPO CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Aetna/Commercial Product,Aetna/Commercial Product,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Meritain Health CPD,Meritain Health CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Starmark CPD,Starmark CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Aetna Medicare,Aetna Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Ambetter ,Ambetter ,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Blue Access,Anthem Blue Access,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Blue Access Choice,Anthem Blue Access Choice,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Blue Preferred,Anthem Blue Preferred,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Pathway,Anthem Pathway,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Alliance,Anthem Alliance,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Anthem Medicare,Anthem Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Cigna,Cigna,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Cigna PPO,Cigna PPO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Cigna Medicare Advantage,Cigna Medicare Advantage,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Essence,Essence,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Healthlink HMO,Healthlink HMO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Healthlink PPO,Healthlink PPO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,HomeState Health Plan,HomeState Health Plan,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Humana Gold,Humana Gold,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Medicaid MO,Medicaid MO,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Medica,Medica,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Tricare,Tricare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,UHC All Payer,UHC All Payer,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,UHC Exchange,UHC Exchange,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,UHC Medicaid,UHC Medicaid,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,UMR CPD,UMR CPD,78.28,,,,,,,per diem,78.28,78.28,"Per diem rate, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,UHC Medicare,UHC Medicare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PULSE OXIMETRY-SINGLE         ,36200900,CDM,460,RC,94760,CPT,,,,Inpatient,,,78.28,78.28,Wellcare,Wellcare,78.28,,,,,,,case rate,78.28,78.28,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR ASSESSMENT                 ,36200940,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PR REASSESSMENT               ,36200950,CDM,419,RC,94799,CPT,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Meritain Health PPO CPD,Meritain Health PPO CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Aetna/Commercial Product,Aetna/Commercial Product,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Meritain Health CPD,Meritain Health CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Starmark CPD,Starmark CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Aetna Medicare,Aetna Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Ambetter ,Ambetter ,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Blue Access,Anthem Blue Access,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Blue Access Choice,Anthem Blue Access Choice,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Blue Preferred,Anthem Blue Preferred,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Pathway,Anthem Pathway,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Alliance,Anthem Alliance,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Anthem Medicare,Anthem Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Cigna,Cigna,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Cigna PPO,Cigna PPO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Cigna Medicare Advantage,Cigna Medicare Advantage,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Essence,Essence,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Healthlink HMO,Healthlink HMO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Healthlink PPO,Healthlink PPO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,HomeState Health Plan,HomeState Health Plan,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Humana Gold,Humana Gold,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Medicaid MO,Medicaid MO,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Medica,Medica,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Tricare,Tricare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,UHC All Payer,UHC All Payer,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,UHC Exchange,UHC Exchange,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,UHC Medicaid,UHC Medicaid,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,UMR CPD,UMR CPD,108.15,,,,,,,per diem,108.15,108.15,"Per diem rate, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,UHC Medicare,UHC Medicare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
OXYGEN PER HOUR               ,36201000,CDM,270,RC,,,,,,Inpatient,,,108.15,108.15,Wellcare,Wellcare,108.15,,,,,,,case rate,108.15,108.15,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Meritain Health PPO CPD,Meritain Health PPO CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Aetna/Commercial Product,Aetna/Commercial Product,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Meritain Health CPD,Meritain Health CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Starmark CPD,Starmark CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Aetna Medicare,Aetna Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Ambetter ,Ambetter ,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Access,Anthem Blue Access,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Access Choice,Anthem Blue Access Choice,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Preferred,Anthem Blue Preferred,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Pathway,Anthem Pathway,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Alliance,Anthem Alliance,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Anthem Medicare,Anthem Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Cigna,Cigna,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Cigna PPO,Cigna PPO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Cigna Medicare Advantage,Cigna Medicare Advantage,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Essence,Essence,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Healthlink HMO,Healthlink HMO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Healthlink PPO,Healthlink PPO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,HomeState Health Plan,HomeState Health Plan,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Humana Gold,Humana Gold,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Medicaid MO,Medicaid MO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Medica,Medica,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Tricare,Tricare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,UHC All Payer,UHC All Payer,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,UHC Exchange,UHC Exchange,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,UHC Medicaid,UHC Medicaid,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,UMR CPD,UMR CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,UHC Medicare,UHC Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
MAXIMUM BREATHING CAPACITY    ,36201050,CDM,460,RC,94200,CPT,,,,Inpatient,,,130.81,130.81,Wellcare,Wellcare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Meritain Health PPO CPD,Meritain Health PPO CPD,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Aetna/Commercial Product,Aetna/Commercial Product,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Meritain Health CPD,Meritain Health CPD,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Starmark CPD,Starmark CPD,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Aetna Medicare,Aetna Medicare,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Ambetter ,Ambetter ,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Blue Access,Anthem Blue Access,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Blue Access Choice,Anthem Blue Access Choice,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Blue Preferred,Anthem Blue Preferred,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Pathway,Anthem Pathway,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Alliance,Anthem Alliance,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Anthem Medicare,Anthem Medicare,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Cigna,Cigna,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Cigna PPO,Cigna PPO,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Cigna Medicare Advantage,Cigna Medicare Advantage,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Essence,Essence,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Healthlink HMO,Healthlink HMO,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Healthlink PPO,Healthlink PPO,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,HomeState Health Plan,HomeState Health Plan,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Humana Gold,Humana Gold,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Medicaid MO,Medicaid MO,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Medica,Medica,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Tricare,Tricare,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,UHC All Payer,UHC All Payer,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,UHC Exchange,UHC Exchange,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,UHC Medicaid,UHC Medicaid,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,UMR CPD,UMR CPD,310.03,,,,,,,per diem,310.03,310.03,"Per diem rate, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,UHC Medicare,UHC Medicare,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
VITAL CAPACITY TOTAL          ,36201320,CDM,460,RC,94150,CPT,,,,Inpatient,,,310.03,310.03,Wellcare,Wellcare,310.03,,,,,,,case rate,310.03,310.03,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health PPO CPD,Meritain Health PPO CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Aetna/Commercial Product,Aetna/Commercial Product,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health CPD,Meritain Health CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Starmark CPD,Starmark CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Aetna Medicare,Aetna Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Ambetter ,Ambetter ,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access,Anthem Blue Access,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access Choice,Anthem Blue Access Choice,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Preferred,Anthem Blue Preferred,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Pathway,Anthem Pathway,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Alliance,Anthem Alliance,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Anthem Medicare,Anthem Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Cigna,Cigna,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Cigna PPO,Cigna PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Cigna Medicare Advantage,Cigna Medicare Advantage,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Essence,Essence,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Healthlink HMO,Healthlink HMO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Healthlink PPO,Healthlink PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,HomeState Health Plan,HomeState Health Plan,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Humana Gold,Humana Gold,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Medicaid MO,Medicaid MO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Medica,Medica,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Tricare,Tricare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,UHC All Payer,UHC All Payer,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,UHC Exchange,UHC Exchange,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicaid,UHC Medicaid,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,UMR CPD,UMR CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicare,UHC Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
AIRWAY INHALATION TREATMENT   ,36201330,CDM,460,RC,94640,CPT,,,,Inpatient,,,120.94,120.94,Wellcare,Wellcare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Meritain Health PPO CPD,Meritain Health PPO CPD,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Aetna/Commercial Product,Aetna/Commercial Product,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Meritain Health CPD,Meritain Health CPD,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Starmark CPD,Starmark CPD,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Aetna Medicare,Aetna Medicare,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Ambetter ,Ambetter ,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Blue Access,Anthem Blue Access,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Blue Access Choice,Anthem Blue Access Choice,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Blue Preferred,Anthem Blue Preferred,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Pathway,Anthem Pathway,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Alliance,Anthem Alliance,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Anthem Medicare,Anthem Medicare,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Cigna,Cigna,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Cigna PPO,Cigna PPO,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Cigna Medicare Advantage,Cigna Medicare Advantage,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Essence,Essence,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Healthlink HMO,Healthlink HMO,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Healthlink PPO,Healthlink PPO,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,HomeState Health Plan,HomeState Health Plan,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Humana Gold,Humana Gold,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Medicaid MO,Medicaid MO,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Medica,Medica,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Tricare,Tricare,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,UHC All Payer,UHC All Payer,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,UHC Exchange,UHC Exchange,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,UHC Medicaid,UHC Medicaid,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,UMR CPD,UMR CPD,447.02,,,,,,,per diem,447.02,447.02,"Per diem rate, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,UHC Medicare,UHC Medicare,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
PULM STRESS TEST - SIMPLE     ,36240010,CDM,460,RC,94620,CPT,,,,Inpatient,,,447.02,447.02,Wellcare,Wellcare,447.02,,,,,,,case rate,447.02,447.02,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Meritain Health PPO CPD,Meritain Health PPO CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Aetna/Commercial Product,Aetna/Commercial Product,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Meritain Health CPD,Meritain Health CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Starmark CPD,Starmark CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Aetna Medicare,Aetna Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Ambetter ,Ambetter ,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Access,Anthem Blue Access,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Access Choice,Anthem Blue Access Choice,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Preferred,Anthem Blue Preferred,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Pathway,Anthem Pathway,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Alliance,Anthem Alliance,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Anthem Medicare,Anthem Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Cigna,Cigna,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Cigna PPO,Cigna PPO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Cigna Medicare Advantage,Cigna Medicare Advantage,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Essence,Essence,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Healthlink HMO,Healthlink HMO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Healthlink PPO,Healthlink PPO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,HomeState Health Plan,HomeState Health Plan,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Humana Gold,Humana Gold,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Medicaid MO,Medicaid MO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Medica,Medica,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Tricare,Tricare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,UHC All Payer,UHC All Payer,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,UHC Exchange,UHC Exchange,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,UHC Medicaid,UHC Medicaid,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,UMR CPD,UMR CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,UHC Medicare,UHC Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
SPIROMETRY/PFT SIMPLE         ,36240100,CDM,460,RC,94010,CPT,,,,Inpatient,,,207.03,207.03,Wellcare,Wellcare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Meritain Health PPO CPD,Meritain Health PPO CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Aetna/Commercial Product,Aetna/Commercial Product,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Meritain Health CPD,Meritain Health CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Starmark CPD,Starmark CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Aetna Medicare,Aetna Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Ambetter ,Ambetter ,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Access,Anthem Blue Access,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Access Choice,Anthem Blue Access Choice,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Preferred,Anthem Blue Preferred,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Pathway,Anthem Pathway,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Alliance,Anthem Alliance,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Anthem Medicare,Anthem Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Cigna,Cigna,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Cigna PPO,Cigna PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Cigna Medicare Advantage,Cigna Medicare Advantage,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Essence,Essence,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Healthlink HMO,Healthlink HMO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Healthlink PPO,Healthlink PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,HomeState Health Plan,HomeState Health Plan,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Humana Gold,Humana Gold,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Medicaid MO,Medicaid MO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Medica,Medica,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Tricare,Tricare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,UHC All Payer,UHC All Payer,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,UHC Exchange,UHC Exchange,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,UHC Medicaid,UHC Medicaid,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,UMR CPD,UMR CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,UHC Medicare,UHC Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
DECALCIFICATION               ,38000016,CDM,310,RC,88311,CPT,,,,Inpatient,,,196.46,196.46,Wellcare,Wellcare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Meritain Health PPO CPD,Meritain Health PPO CPD,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Aetna/Commercial Product,Aetna/Commercial Product,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Meritain Health CPD,Meritain Health CPD,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Starmark CPD,Starmark CPD,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Aetna Medicare,Aetna Medicare,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Ambetter ,Ambetter ,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Blue Access,Anthem Blue Access,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Blue Access Choice,Anthem Blue Access Choice,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Blue Preferred,Anthem Blue Preferred,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Pathway,Anthem Pathway,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Alliance,Anthem Alliance,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Anthem Medicare,Anthem Medicare,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Cigna,Cigna,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Cigna PPO,Cigna PPO,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Cigna Medicare Advantage,Cigna Medicare Advantage,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Essence,Essence,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Healthlink HMO,Healthlink HMO,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Healthlink PPO,Healthlink PPO,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,HomeState Health Plan,HomeState Health Plan,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Humana Gold,Humana Gold,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Medicaid MO,Medicaid MO,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Medica,Medica,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Tricare,Tricare,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,UHC All Payer,UHC All Payer,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,UHC Exchange,UHC Exchange,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,UHC Medicaid,UHC Medicaid,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,UMR CPD,UMR CPD,505.34,,,,,,,per diem,505.34,505.34,"Per diem rate, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,UHC Medicare,UHC Medicare,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
FINE NEEDLE ASP EVAL          ,38000022,CDM,310,RC,88172,CPT,,,,Inpatient,,,505.34,505.34,Wellcare,Wellcare,505.34,,,,,,,case rate,505.34,505.34,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Meritain Health PPO CPD,Meritain Health PPO CPD,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Aetna/Commercial Product,Aetna/Commercial Product,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Meritain Health CPD,Meritain Health CPD,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Starmark CPD,Starmark CPD,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Aetna Medicare,Aetna Medicare,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Ambetter ,Ambetter ,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Blue Access,Anthem Blue Access,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Blue Access Choice,Anthem Blue Access Choice,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Blue Preferred,Anthem Blue Preferred,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Pathway,Anthem Pathway,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Alliance,Anthem Alliance,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Anthem Medicare,Anthem Medicare,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Cigna,Cigna,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Cigna PPO,Cigna PPO,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Cigna Medicare Advantage,Cigna Medicare Advantage,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Essence,Essence,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Healthlink HMO,Healthlink HMO,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Healthlink PPO,Healthlink PPO,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,HomeState Health Plan,HomeState Health Plan,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Humana Gold,Humana Gold,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Medicaid MO,Medicaid MO,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Medica,Medica,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Tricare,Tricare,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,UHC All Payer,UHC All Payer,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,UHC Exchange,UHC Exchange,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,UHC Medicaid,UHC Medicaid,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,UMR CPD,UMR CPD,967.7,,,,,,,per diem,967.7,967.7,"Per diem rate, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,UHC Medicare,UHC Medicare,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
"CELL BLOCK, INTERP COMPLETE   ",38000030,CDM,310,RC,88305,CPT,,,,Inpatient,,,967.7,967.7,Wellcare,Wellcare,967.7,,,,,,,case rate,967.7,967.7,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYTO-SMEAR ANY-SOURCE         ,38000040,CDM,310,RC,88160,CPT,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Meritain Health PPO CPD,Meritain Health PPO CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Aetna/Commercial Product,Aetna/Commercial Product,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Meritain Health CPD,Meritain Health CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Starmark CPD,Starmark CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Aetna Medicare,Aetna Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Ambetter ,Ambetter ,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Blue Access,Anthem Blue Access,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Blue Access Choice,Anthem Blue Access Choice,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Blue Preferred,Anthem Blue Preferred,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Pathway,Anthem Pathway,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Alliance,Anthem Alliance,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Anthem Medicare,Anthem Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Cigna,Cigna,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Cigna PPO,Cigna PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Cigna Medicare Advantage,Cigna Medicare Advantage,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Essence,Essence,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Healthlink HMO,Healthlink HMO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Healthlink PPO,Healthlink PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,HomeState Health Plan,HomeState Health Plan,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Humana Gold,Humana Gold,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Medicaid MO,Medicaid MO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Medica,Medica,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Tricare,Tricare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,UHC All Payer,UHC All Payer,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,UHC Exchange,UHC Exchange,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,UHC Medicaid,UHC Medicaid,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,UMR CPD,UMR CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,UHC Medicare,UHC Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
CYSTO-SMEAR PREP/SCREENING    ,38000050,CDM,310,RC,88161,CPT,,,,Inpatient,,,77.74,77.74,Wellcare,Wellcare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Meritain Health PPO CPD,Meritain Health PPO CPD,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Aetna/Commercial Product,Aetna/Commercial Product,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Meritain Health CPD,Meritain Health CPD,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Starmark CPD,Starmark CPD,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Aetna Medicare,Aetna Medicare,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Ambetter ,Ambetter ,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Blue Access,Anthem Blue Access,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Blue Access Choice,Anthem Blue Access Choice,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Blue Preferred,Anthem Blue Preferred,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Pathway,Anthem Pathway,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Alliance,Anthem Alliance,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Anthem Medicare,Anthem Medicare,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Cigna,Cigna,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Cigna PPO,Cigna PPO,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Cigna Medicare Advantage,Cigna Medicare Advantage,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Essence,Essence,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Healthlink HMO,Healthlink HMO,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Healthlink PPO,Healthlink PPO,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,HomeState Health Plan,HomeState Health Plan,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Humana Gold,Humana Gold,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Medicaid MO,Medicaid MO,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Medica,Medica,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Tricare,Tricare,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,UHC All Payer,UHC All Payer,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,UHC Exchange,UHC Exchange,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,UHC Medicaid,UHC Medicaid,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,UMR CPD,UMR CPD,833.19,,,,,,,per diem,833.19,833.19,"Per diem rate, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,UHC Medicare,UHC Medicare,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
TISSUE CULT. NEOPLASTIC BM-BC ,38000052,CDM,319,RC,88237,CPT,,,,Inpatient,,,833.19,833.19,Wellcare,Wellcare,833.19,,,,,,,case rate,833.19,833.19,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Meritain Health PPO CPD,Meritain Health PPO CPD,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Aetna/Commercial Product,Aetna/Commercial Product,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Meritain Health CPD,Meritain Health CPD,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Starmark CPD,Starmark CPD,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Aetna Medicare,Aetna Medicare,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Ambetter ,Ambetter ,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Blue Access,Anthem Blue Access,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Blue Access Choice,Anthem Blue Access Choice,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Blue Preferred,Anthem Blue Preferred,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Pathway,Anthem Pathway,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Alliance,Anthem Alliance,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Anthem Medicare,Anthem Medicare,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Cigna,Cigna,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Cigna PPO,Cigna PPO,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Cigna Medicare Advantage,Cigna Medicare Advantage,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Essence,Essence,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Healthlink HMO,Healthlink HMO,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Healthlink PPO,Healthlink PPO,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,HomeState Health Plan,HomeState Health Plan,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Humana Gold,Humana Gold,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Medicaid MO,Medicaid MO,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Medica,Medica,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Tricare,Tricare,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,UHC All Payer,UHC All Payer,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,UHC Exchange,UHC Exchange,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,UHC Medicaid,UHC Medicaid,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,UMR CPD,UMR CPD,703.49,,,,,,,per diem,703.49,703.49,"Per diem rate, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,UHC Medicare,UHC Medicare,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
POC CHROM ANALYSIS            ,38000054,CDM,311,RC,88233,CPT,,,,Inpatient,,,703.49,703.49,Wellcare,Wellcare,703.49,,,,,,,case rate,703.49,703.49,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Meritain Health PPO CPD,Meritain Health PPO CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Aetna/Commercial Product,Aetna/Commercial Product,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Meritain Health CPD,Meritain Health CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Starmark CPD,Starmark CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Aetna Medicare,Aetna Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Ambetter ,Ambetter ,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Blue Access,Anthem Blue Access,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Blue Access Choice,Anthem Blue Access Choice,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Blue Preferred,Anthem Blue Preferred,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Pathway,Anthem Pathway,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Alliance,Anthem Alliance,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Anthem Medicare,Anthem Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Cigna,Cigna,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Cigna PPO,Cigna PPO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Cigna Medicare Advantage,Cigna Medicare Advantage,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Essence,Essence,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Healthlink HMO,Healthlink HMO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Healthlink PPO,Healthlink PPO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,HomeState Health Plan,HomeState Health Plan,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Humana Gold,Humana Gold,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Medicaid MO,Medicaid MO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Medica,Medica,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Tricare,Tricare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,UHC All Payer,UHC All Payer,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,UHC Exchange,UHC Exchange,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,UHC Medicaid,UHC Medicaid,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,UMR CPD,UMR CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,UHC Medicare,UHC Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
INTRA-OPERATIVE CONSULTATION  ,38000070,CDM,310,RC,88329,CPT,,,,Inpatient,,,550.51,550.51,Wellcare,Wellcare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Meritain Health PPO CPD,Meritain Health PPO CPD,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Aetna/Commercial Product,Aetna/Commercial Product,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Meritain Health CPD,Meritain Health CPD,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Starmark CPD,Starmark CPD,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Aetna Medicare,Aetna Medicare,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Ambetter ,Ambetter ,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Blue Access,Anthem Blue Access,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Blue Access Choice,Anthem Blue Access Choice,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Blue Preferred,Anthem Blue Preferred,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Pathway,Anthem Pathway,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Alliance,Anthem Alliance,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Anthem Medicare,Anthem Medicare,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Cigna,Cigna,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Cigna PPO,Cigna PPO,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Cigna Medicare Advantage,Cigna Medicare Advantage,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Essence,Essence,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Healthlink HMO,Healthlink HMO,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Healthlink PPO,Healthlink PPO,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,HomeState Health Plan,HomeState Health Plan,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Humana Gold,Humana Gold,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Medicaid MO,Medicaid MO,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Medica,Medica,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Tricare,Tricare,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,UHC All Payer,UHC All Payer,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,UHC Exchange,UHC Exchange,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,UHC Medicaid,UHC Medicaid,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,UMR CPD,UMR CPD,618.8,,,,,,,per diem,618.8,618.8,"Per diem rate, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,UHC Medicare,UHC Medicare,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
TISSUE BLOCK-FROZEN SECTION   ,38000080,CDM,310,RC,88331,CPT,,,,Inpatient,,,618.8,618.8,Wellcare,Wellcare,618.8,,,,,,,case rate,618.8,618.8,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Meritain Health PPO CPD,Meritain Health PPO CPD,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Aetna/Commercial Product,Aetna/Commercial Product,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Meritain Health CPD,Meritain Health CPD,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Starmark CPD,Starmark CPD,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Aetna Medicare,Aetna Medicare,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Ambetter ,Ambetter ,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Blue Access,Anthem Blue Access,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Blue Access Choice,Anthem Blue Access Choice,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Blue Preferred,Anthem Blue Preferred,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Pathway,Anthem Pathway,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Alliance,Anthem Alliance,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Anthem Medicare,Anthem Medicare,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Cigna,Cigna,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Cigna PPO,Cigna PPO,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Cigna Medicare Advantage,Cigna Medicare Advantage,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Essence,Essence,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Healthlink HMO,Healthlink HMO,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Healthlink PPO,Healthlink PPO,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,HomeState Health Plan,HomeState Health Plan,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Humana Gold,Humana Gold,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Medicaid MO,Medicaid MO,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Medica,Medica,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Tricare,Tricare,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,UHC All Payer,UHC All Payer,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,UHC Exchange,UHC Exchange,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,UHC Medicaid,UHC Medicaid,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,UMR CPD,UMR CPD,5.15,,,,,,,per diem,5.15,5.15,"Per diem rate, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,UHC Medicare,UHC Medicare,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE INTRP MULT STAINS    ,38000140,CDM,310,RC,88343,CPT,,,,Inpatient,,,5.15,5.15,Wellcare,Wellcare,5.15,,,,,,,case rate,5.15,5.15,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Meritain Health PPO CPD,Meritain Health PPO CPD,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Aetna/Commercial Product,Aetna/Commercial Product,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Meritain Health CPD,Meritain Health CPD,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Starmark CPD,Starmark CPD,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Aetna Medicare,Aetna Medicare,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Ambetter ,Ambetter ,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Blue Access,Anthem Blue Access,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Blue Access Choice,Anthem Blue Access Choice,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Blue Preferred,Anthem Blue Preferred,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Pathway,Anthem Pathway,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Alliance,Anthem Alliance,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Anthem Medicare,Anthem Medicare,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Cigna,Cigna,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Cigna PPO,Cigna PPO,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Cigna Medicare Advantage,Cigna Medicare Advantage,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Essence,Essence,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Healthlink HMO,Healthlink HMO,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Healthlink PPO,Healthlink PPO,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,HomeState Health Plan,HomeState Health Plan,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Humana Gold,Humana Gold,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Medicaid MO,Medicaid MO,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Medica,Medica,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Tricare,Tricare,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,UHC All Payer,UHC All Payer,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,UHC Exchange,UHC Exchange,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,UHC Medicaid,UHC Medicaid,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,UMR CPD,UMR CPD,1180.32,,,,,,,per diem,1180.32,1180.32,"Per diem rate, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,UHC Medicare,UHC Medicare,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
IMPRXDSE-INTRP 1 STAIN        ,38000141,CDM,310,RC,88342,CPT,,,,Inpatient,,,1180.32,1180.32,Wellcare,Wellcare,1180.32,,,,,,,case rate,1180.32,1180.32,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health PPO CPD,Meritain Health PPO CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/Commercial Product,Aetna/Commercial Product,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health CPD,Meritain Health CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Starmark CPD,Starmark CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna Medicare,Aetna Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Ambetter ,Ambetter ,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access,Anthem Blue Access,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access Choice,Anthem Blue Access Choice,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Preferred,Anthem Blue Preferred,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Pathway,Anthem Pathway,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Alliance,Anthem Alliance,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Medicare,Anthem Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna,Cigna,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna PPO,Cigna PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna Medicare Advantage,Cigna Medicare Advantage,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Essence,Essence,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink HMO,Healthlink HMO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink PPO,Healthlink PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,HomeState Health Plan,HomeState Health Plan,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Humana Gold,Humana Gold,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Medicaid MO,Medicaid MO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Medica,Medica,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Tricare,Tricare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC All Payer,UHC All Payer,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Exchange,UHC Exchange,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicaid,UHC Medicaid,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UMR CPD,UMR CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicare,UHC Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS/SUNDAY/HOL   ,38000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Wellcare,Wellcare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Meritain Health PPO CPD,Meritain Health PPO CPD,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Aetna/Commercial Product,Aetna/Commercial Product,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Meritain Health CPD,Meritain Health CPD,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Starmark CPD,Starmark CPD,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Aetna Medicare,Aetna Medicare,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Ambetter ,Ambetter ,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Blue Access,Anthem Blue Access,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Blue Access Choice,Anthem Blue Access Choice,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Blue Preferred,Anthem Blue Preferred,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Pathway,Anthem Pathway,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Alliance,Anthem Alliance,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Anthem Medicare,Anthem Medicare,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Cigna,Cigna,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Cigna PPO,Cigna PPO,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Cigna Medicare Advantage,Cigna Medicare Advantage,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Essence,Essence,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Healthlink HMO,Healthlink HMO,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Healthlink PPO,Healthlink PPO,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,HomeState Health Plan,HomeState Health Plan,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Humana Gold,Humana Gold,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Medicaid MO,Medicaid MO,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Medica,Medica,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Tricare,Tricare,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,UHC All Payer,UHC All Payer,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,UHC Exchange,UHC Exchange,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,UHC Medicaid,UHC Medicaid,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,UMR CPD,UMR CPD,408.68,,,,,,,per diem,408.68,408.68,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,UHC Medicare,UHC Medicare,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL I         ,38000500,CDM,310,RC,88300,CPT,,,,Inpatient,,,408.68,408.68,Wellcare,Wellcare,408.68,,,,,,,case rate,408.68,408.68,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Meritain Health PPO CPD,Meritain Health PPO CPD,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Aetna/Commercial Product,Aetna/Commercial Product,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Meritain Health CPD,Meritain Health CPD,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Starmark CPD,Starmark CPD,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Aetna Medicare,Aetna Medicare,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Ambetter ,Ambetter ,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Blue Access,Anthem Blue Access,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Blue Access Choice,Anthem Blue Access Choice,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Blue Preferred,Anthem Blue Preferred,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Pathway,Anthem Pathway,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Alliance,Anthem Alliance,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Anthem Medicare,Anthem Medicare,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Cigna,Cigna,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Cigna PPO,Cigna PPO,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Cigna Medicare Advantage,Cigna Medicare Advantage,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Essence,Essence,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Healthlink HMO,Healthlink HMO,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Healthlink PPO,Healthlink PPO,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,HomeState Health Plan,HomeState Health Plan,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Humana Gold,Humana Gold,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Medicaid MO,Medicaid MO,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Medica,Medica,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Tricare,Tricare,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,UHC All Payer,UHC All Payer,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,UHC Exchange,UHC Exchange,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,UHC Medicaid,UHC Medicaid,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,UMR CPD,UMR CPD,772.19,,,,,,,per diem,772.19,772.19,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,UHC Medicare,UHC Medicare,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL II        ,38000501,CDM,310,RC,88302,CPT,,,,Inpatient,,,772.19,772.19,Wellcare,Wellcare,772.19,,,,,,,case rate,772.19,772.19,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Meritain Health PPO CPD,Meritain Health PPO CPD,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Aetna/Commercial Product,Aetna/Commercial Product,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Meritain Health CPD,Meritain Health CPD,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Starmark CPD,Starmark CPD,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Aetna Medicare,Aetna Medicare,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Ambetter ,Ambetter ,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Blue Access,Anthem Blue Access,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Blue Access Choice,Anthem Blue Access Choice,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Blue Preferred,Anthem Blue Preferred,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Pathway,Anthem Pathway,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Alliance,Anthem Alliance,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Anthem Medicare,Anthem Medicare,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Cigna,Cigna,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Cigna PPO,Cigna PPO,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Cigna Medicare Advantage,Cigna Medicare Advantage,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Essence,Essence,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Healthlink HMO,Healthlink HMO,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Healthlink PPO,Healthlink PPO,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,HomeState Health Plan,HomeState Health Plan,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Humana Gold,Humana Gold,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Medicaid MO,Medicaid MO,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Medica,Medica,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Tricare,Tricare,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,UHC All Payer,UHC All Payer,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,UHC Exchange,UHC Exchange,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,UHC Medicaid,UHC Medicaid,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,UMR CPD,UMR CPD,1084.44,,,,,,,per diem,1084.44,1084.44,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,UHC Medicare,UHC Medicare,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL III       ,38000502,CDM,310,RC,88304,CPT,,,,Inpatient,,,1084.44,1084.44,Wellcare,Wellcare,1084.44,,,,,,,case rate,1084.44,1084.44,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Meritain Health PPO CPD,Meritain Health PPO CPD,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Aetna/Commercial Product,Aetna/Commercial Product,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Meritain Health CPD,Meritain Health CPD,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Starmark CPD,Starmark CPD,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Aetna Medicare,Aetna Medicare,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Ambetter ,Ambetter ,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Blue Access,Anthem Blue Access,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Blue Access Choice,Anthem Blue Access Choice,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Blue Preferred,Anthem Blue Preferred,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Pathway,Anthem Pathway,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Alliance,Anthem Alliance,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Anthem Medicare,Anthem Medicare,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Cigna,Cigna,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Cigna PPO,Cigna PPO,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Cigna Medicare Advantage,Cigna Medicare Advantage,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Essence,Essence,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Healthlink HMO,Healthlink HMO,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Healthlink PPO,Healthlink PPO,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,HomeState Health Plan,HomeState Health Plan,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Humana Gold,Humana Gold,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Medicaid MO,Medicaid MO,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Medica,Medica,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Tricare,Tricare,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,UHC All Payer,UHC All Payer,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,UHC Exchange,UHC Exchange,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,UHC Medicaid,UHC Medicaid,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,UMR CPD,UMR CPD,387.28,,,,,,,per diem,387.28,387.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,UHC Medicare,UHC Medicare,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL IV        ,38000503,CDM,310,RC,88305,CPT,,,,Inpatient,,,387.28,387.28,Wellcare,Wellcare,387.28,,,,,,,case rate,387.28,387.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Meritain Health PPO CPD,Meritain Health PPO CPD,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Aetna/Commercial Product,Aetna/Commercial Product,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Meritain Health CPD,Meritain Health CPD,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Starmark CPD,Starmark CPD,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Aetna Medicare,Aetna Medicare,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Ambetter ,Ambetter ,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Blue Access,Anthem Blue Access,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Blue Access Choice,Anthem Blue Access Choice,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Blue Preferred,Anthem Blue Preferred,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Pathway,Anthem Pathway,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Alliance,Anthem Alliance,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Anthem Medicare,Anthem Medicare,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Cigna,Cigna,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Cigna PPO,Cigna PPO,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Cigna Medicare Advantage,Cigna Medicare Advantage,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Essence,Essence,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Healthlink HMO,Healthlink HMO,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Healthlink PPO,Healthlink PPO,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,HomeState Health Plan,HomeState Health Plan,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Humana Gold,Humana Gold,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Medicaid MO,Medicaid MO,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Medica,Medica,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Tricare,Tricare,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,UHC All Payer,UHC All Payer,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,UHC Exchange,UHC Exchange,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,UHC Medicaid,UHC Medicaid,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,UMR CPD,UMR CPD,899.28,,,,,,,per diem,899.28,899.28,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,UHC Medicare,UHC Medicare,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL V         ,38000504,CDM,310,RC,88307,CPT,,,,Inpatient,,,899.28,899.28,Wellcare,Wellcare,899.28,,,,,,,case rate,899.28,899.28,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Meritain Health PPO CPD,Meritain Health PPO CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Aetna/Commercial Product,Aetna/Commercial Product,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Meritain Health CPD,Meritain Health CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Starmark CPD,Starmark CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Aetna Medicare,Aetna Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Ambetter ,Ambetter ,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Access,Anthem Blue Access,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Access Choice,Anthem Blue Access Choice,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Preferred,Anthem Blue Preferred,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Pathway,Anthem Pathway,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Alliance,Anthem Alliance,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Anthem Medicare,Anthem Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Cigna,Cigna,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Cigna PPO,Cigna PPO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Cigna Medicare Advantage,Cigna Medicare Advantage,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Essence,Essence,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Healthlink HMO,Healthlink HMO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Healthlink PPO,Healthlink PPO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,HomeState Health Plan,HomeState Health Plan,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Humana Gold,Humana Gold,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Medicaid MO,Medicaid MO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Medica,Medica,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Tricare,Tricare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,UHC All Payer,UHC All Payer,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,UHC Exchange,UHC Exchange,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,UHC Medicaid,UHC Medicaid,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,UMR CPD,UMR CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,UHC Medicare,UHC Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
SURGICAL PATH LEVEL VI        ,38000505,CDM,310,RC,88309,CPT,,,,Inpatient,,,1096.83,1096.83,Wellcare,Wellcare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Meritain Health PPO CPD,Meritain Health PPO CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Aetna/Commercial Product,Aetna/Commercial Product,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Meritain Health CPD,Meritain Health CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Starmark CPD,Starmark CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Aetna Medicare,Aetna Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Ambetter ,Ambetter ,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Access,Anthem Blue Access,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Access Choice,Anthem Blue Access Choice,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Preferred,Anthem Blue Preferred,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Pathway,Anthem Pathway,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Alliance,Anthem Alliance,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Anthem Medicare,Anthem Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Cigna,Cigna,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Cigna PPO,Cigna PPO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Cigna Medicare Advantage,Cigna Medicare Advantage,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Essence,Essence,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Healthlink HMO,Healthlink HMO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Healthlink PPO,Healthlink PPO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,HomeState Health Plan,HomeState Health Plan,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Humana Gold,Humana Gold,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Medicaid MO,Medicaid MO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Medica,Medica,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Tricare,Tricare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,UHC All Payer,UHC All Payer,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,UHC Exchange,UHC Exchange,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,UHC Medicaid,UHC Medicaid,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,UMR CPD,UMR CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,UHC Medicare,UHC Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
ELECTRON MICROSCOPY           ,38000540,CDM,311,RC,88348,CPT,,,,Inpatient,,,2856.58,2856.58,Wellcare,Wellcare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Meritain Health PPO CPD,Meritain Health PPO CPD,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Aetna/Commercial Product,Aetna/Commercial Product,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Meritain Health CPD,Meritain Health CPD,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Starmark CPD,Starmark CPD,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Aetna Medicare,Aetna Medicare,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Ambetter ,Ambetter ,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Blue Access,Anthem Blue Access,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Blue Access Choice,Anthem Blue Access Choice,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Blue Preferred,Anthem Blue Preferred,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Pathway,Anthem Pathway,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Alliance,Anthem Alliance,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Anthem Medicare,Anthem Medicare,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Cigna,Cigna,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Cigna PPO,Cigna PPO,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Cigna Medicare Advantage,Cigna Medicare Advantage,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Essence,Essence,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Healthlink HMO,Healthlink HMO,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Healthlink PPO,Healthlink PPO,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,HomeState Health Plan,HomeState Health Plan,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Humana Gold,Humana Gold,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Medicaid MO,Medicaid MO,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Medica,Medica,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Tricare,Tricare,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,UHC All Payer,UHC All Payer,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,UHC Exchange,UHC Exchange,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,UHC Medicaid,UHC Medicaid,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,UMR CPD,UMR CPD,31.37,,,,,,,per diem,31.37,31.37,"Per diem rate, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,UHC Medicare,UHC Medicare,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
IMMUNOHIST CYTO EA ADDL       ,38000547,CDM,310,RC,88341,CPT,,,,Inpatient,,,31.37,31.37,Wellcare,Wellcare,31.37,,,,,,,case rate,31.37,31.37,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Meritain Health PPO CPD,Meritain Health PPO CPD,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Aetna/Commercial Product,Aetna/Commercial Product,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Meritain Health CPD,Meritain Health CPD,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Starmark CPD,Starmark CPD,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Aetna Medicare,Aetna Medicare,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Ambetter ,Ambetter ,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Blue Access,Anthem Blue Access,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Blue Access Choice,Anthem Blue Access Choice,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Blue Preferred,Anthem Blue Preferred,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Pathway,Anthem Pathway,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Alliance,Anthem Alliance,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Anthem Medicare,Anthem Medicare,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Cigna,Cigna,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Cigna PPO,Cigna PPO,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Cigna Medicare Advantage,Cigna Medicare Advantage,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Essence,Essence,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Healthlink HMO,Healthlink HMO,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Healthlink PPO,Healthlink PPO,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,HomeState Health Plan,HomeState Health Plan,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Humana Gold,Humana Gold,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Medicaid MO,Medicaid MO,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Medica,Medica,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Tricare,Tricare,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,UHC All Payer,UHC All Payer,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,UHC Exchange,UHC Exchange,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,UHC Medicaid,UHC Medicaid,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,UMR CPD,UMR CPD,158.36,,,,,,,per diem,158.36,158.36,"Per diem rate, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,UHC Medicare,UHC Medicare,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
MOLECULAR CYTOGENETICS        ,38000560,CDM,311,RC,88271,CPT,,,,Inpatient,,,158.36,158.36,Wellcare,Wellcare,158.36,,,,,,,case rate,158.36,158.36,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
IMMUNOFLUORESCENCE            ,38000580,CDM,312,RC,88346,CPT,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Meritain Health PPO CPD,Meritain Health PPO CPD,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Aetna/Commercial Product,Aetna/Commercial Product,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Meritain Health CPD,Meritain Health CPD,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Starmark CPD,Starmark CPD,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Aetna Medicare,Aetna Medicare,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Ambetter ,Ambetter ,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Blue Access,Anthem Blue Access,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Blue Access Choice,Anthem Blue Access Choice,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Blue Preferred,Anthem Blue Preferred,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Pathway,Anthem Pathway,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Alliance,Anthem Alliance,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Anthem Medicare,Anthem Medicare,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Cigna,Cigna,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Cigna PPO,Cigna PPO,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Cigna Medicare Advantage,Cigna Medicare Advantage,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Essence,Essence,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Healthlink HMO,Healthlink HMO,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Healthlink PPO,Healthlink PPO,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,HomeState Health Plan,HomeState Health Plan,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Humana Gold,Humana Gold,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Medicaid MO,Medicaid MO,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Medica,Medica,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Tricare,Tricare,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,UHC All Payer,UHC All Payer,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,UHC Exchange,UHC Exchange,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,UHC Medicaid,UHC Medicaid,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,UMR CPD,UMR CPD,130.21,,,,,,,per diem,130.21,130.21,"Per diem rate, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,UHC Medicare,UHC Medicare,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
CYTOPATH NON-GYN CELL PREP    ,38000609,CDM,311,RC,88112,CPT,,,,Inpatient,,,130.21,130.21,Wellcare,Wellcare,130.21,,,,,,,case rate,130.21,130.21,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Meritain Health PPO CPD,Meritain Health PPO CPD,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Aetna/Commercial Product,Aetna/Commercial Product,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Meritain Health CPD,Meritain Health CPD,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Starmark CPD,Starmark CPD,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Aetna Medicare,Aetna Medicare,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Ambetter ,Ambetter ,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Blue Access,Anthem Blue Access,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Blue Access Choice,Anthem Blue Access Choice,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Blue Preferred,Anthem Blue Preferred,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Pathway,Anthem Pathway,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Alliance,Anthem Alliance,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Anthem Medicare,Anthem Medicare,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Cigna,Cigna,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Cigna PPO,Cigna PPO,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Cigna Medicare Advantage,Cigna Medicare Advantage,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Essence,Essence,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Healthlink HMO,Healthlink HMO,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Healthlink PPO,Healthlink PPO,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,HomeState Health Plan,HomeState Health Plan,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Humana Gold,Humana Gold,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Medicaid MO,Medicaid MO,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Medica,Medica,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Tricare,Tricare,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,UHC All Payer,UHC All Payer,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,UHC Exchange,UHC Exchange,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,UHC Medicaid,UHC Medicaid,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,UMR CPD,UMR CPD,508.82,,,,,,,per diem,508.82,508.82,"Per diem rate, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,UHC Medicare,UHC Medicare,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
BONE MARROW SMEAR INTERP      ,38000630,CDM,310,RC,85097,CPT,,,,Inpatient,,,508.82,508.82,Wellcare,Wellcare,508.82,,,,,,,case rate,508.82,508.82,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Meritain Health PPO CPD,Meritain Health PPO CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Aetna/Commercial Product,Aetna/Commercial Product,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Meritain Health CPD,Meritain Health CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Starmark CPD,Starmark CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Aetna Medicare,Aetna Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Ambetter ,Ambetter ,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Blue Access,Anthem Blue Access,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Blue Access Choice,Anthem Blue Access Choice,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Blue Preferred,Anthem Blue Preferred,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Pathway,Anthem Pathway,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Alliance,Anthem Alliance,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Anthem Medicare,Anthem Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Cigna,Cigna,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Cigna PPO,Cigna PPO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Cigna Medicare Advantage,Cigna Medicare Advantage,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Essence,Essence,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Healthlink HMO,Healthlink HMO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Healthlink PPO,Healthlink PPO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,HomeState Health Plan,HomeState Health Plan,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Humana Gold,Humana Gold,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Medicaid MO,Medicaid MO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Medica,Medica,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Tricare,Tricare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,UHC All Payer,UHC All Payer,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,UHC Exchange,UHC Exchange,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,UHC Medicaid,UHC Medicaid,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,UMR CPD,UMR CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,UHC Medicare,UHC Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOPATH WASH/BRUSH NON-GYN   ,38000635,CDM,311,RC,88104,CPT,,,,Inpatient,,,347.75,347.75,Wellcare,Wellcare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Meritain Health PPO CPD,Meritain Health PPO CPD,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Aetna/Commercial Product,Aetna/Commercial Product,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Meritain Health CPD,Meritain Health CPD,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Starmark CPD,Starmark CPD,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Aetna Medicare,Aetna Medicare,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Ambetter ,Ambetter ,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Blue Access,Anthem Blue Access,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Blue Access Choice,Anthem Blue Access Choice,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Blue Preferred,Anthem Blue Preferred,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Pathway,Anthem Pathway,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Alliance,Anthem Alliance,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Anthem Medicare,Anthem Medicare,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Cigna,Cigna,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Cigna PPO,Cigna PPO,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Cigna Medicare Advantage,Cigna Medicare Advantage,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Essence,Essence,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Healthlink HMO,Healthlink HMO,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Healthlink PPO,Healthlink PPO,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,HomeState Health Plan,HomeState Health Plan,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Humana Gold,Humana Gold,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Medicaid MO,Medicaid MO,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Medica,Medica,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Tricare,Tricare,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,UHC All Payer,UHC All Payer,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,UHC Exchange,UHC Exchange,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,UHC Medicaid,UHC Medicaid,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,UMR CPD,UMR CPD,268.86,,,,,,,per diem,268.86,268.86,"Per diem rate, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,UHC Medicare,UHC Medicare,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
CYTOSPIN                      ,38000640,CDM,311,RC,88108,CPT,,,,Inpatient,,,268.86,268.86,Wellcare,Wellcare,268.86,,,,,,,case rate,268.86,268.86,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Meritain Health PPO CPD,Meritain Health PPO CPD,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Aetna/Commercial Product,Aetna/Commercial Product,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Meritain Health CPD,Meritain Health CPD,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Starmark CPD,Starmark CPD,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Aetna Medicare,Aetna Medicare,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Ambetter ,Ambetter ,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Blue Access,Anthem Blue Access,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Blue Access Choice,Anthem Blue Access Choice,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Blue Preferred,Anthem Blue Preferred,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Pathway,Anthem Pathway,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Alliance,Anthem Alliance,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Anthem Medicare,Anthem Medicare,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Cigna,Cigna,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Cigna PPO,Cigna PPO,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Cigna Medicare Advantage,Cigna Medicare Advantage,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Essence,Essence,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Healthlink HMO,Healthlink HMO,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Healthlink PPO,Healthlink PPO,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,HomeState Health Plan,HomeState Health Plan,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Humana Gold,Humana Gold,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Medicaid MO,Medicaid MO,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Medica,Medica,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Tricare,Tricare,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,UHC All Payer,UHC All Payer,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,UHC Exchange,UHC Exchange,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,UHC Medicaid,UHC Medicaid,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,UMR CPD,UMR CPD,535.11,,,,,,,per diem,535.11,535.11,"Per diem rate, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,UHC Medicare,UHC Medicare,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
"FINE NEEDLE ASP, INTERPRET    ",38000650,CDM,311,RC,88173,CPT,,,,Inpatient,,,535.11,535.11,Wellcare,Wellcare,535.11,,,,,,,case rate,535.11,535.11,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Meritain Health PPO CPD,Meritain Health PPO CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Aetna/Commercial Product,Aetna/Commercial Product,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Meritain Health CPD,Meritain Health CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Starmark CPD,Starmark CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Aetna Medicare,Aetna Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Ambetter ,Ambetter ,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Access,Anthem Blue Access,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Access Choice,Anthem Blue Access Choice,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Preferred,Anthem Blue Preferred,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Pathway,Anthem Pathway,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Alliance,Anthem Alliance,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Anthem Medicare,Anthem Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Cigna,Cigna,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Cigna PPO,Cigna PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Cigna Medicare Advantage,Cigna Medicare Advantage,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Essence,Essence,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Healthlink HMO,Healthlink HMO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Healthlink PPO,Healthlink PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,HomeState Health Plan,HomeState Health Plan,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Humana Gold,Humana Gold,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Medicaid MO,Medicaid MO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Medica,Medica,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Tricare,Tricare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,UHC All Payer,UHC All Payer,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,UHC Exchange,UHC Exchange,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,UHC Medicaid,UHC Medicaid,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,UMR CPD,UMR CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,UHC Medicare,UHC Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
TISSUE BLOCK FROZEN SECT ADD  ,38000655,CDM,310,RC,88332,CPT,,,,Inpatient,,,187.01,187.01,Wellcare,Wellcare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Meritain Health PPO CPD,Meritain Health PPO CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Aetna/Commercial Product,Aetna/Commercial Product,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Meritain Health CPD,Meritain Health CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Starmark CPD,Starmark CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Aetna Medicare,Aetna Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Ambetter ,Ambetter ,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Access,Anthem Blue Access,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Access Choice,Anthem Blue Access Choice,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Blue Preferred,Anthem Blue Preferred,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Pathway,Anthem Pathway,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Alliance,Anthem Alliance,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Anthem Medicare,Anthem Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Cigna,Cigna,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Cigna PPO,Cigna PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Cigna Medicare Advantage,Cigna Medicare Advantage,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Essence,Essence,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Healthlink HMO,Healthlink HMO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Healthlink PPO,Healthlink PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,HomeState Health Plan,HomeState Health Plan,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Humana Gold,Humana Gold,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Medicaid MO,Medicaid MO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Medica,Medica,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Tricare,Tricare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,UHC All Payer,UHC All Payer,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,UHC Exchange,UHC Exchange,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,UHC Medicaid,UHC Medicaid,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,UMR CPD,UMR CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,UHC Medicare,UHC Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
HEMAPATH ENZYMES              ,38000665,CDM,311,RC,88319,CPT,,,,Inpatient,,,196.46,196.46,Wellcare,Wellcare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Meritain Health PPO CPD,Meritain Health PPO CPD,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Aetna/Commercial Product,Aetna/Commercial Product,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Meritain Health CPD,Meritain Health CPD,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Starmark CPD,Starmark CPD,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Aetna Medicare,Aetna Medicare,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Ambetter ,Ambetter ,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Blue Access,Anthem Blue Access,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Blue Access Choice,Anthem Blue Access Choice,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Blue Preferred,Anthem Blue Preferred,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Pathway,Anthem Pathway,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Alliance,Anthem Alliance,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Anthem Medicare,Anthem Medicare,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Cigna,Cigna,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Cigna PPO,Cigna PPO,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Cigna Medicare Advantage,Cigna Medicare Advantage,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Essence,Essence,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Healthlink HMO,Healthlink HMO,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Healthlink PPO,Healthlink PPO,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,HomeState Health Plan,HomeState Health Plan,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Humana Gold,Humana Gold,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Medicaid MO,Medicaid MO,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Medica,Medica,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Tricare,Tricare,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,UHC All Payer,UHC All Payer,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,UHC Exchange,UHC Exchange,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,UHC Medicaid,UHC Medicaid,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,UMR CPD,UMR CPD,243.44,,,,,,,per diem,243.44,243.44,"Per diem rate, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,UHC Medicare,UHC Medicare,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
SPECIAL STAIN GROUP-1         ,38000710,CDM,312,RC,88312,CPT,,,,Inpatient,,,243.44,243.44,Wellcare,Wellcare,243.44,,,,,,,case rate,243.44,243.44,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Meritain Health PPO CPD,Meritain Health PPO CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Aetna/Commercial Product,Aetna/Commercial Product,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Meritain Health CPD,Meritain Health CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Starmark CPD,Starmark CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Aetna Medicare,Aetna Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Ambetter ,Ambetter ,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Blue Access,Anthem Blue Access,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Blue Access Choice,Anthem Blue Access Choice,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Blue Preferred,Anthem Blue Preferred,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Pathway,Anthem Pathway,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Alliance,Anthem Alliance,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Anthem Medicare,Anthem Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Cigna,Cigna,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Cigna PPO,Cigna PPO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Cigna Medicare Advantage,Cigna Medicare Advantage,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Essence,Essence,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Healthlink HMO,Healthlink HMO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Healthlink PPO,Healthlink PPO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,HomeState Health Plan,HomeState Health Plan,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Humana Gold,Humana Gold,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Medicaid MO,Medicaid MO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Medica,Medica,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Tricare,Tricare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,UHC All Payer,UHC All Payer,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,UHC Exchange,UHC Exchange,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,UHC Medicaid,UHC Medicaid,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,UMR CPD,UMR CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,UHC Medicare,UHC Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
STAIN GROUP-II                ,38000715,CDM,312,RC,88313,CPT,,,,Inpatient,,,245.84,245.84,Wellcare,Wellcare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Meritain Health PPO CPD,Meritain Health PPO CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Aetna/Commercial Product,Aetna/Commercial Product,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Meritain Health CPD,Meritain Health CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Starmark CPD,Starmark CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Aetna Medicare,Aetna Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Ambetter ,Ambetter ,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Access,Anthem Blue Access,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Access Choice,Anthem Blue Access Choice,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Preferred,Anthem Blue Preferred,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Pathway,Anthem Pathway,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Alliance,Anthem Alliance,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Anthem Medicare,Anthem Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Cigna,Cigna,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Cigna PPO,Cigna PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Cigna Medicare Advantage,Cigna Medicare Advantage,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Essence,Essence,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Healthlink HMO,Healthlink HMO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Healthlink PPO,Healthlink PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,HomeState Health Plan,HomeState Health Plan,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Humana Gold,Humana Gold,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Medicaid MO,Medicaid MO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Medica,Medica,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Tricare,Tricare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,UHC All Payer,UHC All Payer,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,UHC Exchange,UHC Exchange,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,UHC Medicaid,UHC Medicaid,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,UMR CPD,UMR CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,UHC Medicare,UHC Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-1ST MKR-TECH   ,38000730,CDM,300,RC,88184,CPT,,,,Inpatient,,,134.48,134.48,Wellcare,Wellcare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Meritain Health PPO CPD,Meritain Health PPO CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Aetna/Commercial Product,Aetna/Commercial Product,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Meritain Health CPD,Meritain Health CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Starmark CPD,Starmark CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Aetna Medicare,Aetna Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Ambetter ,Ambetter ,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Blue Access,Anthem Blue Access,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Blue Access Choice,Anthem Blue Access Choice,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Blue Preferred,Anthem Blue Preferred,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Pathway,Anthem Pathway,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Alliance,Anthem Alliance,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Anthem Medicare,Anthem Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Cigna,Cigna,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Cigna PPO,Cigna PPO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Cigna Medicare Advantage,Cigna Medicare Advantage,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Essence,Essence,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Healthlink HMO,Healthlink HMO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Healthlink PPO,Healthlink PPO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,HomeState Health Plan,HomeState Health Plan,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Humana Gold,Humana Gold,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Medicaid MO,Medicaid MO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Medica,Medica,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Tricare,Tricare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,UHC All Payer,UHC All Payer,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,UHC Exchange,UHC Exchange,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,UHC Medicaid,UHC Medicaid,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,UMR CPD,UMR CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,UHC Medicare,UHC Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
FLOW CYTOMETRY-EA ADD MKR-TECH,38000735,CDM,300,RC,88185,CPT,,,,Inpatient,,,128.17,128.17,Wellcare,Wellcare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Meritain Health PPO CPD,Meritain Health PPO CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Aetna/Commercial Product,Aetna/Commercial Product,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Meritain Health CPD,Meritain Health CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Starmark CPD,Starmark CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Aetna Medicare,Aetna Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Ambetter ,Ambetter ,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Blue Access,Anthem Blue Access,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Blue Access Choice,Anthem Blue Access Choice,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Blue Preferred,Anthem Blue Preferred,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Pathway,Anthem Pathway,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Alliance,Anthem Alliance,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Anthem Medicare,Anthem Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Cigna,Cigna,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Cigna PPO,Cigna PPO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Cigna Medicare Advantage,Cigna Medicare Advantage,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Essence,Essence,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Healthlink HMO,Healthlink HMO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Healthlink PPO,Healthlink PPO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,HomeState Health Plan,HomeState Health Plan,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Humana Gold,Humana Gold,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Medicaid MO,Medicaid MO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Medica,Medica,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Tricare,Tricare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,UHC All Payer,UHC All Payer,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,UHC Exchange,UHC Exchange,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,UHC Medicaid,UHC Medicaid,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,UMR CPD,UMR CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,UHC Medicare,UHC Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PAP SMEAR THIN PREP           ,38000930,CDM,311,RC,88142,CPT,G0123,HCPCS,,Inpatient,,,163.89,163.89,Wellcare,Wellcare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Meritain Health PPO CPD,Meritain Health PPO CPD,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Aetna/Commercial Product,Aetna/Commercial Product,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Meritain Health CPD,Meritain Health CPD,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Starmark CPD,Starmark CPD,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Aetna Medicare,Aetna Medicare,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Ambetter ,Ambetter ,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Blue Access,Anthem Blue Access,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Blue Access Choice,Anthem Blue Access Choice,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Blue Preferred,Anthem Blue Preferred,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Pathway,Anthem Pathway,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Alliance,Anthem Alliance,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Anthem Medicare,Anthem Medicare,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Cigna,Cigna,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Cigna PPO,Cigna PPO,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Cigna Medicare Advantage,Cigna Medicare Advantage,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Essence,Essence,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Healthlink HMO,Healthlink HMO,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Healthlink PPO,Healthlink PPO,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,HomeState Health Plan,HomeState Health Plan,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Humana Gold,Humana Gold,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Medicaid MO,Medicaid MO,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Medica,Medica,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Tricare,Tricare,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,UHC All Payer,UHC All Payer,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,UHC Exchange,UHC Exchange,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,UHC Medicaid,UHC Medicaid,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,UMR CPD,UMR CPD,116.34,,,,,,,per diem,116.34,116.34,"Per diem rate, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,UHC Medicare,UHC Medicare,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
PERIPH SMEAR REPT & INTERP    ,38001900,CDM,305,RC,85060,CPT,,,,Inpatient,,,116.34,116.34,Wellcare,Wellcare,116.34,,,,,,,case rate,116.34,116.34,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Meritain Health PPO CPD,Meritain Health PPO CPD,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Aetna/Commercial Product,Aetna/Commercial Product,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Meritain Health CPD,Meritain Health CPD,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Starmark CPD,Starmark CPD,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Aetna Medicare,Aetna Medicare,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Ambetter ,Ambetter ,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Blue Access,Anthem Blue Access,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Blue Access Choice,Anthem Blue Access Choice,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Blue Preferred,Anthem Blue Preferred,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Pathway,Anthem Pathway,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Alliance,Anthem Alliance,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Anthem Medicare,Anthem Medicare,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Cigna,Cigna,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Cigna PPO,Cigna PPO,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Cigna Medicare Advantage,Cigna Medicare Advantage,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Essence,Essence,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Healthlink HMO,Healthlink HMO,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Healthlink PPO,Healthlink PPO,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,HomeState Health Plan,HomeState Health Plan,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Humana Gold,Humana Gold,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Medicaid MO,Medicaid MO,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Medica,Medica,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Tricare,Tricare,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,UHC All Payer,UHC All Payer,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,UHC Exchange,UHC Exchange,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,UHC Medicaid,UHC Medicaid,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,UMR CPD,UMR CPD,697.6,,,,,,,per diem,697.6,697.6,"Per diem rate, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,UHC Medicare,UHC Medicare,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O FNA CYTO 1ST EVAL         ,38010000,CDM,311,RC,,,,,,Inpatient,,,697.6,697.6,Wellcare,Wellcare,697.6,,,,,,,case rate,697.6,697.6,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Meritain Health PPO CPD,Meritain Health PPO CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Aetna/Commercial Product,Aetna/Commercial Product,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Meritain Health CPD,Meritain Health CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Starmark CPD,Starmark CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Aetna Medicare,Aetna Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Ambetter ,Ambetter ,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Access,Anthem Blue Access,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Access Choice,Anthem Blue Access Choice,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Preferred,Anthem Blue Preferred,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Pathway,Anthem Pathway,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Alliance,Anthem Alliance,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Medicare,Anthem Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Cigna,Cigna,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Cigna PPO,Cigna PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Cigna Medicare Advantage,Cigna Medicare Advantage,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Essence,Essence,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Healthlink HMO,Healthlink HMO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Healthlink PPO,Healthlink PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,HomeState Health Plan,HomeState Health Plan,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Humana Gold,Humana Gold,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Medicaid MO,Medicaid MO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Medica,Medica,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Tricare,Tricare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,UHC All Payer,UHC All Payer,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,UHC Exchange,UHC Exchange,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,UHC Medicaid,UHC Medicaid,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,UMR CPD,UMR CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,UHC Medicare,UHC Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ALK1 IMMUNOHIST           ,38010001,CDM,312,RC,,,,,,Inpatient,,,194.36,194.36,Wellcare,Wellcare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO 1ST STAIN     ,38010002,CDM,312,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Meritain Health PPO CPD,Meritain Health PPO CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Aetna/Commercial Product,Aetna/Commercial Product,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Meritain Health CPD,Meritain Health CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Starmark CPD,Starmark CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Aetna Medicare,Aetna Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Ambetter ,Ambetter ,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Blue Access,Anthem Blue Access,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Blue Access Choice,Anthem Blue Access Choice,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Blue Preferred,Anthem Blue Preferred,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Pathway,Anthem Pathway,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Alliance,Anthem Alliance,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Anthem Medicare,Anthem Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Cigna,Cigna,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Cigna PPO,Cigna PPO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Cigna Medicare Advantage,Cigna Medicare Advantage,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Essence,Essence,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Healthlink HMO,Healthlink HMO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Healthlink PPO,Healthlink PPO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,HomeState Health Plan,HomeState Health Plan,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Humana Gold,Humana Gold,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Medicaid MO,Medicaid MO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Medica,Medica,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Tricare,Tricare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,UHC All Payer,UHC All Payer,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,UHC Exchange,UHC Exchange,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,UHC Medicaid,UHC Medicaid,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,UMR CPD,UMR CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,UHC Medicare,UHC Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD1 IMMUNOHIST W/INTR     ,38010003,CDM,312,RC,,,,,,Inpatient,,,239.54,239.54,Wellcare,Wellcare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Meritain Health PPO CPD,Meritain Health PPO CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna/Commercial Product,Aetna/Commercial Product,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Meritain Health CPD,Meritain Health CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Starmark CPD,Starmark CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna Medicare,Aetna Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Ambetter ,Ambetter ,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Access,Anthem Blue Access,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Access Choice,Anthem Blue Access Choice,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Preferred,Anthem Blue Preferred,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Pathway,Anthem Pathway,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Alliance,Anthem Alliance,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Medicare,Anthem Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna,Cigna,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna PPO,Cigna PPO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna Medicare Advantage,Cigna Medicare Advantage,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Essence,Essence,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthlink HMO,Healthlink HMO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthlink PPO,Healthlink PPO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,HomeState Health Plan,HomeState Health Plan,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Humana Gold,Humana Gold,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Medicaid MO,Medicaid MO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Medica,Medica,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Tricare,Tricare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC All Payer,UHC All Payer,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Exchange,UHC Exchange,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Medicaid,UHC Medicaid,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,UMR CPD,UMR CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Medicare,UHC Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O PD-L1 22C3 KEYTRUDA       ,38010004,CDM,312,RC,,,,,,Inpatient,,,1286.99,1286.99,Wellcare,Wellcare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Meritain Health PPO CPD,Meritain Health PPO CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Aetna/Commercial Product,Aetna/Commercial Product,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Meritain Health CPD,Meritain Health CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Starmark CPD,Starmark CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Aetna Medicare,Aetna Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Ambetter ,Ambetter ,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Access,Anthem Blue Access,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Access Choice,Anthem Blue Access Choice,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Blue Preferred,Anthem Blue Preferred,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Pathway,Anthem Pathway,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Alliance,Anthem Alliance,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Anthem Medicare,Anthem Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Cigna,Cigna,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Cigna PPO,Cigna PPO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Cigna Medicare Advantage,Cigna Medicare Advantage,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Essence,Essence,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Healthlink HMO,Healthlink HMO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Healthlink PPO,Healthlink PPO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,HomeState Health Plan,HomeState Health Plan,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Humana Gold,Humana Gold,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Medicaid MO,Medicaid MO,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Medica,Medica,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Tricare,Tricare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,UHC All Payer,UHC All Payer,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,UHC Exchange,UHC Exchange,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,UHC Medicaid,UHC Medicaid,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,UMR CPD,UMR CPD,2856.58,,,,,,,per diem,2856.58,2856.58,"Per diem rate, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,UHC Medicare,UHC Medicare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ELECTR MICROSCPY DXCP     ,38010005,CDM,312,RC,,,,,,Inpatient,,,2856.58,2856.58,Wellcare,Wellcare,2856.58,,,,,,,case rate,2856.58,2856.58,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Meritain Health PPO CPD,Meritain Health PPO CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Aetna/Commercial Product,Aetna/Commercial Product,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Meritain Health CPD,Meritain Health CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Starmark CPD,Starmark CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Aetna Medicare,Aetna Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Ambetter ,Ambetter ,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Blue Access,Anthem Blue Access,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Blue Access Choice,Anthem Blue Access Choice,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Blue Preferred,Anthem Blue Preferred,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Pathway,Anthem Pathway,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Alliance,Anthem Alliance,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Anthem Medicare,Anthem Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Cigna,Cigna,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Cigna PPO,Cigna PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Cigna Medicare Advantage,Cigna Medicare Advantage,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Essence,Essence,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Healthlink HMO,Healthlink HMO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Healthlink PPO,Healthlink PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,HomeState Health Plan,HomeState Health Plan,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Humana Gold,Humana Gold,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Medicaid MO,Medicaid MO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Medica,Medica,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Tricare,Tricare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,UHC All Payer,UHC All Payer,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,UHC Exchange,UHC Exchange,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,UHC Medicaid,UHC Medicaid,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,UMR CPD,UMR CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,UHC Medicare,UHC Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010006,CDM,311,RC,88271,CPT,,,,Inpatient,,,508.49,508.49,Wellcare,Wellcare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health PPO CPD,Meritain Health PPO CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/Commercial Product,Aetna/Commercial Product,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health CPD,Meritain Health CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Starmark CPD,Starmark CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Aetna Medicare,Aetna Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Ambetter ,Ambetter ,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access,Anthem Blue Access,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access Choice,Anthem Blue Access Choice,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Preferred,Anthem Blue Preferred,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Pathway,Anthem Pathway,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Alliance,Anthem Alliance,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Medicare,Anthem Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Cigna,Cigna,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Cigna PPO,Cigna PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Cigna Medicare Advantage,Cigna Medicare Advantage,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Essence,Essence,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink HMO,Healthlink HMO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink PPO,Healthlink PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,HomeState Health Plan,HomeState Health Plan,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Humana Gold,Humana Gold,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Medicaid MO,Medicaid MO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Medica,Medica,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Tricare,Tricare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,UHC All Payer,UHC All Payer,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,UHC Exchange,UHC Exchange,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicaid,UHC Medicaid,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,UMR CPD,UMR CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicare,UHC Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010007,CDM,311,RC,,,,,,Inpatient,,,508.49,508.49,Wellcare,Wellcare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUOR STUDY AB      ,38010008,CDM,312,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Meritain Health PPO CPD,Meritain Health PPO CPD,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Aetna/Commercial Product,Aetna/Commercial Product,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Meritain Health CPD,Meritain Health CPD,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Starmark CPD,Starmark CPD,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Aetna Medicare,Aetna Medicare,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Ambetter ,Ambetter ,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Blue Access,Anthem Blue Access,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Blue Access Choice,Anthem Blue Access Choice,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Blue Preferred,Anthem Blue Preferred,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Pathway,Anthem Pathway,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Alliance,Anthem Alliance,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Anthem Medicare,Anthem Medicare,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Cigna,Cigna,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Cigna PPO,Cigna PPO,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Cigna Medicare Advantage,Cigna Medicare Advantage,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Essence,Essence,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Healthlink HMO,Healthlink HMO,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Healthlink PPO,Healthlink PPO,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,HomeState Health Plan,HomeState Health Plan,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Humana Gold,Humana Gold,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Medicaid MO,Medicaid MO,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Medica,Medica,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Tricare,Tricare,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,UHC All Payer,UHC All Payer,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,UHC Exchange,UHC Exchange,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,UHC Medicaid,UHC Medicaid,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,UMR CPD,UMR CPD,333.04,,,,,,,per diem,333.04,333.04,"Per diem rate, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,UHC Medicare,UHC Medicare,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O FNA INTERP/REPORT         ,38010009,CDM,311,RC,,,,,,Inpatient,,,333.04,333.04,Wellcare,Wellcare,333.04,,,,,,,case rate,333.04,333.04,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Meritain Health PPO CPD,Meritain Health PPO CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Aetna/Commercial Product,Aetna/Commercial Product,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Meritain Health CPD,Meritain Health CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Starmark CPD,Starmark CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Aetna Medicare,Aetna Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Ambetter ,Ambetter ,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Blue Access,Anthem Blue Access,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Blue Access Choice,Anthem Blue Access Choice,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Blue Preferred,Anthem Blue Preferred,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Pathway,Anthem Pathway,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Alliance,Anthem Alliance,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Anthem Medicare,Anthem Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Cigna,Cigna,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Cigna PPO,Cigna PPO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Cigna Medicare Advantage,Cigna Medicare Advantage,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Essence,Essence,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Healthlink HMO,Healthlink HMO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Healthlink PPO,Healthlink PPO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,HomeState Health Plan,HomeState Health Plan,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Humana Gold,Humana Gold,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Medicaid MO,Medicaid MO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Medica,Medica,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Tricare,Tricare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,UHC All Payer,UHC All Payer,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,UHC Exchange,UHC Exchange,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,UHC Medicaid,UHC Medicaid,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,UMR CPD,UMR CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,UHC Medicare,UHC Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUKEMIA         ,38010010,CDM,311,RC,,,,,,Inpatient,,,260.55,260.55,Wellcare,Wellcare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Meritain Health PPO CPD,Meritain Health PPO CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna/Commercial Product,Aetna/Commercial Product,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Meritain Health CPD,Meritain Health CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Starmark CPD,Starmark CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna Medicare,Aetna Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Ambetter ,Ambetter ,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Access,Anthem Blue Access,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Access Choice,Anthem Blue Access Choice,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Preferred,Anthem Blue Preferred,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Pathway,Anthem Pathway,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Alliance,Anthem Alliance,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Medicare,Anthem Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna,Cigna,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna PPO,Cigna PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna Medicare Advantage,Cigna Medicare Advantage,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Essence,Essence,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthlink HMO,Healthlink HMO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthlink PPO,Healthlink PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,HomeState Health Plan,HomeState Health Plan,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Humana Gold,Humana Gold,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Medicaid MO,Medicaid MO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Medica,Medica,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Tricare,Tricare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC All Payer,UHC All Payer,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Exchange,UHC Exchange,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Medicaid,UHC Medicaid,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UMR CPD,UMR CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Medicare,UHC Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O LYMPHOMA/LEUK EA ADD      ,38010011,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Wellcare,Wellcare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AMYLASE                   ,38010012,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Meritain Health PPO CPD,Meritain Health PPO CPD,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Aetna/Commercial Product,Aetna/Commercial Product,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Meritain Health CPD,Meritain Health CPD,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Starmark CPD,Starmark CPD,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Aetna Medicare,Aetna Medicare,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Ambetter ,Ambetter ,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Blue Access,Anthem Blue Access,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Blue Access Choice,Anthem Blue Access Choice,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Blue Preferred,Anthem Blue Preferred,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Pathway,Anthem Pathway,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Alliance,Anthem Alliance,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Anthem Medicare,Anthem Medicare,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Cigna,Cigna,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Cigna PPO,Cigna PPO,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Cigna Medicare Advantage,Cigna Medicare Advantage,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Essence,Essence,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Healthlink HMO,Healthlink HMO,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Healthlink PPO,Healthlink PPO,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,HomeState Health Plan,HomeState Health Plan,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Humana Gold,Humana Gold,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Medicaid MO,Medicaid MO,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Medica,Medica,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Tricare,Tricare,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,UHC All Payer,UHC All Payer,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,UHC Exchange,UHC Exchange,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,UHC Medicaid,UHC Medicaid,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,UMR CPD,UMR CPD,710.21,,,,,,,per diem,710.21,710.21,"Per diem rate, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,UHC Medicare,UHC Medicare,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O IRON LIVER                ,38010013,CDM,301,RC,,,,,,Inpatient,,,710.21,710.21,Wellcare,Wellcare,710.21,,,,,,,case rate,710.21,710.21,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Meritain Health PPO CPD,Meritain Health PPO CPD,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Aetna/Commercial Product,Aetna/Commercial Product,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Meritain Health CPD,Meritain Health CPD,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Starmark CPD,Starmark CPD,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Aetna Medicare,Aetna Medicare,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Ambetter ,Ambetter ,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Blue Access,Anthem Blue Access,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Blue Access Choice,Anthem Blue Access Choice,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Blue Preferred,Anthem Blue Preferred,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Pathway,Anthem Pathway,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Alliance,Anthem Alliance,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Anthem Medicare,Anthem Medicare,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Cigna,Cigna,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Cigna PPO,Cigna PPO,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Cigna Medicare Advantage,Cigna Medicare Advantage,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Essence,Essence,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Healthlink HMO,Healthlink HMO,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Healthlink PPO,Healthlink PPO,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,HomeState Health Plan,HomeState Health Plan,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Humana Gold,Humana Gold,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Medicaid MO,Medicaid MO,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Medica,Medica,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Tricare,Tricare,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,UHC All Payer,UHC All Payer,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,UHC Exchange,UHC Exchange,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,UHC Medicaid,UHC Medicaid,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,UMR CPD,UMR CPD,12886.66,,,,,,,per diem,12886.66,12886.66,"Per diem rate, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,UHC Medicare,UHC Medicare,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O PATHFINDERTG ANALYSIS     ,38010014,CDM,301,RC,,,,,,Inpatient,,,12886.66,12886.66,Wellcare,Wellcare,12886.66,,,,,,,case rate,12886.66,12886.66,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Meritain Health PPO CPD,Meritain Health PPO CPD,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Aetna/Commercial Product,Aetna/Commercial Product,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Meritain Health CPD,Meritain Health CPD,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Starmark CPD,Starmark CPD,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Aetna Medicare,Aetna Medicare,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Ambetter ,Ambetter ,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Blue Access,Anthem Blue Access,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Blue Access Choice,Anthem Blue Access Choice,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Blue Preferred,Anthem Blue Preferred,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Pathway,Anthem Pathway,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Alliance,Anthem Alliance,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Anthem Medicare,Anthem Medicare,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Cigna,Cigna,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Cigna PPO,Cigna PPO,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Cigna Medicare Advantage,Cigna Medicare Advantage,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Essence,Essence,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Healthlink HMO,Healthlink HMO,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Healthlink PPO,Healthlink PPO,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,HomeState Health Plan,HomeState Health Plan,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Humana Gold,Humana Gold,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Medicaid MO,Medicaid MO,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Medica,Medica,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Tricare,Tricare,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,UHC All Payer,UHC All Payer,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,UHC Exchange,UHC Exchange,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,UHC Medicaid,UHC Medicaid,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,UMR CPD,UMR CPD,339.34,,,,,,,per diem,339.34,339.34,"Per diem rate, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,UHC Medicare,UHC Medicare,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O SYT-SSX TRN RTPCR         ,38010015,CDM,301,RC,,,,,,Inpatient,,,339.34,339.34,Wellcare,Wellcare,339.34,,,,,,,case rate,339.34,339.34,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health PPO CPD,Meritain Health PPO CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/Commercial Product,Aetna/Commercial Product,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health CPD,Meritain Health CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Starmark CPD,Starmark CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna Medicare,Aetna Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Ambetter ,Ambetter ,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access,Anthem Blue Access,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access Choice,Anthem Blue Access Choice,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Preferred,Anthem Blue Preferred,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Pathway,Anthem Pathway,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Alliance,Anthem Alliance,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Medicare,Anthem Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna,Cigna,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna PPO,Cigna PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna Medicare Advantage,Cigna Medicare Advantage,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Essence,Essence,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink HMO,Healthlink HMO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink PPO,Healthlink PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,HomeState Health Plan,HomeState Health Plan,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Humana Gold,Humana Gold,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medicaid MO,Medicaid MO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medica,Medica,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Tricare,Tricare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC All Payer,UHC All Payer,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Exchange,UHC Exchange,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicaid,UHC Medicaid,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UMR CPD,UMR CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicare,UHC Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV LOW RISK PARAFFIN     ,38010016,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Wellcare,Wellcare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health PPO CPD,Meritain Health PPO CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/Commercial Product,Aetna/Commercial Product,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health CPD,Meritain Health CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Starmark CPD,Starmark CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna Medicare,Aetna Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Ambetter ,Ambetter ,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access,Anthem Blue Access,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access Choice,Anthem Blue Access Choice,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Preferred,Anthem Blue Preferred,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Pathway,Anthem Pathway,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Alliance,Anthem Alliance,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Medicare,Anthem Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna,Cigna,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna PPO,Cigna PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna Medicare Advantage,Cigna Medicare Advantage,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Essence,Essence,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink HMO,Healthlink HMO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink PPO,Healthlink PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,HomeState Health Plan,HomeState Health Plan,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Humana Gold,Humana Gold,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medicaid MO,Medicaid MO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medica,Medica,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Tricare,Tricare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC All Payer,UHC All Payer,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Exchange,UHC Exchange,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicaid,UHC Medicaid,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UMR CPD,UMR CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicare,UHC Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O HPV HIGH RISK PARAFF      ,38010017,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Wellcare,Wellcare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health PPO CPD,Meritain Health PPO CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna/Commercial Product,Aetna/Commercial Product,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Meritain Health CPD,Meritain Health CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Starmark CPD,Starmark CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Aetna Medicare,Aetna Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Ambetter ,Ambetter ,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access,Anthem Blue Access,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Access Choice,Anthem Blue Access Choice,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Blue Preferred,Anthem Blue Preferred,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Pathway,Anthem Pathway,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Alliance,Anthem Alliance,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Anthem Medicare,Anthem Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna,Cigna,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna PPO,Cigna PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Cigna Medicare Advantage,Cigna Medicare Advantage,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Essence,Essence,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink HMO,Healthlink HMO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Healthlink PPO,Healthlink PPO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,HomeState Health Plan,HomeState Health Plan,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Humana Gold,Humana Gold,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medicaid MO,Medicaid MO,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Medica,Medica,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Tricare,Tricare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC All Payer,UHC All Payer,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Exchange,UHC Exchange,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicaid,UHC Medicaid,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UMR CPD,UMR CPD,508.49,,,,,,,per diem,508.49,508.49,"Per diem rate, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,UHC Medicare,UHC Medicare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O EBV IN SITU PARAFFIN      ,38010018,CDM,312,RC,,,,,,Inpatient,,,508.49,508.49,Wellcare,Wellcare,508.49,,,,,,,case rate,508.49,508.49,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010019,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health PPO CPD,Meritain Health PPO CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/Commercial Product,Aetna/Commercial Product,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health CPD,Meritain Health CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Starmark CPD,Starmark CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna Medicare,Aetna Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Ambetter ,Ambetter ,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access,Anthem Blue Access,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access Choice,Anthem Blue Access Choice,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Preferred,Anthem Blue Preferred,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Pathway,Anthem Pathway,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Alliance,Anthem Alliance,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Medicare,Anthem Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna,Cigna,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna PPO,Cigna PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna Medicare Advantage,Cigna Medicare Advantage,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Essence,Essence,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink HMO,Healthlink HMO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink PPO,Healthlink PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,HomeState Health Plan,HomeState Health Plan,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Humana Gold,Humana Gold,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medicaid MO,Medicaid MO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medica,Medica,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Tricare,Tricare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC All Payer,UHC All Payer,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Exchange,UHC Exchange,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicaid,UHC Medicaid,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UMR CPD,UMR CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicare,UHC Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010020,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Wellcare,Wellcare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health PPO CPD,Meritain Health PPO CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/Commercial Product,Aetna/Commercial Product,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health CPD,Meritain Health CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Starmark CPD,Starmark CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna Medicare,Aetna Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Ambetter ,Ambetter ,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access,Anthem Blue Access,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access Choice,Anthem Blue Access Choice,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Preferred,Anthem Blue Preferred,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Pathway,Anthem Pathway,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Alliance,Anthem Alliance,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Medicare,Anthem Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna,Cigna,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna PPO,Cigna PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna Medicare Advantage,Cigna Medicare Advantage,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Essence,Essence,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink HMO,Healthlink HMO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink PPO,Healthlink PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,HomeState Health Plan,HomeState Health Plan,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Humana Gold,Humana Gold,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medicaid MO,Medicaid MO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medica,Medica,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Tricare,Tricare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC All Payer,UHC All Payer,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Exchange,UHC Exchange,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicaid,UHC Medicaid,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UMR CPD,UMR CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicare,UHC Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O GASTRO STROM TUMR         ,38010021,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Wellcare,Wellcare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010022,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Meritain Health PPO CPD,Meritain Health PPO CPD,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Aetna/Commercial Product,Aetna/Commercial Product,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Meritain Health CPD,Meritain Health CPD,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Starmark CPD,Starmark CPD,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Aetna Medicare,Aetna Medicare,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Ambetter ,Ambetter ,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Blue Access,Anthem Blue Access,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Blue Access Choice,Anthem Blue Access Choice,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Blue Preferred,Anthem Blue Preferred,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Pathway,Anthem Pathway,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Alliance,Anthem Alliance,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Anthem Medicare,Anthem Medicare,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Cigna,Cigna,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Cigna PPO,Cigna PPO,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Cigna Medicare Advantage,Cigna Medicare Advantage,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Essence,Essence,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Healthlink HMO,Healthlink HMO,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Healthlink PPO,Healthlink PPO,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,HomeState Health Plan,HomeState Health Plan,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Humana Gold,Humana Gold,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Medicaid MO,Medicaid MO,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Medica,Medica,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Tricare,Tricare,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,UHC All Payer,UHC All Payer,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,UHC Exchange,UHC Exchange,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,UHC Medicaid,UHC Medicaid,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,UMR CPD,UMR CPD,883.55,,,,,,,per diem,883.55,883.55,"Per diem rate, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,UHC Medicare,UHC Medicare,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O EGFR MUT DET PYRO         ,38010023,CDM,301,RC,,,,,,Inpatient,,,883.55,883.55,Wellcare,Wellcare,883.55,,,,,,,case rate,883.55,883.55,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health PPO CPD,Meritain Health PPO CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/Commercial Product,Aetna/Commercial Product,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health CPD,Meritain Health CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Starmark CPD,Starmark CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Aetna Medicare,Aetna Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Ambetter ,Ambetter ,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access,Anthem Blue Access,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access Choice,Anthem Blue Access Choice,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Preferred,Anthem Blue Preferred,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Pathway,Anthem Pathway,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Alliance,Anthem Alliance,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Medicare,Anthem Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Cigna,Cigna,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Cigna PPO,Cigna PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Cigna Medicare Advantage,Cigna Medicare Advantage,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Essence,Essence,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink HMO,Healthlink HMO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink PPO,Healthlink PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,HomeState Health Plan,HomeState Health Plan,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Humana Gold,Humana Gold,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Medicaid MO,Medicaid MO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Medica,Medica,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Tricare,Tricare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,UHC All Payer,UHC All Payer,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,UHC Exchange,UHC Exchange,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicaid,UHC Medicaid,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,UMR CPD,UMR CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicare,UHC Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010024,CDM,311,RC,,,,,,Inpatient,,,491.68,491.68,Wellcare,Wellcare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Meritain Health PPO CPD,Meritain Health PPO CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Aetna/Commercial Product,Aetna/Commercial Product,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Meritain Health CPD,Meritain Health CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Starmark CPD,Starmark CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Aetna Medicare,Aetna Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Ambetter ,Ambetter ,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Access,Anthem Blue Access,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Access Choice,Anthem Blue Access Choice,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Preferred,Anthem Blue Preferred,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Pathway,Anthem Pathway,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Alliance,Anthem Alliance,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Medicare,Anthem Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Cigna,Cigna,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Cigna PPO,Cigna PPO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Cigna Medicare Advantage,Cigna Medicare Advantage,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Essence,Essence,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Healthlink HMO,Healthlink HMO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Healthlink PPO,Healthlink PPO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,HomeState Health Plan,HomeState Health Plan,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Humana Gold,Humana Gold,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Medicaid MO,Medicaid MO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Medica,Medica,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Tricare,Tricare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,UHC All Payer,UHC All Payer,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,UHC Exchange,UHC Exchange,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,UHC Medicaid,UHC Medicaid,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,UMR CPD,UMR CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,UHC Medicare,UHC Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ALK GENE FISH             ,38010025,CDM,311,RC,,,,,,Inpatient,,,529.5,529.5,Wellcare,Wellcare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health PPO CPD,Meritain Health PPO CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/Commercial Product,Aetna/Commercial Product,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health CPD,Meritain Health CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Starmark CPD,Starmark CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna Medicare,Aetna Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Ambetter ,Ambetter ,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access,Anthem Blue Access,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access Choice,Anthem Blue Access Choice,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Preferred,Anthem Blue Preferred,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Pathway,Anthem Pathway,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Alliance,Anthem Alliance,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Medicare,Anthem Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna,Cigna,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna PPO,Cigna PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna Medicare Advantage,Cigna Medicare Advantage,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Essence,Essence,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink HMO,Healthlink HMO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink PPO,Healthlink PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,HomeState Health Plan,HomeState Health Plan,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Humana Gold,Humana Gold,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Medicaid MO,Medicaid MO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Medica,Medica,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Tricare,Tricare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC All Payer,UHC All Payer,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Exchange,UHC Exchange,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicaid,UHC Medicaid,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UMR CPD,UMR CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicare,UHC Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010026,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Wellcare,Wellcare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health PPO CPD,Meritain Health PPO CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/Commercial Product,Aetna/Commercial Product,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health CPD,Meritain Health CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Starmark CPD,Starmark CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Aetna Medicare,Aetna Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Ambetter ,Ambetter ,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access,Anthem Blue Access,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access Choice,Anthem Blue Access Choice,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Preferred,Anthem Blue Preferred,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Pathway,Anthem Pathway,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Alliance,Anthem Alliance,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Medicare,Anthem Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna,Cigna,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna PPO,Cigna PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Cigna Medicare Advantage,Cigna Medicare Advantage,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Essence,Essence,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink HMO,Healthlink HMO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink PPO,Healthlink PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,HomeState Health Plan,HomeState Health Plan,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Humana Gold,Humana Gold,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Medicaid MO,Medicaid MO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Medica,Medica,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Tricare,Tricare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC All Payer,UHC All Payer,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Exchange,UHC Exchange,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicaid,UHC Medicaid,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UMR CPD,UMR CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicare,UHC Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010027,CDM,301,RC,,,,,,Inpatient,,,392.92,392.92,Wellcare,Wellcare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Meritain Health PPO CPD,Meritain Health PPO CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Aetna/Commercial Product,Aetna/Commercial Product,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Meritain Health CPD,Meritain Health CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Starmark CPD,Starmark CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Aetna Medicare,Aetna Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Ambetter ,Ambetter ,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Access,Anthem Blue Access,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Access Choice,Anthem Blue Access Choice,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Preferred,Anthem Blue Preferred,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Pathway,Anthem Pathway,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Alliance,Anthem Alliance,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Anthem Medicare,Anthem Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Cigna,Cigna,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Cigna PPO,Cigna PPO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Cigna Medicare Advantage,Cigna Medicare Advantage,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Essence,Essence,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Healthlink HMO,Healthlink HMO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Healthlink PPO,Healthlink PPO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,HomeState Health Plan,HomeState Health Plan,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Humana Gold,Humana Gold,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Medicaid MO,Medicaid MO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Medica,Medica,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Tricare,Tricare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,UHC All Payer,UHC All Payer,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,UHC Exchange,UHC Exchange,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,UHC Medicaid,UHC Medicaid,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,UMR CPD,UMR CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,UHC Medicare,UHC Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O 5-FU 7 MUTATIONS          ,38010028,CDM,301,RC,81479,CPT,,,,Inpatient,,,364.56,364.56,Wellcare,Wellcare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Meritain Health PPO CPD,Meritain Health PPO CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Aetna/Commercial Product,Aetna/Commercial Product,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Meritain Health CPD,Meritain Health CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Starmark CPD,Starmark CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Aetna Medicare,Aetna Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Ambetter ,Ambetter ,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Blue Access,Anthem Blue Access,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Blue Access Choice,Anthem Blue Access Choice,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Blue Preferred,Anthem Blue Preferred,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Pathway,Anthem Pathway,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Alliance,Anthem Alliance,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Anthem Medicare,Anthem Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Cigna,Cigna,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Cigna PPO,Cigna PPO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Cigna Medicare Advantage,Cigna Medicare Advantage,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Essence,Essence,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Healthlink HMO,Healthlink HMO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Healthlink PPO,Healthlink PPO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,HomeState Health Plan,HomeState Health Plan,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Humana Gold,Humana Gold,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Medicaid MO,Medicaid MO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Medica,Medica,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Tricare,Tricare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,UHC All Payer,UHC All Payer,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,UHC Exchange,UHC Exchange,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,UHC Medicaid,UHC Medicaid,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,UMR CPD,UMR CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,UHC Medicare,UHC Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O PFTG GNAS                 ,38010029,CDM,301,RC,,,,,,Inpatient,,,183.86,183.86,Wellcare,Wellcare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Meritain Health PPO CPD,Meritain Health PPO CPD,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Aetna/Commercial Product,Aetna/Commercial Product,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Meritain Health CPD,Meritain Health CPD,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Starmark CPD,Starmark CPD,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Aetna Medicare,Aetna Medicare,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Ambetter ,Ambetter ,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Blue Access,Anthem Blue Access,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Blue Access Choice,Anthem Blue Access Choice,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Blue Preferred,Anthem Blue Preferred,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Pathway,Anthem Pathway,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Alliance,Anthem Alliance,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Anthem Medicare,Anthem Medicare,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Cigna,Cigna,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Cigna PPO,Cigna PPO,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Cigna Medicare Advantage,Cigna Medicare Advantage,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Essence,Essence,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Healthlink HMO,Healthlink HMO,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Healthlink PPO,Healthlink PPO,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,HomeState Health Plan,HomeState Health Plan,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Humana Gold,Humana Gold,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Medicaid MO,Medicaid MO,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Medica,Medica,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Tricare,Tricare,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,UHC All Payer,UHC All Payer,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,UHC Exchange,UHC Exchange,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,UHC Medicaid,UHC Medicaid,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,UMR CPD,UMR CPD,303.62,,,,,,,per diem,303.62,303.62,"Per diem rate, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,UHC Medicare,UHC Medicare,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O HER-2/NEU TISSUE ASSY     ,38010030,CDM,312,RC,,,,,,Inpatient,,,303.62,303.62,Wellcare,Wellcare,303.62,,,,,,,case rate,303.62,303.62,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Meritain Health PPO CPD,Meritain Health PPO CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Aetna/Commercial Product,Aetna/Commercial Product,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Meritain Health CPD,Meritain Health CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Starmark CPD,Starmark CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Aetna Medicare,Aetna Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Ambetter ,Ambetter ,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Access,Anthem Blue Access,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Access Choice,Anthem Blue Access Choice,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Preferred,Anthem Blue Preferred,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Pathway,Anthem Pathway,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Alliance,Anthem Alliance,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Medicare,Anthem Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Cigna,Cigna,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Cigna PPO,Cigna PPO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Cigna Medicare Advantage,Cigna Medicare Advantage,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Essence,Essence,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Healthlink HMO,Healthlink HMO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Healthlink PPO,Healthlink PPO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,HomeState Health Plan,HomeState Health Plan,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Humana Gold,Humana Gold,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Medicaid MO,Medicaid MO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Medica,Medica,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Tricare,Tricare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,UHC All Payer,UHC All Payer,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,UHC Exchange,UHC Exchange,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,UHC Medicaid,UHC Medicaid,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,UMR CPD,UMR CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,UHC Medicare,UHC Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O INSITU HYBRID AUTO        ,38010031,CDM,312,RC,,,,,,Inpatient,,,499.04,499.04,Wellcare,Wellcare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Meritain Health PPO CPD,Meritain Health PPO CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Aetna/Commercial Product,Aetna/Commercial Product,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Meritain Health CPD,Meritain Health CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Starmark CPD,Starmark CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Aetna Medicare,Aetna Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Ambetter ,Ambetter ,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Access,Anthem Blue Access,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Access Choice,Anthem Blue Access Choice,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Preferred,Anthem Blue Preferred,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Pathway,Anthem Pathway,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Alliance,Anthem Alliance,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Medicare,Anthem Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Cigna,Cigna,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Cigna PPO,Cigna PPO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Cigna Medicare Advantage,Cigna Medicare Advantage,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Essence,Essence,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Healthlink HMO,Healthlink HMO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Healthlink PPO,Healthlink PPO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,HomeState Health Plan,HomeState Health Plan,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Humana Gold,Humana Gold,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Medicaid MO,Medicaid MO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Medica,Medica,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Tricare,Tricare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,UHC All Payer,UHC All Payer,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,UHC Exchange,UHC Exchange,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,UHC Medicaid,UHC Medicaid,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,UMR CPD,UMR CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,UHC Medicare,UHC Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O FNA CYTO EA ADD EVAL      ,38010032,CDM,311,RC,,,,,,Inpatient,,,110.31,110.31,Wellcare,Wellcare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health PPO CPD,Meritain Health PPO CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/Commercial Product,Aetna/Commercial Product,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health CPD,Meritain Health CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Starmark CPD,Starmark CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Aetna Medicare,Aetna Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Ambetter ,Ambetter ,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access,Anthem Blue Access,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access Choice,Anthem Blue Access Choice,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Preferred,Anthem Blue Preferred,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Pathway,Anthem Pathway,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Alliance,Anthem Alliance,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Medicare,Anthem Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Cigna,Cigna,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Cigna PPO,Cigna PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Cigna Medicare Advantage,Cigna Medicare Advantage,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Essence,Essence,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink HMO,Healthlink HMO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink PPO,Healthlink PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,HomeState Health Plan,HomeState Health Plan,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Humana Gold,Humana Gold,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Medicaid MO,Medicaid MO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Medica,Medica,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Tricare,Tricare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,UHC All Payer,UHC All Payer,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,UHC Exchange,UHC Exchange,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicaid,UHC Medicaid,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,UMR CPD,UMR CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicare,UHC Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O INTRAOP CYTO CNSLT1       ,38010033,CDM,312,RC,,,,,,Inpatient,,,310.98,310.98,Wellcare,Wellcare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health PPO CPD,Meritain Health PPO CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Aetna/Commercial Product,Aetna/Commercial Product,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Meritain Health CPD,Meritain Health CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Starmark CPD,Starmark CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Aetna Medicare,Aetna Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Ambetter ,Ambetter ,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access,Anthem Blue Access,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Access Choice,Anthem Blue Access Choice,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Blue Preferred,Anthem Blue Preferred,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Pathway,Anthem Pathway,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Alliance,Anthem Alliance,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Anthem Medicare,Anthem Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Cigna,Cigna,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Cigna PPO,Cigna PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Cigna Medicare Advantage,Cigna Medicare Advantage,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Essence,Essence,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink HMO,Healthlink HMO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Healthlink PPO,Healthlink PPO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,HomeState Health Plan,HomeState Health Plan,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Humana Gold,Humana Gold,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Medicaid MO,Medicaid MO,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Medica,Medica,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Tricare,Tricare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,UHC All Payer,UHC All Payer,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,UHC Exchange,UHC Exchange,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicaid,UHC Medicaid,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,UMR CPD,UMR CPD,392.92,,,,,,,per diem,392.92,392.92,"Per diem rate, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,UHC Medicare,UHC Medicare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O CYTO SMEAR EXTENDED       ,38010034,CDM,311,RC,,,,,,Inpatient,,,392.92,392.92,Wellcare,Wellcare,392.92,,,,,,,case rate,392.92,392.92,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Meritain Health PPO CPD,Meritain Health PPO CPD,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Aetna/Commercial Product,Aetna/Commercial Product,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Meritain Health CPD,Meritain Health CPD,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Starmark CPD,Starmark CPD,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Aetna Medicare,Aetna Medicare,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Ambetter ,Ambetter ,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Blue Access,Anthem Blue Access,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Blue Access Choice,Anthem Blue Access Choice,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Blue Preferred,Anthem Blue Preferred,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Pathway,Anthem Pathway,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Alliance,Anthem Alliance,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Anthem Medicare,Anthem Medicare,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Cigna,Cigna,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Cigna PPO,Cigna PPO,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Cigna Medicare Advantage,Cigna Medicare Advantage,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Essence,Essence,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Healthlink HMO,Healthlink HMO,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Healthlink PPO,Healthlink PPO,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,HomeState Health Plan,HomeState Health Plan,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Humana Gold,Humana Gold,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Medicaid MO,Medicaid MO,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Medica,Medica,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Tricare,Tricare,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,UHC All Payer,UHC All Payer,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,UHC Exchange,UHC Exchange,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,UHC Medicaid,UHC Medicaid,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,UMR CPD,UMR CPD,165.99,,,,,,,per diem,165.99,165.99,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,UHC Medicare,UHC Medicare,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO ADD STAIN     ,38010035,CDM,312,RC,,,,,,Inpatient,,,165.99,165.99,Wellcare,Wellcare,165.99,,,,,,,case rate,165.99,165.99,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Meritain Health PPO CPD,Meritain Health PPO CPD,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Aetna/Commercial Product,Aetna/Commercial Product,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Meritain Health CPD,Meritain Health CPD,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Starmark CPD,Starmark CPD,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Aetna Medicare,Aetna Medicare,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Ambetter ,Ambetter ,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Blue Access,Anthem Blue Access,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Blue Access Choice,Anthem Blue Access Choice,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Blue Preferred,Anthem Blue Preferred,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Pathway,Anthem Pathway,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Alliance,Anthem Alliance,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Anthem Medicare,Anthem Medicare,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Cigna,Cigna,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Cigna PPO,Cigna PPO,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Cigna Medicare Advantage,Cigna Medicare Advantage,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Essence,Essence,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Healthlink HMO,Healthlink HMO,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Healthlink PPO,Healthlink PPO,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,HomeState Health Plan,HomeState Health Plan,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Humana Gold,Humana Gold,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Medicaid MO,Medicaid MO,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Medica,Medica,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Tricare,Tricare,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,UHC All Payer,UHC All Payer,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,UHC Exchange,UHC Exchange,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,UHC Medicaid,UHC Medicaid,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,UMR CPD,UMR CPD,1438.27,,,,,,,per diem,1438.27,1438.27,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,UHC Medicare,UHC Medicare,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 10-20     ,38010036,CDM,312,RC,,,,,,Inpatient,,,1438.27,1438.27,Wellcare,Wellcare,1438.27,,,,,,,case rate,1438.27,1438.27,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Meritain Health PPO CPD,Meritain Health PPO CPD,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Aetna/Commercial Product,Aetna/Commercial Product,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Meritain Health CPD,Meritain Health CPD,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Starmark CPD,Starmark CPD,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Aetna Medicare,Aetna Medicare,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Ambetter ,Ambetter ,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Blue Access,Anthem Blue Access,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Blue Access Choice,Anthem Blue Access Choice,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Blue Preferred,Anthem Blue Preferred,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Pathway,Anthem Pathway,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Alliance,Anthem Alliance,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Anthem Medicare,Anthem Medicare,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Cigna,Cigna,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Cigna PPO,Cigna PPO,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Cigna Medicare Advantage,Cigna Medicare Advantage,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Essence,Essence,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Healthlink HMO,Healthlink HMO,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Healthlink PPO,Healthlink PPO,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,HomeState Health Plan,HomeState Health Plan,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Humana Gold,Humana Gold,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Medicaid MO,Medicaid MO,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Medica,Medica,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Tricare,Tricare,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,UHC All Payer,UHC All Payer,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,UHC Exchange,UHC Exchange,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,UHC Medicaid,UHC Medicaid,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,UMR CPD,UMR CPD,2883.9,,,,,,,per diem,2883.9,2883.9,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,UHC Medicare,UHC Medicare,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 21-40     ,38010037,CDM,312,RC,,,,,,Inpatient,,,2883.9,2883.9,Wellcare,Wellcare,2883.9,,,,,,,case rate,2883.9,2883.9,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Meritain Health PPO CPD,Meritain Health PPO CPD,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Aetna/Commercial Product,Aetna/Commercial Product,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Meritain Health CPD,Meritain Health CPD,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Starmark CPD,Starmark CPD,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Aetna Medicare,Aetna Medicare,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Ambetter ,Ambetter ,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Blue Access,Anthem Blue Access,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Blue Access Choice,Anthem Blue Access Choice,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Blue Preferred,Anthem Blue Preferred,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Pathway,Anthem Pathway,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Alliance,Anthem Alliance,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Anthem Medicare,Anthem Medicare,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Cigna,Cigna,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Cigna PPO,Cigna PPO,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Cigna Medicare Advantage,Cigna Medicare Advantage,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Essence,Essence,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Healthlink HMO,Healthlink HMO,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Healthlink PPO,Healthlink PPO,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,HomeState Health Plan,HomeState Health Plan,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Humana Gold,Humana Gold,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Medicaid MO,Medicaid MO,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Medica,Medica,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Tricare,Tricare,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,UHC All Payer,UHC All Payer,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,UHC Exchange,UHC Exchange,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,UHC Medicaid,UHC Medicaid,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,UMR CPD,UMR CPD,4818.05,,,,,,,per diem,4818.05,4818.05,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,UHC Medicare,UHC Medicare,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX 41-60     ,38010038,CDM,312,RC,,,,,,Inpatient,,,4818.05,4818.05,Wellcare,Wellcare,4818.05,,,,,,,case rate,4818.05,4818.05,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Meritain Health PPO CPD,Meritain Health PPO CPD,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Aetna/Commercial Product,Aetna/Commercial Product,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Meritain Health CPD,Meritain Health CPD,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Starmark CPD,Starmark CPD,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Aetna Medicare,Aetna Medicare,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Ambetter ,Ambetter ,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Blue Access,Anthem Blue Access,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Blue Access Choice,Anthem Blue Access Choice,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Blue Preferred,Anthem Blue Preferred,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Pathway,Anthem Pathway,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Alliance,Anthem Alliance,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Anthem Medicare,Anthem Medicare,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Cigna,Cigna,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Cigna PPO,Cigna PPO,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Cigna Medicare Advantage,Cigna Medicare Advantage,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Essence,Essence,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Healthlink HMO,Healthlink HMO,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Healthlink PPO,Healthlink PPO,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,HomeState Health Plan,HomeState Health Plan,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Humana Gold,Humana Gold,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Medicaid MO,Medicaid MO,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Medica,Medica,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Tricare,Tricare,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,UHC All Payer,UHC All Payer,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,UHC Exchange,UHC Exchange,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,UHC Medicaid,UHC Medicaid,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,UMR CPD,UMR CPD,5621.76,,,,,,,per diem,5621.76,5621.76,"Per diem rate, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,UHC Medicare,UHC Medicare,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O PROS NDL SAT BX >60       ,38010039,CDM,312,RC,,,,,,Inpatient,,,5621.76,5621.76,Wellcare,Wellcare,5621.76,,,,,,,case rate,5621.76,5621.76,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Meritain Health PPO CPD,Meritain Health PPO CPD,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Aetna/Commercial Product,Aetna/Commercial Product,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Meritain Health CPD,Meritain Health CPD,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Starmark CPD,Starmark CPD,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Aetna Medicare,Aetna Medicare,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Ambetter ,Ambetter ,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Blue Access,Anthem Blue Access,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Blue Access Choice,Anthem Blue Access Choice,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Blue Preferred,Anthem Blue Preferred,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Pathway,Anthem Pathway,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Alliance,Anthem Alliance,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Anthem Medicare,Anthem Medicare,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Cigna,Cigna,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Cigna PPO,Cigna PPO,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Cigna Medicare Advantage,Cigna Medicare Advantage,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Essence,Essence,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Healthlink HMO,Healthlink HMO,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Healthlink PPO,Healthlink PPO,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,HomeState Health Plan,HomeState Health Plan,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Humana Gold,Humana Gold,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Medicaid MO,Medicaid MO,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Medica,Medica,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Tricare,Tricare,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,UHC All Payer,UHC All Payer,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,UHC Exchange,UHC Exchange,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,UHC Medicaid,UHC Medicaid,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,UMR CPD,UMR CPD,213.27,,,,,,,per diem,213.27,213.27,"Per diem rate, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,UHC Medicare,UHC Medicare,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O IMMUNO/CYTO MULTIPLEX     ,38010040,CDM,312,RC,,,,,,Inpatient,,,213.27,213.27,Wellcare,Wellcare,213.27,,,,,,,case rate,213.27,213.27,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR 1ST PROBE     ,38010041,CDM,312,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health PPO CPD,Meritain Health PPO CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/Commercial Product,Aetna/Commercial Product,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health CPD,Meritain Health CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Starmark CPD,Starmark CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Aetna Medicare,Aetna Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Ambetter ,Ambetter ,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access,Anthem Blue Access,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access Choice,Anthem Blue Access Choice,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Preferred,Anthem Blue Preferred,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Pathway,Anthem Pathway,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Alliance,Anthem Alliance,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Medicare,Anthem Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Cigna,Cigna,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Cigna PPO,Cigna PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Cigna Medicare Advantage,Cigna Medicare Advantage,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Essence,Essence,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink HMO,Healthlink HMO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink PPO,Healthlink PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,HomeState Health Plan,HomeState Health Plan,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Humana Gold,Humana Gold,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Medicaid MO,Medicaid MO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Medica,Medica,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Tricare,Tricare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,UHC All Payer,UHC All Payer,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,UHC Exchange,UHC Exchange,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicaid,UHC Medicaid,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,UMR CPD,UMR CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicare,UHC Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR ADD PROBE     ,38010042,CDM,312,RC,,,,,,Inpatient,,,138.68,138.68,Wellcare,Wellcare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Meritain Health PPO CPD,Meritain Health PPO CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Aetna/Commercial Product,Aetna/Commercial Product,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Meritain Health CPD,Meritain Health CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Starmark CPD,Starmark CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Aetna Medicare,Aetna Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Ambetter ,Ambetter ,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Blue Access,Anthem Blue Access,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Blue Access Choice,Anthem Blue Access Choice,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Blue Preferred,Anthem Blue Preferred,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Pathway,Anthem Pathway,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Alliance,Anthem Alliance,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Anthem Medicare,Anthem Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Cigna,Cigna,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Cigna PPO,Cigna PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Cigna Medicare Advantage,Cigna Medicare Advantage,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Essence,Essence,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Healthlink HMO,Healthlink HMO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Healthlink PPO,Healthlink PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,HomeState Health Plan,HomeState Health Plan,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Humana Gold,Humana Gold,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Medicaid MO,Medicaid MO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Medica,Medica,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Tricare,Tricare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,UHC All Payer,UHC All Payer,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,UHC Exchange,UHC Exchange,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,UHC Medicaid,UHC Medicaid,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,UMR CPD,UMR CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,UHC Medicare,UHC Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR MULTIPLEX     ,38010043,CDM,312,RC,88366,CPT,,,,Inpatient,,,138.68,138.68,Wellcare,Wellcare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health PPO CPD,Meritain Health PPO CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/Commercial Product,Aetna/Commercial Product,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health CPD,Meritain Health CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Starmark CPD,Starmark CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Aetna Medicare,Aetna Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Ambetter ,Ambetter ,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access,Anthem Blue Access,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access Choice,Anthem Blue Access Choice,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Preferred,Anthem Blue Preferred,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Pathway,Anthem Pathway,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Alliance,Anthem Alliance,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Medicare,Anthem Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Cigna,Cigna,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Cigna PPO,Cigna PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Cigna Medicare Advantage,Cigna Medicare Advantage,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Essence,Essence,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink HMO,Healthlink HMO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink PPO,Healthlink PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,HomeState Health Plan,HomeState Health Plan,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Humana Gold,Humana Gold,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Medicaid MO,Medicaid MO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Medica,Medica,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Tricare,Tricare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,UHC All Payer,UHC All Payer,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,UHC Exchange,UHC Exchange,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicaid,UHC Medicaid,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,UMR CPD,UMR CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicare,UHC Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO ADD      ,38010044,CDM,312,RC,,,,,,Inpatient,,,502.19,502.19,Wellcare,Wellcare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Meritain Health PPO CPD,Meritain Health PPO CPD,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Aetna/Commercial Product,Aetna/Commercial Product,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Meritain Health CPD,Meritain Health CPD,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Starmark CPD,Starmark CPD,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Aetna Medicare,Aetna Medicare,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Ambetter ,Ambetter ,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Blue Access,Anthem Blue Access,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Blue Access Choice,Anthem Blue Access Choice,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Blue Preferred,Anthem Blue Preferred,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Pathway,Anthem Pathway,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Alliance,Anthem Alliance,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Anthem Medicare,Anthem Medicare,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Cigna,Cigna,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Cigna PPO,Cigna PPO,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Cigna Medicare Advantage,Cigna Medicare Advantage,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Essence,Essence,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Healthlink HMO,Healthlink HMO,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Healthlink PPO,Healthlink PPO,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,HomeState Health Plan,HomeState Health Plan,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Humana Gold,Humana Gold,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Medicaid MO,Medicaid MO,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Medica,Medica,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Tricare,Tricare,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,UHC All Payer,UHC All Payer,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,UHC Exchange,UHC Exchange,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,UHC Medicaid,UHC Medicaid,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,UMR CPD,UMR CPD,950.79,,,,,,,per diem,950.79,950.79,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,UHC Medicare,UHC Medicare,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR AUTO MULT     ,38010045,CDM,312,RC,,,,,,Inpatient,,,950.79,950.79,Wellcare,Wellcare,950.79,,,,,,,case rate,950.79,950.79,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Meritain Health PPO CPD,Meritain Health PPO CPD,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Aetna/Commercial Product,Aetna/Commercial Product,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Meritain Health CPD,Meritain Health CPD,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Starmark CPD,Starmark CPD,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Aetna Medicare,Aetna Medicare,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Ambetter ,Ambetter ,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Blue Access,Anthem Blue Access,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Blue Access Choice,Anthem Blue Access Choice,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Blue Preferred,Anthem Blue Preferred,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Pathway,Anthem Pathway,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Alliance,Anthem Alliance,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Anthem Medicare,Anthem Medicare,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Cigna,Cigna,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Cigna PPO,Cigna PPO,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Cigna Medicare Advantage,Cigna Medicare Advantage,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Essence,Essence,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Healthlink HMO,Healthlink HMO,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Healthlink PPO,Healthlink PPO,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,HomeState Health Plan,HomeState Health Plan,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Humana Gold,Humana Gold,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Medicaid MO,Medicaid MO,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Medica,Medica,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Tricare,Tricare,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,UHC All Payer,UHC All Payer,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,UHC Exchange,UHC Exchange,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,UHC Medicaid,UHC Medicaid,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,UMR CPD,UMR CPD,918.22,,,,,,,per diem,918.22,918.22,"Per diem rate, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,UHC Medicare,UHC Medicare,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O INSITU HYBR HER2 MULT     ,38010046,CDM,312,RC,,,,,,Inpatient,,,918.22,918.22,Wellcare,Wellcare,918.22,,,,,,,case rate,918.22,918.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O IMMUNOFLUORESCENE         ,38010047,CDM,312,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Meritain Health PPO CPD,Meritain Health PPO CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Aetna/Commercial Product,Aetna/Commercial Product,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Meritain Health CPD,Meritain Health CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Starmark CPD,Starmark CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Aetna Medicare,Aetna Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Ambetter ,Ambetter ,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Blue Access,Anthem Blue Access,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Blue Access Choice,Anthem Blue Access Choice,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Blue Preferred,Anthem Blue Preferred,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Pathway,Anthem Pathway,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Alliance,Anthem Alliance,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Anthem Medicare,Anthem Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Cigna,Cigna,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Cigna PPO,Cigna PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Cigna Medicare Advantage,Cigna Medicare Advantage,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Essence,Essence,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Healthlink HMO,Healthlink HMO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Healthlink PPO,Healthlink PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,HomeState Health Plan,HomeState Health Plan,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Humana Gold,Humana Gold,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Medicaid MO,Medicaid MO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Medica,Medica,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Tricare,Tricare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,UHC All Payer,UHC All Payer,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,UHC Exchange,UHC Exchange,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,UHC Medicaid,UHC Medicaid,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,UMR CPD,UMR CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,UHC Medicare,UHC Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
CHG CYTOPATH CELLULAR ENH     ,38010052,CDM,311,RC,,,,,,Inpatient,,,176.11,176.11,Wellcare,Wellcare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Meritain Health PPO CPD,Meritain Health PPO CPD,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Aetna/Commercial Product,Aetna/Commercial Product,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Meritain Health CPD,Meritain Health CPD,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Starmark CPD,Starmark CPD,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Aetna Medicare,Aetna Medicare,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Ambetter ,Ambetter ,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Blue Access,Anthem Blue Access,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Blue Access Choice,Anthem Blue Access Choice,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Blue Preferred,Anthem Blue Preferred,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Pathway,Anthem Pathway,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Alliance,Anthem Alliance,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Anthem Medicare,Anthem Medicare,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Cigna,Cigna,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Cigna PPO,Cigna PPO,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Cigna Medicare Advantage,Cigna Medicare Advantage,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Essence,Essence,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Healthlink HMO,Healthlink HMO,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Healthlink PPO,Healthlink PPO,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,HomeState Health Plan,HomeState Health Plan,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Humana Gold,Humana Gold,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Medicaid MO,Medicaid MO,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Medica,Medica,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Tricare,Tricare,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,UHC All Payer,UHC All Payer,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,UHC Exchange,UHC Exchange,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,UHC Medicaid,UHC Medicaid,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,UMR CPD,UMR CPD,73.32,,,,,,,per diem,73.32,73.32,"Per diem rate, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,UHC Medicare,UHC Medicare,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
PHYS SER DIFFICULT CROSS      ,38010057,CDM,310,RC,86077,CPT,,,,Inpatient,,,73.32,73.32,Wellcare,Wellcare,73.32,,,,,,,case rate,73.32,73.32,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Meritain Health PPO CPD,Meritain Health PPO CPD,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Aetna/Commercial Product,Aetna/Commercial Product,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Meritain Health CPD,Meritain Health CPD,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Starmark CPD,Starmark CPD,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Aetna Medicare,Aetna Medicare,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Ambetter ,Ambetter ,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Blue Access,Anthem Blue Access,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Blue Access Choice,Anthem Blue Access Choice,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Blue Preferred,Anthem Blue Preferred,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Pathway,Anthem Pathway,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Alliance,Anthem Alliance,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Anthem Medicare,Anthem Medicare,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Cigna,Cigna,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Cigna PPO,Cigna PPO,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Cigna Medicare Advantage,Cigna Medicare Advantage,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Essence,Essence,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Healthlink HMO,Healthlink HMO,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Healthlink PPO,Healthlink PPO,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,HomeState Health Plan,HomeState Health Plan,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Humana Gold,Humana Gold,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Medicaid MO,Medicaid MO,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Medica,Medica,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Tricare,Tricare,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,UHC All Payer,UHC All Payer,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,UHC Exchange,UHC Exchange,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,UHC Medicaid,UHC Medicaid,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,UMR CPD,UMR CPD,410.79,,,,,,,per diem,410.79,410.79,"Per diem rate, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,UHC Medicare,UHC Medicare,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL KARTYPE CSOME ANAL     ,38010058,CDM,311,RC,88280,CPT,,,,Inpatient,,,410.79,410.79,Wellcare,Wellcare,410.79,,,,,,,case rate,410.79,410.79,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Meritain Health PPO CPD,Meritain Health PPO CPD,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Aetna/Commercial Product,Aetna/Commercial Product,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Meritain Health CPD,Meritain Health CPD,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Starmark CPD,Starmark CPD,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Aetna Medicare,Aetna Medicare,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Ambetter ,Ambetter ,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Blue Access,Anthem Blue Access,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Blue Access Choice,Anthem Blue Access Choice,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Blue Preferred,Anthem Blue Preferred,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Pathway,Anthem Pathway,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Alliance,Anthem Alliance,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Anthem Medicare,Anthem Medicare,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Cigna,Cigna,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Cigna PPO,Cigna PPO,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Cigna Medicare Advantage,Cigna Medicare Advantage,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Essence,Essence,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Healthlink HMO,Healthlink HMO,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Healthlink PPO,Healthlink PPO,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,HomeState Health Plan,HomeState Health Plan,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Humana Gold,Humana Gold,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Medicaid MO,Medicaid MO,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Medica,Medica,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Tricare,Tricare,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,UHC All Payer,UHC All Payer,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,UHC Exchange,UHC Exchange,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,UHC Medicaid,UHC Medicaid,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,UMR CPD,UMR CPD,155.26,,,,,,,per diem,155.26,155.26,"Per diem rate, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,UHC Medicare,UHC Medicare,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
ADDTNL CELL CSMONE ANAL       ,38010059,CDM,311,RC,88285,CPT,,,,Inpatient,,,155.26,155.26,Wellcare,Wellcare,155.26,,,,,,,case rate,155.26,155.26,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Meritain Health PPO CPD,Meritain Health PPO CPD,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Aetna/Commercial Product,Aetna/Commercial Product,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Meritain Health CPD,Meritain Health CPD,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Starmark CPD,Starmark CPD,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Aetna Medicare,Aetna Medicare,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Ambetter ,Ambetter ,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Blue Access,Anthem Blue Access,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Blue Access Choice,Anthem Blue Access Choice,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Blue Preferred,Anthem Blue Preferred,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Pathway,Anthem Pathway,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Alliance,Anthem Alliance,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Anthem Medicare,Anthem Medicare,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Cigna,Cigna,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Cigna PPO,Cigna PPO,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Cigna Medicare Advantage,Cigna Medicare Advantage,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Essence,Essence,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Healthlink HMO,Healthlink HMO,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Healthlink PPO,Healthlink PPO,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,HomeState Health Plan,HomeState Health Plan,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Humana Gold,Humana Gold,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Medicaid MO,Medicaid MO,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Medica,Medica,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Tricare,Tricare,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,UHC All Payer,UHC All Payer,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,UHC Exchange,UHC Exchange,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,UHC Medicaid,UHC Medicaid,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,UMR CPD,UMR CPD,298.7,,,,,,,per diem,298.7,298.7,"Per diem rate, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,UHC Medicare,UHC Medicare,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL WOUND VACUUM           ,38149994,CDM,270,RC,,,,,,Inpatient,,,298.7,298.7,Wellcare,Wellcare,298.7,,,,,,,case rate,298.7,298.7,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Meritain Health PPO CPD,Meritain Health PPO CPD,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Aetna/Commercial Product,Aetna/Commercial Product,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Meritain Health CPD,Meritain Health CPD,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Starmark CPD,Starmark CPD,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Aetna Medicare,Aetna Medicare,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Ambetter ,Ambetter ,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Blue Access,Anthem Blue Access,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Blue Access Choice,Anthem Blue Access Choice,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Blue Preferred,Anthem Blue Preferred,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Pathway,Anthem Pathway,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Alliance,Anthem Alliance,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Anthem Medicare,Anthem Medicare,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Cigna,Cigna,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Cigna PPO,Cigna PPO,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Cigna Medicare Advantage,Cigna Medicare Advantage,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Essence,Essence,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Healthlink HMO,Healthlink HMO,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Healthlink PPO,Healthlink PPO,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,HomeState Health Plan,HomeState Health Plan,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Humana Gold,Humana Gold,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Medicaid MO,Medicaid MO,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Medica,Medica,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Tricare,Tricare,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,UHC All Payer,UHC All Payer,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,UHC Exchange,UHC Exchange,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,UHC Medicaid,UHC Medicaid,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,UMR CPD,UMR CPD,213.21,,,,,,,per diem,213.21,213.21,"Per diem rate, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,UHC Medicare,UHC Medicare,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL NPWT SIMPLICITY        ,38163207,CDM,270,RC,,,,,,Inpatient,,,213.21,213.21,Wellcare,Wellcare,213.21,,,,,,,case rate,213.21,213.21,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Meritain Health PPO CPD,Meritain Health PPO CPD,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Aetna/Commercial Product,Aetna/Commercial Product,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Meritain Health CPD,Meritain Health CPD,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Starmark CPD,Starmark CPD,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Aetna Medicare,Aetna Medicare,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Ambetter ,Ambetter ,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Blue Access,Anthem Blue Access,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Blue Access Choice,Anthem Blue Access Choice,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Blue Preferred,Anthem Blue Preferred,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Pathway,Anthem Pathway,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Alliance,Anthem Alliance,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Anthem Medicare,Anthem Medicare,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Cigna,Cigna,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Cigna PPO,Cigna PPO,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Cigna Medicare Advantage,Cigna Medicare Advantage,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Essence,Essence,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Healthlink HMO,Healthlink HMO,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Healthlink PPO,Healthlink PPO,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,HomeState Health Plan,HomeState Health Plan,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Humana Gold,Humana Gold,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Medicaid MO,Medicaid MO,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Medica,Medica,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Tricare,Tricare,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,UHC All Payer,UHC All Payer,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,UHC Exchange,UHC Exchange,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,UHC Medicaid,UHC Medicaid,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,UMR CPD,UMR CPD,324.45,,,,,,,per diem,324.45,324.45,"Per diem rate, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,UHC Medicare,UHC Medicare,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
RENTAL VAC KCI INFOVAC        ,38197185,CDM,270,RC,,,,,,Inpatient,,,324.45,324.45,Wellcare,Wellcare,324.45,,,,,,,case rate,324.45,324.45,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Meritain Health PPO CPD,Meritain Health PPO CPD,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Aetna/Commercial Product,Aetna/Commercial Product,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Meritain Health CPD,Meritain Health CPD,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Starmark CPD,Starmark CPD,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Aetna Medicare,Aetna Medicare,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Ambetter ,Ambetter ,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Blue Access,Anthem Blue Access,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Blue Access Choice,Anthem Blue Access Choice,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Blue Preferred,Anthem Blue Preferred,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Pathway,Anthem Pathway,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Alliance,Anthem Alliance,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Anthem Medicare,Anthem Medicare,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Cigna,Cigna,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Cigna PPO,Cigna PPO,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Cigna Medicare Advantage,Cigna Medicare Advantage,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Essence,Essence,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Healthlink HMO,Healthlink HMO,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Healthlink PPO,Healthlink PPO,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,HomeState Health Plan,HomeState Health Plan,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Humana Gold,Humana Gold,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Medicaid MO,Medicaid MO,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Medica,Medica,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Tricare,Tricare,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,UHC All Payer,UHC All Payer,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,UHC Exchange,UHC Exchange,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,UHC Medicaid,UHC Medicaid,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,UMR CPD,UMR CPD,353.28,,,,,,,per diem,353.28,353.28,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,UHC Medicare,UHC Medicare,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38200004,CDM,301,RC,84145,CPT,,,,Inpatient,,,353.28,353.28,Wellcare,Wellcare,353.28,,,,,,,case rate,353.28,353.28,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Meritain Health PPO CPD,Meritain Health PPO CPD,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Aetna/Commercial Product,Aetna/Commercial Product,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Meritain Health CPD,Meritain Health CPD,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Starmark CPD,Starmark CPD,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Aetna Medicare,Aetna Medicare,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Ambetter ,Ambetter ,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Blue Access,Anthem Blue Access,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Blue Access Choice,Anthem Blue Access Choice,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Blue Preferred,Anthem Blue Preferred,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Pathway,Anthem Pathway,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Alliance,Anthem Alliance,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Anthem Medicare,Anthem Medicare,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Cigna,Cigna,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Cigna PPO,Cigna PPO,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Cigna Medicare Advantage,Cigna Medicare Advantage,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Essence,Essence,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Healthlink HMO,Healthlink HMO,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Healthlink PPO,Healthlink PPO,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,HomeState Health Plan,HomeState Health Plan,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Humana Gold,Humana Gold,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Medicaid MO,Medicaid MO,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Medica,Medica,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Tricare,Tricare,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,UHC All Payer,UHC All Payer,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,UHC Exchange,UHC Exchange,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,UHC Medicaid,UHC Medicaid,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,UMR CPD,UMR CPD,274.21,,,,,,,per diem,274.21,274.21,"Per diem rate, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,UHC Medicare,UHC Medicare,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
17 OH PROGESTERONE 17-D       ,38200006,CDM,301,RC,83498,CPT,,,,Inpatient,,,274.21,274.21,Wellcare,Wellcare,274.21,,,,,,,case rate,274.21,274.21,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Meritain Health PPO CPD,Meritain Health PPO CPD,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Aetna/Commercial Product,Aetna/Commercial Product,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Meritain Health CPD,Meritain Health CPD,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Starmark CPD,Starmark CPD,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Aetna Medicare,Aetna Medicare,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Ambetter ,Ambetter ,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Blue Access,Anthem Blue Access,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Blue Access Choice,Anthem Blue Access Choice,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Blue Preferred,Anthem Blue Preferred,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Pathway,Anthem Pathway,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Alliance,Anthem Alliance,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Anthem Medicare,Anthem Medicare,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Cigna,Cigna,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Cigna PPO,Cigna PPO,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Cigna Medicare Advantage,Cigna Medicare Advantage,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Essence,Essence,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Healthlink HMO,Healthlink HMO,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Healthlink PPO,Healthlink PPO,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,HomeState Health Plan,HomeState Health Plan,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Humana Gold,Humana Gold,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Medicaid MO,Medicaid MO,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Medica,Medica,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Tricare,Tricare,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,UHC All Payer,UHC All Payer,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,UHC Exchange,UHC Exchange,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,UHC Medicaid,UHC Medicaid,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,UMR CPD,UMR CPD,126.97,,,,,,,per diem,126.97,126.97,"Per diem rate, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,UHC Medicare,UHC Medicare,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
IGG SUBCLASSES (EACH)         ,38200007,CDM,301,RC,82787,CPT,,,,Inpatient,,,126.97,126.97,Wellcare,Wellcare,126.97,,,,,,,case rate,126.97,126.97,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38200008,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Meritain Health PPO CPD,Meritain Health PPO CPD,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Aetna/Commercial Product,Aetna/Commercial Product,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Meritain Health CPD,Meritain Health CPD,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Starmark CPD,Starmark CPD,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Aetna Medicare,Aetna Medicare,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Ambetter ,Ambetter ,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Blue Access,Anthem Blue Access,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Blue Access Choice,Anthem Blue Access Choice,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Blue Preferred,Anthem Blue Preferred,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Pathway,Anthem Pathway,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Alliance,Anthem Alliance,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Anthem Medicare,Anthem Medicare,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Cigna,Cigna,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Cigna PPO,Cigna PPO,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Cigna Medicare Advantage,Cigna Medicare Advantage,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Essence,Essence,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Healthlink HMO,Healthlink HMO,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Healthlink PPO,Healthlink PPO,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,HomeState Health Plan,HomeState Health Plan,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Humana Gold,Humana Gold,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Medicaid MO,Medicaid MO,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Medica,Medica,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Tricare,Tricare,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,UHC All Payer,UHC All Payer,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,UHC Exchange,UHC Exchange,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,UHC Medicaid,UHC Medicaid,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,UMR CPD,UMR CPD,69.88,,,,,,,per diem,69.88,69.88,"Per diem rate, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,UHC Medicare,UHC Medicare,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
"ALLERGEN, IGE                 ",38200009,CDM,302,RC,86003,CPT,,,,Inpatient,,,69.88,69.88,Wellcare,Wellcare,69.88,,,,,,,case rate,69.88,69.88,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Meritain Health PPO CPD,Meritain Health PPO CPD,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Aetna/Commercial Product,Aetna/Commercial Product,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Meritain Health CPD,Meritain Health CPD,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Starmark CPD,Starmark CPD,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Aetna Medicare,Aetna Medicare,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Ambetter ,Ambetter ,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Blue Access,Anthem Blue Access,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Blue Access Choice,Anthem Blue Access Choice,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Blue Preferred,Anthem Blue Preferred,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Pathway,Anthem Pathway,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Alliance,Anthem Alliance,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Anthem Medicare,Anthem Medicare,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Cigna,Cigna,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Cigna PPO,Cigna PPO,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Cigna Medicare Advantage,Cigna Medicare Advantage,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Essence,Essence,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Healthlink HMO,Healthlink HMO,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Healthlink PPO,Healthlink PPO,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,HomeState Health Plan,HomeState Health Plan,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Humana Gold,Humana Gold,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Medicaid MO,Medicaid MO,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Medica,Medica,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Tricare,Tricare,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,UHC All Payer,UHC All Payer,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,UHC Exchange,UHC Exchange,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,UHC Medicaid,UHC Medicaid,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,UMR CPD,UMR CPD,352.76,,,,,,,per diem,352.76,352.76,"Per diem rate, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,UHC Medicare,UHC Medicare,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
ACETYCHOLINE RECEPTOR AB      ,38200010,CDM,301,RC,84238,CPT,,,,Inpatient,,,352.76,352.76,Wellcare,Wellcare,352.76,,,,,,,case rate,352.76,352.76,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Meritain Health PPO CPD,Meritain Health PPO CPD,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Aetna/Commercial Product,Aetna/Commercial Product,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Meritain Health CPD,Meritain Health CPD,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Starmark CPD,Starmark CPD,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Aetna Medicare,Aetna Medicare,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Ambetter ,Ambetter ,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Blue Access,Anthem Blue Access,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Blue Access Choice,Anthem Blue Access Choice,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Blue Preferred,Anthem Blue Preferred,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Pathway,Anthem Pathway,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Alliance,Anthem Alliance,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Anthem Medicare,Anthem Medicare,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Cigna,Cigna,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Cigna PPO,Cigna PPO,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Cigna Medicare Advantage,Cigna Medicare Advantage,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Essence,Essence,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Healthlink HMO,Healthlink HMO,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Healthlink PPO,Healthlink PPO,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,HomeState Health Plan,HomeState Health Plan,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Humana Gold,Humana Gold,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Medicaid MO,Medicaid MO,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Medica,Medica,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Tricare,Tricare,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,UHC All Payer,UHC All Payer,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,UHC Exchange,UHC Exchange,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,UHC Medicaid,UHC Medicaid,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,UMR CPD,UMR CPD,177.65,,,,,,,per diem,177.65,177.65,"Per diem rate, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,UHC Medicare,UHC Medicare,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
BETA 2 MICROGLOBULIN          ,38200013,CDM,301,RC,82232,CPT,,,,Inpatient,,,177.65,177.65,Wellcare,Wellcare,177.65,,,,,,,case rate,177.65,177.65,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Meritain Health PPO CPD,Meritain Health PPO CPD,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Aetna/Commercial Product,Aetna/Commercial Product,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Meritain Health CPD,Meritain Health CPD,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Starmark CPD,Starmark CPD,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Aetna Medicare,Aetna Medicare,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Ambetter ,Ambetter ,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Blue Access,Anthem Blue Access,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Blue Access Choice,Anthem Blue Access Choice,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Blue Preferred,Anthem Blue Preferred,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Pathway,Anthem Pathway,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Alliance,Anthem Alliance,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Anthem Medicare,Anthem Medicare,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Cigna,Cigna,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Cigna PPO,Cigna PPO,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Cigna Medicare Advantage,Cigna Medicare Advantage,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Essence,Essence,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Healthlink HMO,Healthlink HMO,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Healthlink PPO,Healthlink PPO,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,HomeState Health Plan,HomeState Health Plan,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Humana Gold,Humana Gold,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Medicaid MO,Medicaid MO,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Medica,Medica,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Tricare,Tricare,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,UHC All Payer,UHC All Payer,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,UHC Exchange,UHC Exchange,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,UHC Medicaid,UHC Medicaid,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,UMR CPD,UMR CPD,102.99,,,,,,,per diem,102.99,102.99,"Per diem rate, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,UHC Medicare,UHC Medicare,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
VARICELLA ZOSTER ANTIBODY     ,38200014,CDM,302,RC,86787,CPT,,,,Inpatient,,,102.99,102.99,Wellcare,Wellcare,102.99,,,,,,,case rate,102.99,102.99,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38200016,CDM,301,RC,82784,CPT,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Meritain Health PPO CPD,Meritain Health PPO CPD,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Aetna/Commercial Product,Aetna/Commercial Product,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Meritain Health CPD,Meritain Health CPD,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Starmark CPD,Starmark CPD,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Aetna Medicare,Aetna Medicare,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Ambetter ,Ambetter ,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Blue Access,Anthem Blue Access,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Blue Access Choice,Anthem Blue Access Choice,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Blue Preferred,Anthem Blue Preferred,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Pathway,Anthem Pathway,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Alliance,Anthem Alliance,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Anthem Medicare,Anthem Medicare,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Cigna,Cigna,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Cigna PPO,Cigna PPO,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Cigna Medicare Advantage,Cigna Medicare Advantage,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Essence,Essence,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Healthlink HMO,Healthlink HMO,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Healthlink PPO,Healthlink PPO,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,HomeState Health Plan,HomeState Health Plan,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Humana Gold,Humana Gold,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Medicaid MO,Medicaid MO,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Medica,Medica,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Tricare,Tricare,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,UHC All Payer,UHC All Payer,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,UHC Exchange,UHC Exchange,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,UHC Medicaid,UHC Medicaid,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,UMR CPD,UMR CPD,215.48,,,,,,,per diem,215.48,215.48,"Per diem rate, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,UHC Medicare,UHC Medicare,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
"AEROBIC CULTURE, QUANT        ",38200017,CDM,306,RC,87071,CPT,,,,Inpatient,,,215.48,215.48,Wellcare,Wellcare,215.48,,,,,,,case rate,215.48,215.48,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO BLOOD TYPING              ,38200018,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH BLOOD TYPING               ,38200019,CDM,302,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Meritain Health PPO CPD,Meritain Health PPO CPD,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Aetna/Commercial Product,Aetna/Commercial Product,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Meritain Health CPD,Meritain Health CPD,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Starmark CPD,Starmark CPD,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Aetna Medicare,Aetna Medicare,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Ambetter ,Ambetter ,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Blue Access,Anthem Blue Access,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Blue Access Choice,Anthem Blue Access Choice,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Blue Preferred,Anthem Blue Preferred,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Pathway,Anthem Pathway,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Alliance,Anthem Alliance,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Anthem Medicare,Anthem Medicare,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Cigna,Cigna,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Cigna PPO,Cigna PPO,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Cigna Medicare Advantage,Cigna Medicare Advantage,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Essence,Essence,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Healthlink HMO,Healthlink HMO,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Healthlink PPO,Healthlink PPO,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,HomeState Health Plan,HomeState Health Plan,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Humana Gold,Humana Gold,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Medicaid MO,Medicaid MO,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Medica,Medica,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Tricare,Tricare,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,UHC All Payer,UHC All Payer,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,UHC Exchange,UHC Exchange,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,UHC Medicaid,UHC Medicaid,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,UMR CPD,UMR CPD,691.7,,,,,,,per diem,691.7,691.7,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,UHC Medicare,UHC Medicare,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38200020,CDM,302,RC,86255,CPT,,,,Inpatient,,,691.7,691.7,Wellcare,Wellcare,691.7,,,,,,,case rate,691.7,691.7,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Meritain Health PPO CPD,Meritain Health PPO CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Aetna/Commercial Product,Aetna/Commercial Product,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Meritain Health CPD,Meritain Health CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Starmark CPD,Starmark CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Aetna Medicare,Aetna Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Ambetter ,Ambetter ,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Access,Anthem Blue Access,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Access Choice,Anthem Blue Access Choice,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Preferred,Anthem Blue Preferred,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Pathway,Anthem Pathway,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Alliance,Anthem Alliance,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Anthem Medicare,Anthem Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Cigna,Cigna,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Cigna PPO,Cigna PPO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Cigna Medicare Advantage,Cigna Medicare Advantage,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Essence,Essence,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Healthlink HMO,Healthlink HMO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Healthlink PPO,Healthlink PPO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,HomeState Health Plan,HomeState Health Plan,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Humana Gold,Humana Gold,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Medicaid MO,Medicaid MO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Medica,Medica,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Tricare,Tricare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,UHC All Payer,UHC All Payer,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,UHC Exchange,UHC Exchange,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,UHC Medicaid,UHC Medicaid,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,UMR CPD,UMR CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,UHC Medicare,UHC Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38200021,CDM,301,RC,84703,CPT,,,,Inpatient,,,73.2,73.2,Wellcare,Wellcare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Meritain Health PPO CPD,Meritain Health PPO CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Aetna/Commercial Product,Aetna/Commercial Product,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Meritain Health CPD,Meritain Health CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Starmark CPD,Starmark CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Aetna Medicare,Aetna Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Ambetter ,Ambetter ,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Access,Anthem Blue Access,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Access Choice,Anthem Blue Access Choice,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Preferred,Anthem Blue Preferred,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Pathway,Anthem Pathway,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Alliance,Anthem Alliance,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Anthem Medicare,Anthem Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Cigna,Cigna,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Cigna PPO,Cigna PPO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Cigna Medicare Advantage,Cigna Medicare Advantage,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Essence,Essence,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Healthlink HMO,Healthlink HMO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Healthlink PPO,Healthlink PPO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,HomeState Health Plan,HomeState Health Plan,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Humana Gold,Humana Gold,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Medicaid MO,Medicaid MO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Medica,Medica,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Tricare,Tricare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,UHC All Payer,UHC All Payer,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,UHC Exchange,UHC Exchange,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,UHC Medicaid,UHC Medicaid,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,UMR CPD,UMR CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,UHC Medicare,UHC Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38200022,CDM,301,RC,84702,CPT,,,,Inpatient,,,210.85,210.85,Wellcare,Wellcare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Meritain Health PPO CPD,Meritain Health PPO CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Aetna/Commercial Product,Aetna/Commercial Product,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Meritain Health CPD,Meritain Health CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Starmark CPD,Starmark CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Aetna Medicare,Aetna Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Ambetter ,Ambetter ,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Blue Access,Anthem Blue Access,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Blue Access Choice,Anthem Blue Access Choice,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Blue Preferred,Anthem Blue Preferred,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Pathway,Anthem Pathway,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Alliance,Anthem Alliance,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Anthem Medicare,Anthem Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Cigna,Cigna,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Cigna PPO,Cigna PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Cigna Medicare Advantage,Cigna Medicare Advantage,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Essence,Essence,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Healthlink HMO,Healthlink HMO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Healthlink PPO,Healthlink PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,HomeState Health Plan,HomeState Health Plan,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Humana Gold,Humana Gold,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Medicaid MO,Medicaid MO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Medica,Medica,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Tricare,Tricare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,UHC All Payer,UHC All Payer,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,UHC Exchange,UHC Exchange,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,UHC Medicaid,UHC Medicaid,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,UMR CPD,UMR CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,UHC Medicare,UHC Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
LIPID PANEL                   ,38200024,CDM,301,RC,80061,CPT,,,,Inpatient,,,216.42,216.42,Wellcare,Wellcare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Meritain Health PPO CPD,Meritain Health PPO CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Aetna/Commercial Product,Aetna/Commercial Product,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Meritain Health CPD,Meritain Health CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Starmark CPD,Starmark CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Aetna Medicare,Aetna Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Ambetter ,Ambetter ,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Blue Access,Anthem Blue Access,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Blue Access Choice,Anthem Blue Access Choice,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Blue Preferred,Anthem Blue Preferred,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Pathway,Anthem Pathway,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Alliance,Anthem Alliance,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Anthem Medicare,Anthem Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Cigna,Cigna,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Cigna PPO,Cigna PPO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Cigna Medicare Advantage,Cigna Medicare Advantage,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Essence,Essence,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Healthlink HMO,Healthlink HMO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Healthlink PPO,Healthlink PPO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,HomeState Health Plan,HomeState Health Plan,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Humana Gold,Humana Gold,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Medicaid MO,Medicaid MO,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Medica,Medica,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Tricare,Tricare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,UHC All Payer,UHC All Payer,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,UHC Exchange,UHC Exchange,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,UHC Medicaid,UHC Medicaid,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,UMR CPD,UMR CPD,133.39,,,,,,,per diem,133.39,133.39,"Per diem rate, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,UHC Medicare,UHC Medicare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ACETAMINOPHEN                 ,38200032,CDM,301,RC,82003,CPT,,,,Inpatient,,,133.39,133.39,Wellcare,Wellcare,133.39,,,,,,,case rate,133.39,133.39,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Meritain Health PPO CPD,Meritain Health PPO CPD,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Aetna/Commercial Product,Aetna/Commercial Product,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Meritain Health CPD,Meritain Health CPD,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Starmark CPD,Starmark CPD,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Aetna Medicare,Aetna Medicare,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Ambetter ,Ambetter ,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Blue Access,Anthem Blue Access,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Blue Access Choice,Anthem Blue Access Choice,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Blue Preferred,Anthem Blue Preferred,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Pathway,Anthem Pathway,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Alliance,Anthem Alliance,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Anthem Medicare,Anthem Medicare,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Cigna,Cigna,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Cigna PPO,Cigna PPO,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Cigna Medicare Advantage,Cigna Medicare Advantage,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Essence,Essence,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Healthlink HMO,Healthlink HMO,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Healthlink PPO,Healthlink PPO,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,HomeState Health Plan,HomeState Health Plan,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Humana Gold,Humana Gold,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Medicaid MO,Medicaid MO,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Medica,Medica,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Tricare,Tricare,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,UHC All Payer,UHC All Payer,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,UHC Exchange,UHC Exchange,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,UHC Medicaid,UHC Medicaid,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,UMR CPD,UMR CPD,403.52,,,,,,,per diem,403.52,403.52,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,UHC Medicare,UHC Medicare,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38200035,CDM,301,RC,84588,CPT,,,,Inpatient,,,403.52,403.52,Wellcare,Wellcare,403.52,,,,,,,case rate,403.52,403.52,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
SPECTROPHOTOMETRY ANALYTE NOS ,38200036,CDM,301,RC,84311,CPT,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Meritain Health PPO CPD,Meritain Health PPO CPD,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Aetna/Commercial Product,Aetna/Commercial Product,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Meritain Health CPD,Meritain Health CPD,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Starmark CPD,Starmark CPD,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Aetna Medicare,Aetna Medicare,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Ambetter ,Ambetter ,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Blue Access,Anthem Blue Access,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Blue Access Choice,Anthem Blue Access Choice,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Blue Preferred,Anthem Blue Preferred,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Pathway,Anthem Pathway,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Alliance,Anthem Alliance,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Anthem Medicare,Anthem Medicare,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Cigna,Cigna,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Cigna PPO,Cigna PPO,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Cigna Medicare Advantage,Cigna Medicare Advantage,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Essence,Essence,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Healthlink HMO,Healthlink HMO,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Healthlink PPO,Healthlink PPO,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,HomeState Health Plan,HomeState Health Plan,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Humana Gold,Humana Gold,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Medicaid MO,Medicaid MO,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Medica,Medica,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Tricare,Tricare,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,UHC All Payer,UHC All Payer,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,UHC Exchange,UHC Exchange,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,UHC Medicaid,UHC Medicaid,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,UMR CPD,UMR CPD,77.14,,,,,,,per diem,77.14,77.14,"Per diem rate, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,UHC Medicare,UHC Medicare,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
CITRATE                       ,38200037,CDM,301,RC,82507,CPT,,,,Inpatient,,,77.14,77.14,Wellcare,Wellcare,77.14,,,,,,,case rate,77.14,77.14,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Meritain Health PPO CPD,Meritain Health PPO CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Aetna/Commercial Product,Aetna/Commercial Product,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Meritain Health CPD,Meritain Health CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Starmark CPD,Starmark CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Aetna Medicare,Aetna Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Ambetter ,Ambetter ,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Blue Access,Anthem Blue Access,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Blue Access Choice,Anthem Blue Access Choice,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Blue Preferred,Anthem Blue Preferred,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Pathway,Anthem Pathway,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Alliance,Anthem Alliance,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Anthem Medicare,Anthem Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Cigna,Cigna,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Cigna PPO,Cigna PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Cigna Medicare Advantage,Cigna Medicare Advantage,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Essence,Essence,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Healthlink HMO,Healthlink HMO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Healthlink PPO,Healthlink PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,HomeState Health Plan,HomeState Health Plan,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Humana Gold,Humana Gold,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Medicaid MO,Medicaid MO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Medica,Medica,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Tricare,Tricare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,UHC All Payer,UHC All Payer,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,UHC Exchange,UHC Exchange,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,UHC Medicaid,UHC Medicaid,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,UMR CPD,UMR CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,UHC Medicare,UHC Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
ACETONE SERUM QUAL.           ,38200040,CDM,301,RC,82009,CPT,,,,Inpatient,,,126.07,126.07,Wellcare,Wellcare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Meritain Health PPO CPD,Meritain Health PPO CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Aetna/Commercial Product,Aetna/Commercial Product,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Meritain Health CPD,Meritain Health CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Starmark CPD,Starmark CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Aetna Medicare,Aetna Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Ambetter ,Ambetter ,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Access,Anthem Blue Access,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Access Choice,Anthem Blue Access Choice,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Preferred,Anthem Blue Preferred,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Pathway,Anthem Pathway,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Alliance,Anthem Alliance,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Anthem Medicare,Anthem Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Cigna,Cigna,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Cigna PPO,Cigna PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Cigna Medicare Advantage,Cigna Medicare Advantage,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Essence,Essence,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Healthlink HMO,Healthlink HMO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Healthlink PPO,Healthlink PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,HomeState Health Plan,HomeState Health Plan,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Humana Gold,Humana Gold,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Medicaid MO,Medicaid MO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Medica,Medica,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Tricare,Tricare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,UHC All Payer,UHC All Payer,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,UHC Exchange,UHC Exchange,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,UHC Medicaid,UHC Medicaid,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,UMR CPD,UMR CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,UHC Medicare,UHC Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"ACID PHOS, PROSTATIC          ",38200055,CDM,301,RC,84066,CPT,,,,Inpatient,,,46.23,46.23,Wellcare,Wellcare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Meritain Health PPO CPD,Meritain Health PPO CPD,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Aetna/Commercial Product,Aetna/Commercial Product,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Meritain Health CPD,Meritain Health CPD,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Starmark CPD,Starmark CPD,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Aetna Medicare,Aetna Medicare,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Ambetter ,Ambetter ,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Blue Access,Anthem Blue Access,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Blue Access Choice,Anthem Blue Access Choice,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Blue Preferred,Anthem Blue Preferred,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Pathway,Anthem Pathway,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Alliance,Anthem Alliance,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Anthem Medicare,Anthem Medicare,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Cigna,Cigna,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Cigna PPO,Cigna PPO,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Cigna Medicare Advantage,Cigna Medicare Advantage,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Essence,Essence,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Healthlink HMO,Healthlink HMO,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Healthlink PPO,Healthlink PPO,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,HomeState Health Plan,HomeState Health Plan,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Humana Gold,Humana Gold,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Medicaid MO,Medicaid MO,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Medica,Medica,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Tricare,Tricare,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,UHC All Payer,UHC All Payer,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,UHC Exchange,UHC Exchange,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,UHC Medicaid,UHC Medicaid,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,UMR CPD,UMR CPD,249.51,,,,,,,per diem,249.51,249.51,"Per diem rate, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,UHC Medicare,UHC Medicare,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACID PHOS SERUM TOTAL         ,38200056,CDM,301,RC,84060,CPT,,,,Inpatient,,,249.51,249.51,Wellcare,Wellcare,249.51,,,,,,,case rate,249.51,249.51,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Meritain Health PPO CPD,Meritain Health PPO CPD,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Aetna/Commercial Product,Aetna/Commercial Product,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Meritain Health CPD,Meritain Health CPD,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Starmark CPD,Starmark CPD,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Aetna Medicare,Aetna Medicare,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Ambetter ,Ambetter ,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Blue Access,Anthem Blue Access,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Blue Access Choice,Anthem Blue Access Choice,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Blue Preferred,Anthem Blue Preferred,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Pathway,Anthem Pathway,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Alliance,Anthem Alliance,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Anthem Medicare,Anthem Medicare,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Cigna,Cigna,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Cigna PPO,Cigna PPO,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Cigna Medicare Advantage,Cigna Medicare Advantage,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Essence,Essence,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Healthlink HMO,Healthlink HMO,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Healthlink PPO,Healthlink PPO,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,HomeState Health Plan,HomeState Health Plan,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Humana Gold,Humana Gold,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Medicaid MO,Medicaid MO,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Medica,Medica,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Tricare,Tricare,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,UHC All Payer,UHC All Payer,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,UHC Exchange,UHC Exchange,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,UHC Medicaid,UHC Medicaid,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,UMR CPD,UMR CPD,207.49,,,,,,,per diem,207.49,207.49,"Per diem rate, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,UHC Medicare,UHC Medicare,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTIVATED PROTEIN C RESISTANCE,38200057,CDM,305,RC,85307,CPT,,,,Inpatient,,,207.49,207.49,Wellcare,Wellcare,207.49,,,,,,,case rate,207.49,207.49,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health PPO CPD,Meritain Health PPO CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Aetna/Commercial Product,Aetna/Commercial Product,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health CPD,Meritain Health CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Starmark CPD,Starmark CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Aetna Medicare,Aetna Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Ambetter ,Ambetter ,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access,Anthem Blue Access,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access Choice,Anthem Blue Access Choice,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Preferred,Anthem Blue Preferred,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Pathway,Anthem Pathway,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Alliance,Anthem Alliance,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Anthem Medicare,Anthem Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Cigna,Cigna,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Cigna PPO,Cigna PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Cigna Medicare Advantage,Cigna Medicare Advantage,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Essence,Essence,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Healthlink HMO,Healthlink HMO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Healthlink PPO,Healthlink PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,HomeState Health Plan,HomeState Health Plan,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Humana Gold,Humana Gold,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Medicaid MO,Medicaid MO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Medica,Medica,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Tricare,Tricare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,UHC All Payer,UHC All Payer,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,UHC Exchange,UHC Exchange,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicaid,UHC Medicaid,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,UMR CPD,UMR CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicare,UHC Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
ACTH                          ,38200060,CDM,301,RC,82024,CPT,,,,Inpatient,,,373.44,373.44,Wellcare,Wellcare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Meritain Health PPO CPD,Meritain Health PPO CPD,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Aetna/Commercial Product,Aetna/Commercial Product,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Meritain Health CPD,Meritain Health CPD,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Starmark CPD,Starmark CPD,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Aetna Medicare,Aetna Medicare,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Ambetter ,Ambetter ,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Blue Access,Anthem Blue Access,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Blue Access Choice,Anthem Blue Access Choice,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Blue Preferred,Anthem Blue Preferred,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Pathway,Anthem Pathway,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Alliance,Anthem Alliance,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Anthem Medicare,Anthem Medicare,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Cigna,Cigna,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Cigna PPO,Cigna PPO,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Cigna Medicare Advantage,Cigna Medicare Advantage,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Essence,Essence,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Healthlink HMO,Healthlink HMO,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Healthlink PPO,Healthlink PPO,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,HomeState Health Plan,HomeState Health Plan,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Humana Gold,Humana Gold,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Medicaid MO,Medicaid MO,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Medica,Medica,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Tricare,Tricare,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,UHC All Payer,UHC All Payer,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,UHC Exchange,UHC Exchange,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,UHC Medicaid,UHC Medicaid,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,UMR CPD,UMR CPD,380.86,,,,,,,per diem,380.86,380.86,"Per diem rate, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,UHC Medicare,UHC Medicare,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
GM1 ANTIBODIES                ,38200063,CDM,301,RC,83520,CPT,,,,Inpatient,,,380.86,380.86,Wellcare,Wellcare,380.86,,,,,,,case rate,380.86,380.86,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38200070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Meritain Health PPO CPD,Meritain Health PPO CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Aetna/Commercial Product,Aetna/Commercial Product,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Meritain Health CPD,Meritain Health CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Starmark CPD,Starmark CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Aetna Medicare,Aetna Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Ambetter ,Ambetter ,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Blue Access,Anthem Blue Access,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Blue Access Choice,Anthem Blue Access Choice,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Blue Preferred,Anthem Blue Preferred,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Pathway,Anthem Pathway,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Alliance,Anthem Alliance,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Anthem Medicare,Anthem Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Cigna,Cigna,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Cigna PPO,Cigna PPO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Cigna Medicare Advantage,Cigna Medicare Advantage,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Essence,Essence,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Healthlink HMO,Healthlink HMO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Healthlink PPO,Healthlink PPO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,HomeState Health Plan,HomeState Health Plan,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Humana Gold,Humana Gold,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Medicaid MO,Medicaid MO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Medica,Medica,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Tricare,Tricare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,UHC All Payer,UHC All Payer,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,UHC Exchange,UHC Exchange,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,UHC Medicaid,UHC Medicaid,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,UMR CPD,UMR CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,UHC Medicare,UHC Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
NIACIN LEVEL                  ,38200071,CDM,301,RC,84591,CPT,,,,Inpatient,,,287.86,287.86,Wellcare,Wellcare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Meritain Health PPO CPD,Meritain Health PPO CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Aetna/Commercial Product,Aetna/Commercial Product,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Meritain Health CPD,Meritain Health CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Starmark CPD,Starmark CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Aetna Medicare,Aetna Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Ambetter ,Ambetter ,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Blue Access,Anthem Blue Access,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Blue Access Choice,Anthem Blue Access Choice,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Blue Preferred,Anthem Blue Preferred,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Pathway,Anthem Pathway,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Alliance,Anthem Alliance,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Anthem Medicare,Anthem Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Cigna,Cigna,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Cigna PPO,Cigna PPO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Cigna Medicare Advantage,Cigna Medicare Advantage,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Essence,Essence,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Healthlink HMO,Healthlink HMO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Healthlink PPO,Healthlink PPO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,HomeState Health Plan,HomeState Health Plan,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Humana Gold,Humana Gold,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Medicaid MO,Medicaid MO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Medica,Medica,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Tricare,Tricare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,UHC All Payer,UHC All Payer,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,UHC Exchange,UHC Exchange,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,UHC Medicaid,UHC Medicaid,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,UMR CPD,UMR CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,UHC Medicare,UHC Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
PORPHYRINS STOOL              ,38200072,CDM,301,RC,84126,CPT,,,,Inpatient,,,237.44,237.44,Wellcare,Wellcare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Meritain Health PPO CPD,Meritain Health PPO CPD,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Aetna/Commercial Product,Aetna/Commercial Product,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Meritain Health CPD,Meritain Health CPD,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Starmark CPD,Starmark CPD,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Aetna Medicare,Aetna Medicare,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Ambetter ,Ambetter ,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Blue Access,Anthem Blue Access,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Blue Access Choice,Anthem Blue Access Choice,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Blue Preferred,Anthem Blue Preferred,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Pathway,Anthem Pathway,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Alliance,Anthem Alliance,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Anthem Medicare,Anthem Medicare,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Cigna,Cigna,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Cigna PPO,Cigna PPO,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Cigna Medicare Advantage,Cigna Medicare Advantage,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Essence,Essence,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Healthlink HMO,Healthlink HMO,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Healthlink PPO,Healthlink PPO,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,HomeState Health Plan,HomeState Health Plan,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Humana Gold,Humana Gold,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Medicaid MO,Medicaid MO,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Medica,Medica,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Tricare,Tricare,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,UHC All Payer,UHC All Payer,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,UHC Exchange,UHC Exchange,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,UHC Medicaid,UHC Medicaid,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,UMR CPD,UMR CPD,207.67,,,,,,,per diem,207.67,207.67,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,UHC Medicare,UHC Medicare,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38200073,CDM,306,RC,87206,CPT,,,,Inpatient,,,207.67,207.67,Wellcare,Wellcare,207.67,,,,,,,case rate,207.67,207.67,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Meritain Health PPO CPD,Meritain Health PPO CPD,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Aetna/Commercial Product,Aetna/Commercial Product,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Meritain Health CPD,Meritain Health CPD,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Starmark CPD,Starmark CPD,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Aetna Medicare,Aetna Medicare,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Ambetter ,Ambetter ,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Blue Access,Anthem Blue Access,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Blue Access Choice,Anthem Blue Access Choice,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Blue Preferred,Anthem Blue Preferred,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Pathway,Anthem Pathway,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Alliance,Anthem Alliance,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Anthem Medicare,Anthem Medicare,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Cigna,Cigna,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Cigna PPO,Cigna PPO,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Cigna Medicare Advantage,Cigna Medicare Advantage,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Essence,Essence,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Healthlink HMO,Healthlink HMO,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Healthlink PPO,Healthlink PPO,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,HomeState Health Plan,HomeState Health Plan,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Humana Gold,Humana Gold,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Medicaid MO,Medicaid MO,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Medica,Medica,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Tricare,Tricare,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,UHC All Payer,UHC All Payer,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,UHC Exchange,UHC Exchange,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,UHC Medicaid,UHC Medicaid,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,UMR CPD,UMR CPD,74.94,,,,,,,per diem,74.94,74.94,"Per diem rate, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,UHC Medicare,UHC Medicare,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ACHR BINDING AB SERUM         ,38200076,CDM,300,RC,83519,CPT,,,,Inpatient,,,74.94,74.94,Wellcare,Wellcare,74.94,,,,,,,case rate,74.94,74.94,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health PPO CPD,Meritain Health PPO CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Aetna/Commercial Product,Aetna/Commercial Product,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health CPD,Meritain Health CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Starmark CPD,Starmark CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Aetna Medicare,Aetna Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Ambetter ,Ambetter ,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access,Anthem Blue Access,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access Choice,Anthem Blue Access Choice,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Preferred,Anthem Blue Preferred,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Pathway,Anthem Pathway,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Alliance,Anthem Alliance,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Anthem Medicare,Anthem Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Cigna,Cigna,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Cigna PPO,Cigna PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Cigna Medicare Advantage,Cigna Medicare Advantage,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Essence,Essence,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Healthlink HMO,Healthlink HMO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Healthlink PPO,Healthlink PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,HomeState Health Plan,HomeState Health Plan,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Humana Gold,Humana Gold,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Medicaid MO,Medicaid MO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Medica,Medica,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Tricare,Tricare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,UHC All Payer,UHC All Payer,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,UHC Exchange,UHC Exchange,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicaid,UHC Medicaid,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,UMR CPD,UMR CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicare,UHC Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38200080,CDM,301,RC,82040,CPT,,,,Inpatient,,,70.02,70.02,Wellcare,Wellcare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Meritain Health PPO CPD,Meritain Health PPO CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Aetna/Commercial Product,Aetna/Commercial Product,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Meritain Health CPD,Meritain Health CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Starmark CPD,Starmark CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Aetna Medicare,Aetna Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Ambetter ,Ambetter ,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Access,Anthem Blue Access,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Access Choice,Anthem Blue Access Choice,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Blue Preferred,Anthem Blue Preferred,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Pathway,Anthem Pathway,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Alliance,Anthem Alliance,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Anthem Medicare,Anthem Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Cigna,Cigna,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Cigna PPO,Cigna PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Cigna Medicare Advantage,Cigna Medicare Advantage,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Essence,Essence,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Healthlink HMO,Healthlink HMO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Healthlink PPO,Healthlink PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,HomeState Health Plan,HomeState Health Plan,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Humana Gold,Humana Gold,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Medicaid MO,Medicaid MO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Medica,Medica,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Tricare,Tricare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,UHC All Payer,UHC All Payer,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,UHC Exchange,UHC Exchange,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,UHC Medicaid,UHC Medicaid,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,UMR CPD,UMR CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,UHC Medicare,UHC Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL BIOMARKERS 1 OR 2     ,38200082,CDM,301,RC,80321,CPT,,,,Inpatient,,,46.23,46.23,Wellcare,Wellcare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Meritain Health PPO CPD,Meritain Health PPO CPD,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Aetna/Commercial Product,Aetna/Commercial Product,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Meritain Health CPD,Meritain Health CPD,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Starmark CPD,Starmark CPD,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Aetna Medicare,Aetna Medicare,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Ambetter ,Ambetter ,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Blue Access,Anthem Blue Access,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Blue Access Choice,Anthem Blue Access Choice,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Blue Preferred,Anthem Blue Preferred,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Pathway,Anthem Pathway,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Alliance,Anthem Alliance,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Anthem Medicare,Anthem Medicare,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Cigna,Cigna,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Cigna PPO,Cigna PPO,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Cigna Medicare Advantage,Cigna Medicare Advantage,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Essence,Essence,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Healthlink HMO,Healthlink HMO,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Healthlink PPO,Healthlink PPO,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,HomeState Health Plan,HomeState Health Plan,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Humana Gold,Humana Gold,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Medicaid MO,Medicaid MO,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Medica,Medica,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Tricare,Tricare,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,UHC All Payer,UHC All Payer,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,UHC Exchange,UHC Exchange,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,UHC Medicaid,UHC Medicaid,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,UMR CPD,UMR CPD,169.41,,,,,,,per diem,169.41,169.41,"Per diem rate, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,UHC Medicare,UHC Medicare,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
ALCOHOL (ETOH)BLOOD LEVEL     ,38200090,CDM,301,RC,82055,CPT,,,,Inpatient,,,169.41,169.41,Wellcare,Wellcare,169.41,,,,,,,case rate,169.41,169.41,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Meritain Health PPO CPD,Meritain Health PPO CPD,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Aetna/Commercial Product,Aetna/Commercial Product,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Meritain Health CPD,Meritain Health CPD,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Starmark CPD,Starmark CPD,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Aetna Medicare,Aetna Medicare,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Ambetter ,Ambetter ,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Blue Access,Anthem Blue Access,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Blue Access Choice,Anthem Blue Access Choice,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Blue Preferred,Anthem Blue Preferred,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Pathway,Anthem Pathway,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Alliance,Anthem Alliance,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Anthem Medicare,Anthem Medicare,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Cigna,Cigna,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Cigna PPO,Cigna PPO,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Cigna Medicare Advantage,Cigna Medicare Advantage,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Essence,Essence,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Healthlink HMO,Healthlink HMO,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Healthlink PPO,Healthlink PPO,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,HomeState Health Plan,HomeState Health Plan,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Humana Gold,Humana Gold,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Medicaid MO,Medicaid MO,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Medica,Medica,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Tricare,Tricare,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,UHC All Payer,UHC All Payer,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,UHC Exchange,UHC Exchange,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,UHC Medicaid,UHC Medicaid,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,UMR CPD,UMR CPD,414.68,,,,,,,per diem,414.68,414.68,"Per diem rate, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,UHC Medicare,UHC Medicare,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
"ALPHA-FETOPROTEIN, SERUM      ",38200091,CDM,301,RC,82105,CPT,,,,Inpatient,,,414.68,414.68,Wellcare,Wellcare,414.68,,,,,,,case rate,414.68,414.68,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Meritain Health PPO CPD,Meritain Health PPO CPD,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Aetna/Commercial Product,Aetna/Commercial Product,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Meritain Health CPD,Meritain Health CPD,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Starmark CPD,Starmark CPD,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Aetna Medicare,Aetna Medicare,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Ambetter ,Ambetter ,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Blue Access,Anthem Blue Access,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Blue Access Choice,Anthem Blue Access Choice,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Blue Preferred,Anthem Blue Preferred,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Pathway,Anthem Pathway,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Alliance,Anthem Alliance,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Anthem Medicare,Anthem Medicare,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Cigna,Cigna,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Cigna PPO,Cigna PPO,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Cigna Medicare Advantage,Cigna Medicare Advantage,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Essence,Essence,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Healthlink HMO,Healthlink HMO,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Healthlink PPO,Healthlink PPO,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,HomeState Health Plan,HomeState Health Plan,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Humana Gold,Humana Gold,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Medicaid MO,Medicaid MO,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Medica,Medica,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Tricare,Tricare,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,UHC All Payer,UHC All Payer,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,UHC Exchange,UHC Exchange,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,UHC Medicaid,UHC Medicaid,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,UMR CPD,UMR CPD,393.52,,,,,,,per diem,393.52,393.52,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,UHC Medicare,UHC Medicare,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38200092,CDM,301,RC,82088,CPT,,,,Inpatient,,,393.52,393.52,Wellcare,Wellcare,393.52,,,,,,,case rate,393.52,393.52,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Meritain Health PPO CPD,Meritain Health PPO CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna/Commercial Product,Aetna/Commercial Product,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Meritain Health CPD,Meritain Health CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Starmark CPD,Starmark CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna Medicare,Aetna Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Ambetter ,Ambetter ,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Access,Anthem Blue Access,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Access Choice,Anthem Blue Access Choice,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Preferred,Anthem Blue Preferred,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Pathway,Anthem Pathway,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Alliance,Anthem Alliance,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Medicare,Anthem Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna,Cigna,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna PPO,Cigna PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna Medicare Advantage,Cigna Medicare Advantage,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Essence,Essence,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthlink HMO,Healthlink HMO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthlink PPO,Healthlink PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,HomeState Health Plan,HomeState Health Plan,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Humana Gold,Humana Gold,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Medicaid MO,Medicaid MO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Medica,Medica,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Tricare,Tricare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC All Payer,UHC All Payer,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Exchange,UHC Exchange,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Medicaid,UHC Medicaid,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UMR CPD,UMR CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Medicare,UHC Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38200093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Wellcare,Wellcare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Meritain Health PPO CPD,Meritain Health PPO CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Aetna/Commercial Product,Aetna/Commercial Product,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Meritain Health CPD,Meritain Health CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Starmark CPD,Starmark CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Aetna Medicare,Aetna Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Ambetter ,Ambetter ,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Access,Anthem Blue Access,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Access Choice,Anthem Blue Access Choice,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Preferred,Anthem Blue Preferred,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Pathway,Anthem Pathway,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Alliance,Anthem Alliance,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Anthem Medicare,Anthem Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Cigna,Cigna,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Cigna PPO,Cigna PPO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Cigna Medicare Advantage,Cigna Medicare Advantage,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Essence,Essence,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Healthlink HMO,Healthlink HMO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Healthlink PPO,Healthlink PPO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,HomeState Health Plan,HomeState Health Plan,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Humana Gold,Humana Gold,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Medicaid MO,Medicaid MO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Medica,Medica,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Tricare,Tricare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,UHC All Payer,UHC All Payer,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,UHC Exchange,UHC Exchange,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,UHC Medicaid,UHC Medicaid,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,UMR CPD,UMR CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,UHC Medicare,UHC Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN PHENO     ,38200094,CDM,301,RC,82104,CPT,,,,Inpatient,,,119.77,119.77,Wellcare,Wellcare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Meritain Health PPO CPD,Meritain Health PPO CPD,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Aetna/Commercial Product,Aetna/Commercial Product,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Meritain Health CPD,Meritain Health CPD,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Starmark CPD,Starmark CPD,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Aetna Medicare,Aetna Medicare,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Ambetter ,Ambetter ,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Blue Access,Anthem Blue Access,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Blue Access Choice,Anthem Blue Access Choice,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Blue Preferred,Anthem Blue Preferred,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Pathway,Anthem Pathway,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Alliance,Anthem Alliance,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Anthem Medicare,Anthem Medicare,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Cigna,Cigna,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Cigna PPO,Cigna PPO,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Cigna Medicare Advantage,Cigna Medicare Advantage,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Essence,Essence,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Healthlink HMO,Healthlink HMO,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Healthlink PPO,Healthlink PPO,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,HomeState Health Plan,HomeState Health Plan,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Humana Gold,Humana Gold,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Medicaid MO,Medicaid MO,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Medica,Medica,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Tricare,Tricare,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,UHC All Payer,UHC All Payer,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,UHC Exchange,UHC Exchange,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,UHC Medicaid,UHC Medicaid,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,UMR CPD,UMR CPD,100.83,,,,,,,per diem,100.83,100.83,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,UHC Medicare,UHC Medicare,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38200095,CDM,301,RC,84075,CPT,,,,Inpatient,,,100.83,100.83,Wellcare,Wellcare,100.83,,,,,,,case rate,100.83,100.83,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
ALPHA 2 ANTIPLASMIN           ,38200096,CDM,305,RC,85410,CPT,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CLOTEST                       ,38200099,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Meritain Health PPO CPD,Meritain Health PPO CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Aetna/Commercial Product,Aetna/Commercial Product,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Meritain Health CPD,Meritain Health CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Starmark CPD,Starmark CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Aetna Medicare,Aetna Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Ambetter ,Ambetter ,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Access,Anthem Blue Access,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Access Choice,Anthem Blue Access Choice,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Blue Preferred,Anthem Blue Preferred,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Pathway,Anthem Pathway,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Alliance,Anthem Alliance,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Anthem Medicare,Anthem Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Cigna,Cigna,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Cigna PPO,Cigna PPO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Cigna Medicare Advantage,Cigna Medicare Advantage,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Essence,Essence,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Healthlink HMO,Healthlink HMO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Healthlink PPO,Healthlink PPO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,HomeState Health Plan,HomeState Health Plan,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Humana Gold,Humana Gold,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Medicaid MO,Medicaid MO,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Medica,Medica,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Tricare,Tricare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,UHC All Payer,UHC All Payer,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,UHC Exchange,UHC Exchange,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,UHC Medicaid,UHC Medicaid,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,UMR CPD,UMR CPD,364.56,,,,,,,per diem,364.56,364.56,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,UHC Medicare,UHC Medicare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 1-2    ,38200104,CDM,301,RC,80335,CPT,,,,Inpatient,,,364.56,364.56,Wellcare,Wellcare,364.56,,,,,,,case rate,364.56,364.56,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Meritain Health PPO CPD,Meritain Health PPO CPD,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Aetna/Commercial Product,Aetna/Commercial Product,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Meritain Health CPD,Meritain Health CPD,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Starmark CPD,Starmark CPD,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Aetna Medicare,Aetna Medicare,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Ambetter ,Ambetter ,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Blue Access,Anthem Blue Access,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Blue Access Choice,Anthem Blue Access Choice,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Blue Preferred,Anthem Blue Preferred,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Pathway,Anthem Pathway,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Alliance,Anthem Alliance,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Anthem Medicare,Anthem Medicare,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Cigna,Cigna,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Cigna PPO,Cigna PPO,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Cigna Medicare Advantage,Cigna Medicare Advantage,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Essence,Essence,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Healthlink HMO,Healthlink HMO,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Healthlink PPO,Healthlink PPO,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,HomeState Health Plan,HomeState Health Plan,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Humana Gold,Humana Gold,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Medicaid MO,Medicaid MO,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Medica,Medica,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Tricare,Tricare,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,UHC All Payer,UHC All Payer,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,UHC Exchange,UHC Exchange,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,UHC Medicaid,UHC Medicaid,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,UMR CPD,UMR CPD,520.05,,,,,,,per diem,520.05,520.05,"Per diem rate, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,UHC Medicare,UHC Medicare,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
ANTIDEPRESSANTS TRICYC 6+     ,38200106,CDM,301,RC,80337,CPT,,,,Inpatient,,,520.05,520.05,Wellcare,Wellcare,520.05,,,,,,,case rate,520.05,520.05,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Meritain Health PPO CPD,Meritain Health PPO CPD,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Aetna/Commercial Product,Aetna/Commercial Product,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Meritain Health CPD,Meritain Health CPD,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Starmark CPD,Starmark CPD,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Aetna Medicare,Aetna Medicare,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Ambetter ,Ambetter ,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Blue Access,Anthem Blue Access,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Blue Access Choice,Anthem Blue Access Choice,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Blue Preferred,Anthem Blue Preferred,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Pathway,Anthem Pathway,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Alliance,Anthem Alliance,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Anthem Medicare,Anthem Medicare,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Cigna,Cigna,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Cigna PPO,Cigna PPO,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Cigna Medicare Advantage,Cigna Medicare Advantage,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Essence,Essence,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Healthlink HMO,Healthlink HMO,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Healthlink PPO,Healthlink PPO,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,HomeState Health Plan,HomeState Health Plan,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Humana Gold,Humana Gold,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Medicaid MO,Medicaid MO,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Medica,Medica,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Tricare,Tricare,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,UHC All Payer,UHC All Payer,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,UHC Exchange,UHC Exchange,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,UHC Medicaid,UHC Medicaid,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,UMR CPD,UMR CPD,267.88,,,,,,,per diem,267.88,267.88,"Per diem rate, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,UHC Medicare,UHC Medicare,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
AMIKACIN                      ,38200110,CDM,301,RC,80150,CPT,,,,Inpatient,,,267.88,267.88,Wellcare,Wellcare,267.88,,,,,,,case rate,267.88,267.88,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Meritain Health PPO CPD,Meritain Health PPO CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Aetna/Commercial Product,Aetna/Commercial Product,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Meritain Health CPD,Meritain Health CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Starmark CPD,Starmark CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Aetna Medicare,Aetna Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Ambetter ,Ambetter ,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Access,Anthem Blue Access,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Access Choice,Anthem Blue Access Choice,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Preferred,Anthem Blue Preferred,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Pathway,Anthem Pathway,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Alliance,Anthem Alliance,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Anthem Medicare,Anthem Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Cigna,Cigna,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Cigna PPO,Cigna PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Cigna Medicare Advantage,Cigna Medicare Advantage,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Essence,Essence,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Healthlink HMO,Healthlink HMO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Healthlink PPO,Healthlink PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,HomeState Health Plan,HomeState Health Plan,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Humana Gold,Humana Gold,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Medicaid MO,Medicaid MO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Medica,Medica,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Tricare,Tricare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,UHC All Payer,UHC All Payer,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,UHC Exchange,UHC Exchange,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,UHC Medicaid,UHC Medicaid,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,UMR CPD,UMR CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,UHC Medicare,UHC Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/O MICROSC,38200111,CDM,307,RC,81002,CPT,,,,Inpatient,,,90.35,90.35,Wellcare,Wellcare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE                    ,38200112,CDM,301,RC,80151,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Meritain Health PPO CPD,Meritain Health PPO CPD,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Aetna/Commercial Product,Aetna/Commercial Product,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Meritain Health CPD,Meritain Health CPD,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Starmark CPD,Starmark CPD,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Aetna Medicare,Aetna Medicare,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Ambetter ,Ambetter ,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Blue Access,Anthem Blue Access,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Blue Access Choice,Anthem Blue Access Choice,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Blue Preferred,Anthem Blue Preferred,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Pathway,Anthem Pathway,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Alliance,Anthem Alliance,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Anthem Medicare,Anthem Medicare,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Cigna,Cigna,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Cigna PPO,Cigna PPO,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Cigna Medicare Advantage,Cigna Medicare Advantage,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Essence,Essence,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Healthlink HMO,Healthlink HMO,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Healthlink PPO,Healthlink PPO,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,HomeState Health Plan,HomeState Health Plan,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Humana Gold,Humana Gold,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Medicaid MO,Medicaid MO,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Medica,Medica,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Tricare,Tricare,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,UHC All Payer,UHC All Payer,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,UHC Exchange,UHC Exchange,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,UHC Medicaid,UHC Medicaid,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,UMR CPD,UMR CPD,121.21,,,,,,,per diem,121.21,121.21,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,UHC Medicare,UHC Medicare,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38200116,CDM,301,RC,82010,CPT,,,,Inpatient,,,121.21,121.21,Wellcare,Wellcare,121.21,,,,,,,case rate,121.21,121.21,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Meritain Health PPO CPD,Meritain Health PPO CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Aetna/Commercial Product,Aetna/Commercial Product,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Meritain Health CPD,Meritain Health CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Starmark CPD,Starmark CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Aetna Medicare,Aetna Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Ambetter ,Ambetter ,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Blue Access,Anthem Blue Access,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Blue Access Choice,Anthem Blue Access Choice,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Blue Preferred,Anthem Blue Preferred,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Pathway,Anthem Pathway,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Alliance,Anthem Alliance,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Anthem Medicare,Anthem Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Cigna,Cigna,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Cigna PPO,Cigna PPO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Cigna Medicare Advantage,Cigna Medicare Advantage,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Essence,Essence,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Healthlink HMO,Healthlink HMO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Healthlink PPO,Healthlink PPO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,HomeState Health Plan,HomeState Health Plan,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Humana Gold,Humana Gold,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Medicaid MO,Medicaid MO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Medica,Medica,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Tricare,Tricare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,UHC All Payer,UHC All Payer,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,UHC Exchange,UHC Exchange,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,UHC Medicaid,UHC Medicaid,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,UMR CPD,UMR CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,UHC Medicare,UHC Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
CA 27.29                      ,38200117,CDM,302,RC,86300,CPT,,,,Inpatient,,,129.4,129.4,Wellcare,Wellcare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Meritain Health PPO CPD,Meritain Health PPO CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Aetna/Commercial Product,Aetna/Commercial Product,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Meritain Health CPD,Meritain Health CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Starmark CPD,Starmark CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Aetna Medicare,Aetna Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Ambetter ,Ambetter ,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Blue Access,Anthem Blue Access,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Blue Access Choice,Anthem Blue Access Choice,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Blue Preferred,Anthem Blue Preferred,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Pathway,Anthem Pathway,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Alliance,Anthem Alliance,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Anthem Medicare,Anthem Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Cigna,Cigna,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Cigna PPO,Cigna PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Cigna Medicare Advantage,Cigna Medicare Advantage,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Essence,Essence,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Healthlink HMO,Healthlink HMO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Healthlink PPO,Healthlink PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,HomeState Health Plan,HomeState Health Plan,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Humana Gold,Humana Gold,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Medicaid MO,Medicaid MO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Medica,Medica,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Tricare,Tricare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,UHC All Payer,UHC All Payer,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,UHC Exchange,UHC Exchange,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,UHC Medicaid,UHC Medicaid,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,UMR CPD,UMR CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,UHC Medicare,UHC Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
RISTOCETIN CO FACTOR          ,38200118,CDM,305,RC,85245,CPT,,,,Inpatient,,,264.75,264.75,Wellcare,Wellcare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38200119,CDM,305,RC,85246,CPT,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health PPO CPD,Meritain Health PPO CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Aetna/Commercial Product,Aetna/Commercial Product,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health CPD,Meritain Health CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Starmark CPD,Starmark CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Aetna Medicare,Aetna Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Ambetter ,Ambetter ,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access,Anthem Blue Access,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access Choice,Anthem Blue Access Choice,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Preferred,Anthem Blue Preferred,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Pathway,Anthem Pathway,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Alliance,Anthem Alliance,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Anthem Medicare,Anthem Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Cigna,Cigna,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Cigna PPO,Cigna PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Cigna Medicare Advantage,Cigna Medicare Advantage,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Essence,Essence,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Healthlink HMO,Healthlink HMO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Healthlink PPO,Healthlink PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,HomeState Health Plan,HomeState Health Plan,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Humana Gold,Humana Gold,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Medicaid MO,Medicaid MO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Medica,Medica,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Tricare,Tricare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,UHC All Payer,UHC All Payer,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,UHC Exchange,UHC Exchange,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicaid,UHC Medicaid,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,UMR CPD,UMR CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicare,UHC Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
AMMONIA                       ,38200120,CDM,301,RC,82140,CPT,,,,Inpatient,,,178.23,178.23,Wellcare,Wellcare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health PPO CPD,Meritain Health PPO CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Aetna/Commercial Product,Aetna/Commercial Product,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health CPD,Meritain Health CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Starmark CPD,Starmark CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Aetna Medicare,Aetna Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Ambetter ,Ambetter ,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access,Anthem Blue Access,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access Choice,Anthem Blue Access Choice,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Preferred,Anthem Blue Preferred,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Pathway,Anthem Pathway,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Alliance,Anthem Alliance,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Anthem Medicare,Anthem Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Cigna,Cigna,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Cigna PPO,Cigna PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Cigna Medicare Advantage,Cigna Medicare Advantage,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Essence,Essence,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Healthlink HMO,Healthlink HMO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Healthlink PPO,Healthlink PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,HomeState Health Plan,HomeState Health Plan,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Humana Gold,Humana Gold,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Medicaid MO,Medicaid MO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Medica,Medica,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Tricare,Tricare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,UHC All Payer,UHC All Payer,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,UHC Exchange,UHC Exchange,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicaid,UHC Medicaid,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,UMR CPD,UMR CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicare,UHC Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR MULTIMET,38200122,CDM,305,RC,85247,CPT,,,,Inpatient,,,71.08,71.08,Wellcare,Wellcare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Meritain Health PPO CPD,Meritain Health PPO CPD,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Aetna/Commercial Product,Aetna/Commercial Product,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Meritain Health CPD,Meritain Health CPD,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Starmark CPD,Starmark CPD,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Aetna Medicare,Aetna Medicare,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Ambetter ,Ambetter ,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Blue Access,Anthem Blue Access,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Blue Access Choice,Anthem Blue Access Choice,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Blue Preferred,Anthem Blue Preferred,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Pathway,Anthem Pathway,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Alliance,Anthem Alliance,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Anthem Medicare,Anthem Medicare,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Cigna,Cigna,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Cigna PPO,Cigna PPO,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Cigna Medicare Advantage,Cigna Medicare Advantage,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Essence,Essence,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Healthlink HMO,Healthlink HMO,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Healthlink PPO,Healthlink PPO,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,HomeState Health Plan,HomeState Health Plan,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Humana Gold,Humana Gold,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Medicaid MO,Medicaid MO,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Medica,Medica,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Tricare,Tricare,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,UHC All Payer,UHC All Payer,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,UHC Exchange,UHC Exchange,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,UHC Medicaid,UHC Medicaid,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,UMR CPD,UMR CPD,413.83,,,,,,,per diem,413.83,413.83,"Per diem rate, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,UHC Medicare,UHC Medicare,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
ABG ANALYSIS                  ,38200125,CDM,301,RC,82803,CPT,,,,Inpatient,,,413.83,413.83,Wellcare,Wellcare,413.83,,,,,,,case rate,413.83,413.83,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38200130,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Meritain Health PPO CPD,Meritain Health PPO CPD,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Aetna/Commercial Product,Aetna/Commercial Product,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Meritain Health CPD,Meritain Health CPD,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Starmark CPD,Starmark CPD,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Aetna Medicare,Aetna Medicare,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Ambetter ,Ambetter ,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Blue Access,Anthem Blue Access,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Blue Access Choice,Anthem Blue Access Choice,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Blue Preferred,Anthem Blue Preferred,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Pathway,Anthem Pathway,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Alliance,Anthem Alliance,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Anthem Medicare,Anthem Medicare,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Cigna,Cigna,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Cigna PPO,Cigna PPO,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Cigna Medicare Advantage,Cigna Medicare Advantage,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Essence,Essence,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Healthlink HMO,Healthlink HMO,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Healthlink PPO,Healthlink PPO,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,HomeState Health Plan,HomeState Health Plan,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Humana Gold,Humana Gold,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Medicaid MO,Medicaid MO,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Medica,Medica,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Tricare,Tricare,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,UHC All Payer,UHC All Payer,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,UHC Exchange,UHC Exchange,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,UHC Medicaid,UHC Medicaid,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,UMR CPD,UMR CPD,363.81,,,,,,,per diem,363.81,363.81,"Per diem rate, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,UHC Medicare,UHC Medicare,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
DNA SINGLE STRAND ANTIBODY    ,38200131,CDM,302,RC,86226,CPT,,,,Inpatient,,,363.81,363.81,Wellcare,Wellcare,363.81,,,,,,,case rate,363.81,363.81,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE URINE                 ,38200135,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Meritain Health PPO CPD,Meritain Health PPO CPD,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Aetna/Commercial Product,Aetna/Commercial Product,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Meritain Health CPD,Meritain Health CPD,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Starmark CPD,Starmark CPD,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Aetna Medicare,Aetna Medicare,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Ambetter ,Ambetter ,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Blue Access,Anthem Blue Access,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Blue Access Choice,Anthem Blue Access Choice,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Blue Preferred,Anthem Blue Preferred,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Pathway,Anthem Pathway,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Alliance,Anthem Alliance,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Anthem Medicare,Anthem Medicare,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Cigna,Cigna,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Cigna PPO,Cigna PPO,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Cigna Medicare Advantage,Cigna Medicare Advantage,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Essence,Essence,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Healthlink HMO,Healthlink HMO,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Healthlink PPO,Healthlink PPO,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,HomeState Health Plan,HomeState Health Plan,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Humana Gold,Humana Gold,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Medicaid MO,Medicaid MO,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Medica,Medica,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Tricare,Tricare,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,UHC All Payer,UHC All Payer,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,UHC Exchange,UHC Exchange,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,UHC Medicaid,UHC Medicaid,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,UMR CPD,UMR CPD,162.67,,,,,,,per diem,162.67,162.67,"Per diem rate, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,UHC Medicare,UHC Medicare,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
HDL (DIRECT)                  ,38200138,CDM,301,RC,83718,CPT,,,,Inpatient,,,162.67,162.67,Wellcare,Wellcare,162.67,,,,,,,case rate,162.67,162.67,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health PPO CPD,Meritain Health PPO CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Aetna/Commercial Product,Aetna/Commercial Product,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health CPD,Meritain Health CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Starmark CPD,Starmark CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Aetna Medicare,Aetna Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Ambetter ,Ambetter ,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access,Anthem Blue Access,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access Choice,Anthem Blue Access Choice,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Preferred,Anthem Blue Preferred,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Pathway,Anthem Pathway,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Alliance,Anthem Alliance,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Anthem Medicare,Anthem Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Cigna,Cigna,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Cigna PPO,Cigna PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Cigna Medicare Advantage,Cigna Medicare Advantage,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Essence,Essence,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Healthlink HMO,Healthlink HMO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Healthlink PPO,Healthlink PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,HomeState Health Plan,HomeState Health Plan,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Humana Gold,Humana Gold,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Medicaid MO,Medicaid MO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Medica,Medica,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Tricare,Tricare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,UHC All Payer,UHC All Payer,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,UHC Exchange,UHC Exchange,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicaid,UHC Medicaid,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,UMR CPD,UMR CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicare,UHC Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38200140,CDM,302,RC,86038,CPT,,,,Inpatient,,,162.32,162.32,Wellcare,Wellcare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38200150,CDM,302,RC,86039,CPT,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Meritain Health PPO CPD,Meritain Health PPO CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Aetna/Commercial Product,Aetna/Commercial Product,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Meritain Health CPD,Meritain Health CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Starmark CPD,Starmark CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Aetna Medicare,Aetna Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Ambetter ,Ambetter ,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Blue Access,Anthem Blue Access,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Blue Access Choice,Anthem Blue Access Choice,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Blue Preferred,Anthem Blue Preferred,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Pathway,Anthem Pathway,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Alliance,Anthem Alliance,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Anthem Medicare,Anthem Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Cigna,Cigna,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Cigna PPO,Cigna PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Cigna Medicare Advantage,Cigna Medicare Advantage,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Essence,Essence,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Healthlink HMO,Healthlink HMO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Healthlink PPO,Healthlink PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,HomeState Health Plan,HomeState Health Plan,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Humana Gold,Humana Gold,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Medicaid MO,Medicaid MO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Medica,Medica,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Tricare,Tricare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,UHC All Payer,UHC All Payer,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,UHC Exchange,UHC Exchange,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,UHC Medicaid,UHC Medicaid,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,UMR CPD,UMR CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,UHC Medicare,UHC Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANDROSTENEDIONE LEVEL         ,38200155,CDM,301,RC,82157,CPT,,,,Inpatient,,,133.43,133.43,Wellcare,Wellcare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38200157,CDM,301,RC,82164,CPT,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Meritain Health PPO CPD,Meritain Health PPO CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna/Commercial Product,Aetna/Commercial Product,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Meritain Health CPD,Meritain Health CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Starmark CPD,Starmark CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna Medicare,Aetna Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Ambetter ,Ambetter ,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Access,Anthem Blue Access,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Access Choice,Anthem Blue Access Choice,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Preferred,Anthem Blue Preferred,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Pathway,Anthem Pathway,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Alliance,Anthem Alliance,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Medicare,Anthem Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna,Cigna,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna PPO,Cigna PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna Medicare Advantage,Cigna Medicare Advantage,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Essence,Essence,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthlink HMO,Healthlink HMO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthlink PPO,Healthlink PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,HomeState Health Plan,HomeState Health Plan,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Humana Gold,Humana Gold,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Medicaid MO,Medicaid MO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Medica,Medica,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Tricare,Tricare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC All Payer,UHC All Payer,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Exchange,UHC Exchange,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Medicaid,UHC Medicaid,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,UMR CPD,UMR CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Medicare,UHC Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38200161,CDM,300,RC,U0003,CPT,U0003,HCPCS,,Inpatient,,,103,103,Wellcare,Wellcare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Meritain Health PPO CPD,Meritain Health PPO CPD,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Aetna/Commercial Product,Aetna/Commercial Product,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Meritain Health CPD,Meritain Health CPD,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Starmark CPD,Starmark CPD,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Aetna Medicare,Aetna Medicare,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Ambetter ,Ambetter ,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Blue Access,Anthem Blue Access,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Blue Access Choice,Anthem Blue Access Choice,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Blue Preferred,Anthem Blue Preferred,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Pathway,Anthem Pathway,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Alliance,Anthem Alliance,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Anthem Medicare,Anthem Medicare,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Cigna,Cigna,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Cigna PPO,Cigna PPO,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Cigna Medicare Advantage,Cigna Medicare Advantage,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Essence,Essence,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Healthlink HMO,Healthlink HMO,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Healthlink PPO,Healthlink PPO,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,HomeState Health Plan,HomeState Health Plan,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Humana Gold,Humana Gold,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Medicaid MO,Medicaid MO,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Medica,Medica,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Tricare,Tricare,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,UHC All Payer,UHC All Payer,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,UHC Exchange,UHC Exchange,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,UHC Medicaid,UHC Medicaid,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,UMR CPD,UMR CPD,151.41,,,,,,,per diem,151.41,151.41,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,UHC Medicare,UHC Medicare,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38200166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,151.41,151.41,Wellcare,Wellcare,151.41,,,,,,,case rate,151.41,151.41,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY CYSTICERCOSIS        ,38200175,CDM,302,RC,86682,CPT,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Meritain Health PPO CPD,Meritain Health PPO CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna/Commercial Product,Aetna/Commercial Product,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Meritain Health CPD,Meritain Health CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Starmark CPD,Starmark CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna Medicare,Aetna Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Ambetter ,Ambetter ,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Access,Anthem Blue Access,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Access Choice,Anthem Blue Access Choice,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Preferred,Anthem Blue Preferred,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Pathway,Anthem Pathway,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Alliance,Anthem Alliance,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Medicare,Anthem Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna,Cigna,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna PPO,Cigna PPO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna Medicare Advantage,Cigna Medicare Advantage,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Essence,Essence,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthlink HMO,Healthlink HMO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthlink PPO,Healthlink PPO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,HomeState Health Plan,HomeState Health Plan,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Humana Gold,Humana Gold,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Medicaid MO,Medicaid MO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Medica,Medica,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Tricare,Tricare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC All Payer,UHC All Payer,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Exchange,UHC Exchange,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Medicaid,UHC Medicaid,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UMR CPD,UMR CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Medicare,UHC Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38200180,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Wellcare,Wellcare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,38200190,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health PPO CPD,Meritain Health PPO CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Aetna/Commercial Product,Aetna/Commercial Product,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health CPD,Meritain Health CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Starmark CPD,Starmark CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Aetna Medicare,Aetna Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Ambetter ,Ambetter ,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access,Anthem Blue Access,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access Choice,Anthem Blue Access Choice,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Preferred,Anthem Blue Preferred,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Pathway,Anthem Pathway,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Alliance,Anthem Alliance,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Anthem Medicare,Anthem Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Cigna,Cigna,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Cigna PPO,Cigna PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Cigna Medicare Advantage,Cigna Medicare Advantage,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Essence,Essence,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Healthlink HMO,Healthlink HMO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Healthlink PPO,Healthlink PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,HomeState Health Plan,HomeState Health Plan,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Humana Gold,Humana Gold,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Medicaid MO,Medicaid MO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Medica,Medica,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Tricare,Tricare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,UHC All Payer,UHC All Payer,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,UHC Exchange,UHC Exchange,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicaid,UHC Medicaid,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,UMR CPD,UMR CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicare,UHC Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38200197,CDM,302,RC,86225,CPT,,,,Inpatient,,,159.14,159.14,Wellcare,Wellcare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Meritain Health PPO CPD,Meritain Health PPO CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Aetna/Commercial Product,Aetna/Commercial Product,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Meritain Health CPD,Meritain Health CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Starmark CPD,Starmark CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Aetna Medicare,Aetna Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Ambetter ,Ambetter ,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Blue Access,Anthem Blue Access,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Blue Access Choice,Anthem Blue Access Choice,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Blue Preferred,Anthem Blue Preferred,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Pathway,Anthem Pathway,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Alliance,Anthem Alliance,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Anthem Medicare,Anthem Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Cigna,Cigna,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Cigna PPO,Cigna PPO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Cigna Medicare Advantage,Cigna Medicare Advantage,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Essence,Essence,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Healthlink HMO,Healthlink HMO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Healthlink PPO,Healthlink PPO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,HomeState Health Plan,HomeState Health Plan,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Humana Gold,Humana Gold,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Medicaid MO,Medicaid MO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Medica,Medica,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Tricare,Tricare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,UHC All Payer,UHC All Payer,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,UHC Exchange,UHC Exchange,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,UHC Medicaid,UHC Medicaid,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,UMR CPD,UMR CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,UHC Medicare,UHC Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-MITOCHONDRIAL ANTIB      ,38200198,CDM,302,RC,86255,CPT,,,,Inpatient,,,90.64,90.64,Wellcare,Wellcare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Meritain Health PPO CPD,Meritain Health PPO CPD,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Aetna/Commercial Product,Aetna/Commercial Product,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Meritain Health CPD,Meritain Health CPD,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Starmark CPD,Starmark CPD,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Aetna Medicare,Aetna Medicare,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Ambetter ,Ambetter ,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Blue Access,Anthem Blue Access,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Blue Access Choice,Anthem Blue Access Choice,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Blue Preferred,Anthem Blue Preferred,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Pathway,Anthem Pathway,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Alliance,Anthem Alliance,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Anthem Medicare,Anthem Medicare,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Cigna,Cigna,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Cigna PPO,Cigna PPO,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Cigna Medicare Advantage,Cigna Medicare Advantage,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Essence,Essence,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Healthlink HMO,Healthlink HMO,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Healthlink PPO,Healthlink PPO,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,HomeState Health Plan,HomeState Health Plan,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Humana Gold,Humana Gold,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Medicaid MO,Medicaid MO,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Medica,Medica,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Tricare,Tricare,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,UHC All Payer,UHC All Payer,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,UHC Exchange,UHC Exchange,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,UHC Medicaid,UHC Medicaid,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,UMR CPD,UMR CPD,484.1,,,,,,,per diem,484.1,484.1,"Per diem rate, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,UHC Medicare,UHC Medicare,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-SMOOTH MUSCLE ANTIBODY   ,38200199,CDM,302,RC,86255,CPT,,,,Inpatient,,,484.1,484.1,Wellcare,Wellcare,484.1,,,,,,,case rate,484.1,484.1,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Meritain Health PPO CPD,Meritain Health PPO CPD,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Aetna/Commercial Product,Aetna/Commercial Product,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Meritain Health CPD,Meritain Health CPD,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Starmark CPD,Starmark CPD,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Aetna Medicare,Aetna Medicare,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Ambetter ,Ambetter ,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Blue Access,Anthem Blue Access,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Blue Access Choice,Anthem Blue Access Choice,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Blue Preferred,Anthem Blue Preferred,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Pathway,Anthem Pathway,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Alliance,Anthem Alliance,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Anthem Medicare,Anthem Medicare,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Cigna,Cigna,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Cigna PPO,Cigna PPO,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Cigna Medicare Advantage,Cigna Medicare Advantage,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Essence,Essence,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Healthlink HMO,Healthlink HMO,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Healthlink PPO,Healthlink PPO,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,HomeState Health Plan,HomeState Health Plan,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Humana Gold,Humana Gold,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Medicaid MO,Medicaid MO,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Medica,Medica,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Tricare,Tricare,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,UHC All Payer,UHC All Payer,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,UHC Exchange,UHC Exchange,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,UHC Medicaid,UHC Medicaid,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,UMR CPD,UMR CPD,354.34,,,,,,,per diem,354.34,354.34,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,UHC Medicare,UHC Medicare,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38200200,CDM,302,RC,86022,CPT,,,,Inpatient,,,354.34,354.34,Wellcare,Wellcare,354.34,,,,,,,case rate,354.34,354.34,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Meritain Health PPO CPD,Meritain Health PPO CPD,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Aetna/Commercial Product,Aetna/Commercial Product,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Meritain Health CPD,Meritain Health CPD,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Starmark CPD,Starmark CPD,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Aetna Medicare,Aetna Medicare,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Ambetter ,Ambetter ,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Blue Access,Anthem Blue Access,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Blue Access Choice,Anthem Blue Access Choice,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Blue Preferred,Anthem Blue Preferred,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Pathway,Anthem Pathway,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Alliance,Anthem Alliance,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Anthem Medicare,Anthem Medicare,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Cigna,Cigna,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Cigna PPO,Cigna PPO,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Cigna Medicare Advantage,Cigna Medicare Advantage,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Essence,Essence,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Healthlink HMO,Healthlink HMO,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Healthlink PPO,Healthlink PPO,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,HomeState Health Plan,HomeState Health Plan,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Humana Gold,Humana Gold,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Medicaid MO,Medicaid MO,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Medica,Medica,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Tricare,Tricare,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,UHC All Payer,UHC All Payer,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,UHC Exchange,UHC Exchange,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,UHC Medicaid,UHC Medicaid,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,UMR CPD,UMR CPD,349.66,,,,,,,per diem,349.66,349.66,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,UHC Medicare,UHC Medicare,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38200205,CDM,302,RC,86800,CPT,,,,Inpatient,,,349.66,349.66,Wellcare,Wellcare,349.66,,,,,,,case rate,349.66,349.66,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Meritain Health PPO CPD,Meritain Health PPO CPD,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Aetna/Commercial Product,Aetna/Commercial Product,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Meritain Health CPD,Meritain Health CPD,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Starmark CPD,Starmark CPD,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Aetna Medicare,Aetna Medicare,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Ambetter ,Ambetter ,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Blue Access,Anthem Blue Access,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Blue Access Choice,Anthem Blue Access Choice,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Blue Preferred,Anthem Blue Preferred,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Pathway,Anthem Pathway,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Alliance,Anthem Alliance,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Anthem Medicare,Anthem Medicare,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Cigna,Cigna,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Cigna PPO,Cigna PPO,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Cigna Medicare Advantage,Cigna Medicare Advantage,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Essence,Essence,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Healthlink HMO,Healthlink HMO,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Healthlink PPO,Healthlink PPO,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,HomeState Health Plan,HomeState Health Plan,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Humana Gold,Humana Gold,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Medicaid MO,Medicaid MO,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Medica,Medica,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Tricare,Tricare,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,UHC All Payer,UHC All Payer,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,UHC Exchange,UHC Exchange,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,UHC Medicaid,UHC Medicaid,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,UMR CPD,UMR CPD,366.06,,,,,,,per diem,366.06,366.06,"Per diem rate, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,UHC Medicare,UHC Medicare,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
ANTITHROMBIN III              ,38200210,CDM,305,RC,85300,CPT,,,,Inpatient,,,366.06,366.06,Wellcare,Wellcare,366.06,,,,,,,case rate,366.06,366.06,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Meritain Health PPO CPD,Meritain Health PPO CPD,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Aetna/Commercial Product,Aetna/Commercial Product,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Meritain Health CPD,Meritain Health CPD,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Starmark CPD,Starmark CPD,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Aetna Medicare,Aetna Medicare,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Ambetter ,Ambetter ,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Blue Access,Anthem Blue Access,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Blue Access Choice,Anthem Blue Access Choice,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Blue Preferred,Anthem Blue Preferred,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Pathway,Anthem Pathway,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Alliance,Anthem Alliance,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Anthem Medicare,Anthem Medicare,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Cigna,Cigna,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Cigna PPO,Cigna PPO,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Cigna Medicare Advantage,Cigna Medicare Advantage,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Essence,Essence,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Healthlink HMO,Healthlink HMO,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Healthlink PPO,Healthlink PPO,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,HomeState Health Plan,HomeState Health Plan,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Humana Gold,Humana Gold,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Medicaid MO,Medicaid MO,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Medica,Medica,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Tricare,Tricare,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,UHC All Payer,UHC All Payer,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,UHC Exchange,UHC Exchange,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,UHC Medicaid,UHC Medicaid,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,UMR CPD,UMR CPD,476.97,,,,,,,per diem,476.97,476.97,"Per diem rate, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,UHC Medicare,UHC Medicare,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PLASMINOGEN ACTIVATOR         ,38200211,CDM,305,RC,85415,CPT,,,,Inpatient,,,476.97,476.97,Wellcare,Wellcare,476.97,,,,,,,case rate,476.97,476.97,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Meritain Health PPO CPD,Meritain Health PPO CPD,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Aetna/Commercial Product,Aetna/Commercial Product,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Meritain Health CPD,Meritain Health CPD,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Starmark CPD,Starmark CPD,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Aetna Medicare,Aetna Medicare,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Ambetter ,Ambetter ,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Blue Access,Anthem Blue Access,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Blue Access Choice,Anthem Blue Access Choice,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Blue Preferred,Anthem Blue Preferred,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Pathway,Anthem Pathway,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Alliance,Anthem Alliance,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Anthem Medicare,Anthem Medicare,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Cigna,Cigna,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Cigna PPO,Cigna PPO,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Cigna Medicare Advantage,Cigna Medicare Advantage,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Essence,Essence,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Healthlink HMO,Healthlink HMO,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Healthlink PPO,Healthlink PPO,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,HomeState Health Plan,HomeState Health Plan,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Humana Gold,Humana Gold,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Medicaid MO,Medicaid MO,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Medica,Medica,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Tricare,Tricare,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,UHC All Payer,UHC All Payer,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,UHC Exchange,UHC Exchange,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,UHC Medicaid,UHC Medicaid,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,UMR CPD,UMR CPD,266.96,,,,,,,per diem,266.96,266.96,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,UHC Medicare,UHC Medicare,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38200212,CDM,305,RC,85303,CPT,,,,Inpatient,,,266.96,266.96,Wellcare,Wellcare,266.96,,,,,,,case rate,266.96,266.96,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Meritain Health PPO CPD,Meritain Health PPO CPD,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Aetna/Commercial Product,Aetna/Commercial Product,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Meritain Health CPD,Meritain Health CPD,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Starmark CPD,Starmark CPD,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Aetna Medicare,Aetna Medicare,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Ambetter ,Ambetter ,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Blue Access,Anthem Blue Access,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Blue Access Choice,Anthem Blue Access Choice,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Blue Preferred,Anthem Blue Preferred,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Pathway,Anthem Pathway,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Alliance,Anthem Alliance,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Anthem Medicare,Anthem Medicare,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Cigna,Cigna,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Cigna PPO,Cigna PPO,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Cigna Medicare Advantage,Cigna Medicare Advantage,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Essence,Essence,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Healthlink HMO,Healthlink HMO,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Healthlink PPO,Healthlink PPO,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,HomeState Health Plan,HomeState Health Plan,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Humana Gold,Humana Gold,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Medicaid MO,Medicaid MO,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Medica,Medica,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Tricare,Tricare,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,UHC All Payer,UHC All Payer,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,UHC Exchange,UHC Exchange,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,UHC Medicaid,UHC Medicaid,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,UMR CPD,UMR CPD,465.86,,,,,,,per diem,465.86,465.86,"Per diem rate, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,UHC Medicare,UHC Medicare,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
PROTEIN S ANTIGEN (TOTAL)     ,38200213,CDM,305,RC,85305,CPT,,,,Inpatient,,,465.86,465.86,Wellcare,Wellcare,465.86,,,,,,,case rate,465.86,465.86,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Meritain Health PPO CPD,Meritain Health PPO CPD,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Aetna/Commercial Product,Aetna/Commercial Product,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Meritain Health CPD,Meritain Health CPD,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Starmark CPD,Starmark CPD,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Aetna Medicare,Aetna Medicare,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Ambetter ,Ambetter ,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Blue Access,Anthem Blue Access,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Blue Access Choice,Anthem Blue Access Choice,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Blue Preferred,Anthem Blue Preferred,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Pathway,Anthem Pathway,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Alliance,Anthem Alliance,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Anthem Medicare,Anthem Medicare,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Cigna,Cigna,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Cigna PPO,Cigna PPO,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Cigna Medicare Advantage,Cigna Medicare Advantage,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Essence,Essence,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Healthlink HMO,Healthlink HMO,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Healthlink PPO,Healthlink PPO,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,HomeState Health Plan,HomeState Health Plan,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Humana Gold,Humana Gold,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Medicaid MO,Medicaid MO,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Medica,Medica,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Tricare,Tricare,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,UHC All Payer,UHC All Payer,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,UHC Exchange,UHC Exchange,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,UHC Medicaid,UHC Medicaid,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,UMR CPD,UMR CPD,1039.27,,,,,,,per diem,1039.27,1039.27,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,UHC Medicare,UHC Medicare,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN INHIBITION     ,38200214,CDM,305,RC,85705,CPT,,,,Inpatient,,,1039.27,1039.27,Wellcare,Wellcare,1039.27,,,,,,,case rate,1039.27,1039.27,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Meritain Health PPO CPD,Meritain Health PPO CPD,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Aetna/Commercial Product,Aetna/Commercial Product,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Meritain Health CPD,Meritain Health CPD,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Starmark CPD,Starmark CPD,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Aetna Medicare,Aetna Medicare,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Ambetter ,Ambetter ,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Blue Access,Anthem Blue Access,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Blue Access Choice,Anthem Blue Access Choice,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Blue Preferred,Anthem Blue Preferred,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Pathway,Anthem Pathway,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Alliance,Anthem Alliance,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Anthem Medicare,Anthem Medicare,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Cigna,Cigna,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Cigna PPO,Cigna PPO,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Cigna Medicare Advantage,Cigna Medicare Advantage,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Essence,Essence,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Healthlink HMO,Healthlink HMO,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Healthlink PPO,Healthlink PPO,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,HomeState Health Plan,HomeState Health Plan,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Humana Gold,Humana Gold,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Medicaid MO,Medicaid MO,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Medica,Medica,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Tricare,Tricare,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,UHC All Payer,UHC All Payer,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,UHC Exchange,UHC Exchange,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,UHC Medicaid,UHC Medicaid,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,UMR CPD,UMR CPD,344.64,,,,,,,per diem,344.64,344.64,"Per diem rate, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,UHC Medicare,UHC Medicare,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
PROTEIN C ANTIGEN             ,38200215,CDM,305,RC,85302,CPT,,,,Inpatient,,,344.64,344.64,Wellcare,Wellcare,344.64,,,,,,,case rate,344.64,344.64,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health PPO CPD,Meritain Health PPO CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Aetna/Commercial Product,Aetna/Commercial Product,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health CPD,Meritain Health CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Starmark CPD,Starmark CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Aetna Medicare,Aetna Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Ambetter ,Ambetter ,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access,Anthem Blue Access,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access Choice,Anthem Blue Access Choice,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Preferred,Anthem Blue Preferred,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Pathway,Anthem Pathway,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Alliance,Anthem Alliance,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Anthem Medicare,Anthem Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Cigna,Cigna,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Cigna PPO,Cigna PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Cigna Medicare Advantage,Cigna Medicare Advantage,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Essence,Essence,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Healthlink HMO,Healthlink HMO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Healthlink PPO,Healthlink PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,HomeState Health Plan,HomeState Health Plan,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Humana Gold,Humana Gold,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Medicaid MO,Medicaid MO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Medica,Medica,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Tricare,Tricare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,UHC All Payer,UHC All Payer,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,UHC Exchange,UHC Exchange,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicaid,UHC Medicaid,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,UMR CPD,UMR CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicare,UHC Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38200216,CDM,306,RC,87899,CPT,,,,Inpatient,,,58.35,58.35,Wellcare,Wellcare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Meritain Health PPO CPD,Meritain Health PPO CPD,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Aetna/Commercial Product,Aetna/Commercial Product,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Meritain Health CPD,Meritain Health CPD,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Starmark CPD,Starmark CPD,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Aetna Medicare,Aetna Medicare,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Ambetter ,Ambetter ,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Blue Access,Anthem Blue Access,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Blue Access Choice,Anthem Blue Access Choice,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Blue Preferred,Anthem Blue Preferred,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Pathway,Anthem Pathway,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Alliance,Anthem Alliance,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Anthem Medicare,Anthem Medicare,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Cigna,Cigna,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Cigna PPO,Cigna PPO,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Cigna Medicare Advantage,Cigna Medicare Advantage,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Essence,Essence,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Healthlink HMO,Healthlink HMO,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Healthlink PPO,Healthlink PPO,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,HomeState Health Plan,HomeState Health Plan,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Humana Gold,Humana Gold,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Medicaid MO,Medicaid MO,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Medica,Medica,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Tricare,Tricare,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,UHC All Payer,UHC All Payer,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,UHC Exchange,UHC Exchange,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,UHC Medicaid,UHC Medicaid,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,UMR CPD,UMR CPD,98.65,,,,,,,per diem,98.65,98.65,"Per diem rate, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,UHC Medicare,UHC Medicare,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
C DIFFICILE ANTIGEN           ,38200218,CDM,306,RC,87449,CPT,,,,Inpatient,,,98.65,98.65,Wellcare,Wellcare,98.65,,,,,,,case rate,98.65,98.65,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Meritain Health PPO CPD,Meritain Health PPO CPD,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Aetna/Commercial Product,Aetna/Commercial Product,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Meritain Health CPD,Meritain Health CPD,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Starmark CPD,Starmark CPD,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Aetna Medicare,Aetna Medicare,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Ambetter ,Ambetter ,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Blue Access,Anthem Blue Access,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Blue Access Choice,Anthem Blue Access Choice,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Blue Preferred,Anthem Blue Preferred,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Pathway,Anthem Pathway,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Alliance,Anthem Alliance,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Anthem Medicare,Anthem Medicare,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Cigna,Cigna,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Cigna PPO,Cigna PPO,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Cigna Medicare Advantage,Cigna Medicare Advantage,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Essence,Essence,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Healthlink HMO,Healthlink HMO,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Healthlink PPO,Healthlink PPO,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,HomeState Health Plan,HomeState Health Plan,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Humana Gold,Humana Gold,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Medicaid MO,Medicaid MO,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Medica,Medica,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Tricare,Tricare,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,UHC All Payer,UHC All Payer,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,UHC Exchange,UHC Exchange,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,UHC Medicaid,UHC Medicaid,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,UMR CPD,UMR CPD,824.26,,,,,,,per diem,824.26,824.26,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,UHC Medicare,UHC Medicare,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38200220,CDM,306,RC,87902,CPT,,,,Inpatient,,,824.26,824.26,Wellcare,Wellcare,824.26,,,,,,,case rate,824.26,824.26,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Meritain Health PPO CPD,Meritain Health PPO CPD,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Aetna/Commercial Product,Aetna/Commercial Product,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Meritain Health CPD,Meritain Health CPD,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Starmark CPD,Starmark CPD,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Aetna Medicare,Aetna Medicare,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Ambetter ,Ambetter ,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Blue Access,Anthem Blue Access,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Blue Access Choice,Anthem Blue Access Choice,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Blue Preferred,Anthem Blue Preferred,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Pathway,Anthem Pathway,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Alliance,Anthem Alliance,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Anthem Medicare,Anthem Medicare,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Cigna,Cigna,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Cigna PPO,Cigna PPO,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Cigna Medicare Advantage,Cigna Medicare Advantage,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Essence,Essence,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Healthlink HMO,Healthlink HMO,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Healthlink PPO,Healthlink PPO,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,HomeState Health Plan,HomeState Health Plan,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Humana Gold,Humana Gold,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Medicaid MO,Medicaid MO,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Medica,Medica,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Tricare,Tricare,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,UHC All Payer,UHC All Payer,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,UHC Exchange,UHC Exchange,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,UHC Medicaid,UHC Medicaid,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,UMR CPD,UMR CPD,184.16,,,,,,,per diem,184.16,184.16,"Per diem rate, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,UHC Medicare,UHC Medicare,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
INFLUENZA A&B                 ,38200221,CDM,306,RC,86710,CPT,,,,Inpatient,,,184.16,184.16,Wellcare,Wellcare,184.16,,,,,,,case rate,184.16,184.16,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Meritain Health PPO CPD,Meritain Health PPO CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna/Commercial Product,Aetna/Commercial Product,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Meritain Health CPD,Meritain Health CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Starmark CPD,Starmark CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna Medicare,Aetna Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Ambetter ,Ambetter ,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Access,Anthem Blue Access,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Access Choice,Anthem Blue Access Choice,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Preferred,Anthem Blue Preferred,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Pathway,Anthem Pathway,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Alliance,Anthem Alliance,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Medicare,Anthem Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna,Cigna,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna PPO,Cigna PPO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna Medicare Advantage,Cigna Medicare Advantage,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Essence,Essence,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthlink HMO,Healthlink HMO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthlink PPO,Healthlink PPO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,HomeState Health Plan,HomeState Health Plan,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Humana Gold,Humana Gold,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Medicaid MO,Medicaid MO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Medica,Medica,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Tricare,Tricare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC All Payer,UHC All Payer,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Exchange,UHC Exchange,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Medicaid,UHC Medicaid,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UMR CPD,UMR CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Medicare,UHC Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
BNP (B NATRIURETIC PEPTIDE)   ,38200222,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Wellcare,Wellcare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Meritain Health PPO CPD,Meritain Health PPO CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna/Commercial Product,Aetna/Commercial Product,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Meritain Health CPD,Meritain Health CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Starmark CPD,Starmark CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Aetna Medicare,Aetna Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Ambetter ,Ambetter ,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Access,Anthem Blue Access,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Access Choice,Anthem Blue Access Choice,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Blue Preferred,Anthem Blue Preferred,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Pathway,Anthem Pathway,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Alliance,Anthem Alliance,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Anthem Medicare,Anthem Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna,Cigna,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna PPO,Cigna PPO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Cigna Medicare Advantage,Cigna Medicare Advantage,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Essence,Essence,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthlink HMO,Healthlink HMO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Healthlink PPO,Healthlink PPO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,HomeState Health Plan,HomeState Health Plan,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Humana Gold,Humana Gold,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Medicaid MO,Medicaid MO,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Medica,Medica,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Tricare,Tricare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC All Payer,UHC All Payer,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Exchange,UHC Exchange,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Medicaid,UHC Medicaid,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UMR CPD,UMR CPD,252.49,,,,,,,per diem,252.49,252.49,"Per diem rate, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,UHC Medicare,UHC Medicare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
NT-PRO BNP                    ,38200223,CDM,301,RC,83880,CPT,,,,Inpatient,,,252.49,252.49,Wellcare,Wellcare,252.49,,,,,,,case rate,252.49,252.49,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Meritain Health PPO CPD,Meritain Health PPO CPD,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Aetna/Commercial Product,Aetna/Commercial Product,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Meritain Health CPD,Meritain Health CPD,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Starmark CPD,Starmark CPD,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Aetna Medicare,Aetna Medicare,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Ambetter ,Ambetter ,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Blue Access,Anthem Blue Access,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Blue Access Choice,Anthem Blue Access Choice,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Blue Preferred,Anthem Blue Preferred,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Pathway,Anthem Pathway,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Alliance,Anthem Alliance,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Anthem Medicare,Anthem Medicare,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Cigna,Cigna,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Cigna PPO,Cigna PPO,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Cigna Medicare Advantage,Cigna Medicare Advantage,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Essence,Essence,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Healthlink HMO,Healthlink HMO,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Healthlink PPO,Healthlink PPO,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,HomeState Health Plan,HomeState Health Plan,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Humana Gold,Humana Gold,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Medicaid MO,Medicaid MO,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Medica,Medica,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Tricare,Tricare,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,UHC All Payer,UHC All Payer,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,UHC Exchange,UHC Exchange,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,UHC Medicaid,UHC Medicaid,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,UMR CPD,UMR CPD,166.94,,,,,,,per diem,166.94,166.94,"Per diem rate, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,UHC Medicare,UHC Medicare,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
ANTI STREP O TITER            ,38200230,CDM,302,RC,86060,CPT,,,,Inpatient,,,166.94,166.94,Wellcare,Wellcare,166.94,,,,,,,case rate,166.94,166.94,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYP ADD HIV1,38200241,CDM,306,RC,87904,CPT,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Meritain Health PPO CPD,Meritain Health PPO CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Aetna/Commercial Product,Aetna/Commercial Product,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Meritain Health CPD,Meritain Health CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Starmark CPD,Starmark CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Aetna Medicare,Aetna Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Ambetter ,Ambetter ,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Access,Anthem Blue Access,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Access Choice,Anthem Blue Access Choice,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Preferred,Anthem Blue Preferred,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Pathway,Anthem Pathway,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Alliance,Anthem Alliance,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Anthem Medicare,Anthem Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Cigna,Cigna,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Cigna PPO,Cigna PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Cigna Medicare Advantage,Cigna Medicare Advantage,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Essence,Essence,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Healthlink HMO,Healthlink HMO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Healthlink PPO,Healthlink PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,HomeState Health Plan,HomeState Health Plan,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Humana Gold,Humana Gold,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Medicaid MO,Medicaid MO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Medica,Medica,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Tricare,Tricare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,UHC All Payer,UHC All Payer,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,UHC Exchange,UHC Exchange,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,UHC Medicaid,UHC Medicaid,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,UMR CPD,UMR CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,UHC Medicare,UHC Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
INFECT AGENT PHENOTYPE HIV1   ,38200242,CDM,306,RC,87903,CPT,,,,Inpatient,,,321.48,321.48,Wellcare,Wellcare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Meritain Health PPO CPD,Meritain Health PPO CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Aetna/Commercial Product,Aetna/Commercial Product,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Meritain Health CPD,Meritain Health CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Starmark CPD,Starmark CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Aetna Medicare,Aetna Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Ambetter ,Ambetter ,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Access,Anthem Blue Access,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Access Choice,Anthem Blue Access Choice,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Blue Preferred,Anthem Blue Preferred,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Pathway,Anthem Pathway,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Alliance,Anthem Alliance,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Anthem Medicare,Anthem Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Cigna,Cigna,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Cigna PPO,Cigna PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Cigna Medicare Advantage,Cigna Medicare Advantage,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Essence,Essence,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Healthlink HMO,Healthlink HMO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Healthlink PPO,Healthlink PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,HomeState Health Plan,HomeState Health Plan,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Humana Gold,Humana Gold,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Medicaid MO,Medicaid MO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Medica,Medica,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Tricare,Tricare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,UHC All Payer,UHC All Payer,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,UHC Exchange,UHC Exchange,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,UHC Medicaid,UHC Medicaid,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,UMR CPD,UMR CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,UHC Medicare,UHC Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
HIV GENOTYPE DNA/RNA          ,38200243,CDM,306,RC,87901,CPT,,,,Inpatient,,,321.48,321.48,Wellcare,Wellcare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health PPO CPD,Meritain Health PPO CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Aetna/Commercial Product,Aetna/Commercial Product,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health CPD,Meritain Health CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Starmark CPD,Starmark CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Aetna Medicare,Aetna Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Ambetter ,Ambetter ,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access,Anthem Blue Access,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access Choice,Anthem Blue Access Choice,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Preferred,Anthem Blue Preferred,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Pathway,Anthem Pathway,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Alliance,Anthem Alliance,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Anthem Medicare,Anthem Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Cigna,Cigna,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Cigna PPO,Cigna PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Cigna Medicare Advantage,Cigna Medicare Advantage,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Essence,Essence,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Healthlink HMO,Healthlink HMO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Healthlink PPO,Healthlink PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,HomeState Health Plan,HomeState Health Plan,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Humana Gold,Humana Gold,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Medicaid MO,Medicaid MO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Medica,Medica,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Tricare,Tricare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,UHC All Payer,UHC All Payer,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,UHC Exchange,UHC Exchange,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicaid,UHC Medicaid,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,UMR CPD,UMR CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicare,UHC Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN DIRECT              ,38200250,CDM,301,RC,82248,CPT,,,,Inpatient,,,105.03,105.03,Wellcare,Wellcare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Meritain Health PPO CPD,Meritain Health PPO CPD,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Aetna/Commercial Product,Aetna/Commercial Product,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Meritain Health CPD,Meritain Health CPD,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Starmark CPD,Starmark CPD,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Aetna Medicare,Aetna Medicare,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Ambetter ,Ambetter ,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Blue Access,Anthem Blue Access,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Blue Access Choice,Anthem Blue Access Choice,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Blue Preferred,Anthem Blue Preferred,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Pathway,Anthem Pathway,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Alliance,Anthem Alliance,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Anthem Medicare,Anthem Medicare,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Cigna,Cigna,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Cigna PPO,Cigna PPO,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Cigna Medicare Advantage,Cigna Medicare Advantage,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Essence,Essence,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Healthlink HMO,Healthlink HMO,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Healthlink PPO,Healthlink PPO,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,HomeState Health Plan,HomeState Health Plan,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Humana Gold,Humana Gold,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Medicaid MO,Medicaid MO,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Medica,Medica,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Tricare,Tricare,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,UHC All Payer,UHC All Payer,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,UHC Exchange,UHC Exchange,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,UHC Medicaid,UHC Medicaid,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,UMR CPD,UMR CPD,113.52,,,,,,,per diem,113.52,113.52,"Per diem rate, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,UHC Medicare,UHC Medicare,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BILIRUBIN TOTAL               ,38200260,CDM,301,RC,82247,CPT,,,,Inpatient,,,113.52,113.52,Wellcare,Wellcare,113.52,,,,,,,case rate,113.52,113.52,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Meritain Health PPO CPD,Meritain Health PPO CPD,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Aetna/Commercial Product,Aetna/Commercial Product,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Meritain Health CPD,Meritain Health CPD,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Starmark CPD,Starmark CPD,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Aetna Medicare,Aetna Medicare,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Ambetter ,Ambetter ,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Blue Access,Anthem Blue Access,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Blue Access Choice,Anthem Blue Access Choice,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Blue Preferred,Anthem Blue Preferred,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Pathway,Anthem Pathway,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Alliance,Anthem Alliance,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Anthem Medicare,Anthem Medicare,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Cigna,Cigna,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Cigna PPO,Cigna PPO,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Cigna Medicare Advantage,Cigna Medicare Advantage,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Essence,Essence,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Healthlink HMO,Healthlink HMO,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Healthlink PPO,Healthlink PPO,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,HomeState Health Plan,HomeState Health Plan,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Humana Gold,Humana Gold,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Medicaid MO,Medicaid MO,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Medica,Medica,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Tricare,Tricare,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,UHC All Payer,UHC All Payer,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,UHC Exchange,UHC Exchange,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,UHC Medicaid,UHC Medicaid,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,UMR CPD,UMR CPD,106.16,,,,,,,per diem,106.16,106.16,"Per diem rate, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,UHC Medicare,UHC Medicare,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
BLEEDING TIME                 ,38200290,CDM,305,RC,85002,CPT,,,,Inpatient,,,106.16,106.16,Wellcare,Wellcare,106.16,,,,,,,case rate,106.16,106.16,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Meritain Health PPO CPD,Meritain Health PPO CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Aetna/Commercial Product,Aetna/Commercial Product,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Meritain Health CPD,Meritain Health CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Starmark CPD,Starmark CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Aetna Medicare,Aetna Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Ambetter ,Ambetter ,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Blue Access,Anthem Blue Access,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Blue Access Choice,Anthem Blue Access Choice,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Blue Preferred,Anthem Blue Preferred,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Pathway,Anthem Pathway,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Alliance,Anthem Alliance,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Anthem Medicare,Anthem Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Cigna,Cigna,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Cigna PPO,Cigna PPO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Cigna Medicare Advantage,Cigna Medicare Advantage,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Essence,Essence,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Healthlink HMO,Healthlink HMO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Healthlink PPO,Healthlink PPO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,HomeState Health Plan,HomeState Health Plan,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Humana Gold,Humana Gold,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Medicaid MO,Medicaid MO,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Medica,Medica,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Tricare,Tricare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,UHC All Payer,UHC All Payer,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,UHC Exchange,UHC Exchange,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,UHC Medicaid,UHC Medicaid,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,UMR CPD,UMR CPD,39.14,,,,,,,per diem,39.14,39.14,"Per diem rate, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,UHC Medicare,UHC Medicare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
RETICULATED PLT ASSAY         ,38200293,CDM,305,RC,85055,CPT,,,,Inpatient,,,39.14,39.14,Wellcare,Wellcare,39.14,,,,,,,case rate,39.14,39.14,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Meritain Health PPO CPD,Meritain Health PPO CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Aetna/Commercial Product,Aetna/Commercial Product,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Meritain Health CPD,Meritain Health CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Starmark CPD,Starmark CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Aetna Medicare,Aetna Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Ambetter ,Ambetter ,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Access,Anthem Blue Access,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Access Choice,Anthem Blue Access Choice,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Preferred,Anthem Blue Preferred,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Pathway,Anthem Pathway,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Alliance,Anthem Alliance,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Anthem Medicare,Anthem Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Cigna,Cigna,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Cigna PPO,Cigna PPO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Cigna Medicare Advantage,Cigna Medicare Advantage,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Essence,Essence,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Healthlink HMO,Healthlink HMO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Healthlink PPO,Healthlink PPO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,HomeState Health Plan,HomeState Health Plan,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Humana Gold,Humana Gold,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Medicaid MO,Medicaid MO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Medica,Medica,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Tricare,Tricare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,UHC All Payer,UHC All Payer,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,UHC Exchange,UHC Exchange,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,UHC Medicaid,UHC Medicaid,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,UMR CPD,UMR CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,UHC Medicare,UHC Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38200302,CDM,301,RC,84154,CPT,,,,Inpatient,,,171.87,171.87,Wellcare,Wellcare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health PPO CPD,Meritain Health PPO CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna/Commercial Product,Aetna/Commercial Product,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health CPD,Meritain Health CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Starmark CPD,Starmark CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna Medicare,Aetna Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Ambetter ,Ambetter ,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access,Anthem Blue Access,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access Choice,Anthem Blue Access Choice,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Preferred,Anthem Blue Preferred,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Pathway,Anthem Pathway,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Alliance,Anthem Alliance,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Medicare,Anthem Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna,Cigna,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna PPO,Cigna PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna Medicare Advantage,Cigna Medicare Advantage,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Essence,Essence,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthlink HMO,Healthlink HMO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthlink PPO,Healthlink PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,HomeState Health Plan,HomeState Health Plan,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Humana Gold,Humana Gold,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Medicaid MO,Medicaid MO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Medica,Medica,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Tricare,Tricare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC All Payer,UHC All Payer,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Exchange,UHC Exchange,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicaid,UHC Medicaid,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UMR CPD,UMR CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicare,UHC Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38200310,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Wellcare,Wellcare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health PPO CPD,Meritain Health PPO CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Aetna/Commercial Product,Aetna/Commercial Product,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health CPD,Meritain Health CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Starmark CPD,Starmark CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Aetna Medicare,Aetna Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Ambetter ,Ambetter ,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access,Anthem Blue Access,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access Choice,Anthem Blue Access Choice,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Preferred,Anthem Blue Preferred,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Pathway,Anthem Pathway,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Alliance,Anthem Alliance,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Anthem Medicare,Anthem Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Cigna,Cigna,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Cigna PPO,Cigna PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Cigna Medicare Advantage,Cigna Medicare Advantage,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Essence,Essence,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Healthlink HMO,Healthlink HMO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Healthlink PPO,Healthlink PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,HomeState Health Plan,HomeState Health Plan,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Humana Gold,Humana Gold,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Medicaid MO,Medicaid MO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Medica,Medica,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Tricare,Tricare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,UHC All Payer,UHC All Payer,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,UHC Exchange,UHC Exchange,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicaid,UHC Medicaid,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,UMR CPD,UMR CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicare,UHC Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38200315,CDM,301,RC,83883,CPT,,,,Inpatient,,,194.14,194.14,Wellcare,Wellcare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Meritain Health PPO CPD,Meritain Health PPO CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Aetna/Commercial Product,Aetna/Commercial Product,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Meritain Health CPD,Meritain Health CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Starmark CPD,Starmark CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Aetna Medicare,Aetna Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Ambetter ,Ambetter ,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Access,Anthem Blue Access,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Access Choice,Anthem Blue Access Choice,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Preferred,Anthem Blue Preferred,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Pathway,Anthem Pathway,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Alliance,Anthem Alliance,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Anthem Medicare,Anthem Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Cigna,Cigna,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Cigna PPO,Cigna PPO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Cigna Medicare Advantage,Cigna Medicare Advantage,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Essence,Essence,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Healthlink HMO,Healthlink HMO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Healthlink PPO,Healthlink PPO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,HomeState Health Plan,HomeState Health Plan,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Humana Gold,Humana Gold,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Medicaid MO,Medicaid MO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Medica,Medica,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Tricare,Tricare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,UHC All Payer,UHC All Payer,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,UHC Exchange,UHC Exchange,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,UHC Medicaid,UHC Medicaid,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,UMR CPD,UMR CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,UHC Medicare,UHC Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
INF AG DET BY IA INFLUENZA    ,38200326,CDM,306,RC,87804,CPT,,,,Inpatient,,,158.07,158.07,Wellcare,Wellcare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Meritain Health PPO CPD,Meritain Health PPO CPD,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Aetna/Commercial Product,Aetna/Commercial Product,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Meritain Health CPD,Meritain Health CPD,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Starmark CPD,Starmark CPD,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Aetna Medicare,Aetna Medicare,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Ambetter ,Ambetter ,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Blue Access,Anthem Blue Access,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Blue Access Choice,Anthem Blue Access Choice,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Blue Preferred,Anthem Blue Preferred,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Pathway,Anthem Pathway,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Alliance,Anthem Alliance,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Anthem Medicare,Anthem Medicare,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Cigna,Cigna,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Cigna PPO,Cigna PPO,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Cigna Medicare Advantage,Cigna Medicare Advantage,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Essence,Essence,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Healthlink HMO,Healthlink HMO,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Healthlink PPO,Healthlink PPO,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,HomeState Health Plan,HomeState Health Plan,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Humana Gold,Humana Gold,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Medicaid MO,Medicaid MO,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Medica,Medica,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Tricare,Tricare,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,UHC All Payer,UHC All Payer,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,UHC Exchange,UHC Exchange,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,UHC Medicaid,UHC Medicaid,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,UMR CPD,UMR CPD,105.66,,,,,,,per diem,105.66,105.66,"Per diem rate, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,UHC Medicare,UHC Medicare,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CRP (HIGH SENSITIVITY)        ,38200346,CDM,302,RC,86141,CPT,,,,Inpatient,,,105.66,105.66,Wellcare,Wellcare,105.66,,,,,,,case rate,105.66,105.66,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Meritain Health PPO CPD,Meritain Health PPO CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Aetna/Commercial Product,Aetna/Commercial Product,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Meritain Health CPD,Meritain Health CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Starmark CPD,Starmark CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Aetna Medicare,Aetna Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Ambetter ,Ambetter ,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Access,Anthem Blue Access,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Access Choice,Anthem Blue Access Choice,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Blue Preferred,Anthem Blue Preferred,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Pathway,Anthem Pathway,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Alliance,Anthem Alliance,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Anthem Medicare,Anthem Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Cigna,Cigna,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Cigna PPO,Cigna PPO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Cigna Medicare Advantage,Cigna Medicare Advantage,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Essence,Essence,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Healthlink HMO,Healthlink HMO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Healthlink PPO,Healthlink PPO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,HomeState Health Plan,HomeState Health Plan,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Humana Gold,Humana Gold,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Medicaid MO,Medicaid MO,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Medica,Medica,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Tricare,Tricare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,UHC All Payer,UHC All Payer,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,UHC Exchange,UHC Exchange,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,UHC Medicaid,UHC Medicaid,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,UMR CPD,UMR CPD,130.81,,,,,,,per diem,130.81,130.81,"Per diem rate, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,UHC Medicare,UHC Medicare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 15-3                       ,38200350,CDM,302,RC,86300,CPT,,,,Inpatient,,,130.81,130.81,Wellcare,Wellcare,130.81,,,,,,,case rate,130.81,130.81,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Meritain Health PPO CPD,Meritain Health PPO CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna/Commercial Product,Aetna/Commercial Product,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Meritain Health CPD,Meritain Health CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Starmark CPD,Starmark CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna Medicare,Aetna Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Ambetter ,Ambetter ,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Access,Anthem Blue Access,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Access Choice,Anthem Blue Access Choice,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Preferred,Anthem Blue Preferred,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Pathway,Anthem Pathway,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Alliance,Anthem Alliance,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Medicare,Anthem Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna,Cigna,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna PPO,Cigna PPO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna Medicare Advantage,Cigna Medicare Advantage,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Essence,Essence,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthlink HMO,Healthlink HMO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthlink PPO,Healthlink PPO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,HomeState Health Plan,HomeState Health Plan,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Humana Gold,Humana Gold,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Medicaid MO,Medicaid MO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Medica,Medica,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Tricare,Tricare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC All Payer,UHC All Payer,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Exchange,UHC Exchange,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Medicaid,UHC Medicaid,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UMR CPD,UMR CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Medicare,UHC Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38200360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Wellcare,Wellcare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Meritain Health PPO CPD,Meritain Health PPO CPD,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Aetna/Commercial Product,Aetna/Commercial Product,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Meritain Health CPD,Meritain Health CPD,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Starmark CPD,Starmark CPD,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Aetna Medicare,Aetna Medicare,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Ambetter ,Ambetter ,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Blue Access,Anthem Blue Access,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Blue Access Choice,Anthem Blue Access Choice,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Blue Preferred,Anthem Blue Preferred,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Pathway,Anthem Pathway,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Alliance,Anthem Alliance,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Anthem Medicare,Anthem Medicare,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Cigna,Cigna,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Cigna PPO,Cigna PPO,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Cigna Medicare Advantage,Cigna Medicare Advantage,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Essence,Essence,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Healthlink HMO,Healthlink HMO,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Healthlink PPO,Healthlink PPO,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,HomeState Health Plan,HomeState Health Plan,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Humana Gold,Humana Gold,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Medicaid MO,Medicaid MO,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Medica,Medica,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Tricare,Tricare,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,UHC All Payer,UHC All Payer,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,UHC Exchange,UHC Exchange,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,UHC Medicaid,UHC Medicaid,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,UMR CPD,UMR CPD,282.43,,,,,,,per diem,282.43,282.43,"Per diem rate, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,UHC Medicare,UHC Medicare,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCITONIN                    ,38200361,CDM,301,RC,82308,CPT,,,,Inpatient,,,282.43,282.43,Wellcare,Wellcare,282.43,,,,,,,case rate,282.43,282.43,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Meritain Health PPO CPD,Meritain Health PPO CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Aetna/Commercial Product,Aetna/Commercial Product,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Meritain Health CPD,Meritain Health CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Starmark CPD,Starmark CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Aetna Medicare,Aetna Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Ambetter ,Ambetter ,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Access,Anthem Blue Access,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Access Choice,Anthem Blue Access Choice,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Preferred,Anthem Blue Preferred,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Pathway,Anthem Pathway,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Alliance,Anthem Alliance,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Anthem Medicare,Anthem Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Cigna,Cigna,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Cigna PPO,Cigna PPO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Cigna Medicare Advantage,Cigna Medicare Advantage,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Essence,Essence,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Healthlink HMO,Healthlink HMO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Healthlink PPO,Healthlink PPO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,HomeState Health Plan,HomeState Health Plan,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Humana Gold,Humana Gold,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Medicaid MO,Medicaid MO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Medica,Medica,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Tricare,Tricare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,UHC All Payer,UHC All Payer,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,UHC Exchange,UHC Exchange,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,UHC Medicaid,UHC Medicaid,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,UMR CPD,UMR CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,UHC Medicare,UHC Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM SERUM                 ,38200370,CDM,301,RC,82310,CPT,,,,Inpatient,,,104.03,104.03,Wellcare,Wellcare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health PPO CPD,Meritain Health PPO CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna/Commercial Product,Aetna/Commercial Product,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health CPD,Meritain Health CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Starmark CPD,Starmark CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna Medicare,Aetna Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Ambetter ,Ambetter ,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access,Anthem Blue Access,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access Choice,Anthem Blue Access Choice,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Preferred,Anthem Blue Preferred,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Pathway,Anthem Pathway,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Alliance,Anthem Alliance,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Medicare,Anthem Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna,Cigna,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna PPO,Cigna PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna Medicare Advantage,Cigna Medicare Advantage,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Essence,Essence,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthlink HMO,Healthlink HMO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthlink PPO,Healthlink PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,HomeState Health Plan,HomeState Health Plan,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Humana Gold,Humana Gold,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Medicaid MO,Medicaid MO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Medica,Medica,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Tricare,Tricare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC All Payer,UHC All Payer,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Exchange,UHC Exchange,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicaid,UHC Medicaid,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UMR CPD,UMR CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicare,UHC Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CALCIUM (IONIZED)             ,38200380,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Wellcare,Wellcare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Meritain Health PPO CPD,Meritain Health PPO CPD,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Aetna/Commercial Product,Aetna/Commercial Product,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Meritain Health CPD,Meritain Health CPD,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Starmark CPD,Starmark CPD,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Aetna Medicare,Aetna Medicare,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Ambetter ,Ambetter ,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Blue Access,Anthem Blue Access,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Blue Access Choice,Anthem Blue Access Choice,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Blue Preferred,Anthem Blue Preferred,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Pathway,Anthem Pathway,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Alliance,Anthem Alliance,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Anthem Medicare,Anthem Medicare,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Cigna,Cigna,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Cigna PPO,Cigna PPO,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Cigna Medicare Advantage,Cigna Medicare Advantage,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Essence,Essence,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Healthlink HMO,Healthlink HMO,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Healthlink PPO,Healthlink PPO,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,HomeState Health Plan,HomeState Health Plan,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Humana Gold,Humana Gold,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Medicaid MO,Medicaid MO,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Medica,Medica,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Tricare,Tricare,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,UHC All Payer,UHC All Payer,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,UHC Exchange,UHC Exchange,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,UHC Medicaid,UHC Medicaid,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,UMR CPD,UMR CPD,98.21,,,,,,,per diem,98.21,98.21,"Per diem rate, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,UHC Medicare,UHC Medicare,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARBOXYHEMOGLOBIN             ,38200403,CDM,301,RC,82375,CPT,,,,Inpatient,,,98.21,98.21,Wellcare,Wellcare,98.21,,,,,,,case rate,98.21,98.21,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health PPO CPD,Meritain Health PPO CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna/Commercial Product,Aetna/Commercial Product,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health CPD,Meritain Health CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Starmark CPD,Starmark CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna Medicare,Aetna Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Ambetter ,Ambetter ,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access,Anthem Blue Access,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access Choice,Anthem Blue Access Choice,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Preferred,Anthem Blue Preferred,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Pathway,Anthem Pathway,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Alliance,Anthem Alliance,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Medicare,Anthem Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna,Cigna,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna PPO,Cigna PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna Medicare Advantage,Cigna Medicare Advantage,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Essence,Essence,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthlink HMO,Healthlink HMO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthlink PPO,Healthlink PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,HomeState Health Plan,HomeState Health Plan,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Humana Gold,Humana Gold,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Medicaid MO,Medicaid MO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Medica,Medica,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Tricare,Tricare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC All Payer,UHC All Payer,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Exchange,UHC Exchange,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicaid,UHC Medicaid,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UMR CPD,UMR CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicare,UHC Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38200405,CDM,301,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Wellcare,Wellcare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Meritain Health PPO CPD,Meritain Health PPO CPD,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Aetna/Commercial Product,Aetna/Commercial Product,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Meritain Health CPD,Meritain Health CPD,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Starmark CPD,Starmark CPD,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Aetna Medicare,Aetna Medicare,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Ambetter ,Ambetter ,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Blue Access,Anthem Blue Access,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Blue Access Choice,Anthem Blue Access Choice,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Blue Preferred,Anthem Blue Preferred,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Pathway,Anthem Pathway,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Alliance,Anthem Alliance,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Anthem Medicare,Anthem Medicare,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Cigna,Cigna,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Cigna PPO,Cigna PPO,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Cigna Medicare Advantage,Cigna Medicare Advantage,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Essence,Essence,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Healthlink HMO,Healthlink HMO,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Healthlink PPO,Healthlink PPO,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,HomeState Health Plan,HomeState Health Plan,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Humana Gold,Humana Gold,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Medicaid MO,Medicaid MO,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Medica,Medica,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Tricare,Tricare,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,UHC All Payer,UHC All Payer,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,UHC Exchange,UHC Exchange,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,UHC Medicaid,UHC Medicaid,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,UMR CPD,UMR CPD,278.63,,,,,,,per diem,278.63,278.63,"Per diem rate, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,UHC Medicare,UHC Medicare,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CAROTENE BLOOD LEVEL          ,38200420,CDM,301,RC,82380,CPT,,,,Inpatient,,,278.63,278.63,Wellcare,Wellcare,278.63,,,,,,,case rate,278.63,278.63,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Meritain Health PPO CPD,Meritain Health PPO CPD,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Aetna/Commercial Product,Aetna/Commercial Product,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Meritain Health CPD,Meritain Health CPD,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Starmark CPD,Starmark CPD,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Aetna Medicare,Aetna Medicare,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Ambetter ,Ambetter ,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Blue Access,Anthem Blue Access,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Blue Access Choice,Anthem Blue Access Choice,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Blue Preferred,Anthem Blue Preferred,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Pathway,Anthem Pathway,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Alliance,Anthem Alliance,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Anthem Medicare,Anthem Medicare,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Cigna,Cigna,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Cigna PPO,Cigna PPO,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Cigna Medicare Advantage,Cigna Medicare Advantage,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Essence,Essence,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Healthlink HMO,Healthlink HMO,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Healthlink PPO,Healthlink PPO,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,HomeState Health Plan,HomeState Health Plan,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Humana Gold,Humana Gold,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Medicaid MO,Medicaid MO,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Medica,Medica,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Tricare,Tricare,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,UHC All Payer,UHC All Payer,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,UHC Exchange,UHC Exchange,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,UHC Medicaid,UHC Medicaid,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,UMR CPD,UMR CPD,464.58,,,,,,,per diem,464.58,464.58,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,UHC Medicare,UHC Medicare,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38200436,CDM,301,RC,82384,CPT,,,,Inpatient,,,464.58,464.58,Wellcare,Wellcare,464.58,,,,,,,case rate,464.58,464.58,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
FUNGAL SENSITIVITY            ,38200452,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Meritain Health PPO CPD,Meritain Health PPO CPD,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Aetna/Commercial Product,Aetna/Commercial Product,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Meritain Health CPD,Meritain Health CPD,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Starmark CPD,Starmark CPD,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Aetna Medicare,Aetna Medicare,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Ambetter ,Ambetter ,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Blue Access,Anthem Blue Access,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Blue Access Choice,Anthem Blue Access Choice,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Blue Preferred,Anthem Blue Preferred,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Pathway,Anthem Pathway,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Alliance,Anthem Alliance,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Anthem Medicare,Anthem Medicare,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Cigna,Cigna,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Cigna PPO,Cigna PPO,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Cigna Medicare Advantage,Cigna Medicare Advantage,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Essence,Essence,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Healthlink HMO,Healthlink HMO,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Healthlink PPO,Healthlink PPO,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,HomeState Health Plan,HomeState Health Plan,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Humana Gold,Humana Gold,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Medicaid MO,Medicaid MO,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Medica,Medica,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Tricare,Tricare,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,UHC All Payer,UHC All Payer,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,UHC Exchange,UHC Exchange,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,UHC Medicaid,UHC Medicaid,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,UMR CPD,UMR CPD,422.3,,,,,,,per diem,422.3,422.3,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,UHC Medicare,UHC Medicare,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38200456,CDM,301,RC,80400,CPT,,,,Inpatient,,,422.3,422.3,Wellcare,Wellcare,422.3,,,,,,,case rate,422.3,422.3,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Meritain Health PPO CPD,Meritain Health PPO CPD,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Aetna/Commercial Product,Aetna/Commercial Product,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Meritain Health CPD,Meritain Health CPD,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Starmark CPD,Starmark CPD,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Aetna Medicare,Aetna Medicare,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Ambetter ,Ambetter ,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Blue Access,Anthem Blue Access,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Blue Access Choice,Anthem Blue Access Choice,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Blue Preferred,Anthem Blue Preferred,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Pathway,Anthem Pathway,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Alliance,Anthem Alliance,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Anthem Medicare,Anthem Medicare,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Cigna,Cigna,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Cigna PPO,Cigna PPO,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Cigna Medicare Advantage,Cigna Medicare Advantage,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Essence,Essence,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Healthlink HMO,Healthlink HMO,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Healthlink PPO,Healthlink PPO,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,HomeState Health Plan,HomeState Health Plan,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Humana Gold,Humana Gold,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Medicaid MO,Medicaid MO,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Medica,Medica,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Tricare,Tricare,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,UHC All Payer,UHC All Payer,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,UHC Exchange,UHC Exchange,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,UHC Medicaid,UHC Medicaid,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,UMR CPD,UMR CPD,150.38,,,,,,,per diem,150.38,150.38,"Per diem rate, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,UHC Medicare,UHC Medicare,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
"CBC, W/ AUTO DIFF             ",38200470,CDM,305,RC,85025,CPT,,,,Inpatient,,,150.38,150.38,Wellcare,Wellcare,150.38,,,,,,,case rate,150.38,150.38,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Meritain Health PPO CPD,Meritain Health PPO CPD,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Aetna/Commercial Product,Aetna/Commercial Product,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Meritain Health CPD,Meritain Health CPD,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Starmark CPD,Starmark CPD,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Aetna Medicare,Aetna Medicare,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Ambetter ,Ambetter ,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Blue Access,Anthem Blue Access,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Blue Access Choice,Anthem Blue Access Choice,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Blue Preferred,Anthem Blue Preferred,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Pathway,Anthem Pathway,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Alliance,Anthem Alliance,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Anthem Medicare,Anthem Medicare,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Cigna,Cigna,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Cigna PPO,Cigna PPO,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Cigna Medicare Advantage,Cigna Medicare Advantage,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Essence,Essence,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Healthlink HMO,Healthlink HMO,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Healthlink PPO,Healthlink PPO,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,HomeState Health Plan,HomeState Health Plan,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Humana Gold,Humana Gold,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Medicaid MO,Medicaid MO,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Medica,Medica,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Tricare,Tricare,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,UHC All Payer,UHC All Payer,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,UHC Exchange,UHC Exchange,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,UHC Medicaid,UHC Medicaid,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,UMR CPD,UMR CPD,340.02,,,,,,,per diem,340.02,340.02,"Per diem rate, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,UHC Medicare,UHC Medicare,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
BETA 2 GLYCOPROTEIN AB        ,38200471,CDM,302,RC,86146,CPT,,,,Inpatient,,,340.02,340.02,Wellcare,Wellcare,340.02,,,,,,,case rate,340.02,340.02,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
LEVITIRACETAM                 ,38200472,CDM,301,RC,80177,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Meritain Health PPO CPD,Meritain Health PPO CPD,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Aetna/Commercial Product,Aetna/Commercial Product,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Meritain Health CPD,Meritain Health CPD,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Starmark CPD,Starmark CPD,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Aetna Medicare,Aetna Medicare,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Ambetter ,Ambetter ,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Blue Access,Anthem Blue Access,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Blue Access Choice,Anthem Blue Access Choice,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Blue Preferred,Anthem Blue Preferred,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Pathway,Anthem Pathway,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Alliance,Anthem Alliance,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Anthem Medicare,Anthem Medicare,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Cigna,Cigna,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Cigna PPO,Cigna PPO,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Cigna Medicare Advantage,Cigna Medicare Advantage,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Essence,Essence,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Healthlink HMO,Healthlink HMO,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Healthlink PPO,Healthlink PPO,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,HomeState Health Plan,HomeState Health Plan,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Humana Gold,Humana Gold,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Medicaid MO,Medicaid MO,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Medica,Medica,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Tricare,Tricare,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,UHC All Payer,UHC All Payer,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,UHC Exchange,UHC Exchange,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,UHC Medicaid,UHC Medicaid,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,UMR CPD,UMR CPD,368.13,,,,,,,per diem,368.13,368.13,"Per diem rate, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,UHC Medicare,UHC Medicare,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
TRYPSIN                       ,38200474,CDM,301,RC,83519,CPT,,,,Inpatient,,,368.13,368.13,Wellcare,Wellcare,368.13,,,,,,,case rate,368.13,368.13,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
E HISTOLYTICA-EIA             ,38200475,CDM,306,RC,87337,CPT,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Meritain Health PPO CPD,Meritain Health PPO CPD,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Aetna/Commercial Product,Aetna/Commercial Product,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Meritain Health CPD,Meritain Health CPD,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Starmark CPD,Starmark CPD,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Aetna Medicare,Aetna Medicare,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Ambetter ,Ambetter ,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Blue Access,Anthem Blue Access,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Blue Access Choice,Anthem Blue Access Choice,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Blue Preferred,Anthem Blue Preferred,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Pathway,Anthem Pathway,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Alliance,Anthem Alliance,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Anthem Medicare,Anthem Medicare,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Cigna,Cigna,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Cigna PPO,Cigna PPO,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Cigna Medicare Advantage,Cigna Medicare Advantage,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Essence,Essence,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Healthlink HMO,Healthlink HMO,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Healthlink PPO,Healthlink PPO,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,HomeState Health Plan,HomeState Health Plan,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Humana Gold,Humana Gold,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Medicaid MO,Medicaid MO,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Medica,Medica,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Tricare,Tricare,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,UHC All Payer,UHC All Payer,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,UHC Exchange,UHC Exchange,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,UHC Medicaid,UHC Medicaid,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,UMR CPD,UMR CPD,118.48,,,,,,,per diem,118.48,118.48,"Per diem rate, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,UHC Medicare,UHC Medicare,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
DRUG QUANT CHROM SGL ANALYTE  ,38200477,CDM,301,RC,82491,CPT,,,,Inpatient,,,118.48,118.48,Wellcare,Wellcare,118.48,,,,,,,case rate,118.48,118.48,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health PPO CPD,Meritain Health PPO CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna/Commercial Product,Aetna/Commercial Product,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health CPD,Meritain Health CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Starmark CPD,Starmark CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Aetna Medicare,Aetna Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Ambetter ,Ambetter ,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access,Anthem Blue Access,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access Choice,Anthem Blue Access Choice,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Preferred,Anthem Blue Preferred,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Pathway,Anthem Pathway,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Alliance,Anthem Alliance,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Anthem Medicare,Anthem Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna,Cigna,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna PPO,Cigna PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Cigna Medicare Advantage,Cigna Medicare Advantage,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Essence,Essence,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthlink HMO,Healthlink HMO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Healthlink PPO,Healthlink PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,HomeState Health Plan,HomeState Health Plan,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Humana Gold,Humana Gold,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Medicaid MO,Medicaid MO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Medica,Medica,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Tricare,Tricare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC All Payer,UHC All Payer,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Exchange,UHC Exchange,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicaid,UHC Medicaid,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UMR CPD,UMR CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicare,UHC Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CEA                           ,38200480,CDM,300,RC,82378,CPT,,,,Inpatient,,,235.52,235.52,Wellcare,Wellcare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Meritain Health PPO CPD,Meritain Health PPO CPD,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Aetna/Commercial Product,Aetna/Commercial Product,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Meritain Health CPD,Meritain Health CPD,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Starmark CPD,Starmark CPD,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Aetna Medicare,Aetna Medicare,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Ambetter ,Ambetter ,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Blue Access,Anthem Blue Access,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Blue Access Choice,Anthem Blue Access Choice,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Blue Preferred,Anthem Blue Preferred,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Pathway,Anthem Pathway,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Alliance,Anthem Alliance,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Anthem Medicare,Anthem Medicare,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Cigna,Cigna,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Cigna PPO,Cigna PPO,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Cigna Medicare Advantage,Cigna Medicare Advantage,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Essence,Essence,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Healthlink HMO,Healthlink HMO,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Healthlink PPO,Healthlink PPO,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,HomeState Health Plan,HomeState Health Plan,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Humana Gold,Humana Gold,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Medicaid MO,Medicaid MO,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Medica,Medica,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Tricare,Tricare,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,UHC All Payer,UHC All Payer,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,UHC Exchange,UHC Exchange,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,UHC Medicaid,UHC Medicaid,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,UMR CPD,UMR CPD,154.55,,,,,,,per diem,154.55,154.55,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,UHC Medicare,UHC Medicare,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38200490,CDM,300,RC,89050,CPT,,,,Inpatient,,,154.55,154.55,Wellcare,Wellcare,154.55,,,,,,,case rate,154.55,154.55,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Meritain Health PPO CPD,Meritain Health PPO CPD,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Aetna/Commercial Product,Aetna/Commercial Product,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Meritain Health CPD,Meritain Health CPD,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Starmark CPD,Starmark CPD,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Aetna Medicare,Aetna Medicare,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Ambetter ,Ambetter ,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Blue Access,Anthem Blue Access,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Blue Access Choice,Anthem Blue Access Choice,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Blue Preferred,Anthem Blue Preferred,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Pathway,Anthem Pathway,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Alliance,Anthem Alliance,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Anthem Medicare,Anthem Medicare,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Cigna,Cigna,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Cigna PPO,Cigna PPO,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Cigna Medicare Advantage,Cigna Medicare Advantage,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Essence,Essence,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Healthlink HMO,Healthlink HMO,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Healthlink PPO,Healthlink PPO,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,HomeState Health Plan,HomeState Health Plan,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Humana Gold,Humana Gold,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Medicaid MO,Medicaid MO,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Medica,Medica,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Tricare,Tricare,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,UHC All Payer,UHC All Payer,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,UHC Exchange,UHC Exchange,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,UHC Medicaid,UHC Medicaid,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,UMR CPD,UMR CPD,177.71,,,,,,,per diem,177.71,177.71,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,UHC Medicare,UHC Medicare,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38200491,CDM,300,RC,89051,CPT,,,,Inpatient,,,177.71,177.71,Wellcare,Wellcare,177.71,,,,,,,case rate,177.71,177.71,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Meritain Health PPO CPD,Meritain Health PPO CPD,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Aetna/Commercial Product,Aetna/Commercial Product,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Meritain Health CPD,Meritain Health CPD,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Starmark CPD,Starmark CPD,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Aetna Medicare,Aetna Medicare,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Ambetter ,Ambetter ,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Blue Access,Anthem Blue Access,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Blue Access Choice,Anthem Blue Access Choice,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Blue Preferred,Anthem Blue Preferred,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Pathway,Anthem Pathway,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Alliance,Anthem Alliance,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Anthem Medicare,Anthem Medicare,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Cigna,Cigna,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Cigna PPO,Cigna PPO,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Cigna Medicare Advantage,Cigna Medicare Advantage,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Essence,Essence,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Healthlink HMO,Healthlink HMO,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Healthlink PPO,Healthlink PPO,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,HomeState Health Plan,HomeState Health Plan,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Humana Gold,Humana Gold,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Medicaid MO,Medicaid MO,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Medica,Medica,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Tricare,Tricare,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,UHC All Payer,UHC All Payer,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,UHC Exchange,UHC Exchange,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,UHC Medicaid,UHC Medicaid,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,UMR CPD,UMR CPD,134.73,,,,,,,per diem,134.73,134.73,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,UHC Medicare,UHC Medicare,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38200495,CDM,301,RC,82390,CPT,,,,Inpatient,,,134.73,134.73,Wellcare,Wellcare,134.73,,,,,,,case rate,134.73,134.73,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Meritain Health PPO CPD,Meritain Health PPO CPD,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Aetna/Commercial Product,Aetna/Commercial Product,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Meritain Health CPD,Meritain Health CPD,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Starmark CPD,Starmark CPD,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Aetna Medicare,Aetna Medicare,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Ambetter ,Ambetter ,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Blue Access,Anthem Blue Access,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Blue Access Choice,Anthem Blue Access Choice,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Blue Preferred,Anthem Blue Preferred,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Pathway,Anthem Pathway,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Alliance,Anthem Alliance,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Anthem Medicare,Anthem Medicare,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Cigna,Cigna,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Cigna PPO,Cigna PPO,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Cigna Medicare Advantage,Cigna Medicare Advantage,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Essence,Essence,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Healthlink HMO,Healthlink HMO,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Healthlink PPO,Healthlink PPO,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,HomeState Health Plan,HomeState Health Plan,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Humana Gold,Humana Gold,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Medicaid MO,Medicaid MO,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Medica,Medica,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Tricare,Tricare,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,UHC All Payer,UHC All Payer,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,UHC Exchange,UHC Exchange,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,UHC Medicaid,UHC Medicaid,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,UMR CPD,UMR CPD,315.45,,,,,,,per diem,315.45,315.45,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,UHC Medicare,UHC Medicare,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38200498,CDM,302,RC,86162,CPT,,,,Inpatient,,,315.45,315.45,Wellcare,Wellcare,315.45,,,,,,,case rate,315.45,315.45,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Meritain Health PPO CPD,Meritain Health PPO CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Aetna/Commercial Product,Aetna/Commercial Product,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Meritain Health CPD,Meritain Health CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Starmark CPD,Starmark CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Aetna Medicare,Aetna Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Ambetter ,Ambetter ,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Blue Access,Anthem Blue Access,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Blue Access Choice,Anthem Blue Access Choice,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Blue Preferred,Anthem Blue Preferred,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Pathway,Anthem Pathway,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Alliance,Anthem Alliance,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Anthem Medicare,Anthem Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Cigna,Cigna,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Cigna PPO,Cigna PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Cigna Medicare Advantage,Cigna Medicare Advantage,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Essence,Essence,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Healthlink HMO,Healthlink HMO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Healthlink PPO,Healthlink PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,HomeState Health Plan,HomeState Health Plan,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Humana Gold,Humana Gold,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Medicaid MO,Medicaid MO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Medica,Medica,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Tricare,Tricare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,UHC All Payer,UHC All Payer,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,UHC Exchange,UHC Exchange,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,UHC Medicaid,UHC Medicaid,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,UMR CPD,UMR CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,UHC Medicare,UHC Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
"GAMMAGLOBULIN IGD, FLUID      ",38200500,CDM,301,RC,82784,CPT,,,,Inpatient,,,150.24,150.24,Wellcare,Wellcare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
M TUBERCULOSIS DNA AMP PROBE  ,38200504,CDM,306,RC,87556,CPT,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38200505,CDM,301,RC,84270,CPT,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Meritain Health PPO CPD,Meritain Health PPO CPD,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Aetna/Commercial Product,Aetna/Commercial Product,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Meritain Health CPD,Meritain Health CPD,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Starmark CPD,Starmark CPD,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Aetna Medicare,Aetna Medicare,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Ambetter ,Ambetter ,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Blue Access,Anthem Blue Access,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Blue Access Choice,Anthem Blue Access Choice,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Blue Preferred,Anthem Blue Preferred,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Pathway,Anthem Pathway,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Alliance,Anthem Alliance,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Anthem Medicare,Anthem Medicare,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Cigna,Cigna,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Cigna PPO,Cigna PPO,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Cigna Medicare Advantage,Cigna Medicare Advantage,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Essence,Essence,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Healthlink HMO,Healthlink HMO,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Healthlink PPO,Healthlink PPO,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,HomeState Health Plan,HomeState Health Plan,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Humana Gold,Humana Gold,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Medicaid MO,Medicaid MO,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Medica,Medica,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Tricare,Tricare,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,UHC All Payer,UHC All Payer,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,UHC Exchange,UHC Exchange,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,UHC Medicaid,UHC Medicaid,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,UMR CPD,UMR CPD,49.23,,,,,,,per diem,49.23,49.23,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,UHC Medicare,UHC Medicare,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38200513,CDM,301,RC,82043,CPT,,,,Inpatient,,,49.23,49.23,Wellcare,Wellcare,49.23,,,,,,,case rate,49.23,49.23,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Meritain Health PPO CPD,Meritain Health PPO CPD,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Aetna/Commercial Product,Aetna/Commercial Product,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Meritain Health CPD,Meritain Health CPD,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Starmark CPD,Starmark CPD,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Aetna Medicare,Aetna Medicare,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Ambetter ,Ambetter ,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Blue Access,Anthem Blue Access,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Blue Access Choice,Anthem Blue Access Choice,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Blue Preferred,Anthem Blue Preferred,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Pathway,Anthem Pathway,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Alliance,Anthem Alliance,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Anthem Medicare,Anthem Medicare,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Cigna,Cigna,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Cigna PPO,Cigna PPO,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Cigna Medicare Advantage,Cigna Medicare Advantage,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Essence,Essence,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Healthlink HMO,Healthlink HMO,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Healthlink PPO,Healthlink PPO,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,HomeState Health Plan,HomeState Health Plan,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Humana Gold,Humana Gold,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Medicaid MO,Medicaid MO,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Medica,Medica,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Tricare,Tricare,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,UHC All Payer,UHC All Payer,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,UHC Exchange,UHC Exchange,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,UHC Medicaid,UHC Medicaid,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,UMR CPD,UMR CPD,120.31,,,,,,,per diem,120.31,120.31,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,UHC Medicare,UHC Medicare,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38200517,CDM,306,RC,87491,CPT,,,,Inpatient,,,120.31,120.31,Wellcare,Wellcare,120.31,,,,,,,case rate,120.31,120.31,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Meritain Health PPO CPD,Meritain Health PPO CPD,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Aetna/Commercial Product,Aetna/Commercial Product,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Meritain Health CPD,Meritain Health CPD,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Starmark CPD,Starmark CPD,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Aetna Medicare,Aetna Medicare,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Ambetter ,Ambetter ,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Blue Access,Anthem Blue Access,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Blue Access Choice,Anthem Blue Access Choice,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Blue Preferred,Anthem Blue Preferred,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Pathway,Anthem Pathway,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Alliance,Anthem Alliance,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Anthem Medicare,Anthem Medicare,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Cigna,Cigna,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Cigna PPO,Cigna PPO,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Cigna Medicare Advantage,Cigna Medicare Advantage,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Essence,Essence,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Healthlink HMO,Healthlink HMO,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Healthlink PPO,Healthlink PPO,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,HomeState Health Plan,HomeState Health Plan,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Humana Gold,Humana Gold,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Medicaid MO,Medicaid MO,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Medica,Medica,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Tricare,Tricare,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,UHC All Payer,UHC All Payer,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,UHC Exchange,UHC Exchange,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,UHC Medicaid,UHC Medicaid,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,UMR CPD,UMR CPD,325.69,,,,,,,per diem,325.69,325.69,"Per diem rate, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,UHC Medicare,UHC Medicare,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEINS FRACTION         ,38200521,CDM,301,RC,83701,CPT,,,,Inpatient,,,325.69,325.69,Wellcare,Wellcare,325.69,,,,,,,case rate,325.69,325.69,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Meritain Health PPO CPD,Meritain Health PPO CPD,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Aetna/Commercial Product,Aetna/Commercial Product,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Meritain Health CPD,Meritain Health CPD,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Starmark CPD,Starmark CPD,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Aetna Medicare,Aetna Medicare,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Ambetter ,Ambetter ,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Blue Access,Anthem Blue Access,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Blue Access Choice,Anthem Blue Access Choice,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Blue Preferred,Anthem Blue Preferred,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Pathway,Anthem Pathway,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Alliance,Anthem Alliance,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Anthem Medicare,Anthem Medicare,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Cigna,Cigna,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Cigna PPO,Cigna PPO,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Cigna Medicare Advantage,Cigna Medicare Advantage,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Essence,Essence,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Healthlink HMO,Healthlink HMO,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Healthlink PPO,Healthlink PPO,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,HomeState Health Plan,HomeState Health Plan,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Humana Gold,Humana Gold,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Medicaid MO,Medicaid MO,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Medica,Medica,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Tricare,Tricare,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,UHC All Payer,UHC All Payer,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,UHC Exchange,UHC Exchange,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,UHC Medicaid,UHC Medicaid,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,UMR CPD,UMR CPD,255.3,,,,,,,per diem,255.3,255.3,"Per diem rate, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,UHC Medicare,UHC Medicare,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
LIPOPROTEIN PARTICLE QUANT    ,38200522,CDM,301,RC,83704,CPT,,,,Inpatient,,,255.3,255.3,Wellcare,Wellcare,255.3,,,,,,,case rate,255.3,255.3,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Meritain Health PPO CPD,Meritain Health PPO CPD,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Aetna/Commercial Product,Aetna/Commercial Product,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Meritain Health CPD,Meritain Health CPD,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Starmark CPD,Starmark CPD,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Aetna Medicare,Aetna Medicare,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Ambetter ,Ambetter ,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Blue Access,Anthem Blue Access,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Blue Access Choice,Anthem Blue Access Choice,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Blue Preferred,Anthem Blue Preferred,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Pathway,Anthem Pathway,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Alliance,Anthem Alliance,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Anthem Medicare,Anthem Medicare,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Cigna,Cigna,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Cigna PPO,Cigna PPO,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Cigna Medicare Advantage,Cigna Medicare Advantage,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Essence,Essence,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Healthlink HMO,Healthlink HMO,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Healthlink PPO,Healthlink PPO,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,HomeState Health Plan,HomeState Health Plan,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Humana Gold,Humana Gold,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Medicaid MO,Medicaid MO,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Medica,Medica,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Tricare,Tricare,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,UHC All Payer,UHC All Payer,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,UHC Exchange,UHC Exchange,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,UHC Medicaid,UHC Medicaid,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,UMR CPD,UMR CPD,82.38,,,,,,,per diem,82.38,82.38,"Per diem rate, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,UHC Medicare,UHC Medicare,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHLORIDE BLOOD                ,38200530,CDM,301,RC,82435,CPT,,,,Inpatient,,,82.38,82.38,Wellcare,Wellcare,82.38,,,,,,,case rate,82.38,82.38,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Meritain Health PPO CPD,Meritain Health PPO CPD,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Aetna/Commercial Product,Aetna/Commercial Product,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Meritain Health CPD,Meritain Health CPD,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Starmark CPD,Starmark CPD,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Aetna Medicare,Aetna Medicare,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Ambetter ,Ambetter ,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Blue Access,Anthem Blue Access,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Blue Access Choice,Anthem Blue Access Choice,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Blue Preferred,Anthem Blue Preferred,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Pathway,Anthem Pathway,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Alliance,Anthem Alliance,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Anthem Medicare,Anthem Medicare,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Cigna,Cigna,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Cigna PPO,Cigna PPO,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Cigna Medicare Advantage,Cigna Medicare Advantage,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Essence,Essence,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Healthlink HMO,Healthlink HMO,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Healthlink PPO,Healthlink PPO,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,HomeState Health Plan,HomeState Health Plan,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Humana Gold,Humana Gold,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Medicaid MO,Medicaid MO,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Medica,Medica,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Tricare,Tricare,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,UHC All Payer,UHC All Payer,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,UHC Exchange,UHC Exchange,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,UHC Medicaid,UHC Medicaid,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,UMR CPD,UMR CPD,104.52,,,,,,,per diem,104.52,104.52,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,UHC Medicare,UHC Medicare,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38200540,CDM,301,RC,82465,CPT,,,,Inpatient,,,104.52,104.52,Wellcare,Wellcare,104.52,,,,,,,case rate,104.52,104.52,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Meritain Health PPO CPD,Meritain Health PPO CPD,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Aetna/Commercial Product,Aetna/Commercial Product,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Meritain Health CPD,Meritain Health CPD,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Starmark CPD,Starmark CPD,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Aetna Medicare,Aetna Medicare,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Ambetter ,Ambetter ,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Blue Access,Anthem Blue Access,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Blue Access Choice,Anthem Blue Access Choice,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Blue Preferred,Anthem Blue Preferred,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Pathway,Anthem Pathway,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Alliance,Anthem Alliance,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Anthem Medicare,Anthem Medicare,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Cigna,Cigna,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Cigna PPO,Cigna PPO,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Cigna Medicare Advantage,Cigna Medicare Advantage,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Essence,Essence,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Healthlink HMO,Healthlink HMO,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Healthlink PPO,Healthlink PPO,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,HomeState Health Plan,HomeState Health Plan,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Humana Gold,Humana Gold,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Medicaid MO,Medicaid MO,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Medica,Medica,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Tricare,Tricare,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,UHC All Payer,UHC All Payer,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,UHC Exchange,UHC Exchange,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,UHC Medicaid,UHC Medicaid,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,UMR CPD,UMR CPD,86.1,,,,,,,per diem,86.1,86.1,"Per diem rate, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,UHC Medicare,UHC Medicare,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLESTEROL - DIRECT LDL CHOOL,38200555,CDM,301,RC,83721,CPT,,,,Inpatient,,,86.1,86.1,Wellcare,Wellcare,86.1,,,,,,,case rate,86.1,86.1,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CHOLINESTERASE                ,38200560,CDM,301,RC,82480,CPT,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Meritain Health PPO CPD,Meritain Health PPO CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Aetna/Commercial Product,Aetna/Commercial Product,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Meritain Health CPD,Meritain Health CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Starmark CPD,Starmark CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Aetna Medicare,Aetna Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Ambetter ,Ambetter ,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Access,Anthem Blue Access,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Access Choice,Anthem Blue Access Choice,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Preferred,Anthem Blue Preferred,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Pathway,Anthem Pathway,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Alliance,Anthem Alliance,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Anthem Medicare,Anthem Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Cigna,Cigna,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Cigna PPO,Cigna PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Cigna Medicare Advantage,Cigna Medicare Advantage,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Essence,Essence,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Healthlink HMO,Healthlink HMO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Healthlink PPO,Healthlink PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,HomeState Health Plan,HomeState Health Plan,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Humana Gold,Humana Gold,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Medicaid MO,Medicaid MO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Medica,Medica,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Tricare,Tricare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,UHC All Payer,UHC All Payer,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,UHC Exchange,UHC Exchange,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,UHC Medicaid,UHC Medicaid,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,UMR CPD,UMR CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,UHC Medicare,UHC Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CLOZAPINE/CLOZARIL            ,38200569,CDM,301,RC,80159,CPT,,,,Inpatient,,,118.82,118.82,Wellcare,Wellcare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Meritain Health PPO CPD,Meritain Health PPO CPD,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Aetna/Commercial Product,Aetna/Commercial Product,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Meritain Health CPD,Meritain Health CPD,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Starmark CPD,Starmark CPD,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Aetna Medicare,Aetna Medicare,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Ambetter ,Ambetter ,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Blue Access,Anthem Blue Access,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Blue Access Choice,Anthem Blue Access Choice,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Blue Preferred,Anthem Blue Preferred,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Pathway,Anthem Pathway,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Alliance,Anthem Alliance,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Anthem Medicare,Anthem Medicare,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Cigna,Cigna,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Cigna PPO,Cigna PPO,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Cigna Medicare Advantage,Cigna Medicare Advantage,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Essence,Essence,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Healthlink HMO,Healthlink HMO,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Healthlink PPO,Healthlink PPO,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,HomeState Health Plan,HomeState Health Plan,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Humana Gold,Humana Gold,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Medicaid MO,Medicaid MO,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Medica,Medica,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Tricare,Tricare,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,UHC All Payer,UHC All Payer,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,UHC Exchange,UHC Exchange,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,UHC Medicaid,UHC Medicaid,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,UMR CPD,UMR CPD,265.74,,,,,,,per diem,265.74,265.74,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,UHC Medicare,UHC Medicare,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38200570,CDM,306,RC,86644,CPT,,,,Inpatient,,,265.74,265.74,Wellcare,Wellcare,265.74,,,,,,,case rate,265.74,265.74,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Meritain Health PPO CPD,Meritain Health PPO CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna/Commercial Product,Aetna/Commercial Product,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Meritain Health CPD,Meritain Health CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Starmark CPD,Starmark CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna Medicare,Aetna Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Ambetter ,Ambetter ,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Access,Anthem Blue Access,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Access Choice,Anthem Blue Access Choice,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Preferred,Anthem Blue Preferred,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Pathway,Anthem Pathway,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Alliance,Anthem Alliance,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Medicare,Anthem Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna,Cigna,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna PPO,Cigna PPO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna Medicare Advantage,Cigna Medicare Advantage,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Essence,Essence,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthlink HMO,Healthlink HMO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthlink PPO,Healthlink PPO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,HomeState Health Plan,HomeState Health Plan,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Humana Gold,Humana Gold,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Medicaid MO,Medicaid MO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Medica,Medica,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Tricare,Tricare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC All Payer,UHC All Payer,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Exchange,UHC Exchange,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Medicaid,UHC Medicaid,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UMR CPD,UMR CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Medicare,UHC Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38200571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Wellcare,Wellcare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Meritain Health PPO CPD,Meritain Health PPO CPD,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Aetna/Commercial Product,Aetna/Commercial Product,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Meritain Health CPD,Meritain Health CPD,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Starmark CPD,Starmark CPD,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Aetna Medicare,Aetna Medicare,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Ambetter ,Ambetter ,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Blue Access,Anthem Blue Access,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Blue Access Choice,Anthem Blue Access Choice,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Blue Preferred,Anthem Blue Preferred,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Pathway,Anthem Pathway,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Alliance,Anthem Alliance,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Anthem Medicare,Anthem Medicare,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Cigna,Cigna,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Cigna PPO,Cigna PPO,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Cigna Medicare Advantage,Cigna Medicare Advantage,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Essence,Essence,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Healthlink HMO,Healthlink HMO,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Healthlink PPO,Healthlink PPO,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,HomeState Health Plan,HomeState Health Plan,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Humana Gold,Humana Gold,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Medicaid MO,Medicaid MO,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Medica,Medica,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Tricare,Tricare,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,UHC All Payer,UHC All Payer,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,UHC Exchange,UHC Exchange,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,UHC Medicaid,UHC Medicaid,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,UMR CPD,UMR CPD,401.22,,,,,,,per diem,401.22,401.22,"Per diem rate, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,UHC Medicare,UHC Medicare,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
CMV IGG ANTIBODY              ,38200572,CDM,302,RC,86644,CPT,,,,Inpatient,,,401.22,401.22,Wellcare,Wellcare,401.22,,,,,,,case rate,401.22,401.22,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Meritain Health PPO CPD,Meritain Health PPO CPD,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Aetna/Commercial Product,Aetna/Commercial Product,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Meritain Health CPD,Meritain Health CPD,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Starmark CPD,Starmark CPD,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Aetna Medicare,Aetna Medicare,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Ambetter ,Ambetter ,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Blue Access,Anthem Blue Access,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Blue Access Choice,Anthem Blue Access Choice,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Blue Preferred,Anthem Blue Preferred,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Pathway,Anthem Pathway,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Alliance,Anthem Alliance,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Anthem Medicare,Anthem Medicare,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Cigna,Cigna,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Cigna PPO,Cigna PPO,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Cigna Medicare Advantage,Cigna Medicare Advantage,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Essence,Essence,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Healthlink HMO,Healthlink HMO,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Healthlink PPO,Healthlink PPO,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,HomeState Health Plan,HomeState Health Plan,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Humana Gold,Humana Gold,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Medicaid MO,Medicaid MO,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Medica,Medica,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Tricare,Tricare,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,UHC All Payer,UHC All Payer,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,UHC Exchange,UHC Exchange,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,UHC Medicaid,UHC Medicaid,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,UMR CPD,UMR CPD,59.96,,,,,,,per diem,59.96,59.96,"Per diem rate, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,UHC Medicare,UHC Medicare,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
C02 CONTENT                   ,38200580,CDM,301,RC,82374,CPT,,,,Inpatient,,,59.96,59.96,Wellcare,Wellcare,59.96,,,,,,,case rate,59.96,59.96,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Meritain Health PPO CPD,Meritain Health PPO CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Aetna/Commercial Product,Aetna/Commercial Product,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Meritain Health CPD,Meritain Health CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Starmark CPD,Starmark CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Aetna Medicare,Aetna Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Ambetter ,Ambetter ,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Blue Access,Anthem Blue Access,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Blue Access Choice,Anthem Blue Access Choice,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Blue Preferred,Anthem Blue Preferred,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Pathway,Anthem Pathway,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Alliance,Anthem Alliance,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Anthem Medicare,Anthem Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Cigna,Cigna,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Cigna PPO,Cigna PPO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Cigna Medicare Advantage,Cigna Medicare Advantage,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Essence,Essence,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Healthlink HMO,Healthlink HMO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Healthlink PPO,Healthlink PPO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,HomeState Health Plan,HomeState Health Plan,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Humana Gold,Humana Gold,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Medicaid MO,Medicaid MO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Medica,Medica,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Tricare,Tricare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,UHC All Payer,UHC All Payer,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,UHC Exchange,UHC Exchange,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,UHC Medicaid,UHC Medicaid,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,UMR CPD,UMR CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,UHC Medicare,UHC Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38200590,CDM,305,RC,85240,CPT,,,,Inpatient,,,519,519,Wellcare,Wellcare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Meritain Health PPO CPD,Meritain Health PPO CPD,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Aetna/Commercial Product,Aetna/Commercial Product,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Meritain Health CPD,Meritain Health CPD,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Starmark CPD,Starmark CPD,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Aetna Medicare,Aetna Medicare,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Ambetter ,Ambetter ,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Blue Access,Anthem Blue Access,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Blue Access Choice,Anthem Blue Access Choice,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Blue Preferred,Anthem Blue Preferred,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Pathway,Anthem Pathway,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Alliance,Anthem Alliance,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Anthem Medicare,Anthem Medicare,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Cigna,Cigna,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Cigna PPO,Cigna PPO,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Cigna Medicare Advantage,Cigna Medicare Advantage,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Essence,Essence,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Healthlink HMO,Healthlink HMO,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Healthlink PPO,Healthlink PPO,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,HomeState Health Plan,HomeState Health Plan,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Humana Gold,Humana Gold,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Medicaid MO,Medicaid MO,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Medica,Medica,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Tricare,Tricare,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,UHC All Payer,UHC All Payer,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,UHC Exchange,UHC Exchange,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,UHC Medicaid,UHC Medicaid,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,UMR CPD,UMR CPD,68.5,,,,,,,per diem,68.5,68.5,"Per diem rate, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,UHC Medicare,UHC Medicare,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COLD AGGLUTININ               ,38200600,CDM,302,RC,86156,CPT,,,,Inpatient,,,68.5,68.5,Wellcare,Wellcare,68.5,,,,,,,case rate,68.5,68.5,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health PPO CPD,Meritain Health PPO CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Aetna/Commercial Product,Aetna/Commercial Product,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health CPD,Meritain Health CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Starmark CPD,Starmark CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Aetna Medicare,Aetna Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Ambetter ,Ambetter ,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access,Anthem Blue Access,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access Choice,Anthem Blue Access Choice,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Preferred,Anthem Blue Preferred,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Pathway,Anthem Pathway,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Alliance,Anthem Alliance,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Anthem Medicare,Anthem Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Cigna,Cigna,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Cigna PPO,Cigna PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Cigna Medicare Advantage,Cigna Medicare Advantage,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Essence,Essence,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Healthlink HMO,Healthlink HMO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Healthlink PPO,Healthlink PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,HomeState Health Plan,HomeState Health Plan,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Humana Gold,Humana Gold,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Medicaid MO,Medicaid MO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Medica,Medica,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Tricare,Tricare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,UHC All Payer,UHC All Payer,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,UHC Exchange,UHC Exchange,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicaid,UHC Medicaid,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,UMR CPD,UMR CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicare,UHC Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38200630,CDM,302,RC,86160,CPT,,,,Inpatient,,,141.1,141.1,Wellcare,Wellcare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Meritain Health PPO CPD,Meritain Health PPO CPD,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Aetna/Commercial Product,Aetna/Commercial Product,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Meritain Health CPD,Meritain Health CPD,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Starmark CPD,Starmark CPD,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Aetna Medicare,Aetna Medicare,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Ambetter ,Ambetter ,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Blue Access,Anthem Blue Access,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Blue Access Choice,Anthem Blue Access Choice,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Blue Preferred,Anthem Blue Preferred,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Pathway,Anthem Pathway,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Alliance,Anthem Alliance,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Anthem Medicare,Anthem Medicare,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Cigna,Cigna,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Cigna PPO,Cigna PPO,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Cigna Medicare Advantage,Cigna Medicare Advantage,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Essence,Essence,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Healthlink HMO,Healthlink HMO,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Healthlink PPO,Healthlink PPO,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,HomeState Health Plan,HomeState Health Plan,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Humana Gold,Humana Gold,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Medicaid MO,Medicaid MO,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Medica,Medica,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Tricare,Tricare,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,UHC All Payer,UHC All Payer,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,UHC Exchange,UHC Exchange,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,UHC Medicaid,UHC Medicaid,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,UMR CPD,UMR CPD,190.51,,,,,,,per diem,190.51,190.51,"Per diem rate, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,UHC Medicare,UHC Medicare,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COMPLEMENT C-4                ,38200640,CDM,302,RC,86160,CPT,,,,Inpatient,,,190.51,190.51,Wellcare,Wellcare,190.51,,,,,,,case rate,190.51,190.51,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Meritain Health PPO CPD,Meritain Health PPO CPD,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Aetna/Commercial Product,Aetna/Commercial Product,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Meritain Health CPD,Meritain Health CPD,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Starmark CPD,Starmark CPD,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Aetna Medicare,Aetna Medicare,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Ambetter ,Ambetter ,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Blue Access,Anthem Blue Access,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Blue Access Choice,Anthem Blue Access Choice,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Blue Preferred,Anthem Blue Preferred,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Pathway,Anthem Pathway,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Alliance,Anthem Alliance,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Anthem Medicare,Anthem Medicare,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Cigna,Cigna,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Cigna PPO,Cigna PPO,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Cigna Medicare Advantage,Cigna Medicare Advantage,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Essence,Essence,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Healthlink HMO,Healthlink HMO,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Healthlink PPO,Healthlink PPO,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,HomeState Health Plan,HomeState Health Plan,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Humana Gold,Humana Gold,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Medicaid MO,Medicaid MO,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Medica,Medica,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Tricare,Tricare,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,UHC All Payer,UHC All Payer,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,UHC Exchange,UHC Exchange,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,UHC Medicaid,UHC Medicaid,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,UMR CPD,UMR CPD,48.94,,,,,,,per diem,48.94,48.94,"Per diem rate, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,UHC Medicare,UHC Medicare,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
COPPER                        ,38200675,CDM,301,RC,82525,CPT,,,,Inpatient,,,48.94,48.94,Wellcare,Wellcare,48.94,,,,,,,case rate,48.94,48.94,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Meritain Health PPO CPD,Meritain Health PPO CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Aetna/Commercial Product,Aetna/Commercial Product,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Meritain Health CPD,Meritain Health CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Starmark CPD,Starmark CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Aetna Medicare,Aetna Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Ambetter ,Ambetter ,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Access,Anthem Blue Access,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Access Choice,Anthem Blue Access Choice,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Preferred,Anthem Blue Preferred,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Pathway,Anthem Pathway,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Alliance,Anthem Alliance,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Anthem Medicare,Anthem Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Cigna,Cigna,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Cigna PPO,Cigna PPO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Cigna Medicare Advantage,Cigna Medicare Advantage,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Essence,Essence,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Healthlink HMO,Healthlink HMO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Healthlink PPO,Healthlink PPO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,HomeState Health Plan,HomeState Health Plan,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Humana Gold,Humana Gold,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Medicaid MO,Medicaid MO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Medica,Medica,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Tricare,Tricare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,UHC All Payer,UHC All Payer,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,UHC Exchange,UHC Exchange,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,UHC Medicaid,UHC Medicaid,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,UMR CPD,UMR CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,UHC Medicare,UHC Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38200680,CDM,301,RC,82533,CPT,,,,Inpatient,,,229.15,229.15,Wellcare,Wellcare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health PPO CPD,Meritain Health PPO CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Aetna/Commercial Product,Aetna/Commercial Product,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health CPD,Meritain Health CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Starmark CPD,Starmark CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Aetna Medicare,Aetna Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Ambetter ,Ambetter ,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access,Anthem Blue Access,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access Choice,Anthem Blue Access Choice,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Preferred,Anthem Blue Preferred,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Pathway,Anthem Pathway,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Alliance,Anthem Alliance,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Anthem Medicare,Anthem Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Cigna,Cigna,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Cigna PPO,Cigna PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Cigna Medicare Advantage,Cigna Medicare Advantage,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Essence,Essence,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Healthlink HMO,Healthlink HMO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Healthlink PPO,Healthlink PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,HomeState Health Plan,HomeState Health Plan,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Humana Gold,Humana Gold,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Medicaid MO,Medicaid MO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Medica,Medica,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Tricare,Tricare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,UHC All Payer,UHC All Payer,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,UHC Exchange,UHC Exchange,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicaid,UHC Medicaid,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,UMR CPD,UMR CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicare,UHC Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38200685,CDM,302,RC,86360,CPT,,,,Inpatient,,,239.76,239.76,Wellcare,Wellcare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
SACCHAROMYCES CEREVISIAE AB   ,38200686,CDM,302,RC,86671,CPT,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Meritain Health PPO CPD,Meritain Health PPO CPD,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Aetna/Commercial Product,Aetna/Commercial Product,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Meritain Health CPD,Meritain Health CPD,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Starmark CPD,Starmark CPD,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Aetna Medicare,Aetna Medicare,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Ambetter ,Ambetter ,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Blue Access,Anthem Blue Access,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Blue Access Choice,Anthem Blue Access Choice,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Blue Preferred,Anthem Blue Preferred,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Pathway,Anthem Pathway,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Alliance,Anthem Alliance,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Anthem Medicare,Anthem Medicare,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Cigna,Cigna,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Cigna PPO,Cigna PPO,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Cigna Medicare Advantage,Cigna Medicare Advantage,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Essence,Essence,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Healthlink HMO,Healthlink HMO,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Healthlink PPO,Healthlink PPO,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,HomeState Health Plan,HomeState Health Plan,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Humana Gold,Humana Gold,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Medicaid MO,Medicaid MO,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Medica,Medica,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Tricare,Tricare,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,UHC All Payer,UHC All Payer,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,UHC Exchange,UHC Exchange,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,UHC Medicaid,UHC Medicaid,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,UMR CPD,UMR CPD,221.25,,,,,,,per diem,221.25,221.25,"Per diem rate, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,UHC Medicare,UHC Medicare,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
"ANTIBODY ID, LEUKOCYTE        ",38200687,CDM,302,RC,86021,CPT,,,,Inpatient,,,221.25,221.25,Wellcare,Wellcare,221.25,,,,,,,case rate,221.25,221.25,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
BORDETELLA PERTUSSIS AB       ,38200688,CDM,302,RC,86615,CPT,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health PPO CPD,Meritain Health PPO CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Aetna/Commercial Product,Aetna/Commercial Product,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health CPD,Meritain Health CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Starmark CPD,Starmark CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Aetna Medicare,Aetna Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Ambetter ,Ambetter ,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access,Anthem Blue Access,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access Choice,Anthem Blue Access Choice,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Preferred,Anthem Blue Preferred,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Pathway,Anthem Pathway,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Alliance,Anthem Alliance,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Anthem Medicare,Anthem Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Cigna,Cigna,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Cigna PPO,Cigna PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Cigna Medicare Advantage,Cigna Medicare Advantage,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Essence,Essence,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Healthlink HMO,Healthlink HMO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Healthlink PPO,Healthlink PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,HomeState Health Plan,HomeState Health Plan,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Humana Gold,Humana Gold,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Medicaid MO,Medicaid MO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Medica,Medica,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Tricare,Tricare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,UHC All Payer,UHC All Payer,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,UHC Exchange,UHC Exchange,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicaid,UHC Medicaid,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,UMR CPD,UMR CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicare,UHC Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OXCARBAZEPINE (TRILEPTAL)     ,38200689,CDM,301,RC,80183,CPT,,,,Inpatient,,,235.52,235.52,Wellcare,Wellcare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health PPO CPD,Meritain Health PPO CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna/Commercial Product,Aetna/Commercial Product,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health CPD,Meritain Health CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Starmark CPD,Starmark CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna Medicare,Aetna Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Ambetter ,Ambetter ,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access,Anthem Blue Access,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access Choice,Anthem Blue Access Choice,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Preferred,Anthem Blue Preferred,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Pathway,Anthem Pathway,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Alliance,Anthem Alliance,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Medicare,Anthem Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna,Cigna,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna PPO,Cigna PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna Medicare Advantage,Cigna Medicare Advantage,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Essence,Essence,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthlink HMO,Healthlink HMO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthlink PPO,Healthlink PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,HomeState Health Plan,HomeState Health Plan,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Humana Gold,Humana Gold,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Medicaid MO,Medicaid MO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Medica,Medica,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Tricare,Tricare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC All Payer,UHC All Payer,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Exchange,UHC Exchange,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicaid,UHC Medicaid,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UMR CPD,UMR CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicare,UHC Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE (AUTO)               ,38200690,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Wellcare,Wellcare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Meritain Health PPO CPD,Meritain Health PPO CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Aetna/Commercial Product,Aetna/Commercial Product,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Meritain Health CPD,Meritain Health CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Starmark CPD,Starmark CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Aetna Medicare,Aetna Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Ambetter ,Ambetter ,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Access,Anthem Blue Access,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Access Choice,Anthem Blue Access Choice,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Blue Preferred,Anthem Blue Preferred,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Pathway,Anthem Pathway,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Alliance,Anthem Alliance,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Anthem Medicare,Anthem Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Cigna,Cigna,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Cigna PPO,Cigna PPO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Cigna Medicare Advantage,Cigna Medicare Advantage,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Essence,Essence,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Healthlink HMO,Healthlink HMO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Healthlink PPO,Healthlink PPO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,HomeState Health Plan,HomeState Health Plan,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Humana Gold,Humana Gold,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Medicaid MO,Medicaid MO,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Medica,Medica,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Tricare,Tricare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,UHC All Payer,UHC All Payer,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,UHC Exchange,UHC Exchange,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,UHC Medicaid,UHC Medicaid,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,UMR CPD,UMR CPD,158.07,,,,,,,per diem,158.07,158.07,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,UHC Medicare,UHC Medicare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38200691,CDM,301,RC,83516,CPT,,,,Inpatient,,,158.07,158.07,Wellcare,Wellcare,158.07,,,,,,,case rate,158.07,158.07,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health PPO CPD,Meritain Health PPO CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Aetna/Commercial Product,Aetna/Commercial Product,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health CPD,Meritain Health CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Starmark CPD,Starmark CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Aetna Medicare,Aetna Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Ambetter ,Ambetter ,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access,Anthem Blue Access,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access Choice,Anthem Blue Access Choice,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Preferred,Anthem Blue Preferred,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Pathway,Anthem Pathway,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Alliance,Anthem Alliance,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Anthem Medicare,Anthem Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Cigna,Cigna,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Cigna PPO,Cigna PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Cigna Medicare Advantage,Cigna Medicare Advantage,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Essence,Essence,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Healthlink HMO,Healthlink HMO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Healthlink PPO,Healthlink PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,HomeState Health Plan,HomeState Health Plan,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Humana Gold,Humana Gold,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Medicaid MO,Medicaid MO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Medica,Medica,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Tricare,Tricare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,UHC All Payer,UHC All Payer,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,UHC Exchange,UHC Exchange,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicaid,UHC Medicaid,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,UMR CPD,UMR CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicare,UHC Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
TISSUE HOMOGENIZATION         ,38200692,CDM,306,RC,87176,CPT,,,,Inpatient,,,98.76,98.76,Wellcare,Wellcare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
HISTAMINE URINE 24HR          ,38200693,CDM,301,RC,83088,CPT,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE URINE 24HR         ,38200694,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Meritain Health PPO CPD,Meritain Health PPO CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Aetna/Commercial Product,Aetna/Commercial Product,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Meritain Health CPD,Meritain Health CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Starmark CPD,Starmark CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Aetna Medicare,Aetna Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Ambetter ,Ambetter ,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Blue Access,Anthem Blue Access,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Blue Access Choice,Anthem Blue Access Choice,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Blue Preferred,Anthem Blue Preferred,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Pathway,Anthem Pathway,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Alliance,Anthem Alliance,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Anthem Medicare,Anthem Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Cigna,Cigna,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Cigna PPO,Cigna PPO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Cigna Medicare Advantage,Cigna Medicare Advantage,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Essence,Essence,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Healthlink HMO,Healthlink HMO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Healthlink PPO,Healthlink PPO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,HomeState Health Plan,HomeState Health Plan,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Humana Gold,Humana Gold,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Medicaid MO,Medicaid MO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Medica,Medica,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Tricare,Tricare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,UHC All Payer,UHC All Payer,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,UHC Exchange,UHC Exchange,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,UHC Medicaid,UHC Medicaid,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,UMR CPD,UMR CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,UHC Medicare,UHC Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
VASOACTIVE INTESTINAL PEPTIDE ,38200696,CDM,301,RC,84586,CPT,,,,Inpatient,,,521.1,521.1,Wellcare,Wellcare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Meritain Health PPO CPD,Meritain Health PPO CPD,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Aetna/Commercial Product,Aetna/Commercial Product,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Meritain Health CPD,Meritain Health CPD,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Starmark CPD,Starmark CPD,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Aetna Medicare,Aetna Medicare,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Ambetter ,Ambetter ,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Blue Access,Anthem Blue Access,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Blue Access Choice,Anthem Blue Access Choice,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Blue Preferred,Anthem Blue Preferred,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Pathway,Anthem Pathway,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Alliance,Anthem Alliance,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Anthem Medicare,Anthem Medicare,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Cigna,Cigna,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Cigna PPO,Cigna PPO,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Cigna Medicare Advantage,Cigna Medicare Advantage,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Essence,Essence,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Healthlink HMO,Healthlink HMO,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Healthlink PPO,Healthlink PPO,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,HomeState Health Plan,HomeState Health Plan,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Humana Gold,Humana Gold,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Medicaid MO,Medicaid MO,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Medica,Medica,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Tricare,Tricare,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,UHC All Payer,UHC All Payer,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,UHC Exchange,UHC Exchange,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,UHC Medicaid,UHC Medicaid,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,UMR CPD,UMR CPD,249.85,,,,,,,per diem,249.85,249.85,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,UHC Medicare,UHC Medicare,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38200700,CDM,301,RC,84681,CPT,,,,Inpatient,,,249.85,249.85,Wellcare,Wellcare,249.85,,,,,,,case rate,249.85,249.85,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health PPO CPD,Meritain Health PPO CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna/Commercial Product,Aetna/Commercial Product,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health CPD,Meritain Health CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Starmark CPD,Starmark CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna Medicare,Aetna Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Ambetter ,Ambetter ,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access,Anthem Blue Access,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access Choice,Anthem Blue Access Choice,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Preferred,Anthem Blue Preferred,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Pathway,Anthem Pathway,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Alliance,Anthem Alliance,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Medicare,Anthem Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna,Cigna,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna PPO,Cigna PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna Medicare Advantage,Cigna Medicare Advantage,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Essence,Essence,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthlink HMO,Healthlink HMO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthlink PPO,Healthlink PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,HomeState Health Plan,HomeState Health Plan,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Humana Gold,Humana Gold,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Medicaid MO,Medicaid MO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Medica,Medica,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Tricare,Tricare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC All Payer,UHC All Payer,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Exchange,UHC Exchange,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicaid,UHC Medicaid,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UMR CPD,UMR CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicare,UHC Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK-TOTAL                     ,38200710,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Wellcare,Wellcare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Meritain Health PPO CPD,Meritain Health PPO CPD,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Aetna/Commercial Product,Aetna/Commercial Product,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Meritain Health CPD,Meritain Health CPD,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Starmark CPD,Starmark CPD,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Aetna Medicare,Aetna Medicare,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Ambetter ,Ambetter ,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Blue Access,Anthem Blue Access,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Blue Access Choice,Anthem Blue Access Choice,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Blue Preferred,Anthem Blue Preferred,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Pathway,Anthem Pathway,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Alliance,Anthem Alliance,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Anthem Medicare,Anthem Medicare,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Cigna,Cigna,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Cigna PPO,Cigna PPO,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Cigna Medicare Advantage,Cigna Medicare Advantage,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Essence,Essence,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Healthlink HMO,Healthlink HMO,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Healthlink PPO,Healthlink PPO,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,HomeState Health Plan,HomeState Health Plan,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Humana Gold,Humana Gold,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Medicaid MO,Medicaid MO,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Medica,Medica,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Tricare,Tricare,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,UHC All Payer,UHC All Payer,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,UHC Exchange,UHC Exchange,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,UHC Medicaid,UHC Medicaid,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,UMR CPD,UMR CPD,134.47,,,,,,,per diem,134.47,134.47,"Per diem rate, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,UHC Medicare,UHC Medicare,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
CPK ISOENZYMES                ,38200720,CDM,301,RC,82552,CPT,,,,Inpatient,,,134.47,134.47,Wellcare,Wellcare,134.47,,,,,,,case rate,134.47,134.47,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health PPO CPD,Meritain Health PPO CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Aetna/Commercial Product,Aetna/Commercial Product,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health CPD,Meritain Health CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Starmark CPD,Starmark CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Aetna Medicare,Aetna Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Ambetter ,Ambetter ,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access,Anthem Blue Access,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access Choice,Anthem Blue Access Choice,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Preferred,Anthem Blue Preferred,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Pathway,Anthem Pathway,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Alliance,Anthem Alliance,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Anthem Medicare,Anthem Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Cigna,Cigna,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Cigna PPO,Cigna PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Cigna Medicare Advantage,Cigna Medicare Advantage,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Essence,Essence,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Healthlink HMO,Healthlink HMO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Healthlink PPO,Healthlink PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,HomeState Health Plan,HomeState Health Plan,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Humana Gold,Humana Gold,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Medicaid MO,Medicaid MO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Medica,Medica,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Tricare,Tricare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,UHC All Payer,UHC All Payer,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,UHC Exchange,UHC Exchange,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicaid,UHC Medicaid,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,UMR CPD,UMR CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicare,UHC Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CPK-MB,COLORIMETRIC           ",38200730,CDM,300,RC,82553,CPT,,,,Inpatient,,,180.35,180.35,Wellcare,Wellcare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
"CREATININE, BLOOD             ",38200740,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38200750,CDM,301,RC,82575,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Meritain Health PPO CPD,Meritain Health PPO CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Aetna/Commercial Product,Aetna/Commercial Product,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Meritain Health CPD,Meritain Health CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Starmark CPD,Starmark CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Aetna Medicare,Aetna Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Ambetter ,Ambetter ,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Access,Anthem Blue Access,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Access Choice,Anthem Blue Access Choice,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Preferred,Anthem Blue Preferred,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Pathway,Anthem Pathway,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Alliance,Anthem Alliance,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Anthem Medicare,Anthem Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Cigna,Cigna,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Cigna PPO,Cigna PPO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Cigna Medicare Advantage,Cigna Medicare Advantage,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Essence,Essence,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Healthlink HMO,Healthlink HMO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Healthlink PPO,Healthlink PPO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,HomeState Health Plan,HomeState Health Plan,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Humana Gold,Humana Gold,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Medicaid MO,Medicaid MO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Medica,Medica,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Tricare,Tricare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,UHC All Payer,UHC All Payer,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,UHC Exchange,UHC Exchange,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,UHC Medicaid,UHC Medicaid,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,UMR CPD,UMR CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,UHC Medicare,UHC Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CREATINE                      ,38200760,CDM,301,RC,82540,CPT,,,,Inpatient,,,90.18,90.18,Wellcare,Wellcare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health PPO CPD,Meritain Health PPO CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna/Commercial Product,Aetna/Commercial Product,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health CPD,Meritain Health CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Starmark CPD,Starmark CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna Medicare,Aetna Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Ambetter ,Ambetter ,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access,Anthem Blue Access,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access Choice,Anthem Blue Access Choice,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Preferred,Anthem Blue Preferred,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Pathway,Anthem Pathway,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Alliance,Anthem Alliance,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Medicare,Anthem Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna,Cigna,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna PPO,Cigna PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna Medicare Advantage,Cigna Medicare Advantage,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Essence,Essence,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthlink HMO,Healthlink HMO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthlink PPO,Healthlink PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,HomeState Health Plan,HomeState Health Plan,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Humana Gold,Humana Gold,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Medicaid MO,Medicaid MO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Medica,Medica,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Tricare,Tricare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC All Payer,UHC All Payer,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Exchange,UHC Exchange,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicaid,UHC Medicaid,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UMR CPD,UMR CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicare,UHC Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38200770,CDM,302,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Wellcare,Wellcare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Meritain Health PPO CPD,Meritain Health PPO CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Aetna/Commercial Product,Aetna/Commercial Product,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Meritain Health CPD,Meritain Health CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Starmark CPD,Starmark CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Aetna Medicare,Aetna Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Ambetter ,Ambetter ,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Access,Anthem Blue Access,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Access Choice,Anthem Blue Access Choice,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Preferred,Anthem Blue Preferred,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Pathway,Anthem Pathway,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Alliance,Anthem Alliance,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Anthem Medicare,Anthem Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Cigna,Cigna,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Cigna PPO,Cigna PPO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Cigna Medicare Advantage,Cigna Medicare Advantage,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Essence,Essence,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Healthlink HMO,Healthlink HMO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Healthlink PPO,Healthlink PPO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,HomeState Health Plan,HomeState Health Plan,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Humana Gold,Humana Gold,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Medicaid MO,Medicaid MO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Medica,Medica,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Tricare,Tricare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,UHC All Payer,UHC All Payer,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,UHC Exchange,UHC Exchange,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,UHC Medicaid,UHC Medicaid,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,UMR CPD,UMR CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,UHC Medicare,UHC Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
C-REACTIVE PROTEIN            ,38200780,CDM,302,RC,86140,CPT,,,,Inpatient,,,138.98,138.98,Wellcare,Wellcare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Meritain Health PPO CPD,Meritain Health PPO CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Aetna/Commercial Product,Aetna/Commercial Product,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Meritain Health CPD,Meritain Health CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Starmark CPD,Starmark CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Aetna Medicare,Aetna Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Ambetter ,Ambetter ,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Blue Access,Anthem Blue Access,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Blue Access Choice,Anthem Blue Access Choice,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Blue Preferred,Anthem Blue Preferred,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Pathway,Anthem Pathway,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Alliance,Anthem Alliance,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Anthem Medicare,Anthem Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Cigna,Cigna,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Cigna PPO,Cigna PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Cigna Medicare Advantage,Cigna Medicare Advantage,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Essence,Essence,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Healthlink HMO,Healthlink HMO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Healthlink PPO,Healthlink PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,HomeState Health Plan,HomeState Health Plan,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Humana Gold,Humana Gold,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Medicaid MO,Medicaid MO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Medica,Medica,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Tricare,Tricare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,UHC All Payer,UHC All Payer,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,UHC Exchange,UHC Exchange,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,UHC Medicaid,UHC Medicaid,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,UMR CPD,UMR CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,UHC Medicare,UHC Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
REPTILASE TIME TEST           ,38200790,CDM,305,RC,85635,CPT,,,,Inpatient,,,69.34,69.34,Wellcare,Wellcare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Meritain Health PPO CPD,Meritain Health PPO CPD,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Aetna/Commercial Product,Aetna/Commercial Product,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Meritain Health CPD,Meritain Health CPD,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Starmark CPD,Starmark CPD,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Aetna Medicare,Aetna Medicare,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Ambetter ,Ambetter ,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Blue Access,Anthem Blue Access,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Blue Access Choice,Anthem Blue Access Choice,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Blue Preferred,Anthem Blue Preferred,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Pathway,Anthem Pathway,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Alliance,Anthem Alliance,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Anthem Medicare,Anthem Medicare,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Cigna,Cigna,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Cigna PPO,Cigna PPO,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Cigna Medicare Advantage,Cigna Medicare Advantage,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Essence,Essence,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Healthlink HMO,Healthlink HMO,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Healthlink PPO,Healthlink PPO,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,HomeState Health Plan,HomeState Health Plan,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Humana Gold,Humana Gold,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Medicaid MO,Medicaid MO,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Medica,Medica,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Tricare,Tricare,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,UHC All Payer,UHC All Payer,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,UHC Exchange,UHC Exchange,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,UHC Medicaid,UHC Medicaid,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,UMR CPD,UMR CPD,260.02,,,,,,,per diem,260.02,260.02,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,UHC Medicare,UHC Medicare,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38200795,CDM,302,RC,86480,CPT,,,,Inpatient,,,260.02,260.02,Wellcare,Wellcare,260.02,,,,,,,case rate,260.02,260.02,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Meritain Health PPO CPD,Meritain Health PPO CPD,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Aetna/Commercial Product,Aetna/Commercial Product,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Meritain Health CPD,Meritain Health CPD,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Starmark CPD,Starmark CPD,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Aetna Medicare,Aetna Medicare,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Ambetter ,Ambetter ,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Blue Access,Anthem Blue Access,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Blue Access Choice,Anthem Blue Access Choice,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Blue Preferred,Anthem Blue Preferred,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Pathway,Anthem Pathway,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Alliance,Anthem Alliance,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Anthem Medicare,Anthem Medicare,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Cigna,Cigna,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Cigna PPO,Cigna PPO,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Cigna Medicare Advantage,Cigna Medicare Advantage,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Essence,Essence,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Healthlink HMO,Healthlink HMO,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Healthlink PPO,Healthlink PPO,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,HomeState Health Plan,HomeState Health Plan,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Humana Gold,Humana Gold,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Medicaid MO,Medicaid MO,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Medica,Medica,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Tricare,Tricare,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,UHC All Payer,UHC All Payer,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,UHC Exchange,UHC Exchange,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,UHC Medicaid,UHC Medicaid,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,UMR CPD,UMR CPD,228.09,,,,,,,per diem,228.09,228.09,"Per diem rate, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,UHC Medicare,UHC Medicare,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
TB AG RESPONSE T-CELL SUSP    ,38200796,CDM,302,RC,86481,CPT,,,,Inpatient,,,228.09,228.09,Wellcare,Wellcare,228.09,,,,,,,case rate,228.09,228.09,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Meritain Health PPO CPD,Meritain Health PPO CPD,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Aetna/Commercial Product,Aetna/Commercial Product,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Meritain Health CPD,Meritain Health CPD,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Starmark CPD,Starmark CPD,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Aetna Medicare,Aetna Medicare,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Ambetter ,Ambetter ,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Blue Access,Anthem Blue Access,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Blue Access Choice,Anthem Blue Access Choice,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Blue Preferred,Anthem Blue Preferred,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Pathway,Anthem Pathway,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Alliance,Anthem Alliance,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Anthem Medicare,Anthem Medicare,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Cigna,Cigna,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Cigna PPO,Cigna PPO,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Cigna Medicare Advantage,Cigna Medicare Advantage,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Essence,Essence,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Healthlink HMO,Healthlink HMO,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Healthlink PPO,Healthlink PPO,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,HomeState Health Plan,HomeState Health Plan,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Humana Gold,Humana Gold,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Medicaid MO,Medicaid MO,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Medica,Medica,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Tricare,Tricare,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,UHC All Payer,UHC All Payer,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,UHC Exchange,UHC Exchange,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,UHC Medicaid,UHC Medicaid,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,UMR CPD,UMR CPD,111.29,,,,,,,per diem,111.29,111.29,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,UHC Medicare,UHC Medicare,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AB               ,38200800,CDM,302,RC,86641,CPT,,,,Inpatient,,,111.29,111.29,Wellcare,Wellcare,111.29,,,,,,,case rate,111.29,111.29,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN (CSF)    ,38200801,CDM,306,RC,87327,CPT,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Meritain Health PPO CPD,Meritain Health PPO CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Aetna/Commercial Product,Aetna/Commercial Product,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Meritain Health CPD,Meritain Health CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Starmark CPD,Starmark CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Aetna Medicare,Aetna Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Ambetter ,Ambetter ,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Blue Access,Anthem Blue Access,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Blue Access Choice,Anthem Blue Access Choice,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Blue Preferred,Anthem Blue Preferred,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Pathway,Anthem Pathway,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Alliance,Anthem Alliance,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Anthem Medicare,Anthem Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Cigna,Cigna,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Cigna PPO,Cigna PPO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Cigna Medicare Advantage,Cigna Medicare Advantage,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Essence,Essence,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Healthlink HMO,Healthlink HMO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Healthlink PPO,Healthlink PPO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,HomeState Health Plan,HomeState Health Plan,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Humana Gold,Humana Gold,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Medicaid MO,Medicaid MO,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Medica,Medica,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Tricare,Tricare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,UHC All Payer,UHC All Payer,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,UHC Exchange,UHC Exchange,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,UHC Medicaid,UHC Medicaid,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,UMR CPD,UMR CPD,115.83,,,,,,,per diem,115.83,115.83,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,UHC Medicare,UHC Medicare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM ANTIGEN       ,38200805,CDM,306,RC,87328,CPT,,,,Inpatient,,,115.83,115.83,Wellcare,Wellcare,115.83,,,,,,,case rate,115.83,115.83,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Meritain Health PPO CPD,Meritain Health PPO CPD,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Aetna/Commercial Product,Aetna/Commercial Product,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Meritain Health CPD,Meritain Health CPD,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Starmark CPD,Starmark CPD,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Aetna Medicare,Aetna Medicare,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Ambetter ,Ambetter ,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Blue Access,Anthem Blue Access,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Blue Access Choice,Anthem Blue Access Choice,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Blue Preferred,Anthem Blue Preferred,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Pathway,Anthem Pathway,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Alliance,Anthem Alliance,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Anthem Medicare,Anthem Medicare,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Cigna,Cigna,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Cigna PPO,Cigna PPO,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Cigna Medicare Advantage,Cigna Medicare Advantage,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Essence,Essence,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Healthlink HMO,Healthlink HMO,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Healthlink PPO,Healthlink PPO,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,HomeState Health Plan,HomeState Health Plan,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Humana Gold,Humana Gold,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Medicaid MO,Medicaid MO,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Medica,Medica,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Tricare,Tricare,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,UHC All Payer,UHC All Payer,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,UHC Exchange,UHC Exchange,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,UHC Medicaid,UHC Medicaid,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,UMR CPD,UMR CPD,134.8,,,,,,,per diem,134.8,134.8,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,UHC Medicare,UHC Medicare,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38200810,CDM,301,RC,82945,CPT,,,,Inpatient,,,134.8,134.8,Wellcare,Wellcare,134.8,,,,,,,case rate,134.8,134.8,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health PPO CPD,Meritain Health PPO CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Aetna/Commercial Product,Aetna/Commercial Product,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health CPD,Meritain Health CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Starmark CPD,Starmark CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Aetna Medicare,Aetna Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Ambetter ,Ambetter ,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access,Anthem Blue Access,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access Choice,Anthem Blue Access Choice,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Preferred,Anthem Blue Preferred,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Pathway,Anthem Pathway,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Alliance,Anthem Alliance,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Anthem Medicare,Anthem Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Cigna,Cigna,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Cigna PPO,Cigna PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Cigna Medicare Advantage,Cigna Medicare Advantage,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Essence,Essence,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Healthlink HMO,Healthlink HMO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Healthlink PPO,Healthlink PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,HomeState Health Plan,HomeState Health Plan,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Humana Gold,Humana Gold,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Medicaid MO,Medicaid MO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Medica,Medica,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Tricare,Tricare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,UHC All Payer,UHC All Payer,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,UHC Exchange,UHC Exchange,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicaid,UHC Medicaid,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,UMR CPD,UMR CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicare,UHC Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38200830,CDM,306,RC,87102,CPT,,,,Inpatient,,,186.72,186.72,Wellcare,Wellcare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE-ROUTINE               ,38200840,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
AEROBIC ORGANISM ID           ,38200845,CDM,306,RC,87077,CPT,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38200850,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health PPO CPD,Meritain Health PPO CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna/Commercial Product,Aetna/Commercial Product,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health CPD,Meritain Health CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Starmark CPD,Starmark CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna Medicare,Aetna Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Ambetter ,Ambetter ,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access,Anthem Blue Access,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access Choice,Anthem Blue Access Choice,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Preferred,Anthem Blue Preferred,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Pathway,Anthem Pathway,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Alliance,Anthem Alliance,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Medicare,Anthem Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna,Cigna,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna PPO,Cigna PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna Medicare Advantage,Cigna Medicare Advantage,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Essence,Essence,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthlink HMO,Healthlink HMO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthlink PPO,Healthlink PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,HomeState Health Plan,HomeState Health Plan,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Humana Gold,Humana Gold,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Medicaid MO,Medicaid MO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Medica,Medica,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Tricare,Tricare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC All Payer,UHC All Payer,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Exchange,UHC Exchange,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicaid,UHC Medicaid,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UMR CPD,UMR CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicare,UHC Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BACTERIA              ,38200860,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Wellcare,Wellcare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health PPO CPD,Meritain Health PPO CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna/Commercial Product,Aetna/Commercial Product,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health CPD,Meritain Health CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Starmark CPD,Starmark CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Aetna Medicare,Aetna Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Ambetter ,Ambetter ,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access,Anthem Blue Access,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access Choice,Anthem Blue Access Choice,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Preferred,Anthem Blue Preferred,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Pathway,Anthem Pathway,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Alliance,Anthem Alliance,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Anthem Medicare,Anthem Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna,Cigna,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna PPO,Cigna PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Cigna Medicare Advantage,Cigna Medicare Advantage,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Essence,Essence,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthlink HMO,Healthlink HMO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Healthlink PPO,Healthlink PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,HomeState Health Plan,HomeState Health Plan,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Humana Gold,Humana Gold,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Medicaid MO,Medicaid MO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Medica,Medica,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Tricare,Tricare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC All Payer,UHC All Payer,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Exchange,UHC Exchange,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicaid,UHC Medicaid,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UMR CPD,UMR CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicare,UHC Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
CULTURE BLOOD                 ,38200880,CDM,306,RC,87040,CPT,,,,Inpatient,,,239.76,239.76,Wellcare,Wellcare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
C. DIFF. CULTURE (STOOL)      ,38200885,CDM,306,RC,87075,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE CAMPY                 ,38200890,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
TIAGABINE (GABITRIL)          ,38200894,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"CULTURE, CATH-TIP             ",38200895,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Meritain Health PPO CPD,Meritain Health PPO CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Aetna/Commercial Product,Aetna/Commercial Product,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Meritain Health CPD,Meritain Health CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Starmark CPD,Starmark CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Aetna Medicare,Aetna Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Ambetter ,Ambetter ,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Blue Access,Anthem Blue Access,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Blue Access Choice,Anthem Blue Access Choice,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Blue Preferred,Anthem Blue Preferred,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Pathway,Anthem Pathway,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Alliance,Anthem Alliance,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Anthem Medicare,Anthem Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Cigna,Cigna,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Cigna PPO,Cigna PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Cigna Medicare Advantage,Cigna Medicare Advantage,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Essence,Essence,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Healthlink HMO,Healthlink HMO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Healthlink PPO,Healthlink PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,HomeState Health Plan,HomeState Health Plan,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Humana Gold,Humana Gold,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Medicaid MO,Medicaid MO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Medica,Medica,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Tricare,Tricare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,UHC All Payer,UHC All Payer,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,UHC Exchange,UHC Exchange,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,UHC Medicaid,UHC Medicaid,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,UMR CPD,UMR CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,UHC Medicare,UHC Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE CHLAMYDIA             ,38200900,CDM,306,RC,87110,CPT,,,,Inpatient,,,433.9,433.9,Wellcare,Wellcare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Meritain Health PPO CPD,Meritain Health PPO CPD,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Aetna/Commercial Product,Aetna/Commercial Product,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Meritain Health CPD,Meritain Health CPD,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Starmark CPD,Starmark CPD,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Aetna Medicare,Aetna Medicare,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Ambetter ,Ambetter ,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Blue Access,Anthem Blue Access,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Blue Access Choice,Anthem Blue Access Choice,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Blue Preferred,Anthem Blue Preferred,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Pathway,Anthem Pathway,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Alliance,Anthem Alliance,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Anthem Medicare,Anthem Medicare,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Cigna,Cigna,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Cigna PPO,Cigna PPO,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Cigna Medicare Advantage,Cigna Medicare Advantage,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Essence,Essence,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Healthlink HMO,Healthlink HMO,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Healthlink PPO,Healthlink PPO,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,HomeState Health Plan,HomeState Health Plan,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Humana Gold,Humana Gold,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Medicaid MO,Medicaid MO,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Medica,Medica,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Tricare,Tricare,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,UHC All Payer,UHC All Payer,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,UHC Exchange,UHC Exchange,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,UHC Medicaid,UHC Medicaid,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,UMR CPD,UMR CPD,108.88,,,,,,,per diem,108.88,108.88,"Per diem rate, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,UHC Medicare,UHC Medicare,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE VIRAL                 ,38200901,CDM,306,RC,87252,CPT,,,,Inpatient,,,108.88,108.88,Wellcare,Wellcare,108.88,,,,,,,case rate,108.88,108.88,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE CSF                   ,38200910,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GC                    ,38200920,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health PPO CPD,Meritain Health PPO CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna/Commercial Product,Aetna/Commercial Product,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health CPD,Meritain Health CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Starmark CPD,Starmark CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna Medicare,Aetna Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Ambetter ,Ambetter ,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access,Anthem Blue Access,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access Choice,Anthem Blue Access Choice,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Preferred,Anthem Blue Preferred,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Pathway,Anthem Pathway,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Alliance,Anthem Alliance,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Medicare,Anthem Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna,Cigna,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna PPO,Cigna PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna Medicare Advantage,Cigna Medicare Advantage,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Essence,Essence,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthlink HMO,Healthlink HMO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthlink PPO,Healthlink PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,HomeState Health Plan,HomeState Health Plan,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Humana Gold,Humana Gold,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Medicaid MO,Medicaid MO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Medica,Medica,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Tricare,Tricare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC All Payer,UHC All Payer,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Exchange,UHC Exchange,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicaid,UHC Medicaid,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UMR CPD,UMR CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicare,UHC Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE GRP & TYP AGGL        ,38200921,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Wellcare,Wellcare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE NARES                 ,38200923,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE KPC SCREEN            ,38200924,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN MRSA           ,38200930,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE SCREEN ACINETOBACTER  ,38200935,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health PPO CPD,Meritain Health PPO CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna/Commercial Product,Aetna/Commercial Product,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health CPD,Meritain Health CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Starmark CPD,Starmark CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna Medicare,Aetna Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Ambetter ,Ambetter ,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access,Anthem Blue Access,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access Choice,Anthem Blue Access Choice,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Preferred,Anthem Blue Preferred,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Pathway,Anthem Pathway,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Alliance,Anthem Alliance,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Medicare,Anthem Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna,Cigna,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna PPO,Cigna PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna Medicare Advantage,Cigna Medicare Advantage,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Essence,Essence,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthlink HMO,Healthlink HMO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthlink PPO,Healthlink PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,HomeState Health Plan,HomeState Health Plan,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Humana Gold,Humana Gold,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Medicaid MO,Medicaid MO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Medica,Medica,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Tricare,Tricare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC All Payer,UHC All Payer,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Exchange,UHC Exchange,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicaid,UHC Medicaid,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UMR CPD,UMR CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicare,UHC Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE STOOL                 ,38200950,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Wellcare,Wellcare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE THROAT                ,38200970,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE WOUND                 ,38200975,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38200980,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Meritain Health PPO CPD,Meritain Health PPO CPD,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Aetna/Commercial Product,Aetna/Commercial Product,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Meritain Health CPD,Meritain Health CPD,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Starmark CPD,Starmark CPD,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Aetna Medicare,Aetna Medicare,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Ambetter ,Ambetter ,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Blue Access,Anthem Blue Access,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Blue Access Choice,Anthem Blue Access Choice,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Blue Preferred,Anthem Blue Preferred,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Pathway,Anthem Pathway,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Alliance,Anthem Alliance,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Anthem Medicare,Anthem Medicare,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Cigna,Cigna,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Cigna PPO,Cigna PPO,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Cigna Medicare Advantage,Cigna Medicare Advantage,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Essence,Essence,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Healthlink HMO,Healthlink HMO,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Healthlink PPO,Healthlink PPO,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,HomeState Health Plan,HomeState Health Plan,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Humana Gold,Humana Gold,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Medicaid MO,Medicaid MO,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Medica,Medica,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Tricare,Tricare,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,UHC All Payer,UHC All Payer,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,UHC Exchange,UHC Exchange,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,UHC Medicaid,UHC Medicaid,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,UMR CPD,UMR CPD,187.78,,,,,,,per diem,187.78,187.78,"Per diem rate, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,UHC Medicare,UHC Medicare,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
CULTURE URINE W/COLONY COUNT  ,38200981,CDM,306,RC,87086,CPT,,,,Inpatient,,,187.78,187.78,Wellcare,Wellcare,187.78,,,,,,,case rate,187.78,187.78,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIBODY-DIRECT ,38200982,CDM,300,RC,86023,CPT,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Meritain Health PPO CPD,Meritain Health PPO CPD,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Aetna/Commercial Product,Aetna/Commercial Product,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Meritain Health CPD,Meritain Health CPD,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Starmark CPD,Starmark CPD,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Aetna Medicare,Aetna Medicare,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Ambetter ,Ambetter ,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Blue Access,Anthem Blue Access,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Blue Access Choice,Anthem Blue Access Choice,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Blue Preferred,Anthem Blue Preferred,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Pathway,Anthem Pathway,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Alliance,Anthem Alliance,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Anthem Medicare,Anthem Medicare,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Cigna,Cigna,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Cigna PPO,Cigna PPO,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Cigna Medicare Advantage,Cigna Medicare Advantage,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Essence,Essence,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Healthlink HMO,Healthlink HMO,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Healthlink PPO,Healthlink PPO,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,HomeState Health Plan,HomeState Health Plan,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Humana Gold,Humana Gold,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Medicaid MO,Medicaid MO,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Medica,Medica,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Tricare,Tricare,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,UHC All Payer,UHC All Payer,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,UHC Exchange,UHC Exchange,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,UHC Medicaid,UHC Medicaid,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,UMR CPD,UMR CPD,358.06,,,,,,,per diem,358.06,358.06,"Per diem rate, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,UHC Medicare,UHC Medicare,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
CYCLOSPORINE                  ,38200985,CDM,301,RC,80158,CPT,,,,Inpatient,,,358.06,358.06,Wellcare,Wellcare,358.06,,,,,,,case rate,358.06,358.06,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health PPO CPD,Meritain Health PPO CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna/Commercial Product,Aetna/Commercial Product,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health CPD,Meritain Health CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Starmark CPD,Starmark CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna Medicare,Aetna Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Ambetter ,Ambetter ,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access,Anthem Blue Access,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access Choice,Anthem Blue Access Choice,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Preferred,Anthem Blue Preferred,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Pathway,Anthem Pathway,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Alliance,Anthem Alliance,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Medicare,Anthem Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna,Cigna,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna PPO,Cigna PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna Medicare Advantage,Cigna Medicare Advantage,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Essence,Essence,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthlink HMO,Healthlink HMO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthlink PPO,Healthlink PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,HomeState Health Plan,HomeState Health Plan,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Humana Gold,Humana Gold,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Medicaid MO,Medicaid MO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Medica,Medica,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Tricare,Tricare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC All Payer,UHC All Payer,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Exchange,UHC Exchange,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicaid,UHC Medicaid,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UMR CPD,UMR CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicare,UHC Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FIBRIN-D-DIMER QUANT          ,38201010,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Wellcare,Wellcare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Meritain Health PPO CPD,Meritain Health PPO CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Aetna/Commercial Product,Aetna/Commercial Product,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Meritain Health CPD,Meritain Health CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Starmark CPD,Starmark CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Aetna Medicare,Aetna Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Ambetter ,Ambetter ,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Access,Anthem Blue Access,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Access Choice,Anthem Blue Access Choice,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Blue Preferred,Anthem Blue Preferred,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Pathway,Anthem Pathway,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Alliance,Anthem Alliance,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Anthem Medicare,Anthem Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Cigna,Cigna,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Cigna PPO,Cigna PPO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Cigna Medicare Advantage,Cigna Medicare Advantage,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Essence,Essence,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Healthlink HMO,Healthlink HMO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Healthlink PPO,Healthlink PPO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,HomeState Health Plan,HomeState Health Plan,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Humana Gold,Humana Gold,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Medicaid MO,Medicaid MO,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Medica,Medica,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Tricare,Tricare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,UHC All Payer,UHC All Payer,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,UHC Exchange,UHC Exchange,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,UHC Medicaid,UHC Medicaid,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,UMR CPD,UMR CPD,81.67,,,,,,,per diem,81.67,81.67,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,UHC Medicare,UHC Medicare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGG)    ,38201011,CDM,302,RC,86631,CPT,,,,Inpatient,,,81.67,81.67,Wellcare,Wellcare,81.67,,,,,,,case rate,81.67,81.67,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
CHLAMYDIA. PNEUMONIA (IGM)    ,38201012,CDM,302,RC,86632,CPT,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Meritain Health PPO CPD,Meritain Health PPO CPD,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Aetna/Commercial Product,Aetna/Commercial Product,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Meritain Health CPD,Meritain Health CPD,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Starmark CPD,Starmark CPD,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Aetna Medicare,Aetna Medicare,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Ambetter ,Ambetter ,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Blue Access,Anthem Blue Access,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Blue Access Choice,Anthem Blue Access Choice,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Blue Preferred,Anthem Blue Preferred,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Pathway,Anthem Pathway,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Alliance,Anthem Alliance,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Anthem Medicare,Anthem Medicare,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Cigna,Cigna,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Cigna PPO,Cigna PPO,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Cigna Medicare Advantage,Cigna Medicare Advantage,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Essence,Essence,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Healthlink HMO,Healthlink HMO,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Healthlink PPO,Healthlink PPO,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,HomeState Health Plan,HomeState Health Plan,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Humana Gold,Humana Gold,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Medicaid MO,Medicaid MO,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Medica,Medica,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Tricare,Tricare,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,UHC All Payer,UHC All Payer,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,UHC Exchange,UHC Exchange,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,UHC Medicaid,UHC Medicaid,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,UMR CPD,UMR CPD,356.7,,,,,,,per diem,356.7,356.7,"Per diem rate, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,UHC Medicare,UHC Medicare,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
DHEA-S                        ,38201015,CDM,301,RC,82627,CPT,,,,Inpatient,,,356.7,356.7,Wellcare,Wellcare,356.7,,,,,,,case rate,356.7,356.7,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Meritain Health PPO CPD,Meritain Health PPO CPD,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Aetna/Commercial Product,Aetna/Commercial Product,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Meritain Health CPD,Meritain Health CPD,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Starmark CPD,Starmark CPD,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Aetna Medicare,Aetna Medicare,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Ambetter ,Ambetter ,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Blue Access,Anthem Blue Access,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Blue Access Choice,Anthem Blue Access Choice,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Blue Preferred,Anthem Blue Preferred,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Pathway,Anthem Pathway,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Alliance,Anthem Alliance,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Anthem Medicare,Anthem Medicare,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Cigna,Cigna,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Cigna PPO,Cigna PPO,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Cigna Medicare Advantage,Cigna Medicare Advantage,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Essence,Essence,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Healthlink HMO,Healthlink HMO,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Healthlink PPO,Healthlink PPO,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,HomeState Health Plan,HomeState Health Plan,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Humana Gold,Humana Gold,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Medicaid MO,Medicaid MO,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Medica,Medica,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Tricare,Tricare,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,UHC All Payer,UHC All Payer,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,UHC Exchange,UHC Exchange,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,UHC Medicaid,UHC Medicaid,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,UMR CPD,UMR CPD,29.71,,,,,,,per diem,29.71,29.71,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,UHC Medicare,UHC Medicare,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38201020,CDM,305,RC,85007,CPT,,,,Inpatient,,,29.71,29.71,Wellcare,Wellcare,29.71,,,,,,,case rate,29.71,29.71,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGITOXIN                     ,38201030,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health PPO CPD,Meritain Health PPO CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna/Commercial Product,Aetna/Commercial Product,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health CPD,Meritain Health CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Starmark CPD,Starmark CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna Medicare,Aetna Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Ambetter ,Ambetter ,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access,Anthem Blue Access,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access Choice,Anthem Blue Access Choice,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Preferred,Anthem Blue Preferred,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Pathway,Anthem Pathway,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Alliance,Anthem Alliance,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Medicare,Anthem Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna,Cigna,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna PPO,Cigna PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna Medicare Advantage,Cigna Medicare Advantage,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Essence,Essence,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthlink HMO,Healthlink HMO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthlink PPO,Healthlink PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,HomeState Health Plan,HomeState Health Plan,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Humana Gold,Humana Gold,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Medicaid MO,Medicaid MO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Medica,Medica,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Tricare,Tricare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC All Payer,UHC All Payer,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Exchange,UHC Exchange,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicaid,UHC Medicaid,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UMR CPD,UMR CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicare,UHC Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38201040,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Wellcare,Wellcare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Meritain Health PPO CPD,Meritain Health PPO CPD,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Aetna/Commercial Product,Aetna/Commercial Product,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Meritain Health CPD,Meritain Health CPD,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Starmark CPD,Starmark CPD,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Aetna Medicare,Aetna Medicare,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Ambetter ,Ambetter ,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Blue Access,Anthem Blue Access,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Blue Access Choice,Anthem Blue Access Choice,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Blue Preferred,Anthem Blue Preferred,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Pathway,Anthem Pathway,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Alliance,Anthem Alliance,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Anthem Medicare,Anthem Medicare,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Cigna,Cigna,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Cigna PPO,Cigna PPO,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Cigna Medicare Advantage,Cigna Medicare Advantage,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Essence,Essence,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Healthlink HMO,Healthlink HMO,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Healthlink PPO,Healthlink PPO,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,HomeState Health Plan,HomeState Health Plan,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Humana Gold,Humana Gold,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Medicaid MO,Medicaid MO,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Medica,Medica,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Tricare,Tricare,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,UHC All Payer,UHC All Payer,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,UHC Exchange,UHC Exchange,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,UHC Medicaid,UHC Medicaid,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,UMR CPD,UMR CPD,209,,,,,,,per diem,209,209,"Per diem rate, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,UHC Medicare,UHC Medicare,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
DILANTIN (PHENYTOIN-TOTAL)    ,38201050,CDM,301,RC,80185,CPT,,,,Inpatient,,,209,209,Wellcare,Wellcare,209,,,,,,,case rate,209,209,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Meritain Health PPO CPD,Meritain Health PPO CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Aetna/Commercial Product,Aetna/Commercial Product,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Meritain Health CPD,Meritain Health CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Starmark CPD,Starmark CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Aetna Medicare,Aetna Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Ambetter ,Ambetter ,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Access,Anthem Blue Access,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Access Choice,Anthem Blue Access Choice,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Preferred,Anthem Blue Preferred,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Pathway,Anthem Pathway,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Alliance,Anthem Alliance,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Anthem Medicare,Anthem Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Cigna,Cigna,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Cigna PPO,Cigna PPO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Cigna Medicare Advantage,Cigna Medicare Advantage,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Essence,Essence,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Healthlink HMO,Healthlink HMO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Healthlink PPO,Healthlink PPO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,HomeState Health Plan,HomeState Health Plan,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Humana Gold,Humana Gold,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Medicaid MO,Medicaid MO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Medica,Medica,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Tricare,Tricare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,UHC All Payer,UHC All Payer,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,UHC Exchange,UHC Exchange,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,UHC Medicaid,UHC Medicaid,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,UMR CPD,UMR CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,UHC Medicare,UHC Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38201051,CDM,301,RC,80186,CPT,,,,Inpatient,,,129.43,129.43,Wellcare,Wellcare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Meritain Health PPO CPD,Meritain Health PPO CPD,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Aetna/Commercial Product,Aetna/Commercial Product,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Meritain Health CPD,Meritain Health CPD,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Starmark CPD,Starmark CPD,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Aetna Medicare,Aetna Medicare,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Ambetter ,Ambetter ,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Blue Access,Anthem Blue Access,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Blue Access Choice,Anthem Blue Access Choice,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Blue Preferred,Anthem Blue Preferred,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Pathway,Anthem Pathway,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Alliance,Anthem Alliance,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Anthem Medicare,Anthem Medicare,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Cigna,Cigna,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Cigna PPO,Cigna PPO,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Cigna Medicare Advantage,Cigna Medicare Advantage,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Essence,Essence,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Healthlink HMO,Healthlink HMO,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Healthlink PPO,Healthlink PPO,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,HomeState Health Plan,HomeState Health Plan,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Humana Gold,Humana Gold,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Medicaid MO,Medicaid MO,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Medica,Medica,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Tricare,Tricare,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,UHC All Payer,UHC All Payer,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,UHC Exchange,UHC Exchange,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,UHC Medicaid,UHC Medicaid,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,UMR CPD,UMR CPD,345.05,,,,,,,per diem,345.05,345.05,"Per diem rate, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,UHC Medicare,UHC Medicare,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN-COMPL QUAL        ,38201080,CDM,301,RC,80100,CPT,G0431,HCPCS,,Inpatient,,,345.05,345.05,Wellcare,Wellcare,345.05,,,,,,,case rate,345.05,345.05,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Meritain Health PPO CPD,Meritain Health PPO CPD,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Aetna/Commercial Product,Aetna/Commercial Product,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Meritain Health CPD,Meritain Health CPD,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Starmark CPD,Starmark CPD,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Aetna Medicare,Aetna Medicare,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Ambetter ,Ambetter ,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Blue Access,Anthem Blue Access,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Blue Access Choice,Anthem Blue Access Choice,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Blue Preferred,Anthem Blue Preferred,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Pathway,Anthem Pathway,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Alliance,Anthem Alliance,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Anthem Medicare,Anthem Medicare,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Cigna,Cigna,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Cigna PPO,Cigna PPO,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Cigna Medicare Advantage,Cigna Medicare Advantage,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Essence,Essence,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Healthlink HMO,Healthlink HMO,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Healthlink PPO,Healthlink PPO,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,HomeState Health Plan,HomeState Health Plan,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Humana Gold,Humana Gold,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Medicaid MO,Medicaid MO,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Medica,Medica,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Tricare,Tricare,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,UHC All Payer,UHC All Payer,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,UHC Exchange,UHC Exchange,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,UHC Medicaid,UHC Medicaid,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,UMR CPD,UMR CPD,72.14,,,,,,,per diem,72.14,72.14,"Per diem rate, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,UHC Medicare,UHC Medicare,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN W/URINE ALCOHOL   ,38201081,CDM,301,RC,80101,CPT,,,,Inpatient,,,72.14,72.14,Wellcare,Wellcare,72.14,,,,,,,case rate,72.14,72.14,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Meritain Health PPO CPD,Meritain Health PPO CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Aetna/Commercial Product,Aetna/Commercial Product,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Meritain Health CPD,Meritain Health CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Starmark CPD,Starmark CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Aetna Medicare,Aetna Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Ambetter ,Ambetter ,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Blue Access,Anthem Blue Access,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Blue Access Choice,Anthem Blue Access Choice,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Blue Preferred,Anthem Blue Preferred,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Pathway,Anthem Pathway,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Alliance,Anthem Alliance,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Anthem Medicare,Anthem Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Cigna,Cigna,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Cigna PPO,Cigna PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Cigna Medicare Advantage,Cigna Medicare Advantage,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Essence,Essence,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Healthlink HMO,Healthlink HMO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Healthlink PPO,Healthlink PPO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,HomeState Health Plan,HomeState Health Plan,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Humana Gold,Humana Gold,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Medicaid MO,Medicaid MO,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Medica,Medica,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Tricare,Tricare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,UHC All Payer,UHC All Payer,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,UHC Exchange,UHC Exchange,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,UHC Medicaid,UHC Medicaid,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,UMR CPD,UMR CPD,12.36,,,,,,,per diem,12.36,12.36,"Per diem rate, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,UHC Medicare,UHC Medicare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCREEN-SERUM             ,38201090,CDM,301,RC,80100,CPT,,,,Inpatient,,,12.36,12.36,Wellcare,Wellcare,12.36,,,,,,,case rate,12.36,12.36,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN A NON TLC DVC/DOS   ,38201095,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Meritain Health PPO CPD,Meritain Health PPO CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Aetna/Commercial Product,Aetna/Commercial Product,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Meritain Health CPD,Meritain Health CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Starmark CPD,Starmark CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Aetna Medicare,Aetna Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Ambetter ,Ambetter ,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Blue Access,Anthem Blue Access,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Blue Access Choice,Anthem Blue Access Choice,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Blue Preferred,Anthem Blue Preferred,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Pathway,Anthem Pathway,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Alliance,Anthem Alliance,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Anthem Medicare,Anthem Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Cigna,Cigna,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Cigna PPO,Cigna PPO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Cigna Medicare Advantage,Cigna Medicare Advantage,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Essence,Essence,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Healthlink HMO,Healthlink HMO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Healthlink PPO,Healthlink PPO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,HomeState Health Plan,HomeState Health Plan,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Humana Gold,Humana Gold,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Medicaid MO,Medicaid MO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Medica,Medica,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Tricare,Tricare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,UHC All Payer,UHC All Payer,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,UHC Exchange,UHC Exchange,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,UHC Medicaid,UHC Medicaid,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,UMR CPD,UMR CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,UHC Medicare,UHC Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN CLASS A /DOS        ,38201096,CDM,301,RC,G0479,HCPCS,,,,Inpatient,,,394.65,394.65,Wellcare,Wellcare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Meritain Health PPO CPD,Meritain Health PPO CPD,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Aetna/Commercial Product,Aetna/Commercial Product,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Meritain Health CPD,Meritain Health CPD,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Starmark CPD,Starmark CPD,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Aetna Medicare,Aetna Medicare,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Ambetter ,Ambetter ,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Blue Access,Anthem Blue Access,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Blue Access Choice,Anthem Blue Access Choice,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Blue Preferred,Anthem Blue Preferred,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Pathway,Anthem Pathway,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Alliance,Anthem Alliance,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Anthem Medicare,Anthem Medicare,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Cigna,Cigna,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Cigna PPO,Cigna PPO,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Cigna Medicare Advantage,Cigna Medicare Advantage,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Essence,Essence,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Healthlink HMO,Healthlink HMO,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Healthlink PPO,Healthlink PPO,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,HomeState Health Plan,HomeState Health Plan,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Humana Gold,Humana Gold,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Medicaid MO,Medicaid MO,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Medica,Medica,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Tricare,Tricare,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,UHC All Payer,UHC All Payer,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,UHC Exchange,UHC Exchange,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,UHC Medicaid,UHC Medicaid,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,UMR CPD,UMR CPD,642.81,,,,,,,per diem,642.81,642.81,"Per diem rate, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,UHC Medicare,UHC Medicare,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN PRESUMP CLASS B     ,38201097,CDM,301,RC,80307,CPT,,,,Inpatient,,,642.81,642.81,Wellcare,Wellcare,642.81,,,,,,,case rate,642.81,642.81,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Meritain Health PPO CPD,Meritain Health PPO CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna/Commercial Product,Aetna/Commercial Product,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Meritain Health CPD,Meritain Health CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Starmark CPD,Starmark CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna Medicare,Aetna Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Ambetter ,Ambetter ,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Access,Anthem Blue Access,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Access Choice,Anthem Blue Access Choice,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Preferred,Anthem Blue Preferred,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Pathway,Anthem Pathway,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Alliance,Anthem Alliance,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Medicare,Anthem Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna,Cigna,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna PPO,Cigna PPO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna Medicare Advantage,Cigna Medicare Advantage,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Essence,Essence,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthlink HMO,Healthlink HMO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthlink PPO,Healthlink PPO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,HomeState Health Plan,HomeState Health Plan,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Humana Gold,Humana Gold,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Medicaid MO,Medicaid MO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Medica,Medica,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Tricare,Tricare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC All Payer,UHC All Payer,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Exchange,UHC Exchange,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Medicaid,UHC Medicaid,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UMR CPD,UMR CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Medicare,UHC Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
DRUG SCRN ALL CLASS NOS EA    ,38201099,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Wellcare,Wellcare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Meritain Health PPO CPD,Meritain Health PPO CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Aetna/Commercial Product,Aetna/Commercial Product,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Meritain Health CPD,Meritain Health CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Starmark CPD,Starmark CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Aetna Medicare,Aetna Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Ambetter ,Ambetter ,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Blue Access,Anthem Blue Access,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Blue Access Choice,Anthem Blue Access Choice,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Blue Preferred,Anthem Blue Preferred,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Pathway,Anthem Pathway,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Alliance,Anthem Alliance,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Anthem Medicare,Anthem Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Cigna,Cigna,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Cigna PPO,Cigna PPO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Cigna Medicare Advantage,Cigna Medicare Advantage,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Essence,Essence,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Healthlink HMO,Healthlink HMO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Healthlink PPO,Healthlink PPO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,HomeState Health Plan,HomeState Health Plan,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Humana Gold,Humana Gold,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Medicaid MO,Medicaid MO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Medica,Medica,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Tricare,Tricare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,UHC All Payer,UHC All Payer,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,UHC Exchange,UHC Exchange,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,UHC Medicaid,UHC Medicaid,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,UMR CPD,UMR CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,UHC Medicare,UHC Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ALCOHOLS SCREENING            ,38201100,CDM,301,RC,80320,CPT,,,,Inpatient,,,122,122,Wellcare,Wellcare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Meritain Health PPO CPD,Meritain Health PPO CPD,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Aetna/Commercial Product,Aetna/Commercial Product,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Meritain Health CPD,Meritain Health CPD,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Starmark CPD,Starmark CPD,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Aetna Medicare,Aetna Medicare,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Ambetter ,Ambetter ,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Blue Access,Anthem Blue Access,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Blue Access Choice,Anthem Blue Access Choice,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Blue Preferred,Anthem Blue Preferred,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Pathway,Anthem Pathway,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Alliance,Anthem Alliance,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Anthem Medicare,Anthem Medicare,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Cigna,Cigna,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Cigna PPO,Cigna PPO,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Cigna Medicare Advantage,Cigna Medicare Advantage,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Essence,Essence,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Healthlink HMO,Healthlink HMO,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Healthlink PPO,Healthlink PPO,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,HomeState Health Plan,HomeState Health Plan,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Humana Gold,Humana Gold,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Medicaid MO,Medicaid MO,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Medica,Medica,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Tricare,Tricare,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,UHC All Payer,UHC All Payer,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,UHC Exchange,UHC Exchange,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,UHC Medicaid,UHC Medicaid,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,UMR CPD,UMR CPD,259.27,,,,,,,per diem,259.27,259.27,"Per diem rate, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,UHC Medicare,UHC Medicare,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROLYTE PANEL             ,38201120,CDM,301,RC,80051,CPT,,,,Inpatient,,,259.27,259.27,Wellcare,Wellcare,259.27,,,,,,,case rate,259.27,259.27,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Meritain Health PPO CPD,Meritain Health PPO CPD,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Aetna/Commercial Product,Aetna/Commercial Product,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Meritain Health CPD,Meritain Health CPD,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Starmark CPD,Starmark CPD,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Aetna Medicare,Aetna Medicare,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Ambetter ,Ambetter ,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Blue Access,Anthem Blue Access,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Blue Access Choice,Anthem Blue Access Choice,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Blue Preferred,Anthem Blue Preferred,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Pathway,Anthem Pathway,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Alliance,Anthem Alliance,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Anthem Medicare,Anthem Medicare,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Cigna,Cigna,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Cigna PPO,Cigna PPO,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Cigna Medicare Advantage,Cigna Medicare Advantage,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Essence,Essence,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Healthlink HMO,Healthlink HMO,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Healthlink PPO,Healthlink PPO,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,HomeState Health Plan,HomeState Health Plan,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Humana Gold,Humana Gold,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Medicaid MO,Medicaid MO,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Medica,Medica,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Tricare,Tricare,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,UHC All Payer,UHC All Payer,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,UHC Exchange,UHC Exchange,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,UHC Medicaid,UHC Medicaid,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,UMR CPD,UMR CPD,105.89,,,,,,,per diem,105.89,105.89,"Per diem rate, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,UHC Medicare,UHC Medicare,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ELECTROPHORESIS HEMOGLOBLIN   ,38201130,CDM,301,RC,83020,CPT,,,,Inpatient,,,105.89,105.89,Wellcare,Wellcare,105.89,,,,,,,case rate,105.89,105.89,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Meritain Health PPO CPD,Meritain Health PPO CPD,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Aetna/Commercial Product,Aetna/Commercial Product,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Meritain Health CPD,Meritain Health CPD,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Starmark CPD,Starmark CPD,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Aetna Medicare,Aetna Medicare,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Ambetter ,Ambetter ,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Blue Access,Anthem Blue Access,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Blue Access Choice,Anthem Blue Access Choice,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Blue Preferred,Anthem Blue Preferred,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Pathway,Anthem Pathway,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Alliance,Anthem Alliance,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Anthem Medicare,Anthem Medicare,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Cigna,Cigna,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Cigna PPO,Cigna PPO,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Cigna Medicare Advantage,Cigna Medicare Advantage,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Essence,Essence,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Healthlink HMO,Healthlink HMO,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Healthlink PPO,Healthlink PPO,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,HomeState Health Plan,HomeState Health Plan,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Humana Gold,Humana Gold,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Medicaid MO,Medicaid MO,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Medica,Medica,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Tricare,Tricare,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,UHC All Payer,UHC All Payer,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,UHC Exchange,UHC Exchange,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,UHC Medicaid,UHC Medicaid,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,UMR CPD,UMR CPD,233.93,,,,,,,per diem,233.93,233.93,"Per diem rate, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,UHC Medicare,UHC Medicare,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ERYTHROPOIETIN                ,38201155,CDM,301,RC,82668,CPT,,,,Inpatient,,,233.93,233.93,Wellcare,Wellcare,233.93,,,,,,,case rate,233.93,233.93,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Meritain Health PPO CPD,Meritain Health PPO CPD,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Aetna/Commercial Product,Aetna/Commercial Product,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Meritain Health CPD,Meritain Health CPD,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Starmark CPD,Starmark CPD,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Aetna Medicare,Aetna Medicare,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Ambetter ,Ambetter ,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Blue Access,Anthem Blue Access,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Blue Access Choice,Anthem Blue Access Choice,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Blue Preferred,Anthem Blue Preferred,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Pathway,Anthem Pathway,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Alliance,Anthem Alliance,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Anthem Medicare,Anthem Medicare,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Cigna,Cigna,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Cigna PPO,Cigna PPO,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Cigna Medicare Advantage,Cigna Medicare Advantage,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Essence,Essence,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Healthlink HMO,Healthlink HMO,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Healthlink PPO,Healthlink PPO,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,HomeState Health Plan,HomeState Health Plan,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Humana Gold,Humana Gold,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Medicaid MO,Medicaid MO,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Medica,Medica,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Tricare,Tricare,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,UHC All Payer,UHC All Payer,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,UHC Exchange,UHC Exchange,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,UHC Medicaid,UHC Medicaid,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,UMR CPD,UMR CPD,186.77,,,,,,,per diem,186.77,186.77,"Per diem rate, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,UHC Medicare,UHC Medicare,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRADIOL                     ,38201170,CDM,301,RC,82670,CPT,,,,Inpatient,,,186.77,186.77,Wellcare,Wellcare,186.77,,,,,,,case rate,186.77,186.77,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
ESTRIOL                       ,38201171,CDM,301,RC,82677,CPT,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Meritain Health PPO CPD,Meritain Health PPO CPD,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Aetna/Commercial Product,Aetna/Commercial Product,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Meritain Health CPD,Meritain Health CPD,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Starmark CPD,Starmark CPD,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Aetna Medicare,Aetna Medicare,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Ambetter ,Ambetter ,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Blue Access,Anthem Blue Access,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Blue Access Choice,Anthem Blue Access Choice,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Blue Preferred,Anthem Blue Preferred,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Pathway,Anthem Pathway,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Alliance,Anthem Alliance,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Anthem Medicare,Anthem Medicare,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Cigna,Cigna,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Cigna PPO,Cigna PPO,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Cigna Medicare Advantage,Cigna Medicare Advantage,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Essence,Essence,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Healthlink HMO,Healthlink HMO,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Healthlink PPO,Healthlink PPO,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,HomeState Health Plan,HomeState Health Plan,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Humana Gold,Humana Gold,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Medicaid MO,Medicaid MO,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Medica,Medica,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Tricare,Tricare,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,UHC All Payer,UHC All Payer,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,UHC Exchange,UHC Exchange,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,UHC Medicaid,UHC Medicaid,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,UMR CPD,UMR CPD,319.54,,,,,,,per diem,319.54,319.54,"Per diem rate, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,UHC Medicare,UHC Medicare,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
"FECAL FAT, QUALITATIVE        ",38201180,CDM,301,RC,82705,CPT,,,,Inpatient,,,319.54,319.54,Wellcare,Wellcare,319.54,,,,,,,case rate,319.54,319.54,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Meritain Health PPO CPD,Meritain Health PPO CPD,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Aetna/Commercial Product,Aetna/Commercial Product,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Meritain Health CPD,Meritain Health CPD,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Starmark CPD,Starmark CPD,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Aetna Medicare,Aetna Medicare,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Ambetter ,Ambetter ,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Blue Access,Anthem Blue Access,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Blue Access Choice,Anthem Blue Access Choice,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Blue Preferred,Anthem Blue Preferred,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Pathway,Anthem Pathway,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Alliance,Anthem Alliance,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Anthem Medicare,Anthem Medicare,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Cigna,Cigna,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Cigna PPO,Cigna PPO,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Cigna Medicare Advantage,Cigna Medicare Advantage,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Essence,Essence,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Healthlink HMO,Healthlink HMO,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Healthlink PPO,Healthlink PPO,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,HomeState Health Plan,HomeState Health Plan,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Humana Gold,Humana Gold,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Medicaid MO,Medicaid MO,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Medica,Medica,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Tricare,Tricare,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,UHC All Payer,UHC All Payer,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,UHC Exchange,UHC Exchange,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,UHC Medicaid,UHC Medicaid,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,UMR CPD,UMR CPD,79.35,,,,,,,per diem,79.35,79.35,"Per diem rate, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,UHC Medicare,UHC Medicare,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FECAL HGB IMMUNOASSAY         ,38201181,CDM,301,RC,82274,CPT,,,,Inpatient,,,79.35,79.35,Wellcare,Wellcare,79.35,,,,,,,case rate,79.35,79.35,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Meritain Health PPO CPD,Meritain Health PPO CPD,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Aetna/Commercial Product,Aetna/Commercial Product,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Meritain Health CPD,Meritain Health CPD,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Starmark CPD,Starmark CPD,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Aetna Medicare,Aetna Medicare,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Ambetter ,Ambetter ,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Blue Access,Anthem Blue Access,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Blue Access Choice,Anthem Blue Access Choice,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Blue Preferred,Anthem Blue Preferred,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Pathway,Anthem Pathway,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Alliance,Anthem Alliance,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Anthem Medicare,Anthem Medicare,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Cigna,Cigna,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Cigna PPO,Cigna PPO,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Cigna Medicare Advantage,Cigna Medicare Advantage,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Essence,Essence,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Healthlink HMO,Healthlink HMO,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Healthlink PPO,Healthlink PPO,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,HomeState Health Plan,HomeState Health Plan,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Humana Gold,Humana Gold,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Medicaid MO,Medicaid MO,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Medica,Medica,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Tricare,Tricare,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,UHC All Payer,UHC All Payer,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,UHC Exchange,UHC Exchange,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,UHC Medicaid,UHC Medicaid,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,UMR CPD,UMR CPD,255.53,,,,,,,per diem,255.53,255.53,"Per diem rate, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,UHC Medicare,UHC Medicare,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FDP (FSP)                     ,38201190,CDM,305,RC,85362,CPT,,,,Inpatient,,,255.53,255.53,Wellcare,Wellcare,255.53,,,,,,,case rate,255.53,255.53,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Meritain Health PPO CPD,Meritain Health PPO CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Aetna/Commercial Product,Aetna/Commercial Product,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Meritain Health CPD,Meritain Health CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Starmark CPD,Starmark CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Aetna Medicare,Aetna Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Ambetter ,Ambetter ,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Access,Anthem Blue Access,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Access Choice,Anthem Blue Access Choice,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Preferred,Anthem Blue Preferred,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Pathway,Anthem Pathway,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Alliance,Anthem Alliance,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Anthem Medicare,Anthem Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Cigna,Cigna,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Cigna PPO,Cigna PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Cigna Medicare Advantage,Cigna Medicare Advantage,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Essence,Essence,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Healthlink HMO,Healthlink HMO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Healthlink PPO,Healthlink PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,HomeState Health Plan,HomeState Health Plan,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Humana Gold,Humana Gold,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Medicaid MO,Medicaid MO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Medica,Medica,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Tricare,Tricare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,UHC All Payer,UHC All Payer,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,UHC Exchange,UHC Exchange,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,UHC Medicaid,UHC Medicaid,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,UMR CPD,UMR CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,UHC Medicare,UHC Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38201200,CDM,301,RC,82728,CPT,,,,Inpatient,,,200.51,200.51,Wellcare,Wellcare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Meritain Health PPO CPD,Meritain Health PPO CPD,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Aetna/Commercial Product,Aetna/Commercial Product,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Meritain Health CPD,Meritain Health CPD,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Starmark CPD,Starmark CPD,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Aetna Medicare,Aetna Medicare,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Ambetter ,Ambetter ,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Blue Access,Anthem Blue Access,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Blue Access Choice,Anthem Blue Access Choice,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Blue Preferred,Anthem Blue Preferred,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Pathway,Anthem Pathway,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Alliance,Anthem Alliance,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Anthem Medicare,Anthem Medicare,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Cigna,Cigna,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Cigna PPO,Cigna PPO,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Cigna Medicare Advantage,Cigna Medicare Advantage,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Essence,Essence,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Healthlink HMO,Healthlink HMO,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Healthlink PPO,Healthlink PPO,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,HomeState Health Plan,HomeState Health Plan,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Humana Gold,Humana Gold,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Medicaid MO,Medicaid MO,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Medica,Medica,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Tricare,Tricare,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,UHC All Payer,UHC All Payer,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,UHC Exchange,UHC Exchange,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,UHC Medicaid,UHC Medicaid,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,UMR CPD,UMR CPD,210.32,,,,,,,per diem,210.32,210.32,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,UHC Medicare,UHC Medicare,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38201220,CDM,305,RC,85384,CPT,,,,Inpatient,,,210.32,210.32,Wellcare,Wellcare,210.32,,,,,,,case rate,210.32,210.32,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Meritain Health PPO CPD,Meritain Health PPO CPD,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Aetna/Commercial Product,Aetna/Commercial Product,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Meritain Health CPD,Meritain Health CPD,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Starmark CPD,Starmark CPD,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Aetna Medicare,Aetna Medicare,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Ambetter ,Ambetter ,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Blue Access,Anthem Blue Access,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Blue Access Choice,Anthem Blue Access Choice,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Blue Preferred,Anthem Blue Preferred,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Pathway,Anthem Pathway,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Alliance,Anthem Alliance,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Anthem Medicare,Anthem Medicare,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Cigna,Cigna,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Cigna PPO,Cigna PPO,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Cigna Medicare Advantage,Cigna Medicare Advantage,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Essence,Essence,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Healthlink HMO,Healthlink HMO,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Healthlink PPO,Healthlink PPO,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,HomeState Health Plan,HomeState Health Plan,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Humana Gold,Humana Gold,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Medicaid MO,Medicaid MO,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Medica,Medica,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Tricare,Tricare,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,UHC All Payer,UHC All Payer,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,UHC Exchange,UHC Exchange,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,UHC Medicaid,UHC Medicaid,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,UMR CPD,UMR CPD,172.93,,,,,,,per diem,172.93,172.93,"Per diem rate, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,UHC Medicare,UHC Medicare,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
FOLIC ACID                    ,38201240,CDM,301,RC,82746,CPT,,,,Inpatient,,,172.93,172.93,Wellcare,Wellcare,172.93,,,,,,,case rate,172.93,172.93,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Meritain Health PPO CPD,Meritain Health PPO CPD,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Aetna/Commercial Product,Aetna/Commercial Product,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Meritain Health CPD,Meritain Health CPD,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Starmark CPD,Starmark CPD,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Aetna Medicare,Aetna Medicare,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Ambetter ,Ambetter ,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Blue Access,Anthem Blue Access,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Blue Access Choice,Anthem Blue Access Choice,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Blue Preferred,Anthem Blue Preferred,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Pathway,Anthem Pathway,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Alliance,Anthem Alliance,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Anthem Medicare,Anthem Medicare,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Cigna,Cigna,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Cigna PPO,Cigna PPO,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Cigna Medicare Advantage,Cigna Medicare Advantage,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Essence,Essence,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Healthlink HMO,Healthlink HMO,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Healthlink PPO,Healthlink PPO,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,HomeState Health Plan,HomeState Health Plan,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Humana Gold,Humana Gold,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Medicaid MO,Medicaid MO,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Medica,Medica,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Tricare,Tricare,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,UHC All Payer,UHC All Payer,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,UHC Exchange,UHC Exchange,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,UHC Medicaid,UHC Medicaid,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,UMR CPD,UMR CPD,141.53,,,,,,,per diem,141.53,141.53,"Per diem rate, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,UHC Medicare,UHC Medicare,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
TREPONEMA PALLIDUM            ,38201256,CDM,302,RC,86780,CPT,,,,Inpatient,,,141.53,141.53,Wellcare,Wellcare,141.53,,,,,,,case rate,141.53,141.53,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Meritain Health PPO CPD,Meritain Health PPO CPD,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Aetna/Commercial Product,Aetna/Commercial Product,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Meritain Health CPD,Meritain Health CPD,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Starmark CPD,Starmark CPD,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Aetna Medicare,Aetna Medicare,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Ambetter ,Ambetter ,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Blue Access,Anthem Blue Access,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Blue Access Choice,Anthem Blue Access Choice,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Blue Preferred,Anthem Blue Preferred,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Pathway,Anthem Pathway,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Alliance,Anthem Alliance,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Anthem Medicare,Anthem Medicare,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Cigna,Cigna,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Cigna PPO,Cigna PPO,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Cigna Medicare Advantage,Cigna Medicare Advantage,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Essence,Essence,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Healthlink HMO,Healthlink HMO,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Healthlink PPO,Healthlink PPO,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,HomeState Health Plan,HomeState Health Plan,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Humana Gold,Humana Gold,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Medicaid MO,Medicaid MO,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Medica,Medica,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Tricare,Tricare,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,UHC All Payer,UHC All Payer,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,UHC Exchange,UHC Exchange,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,UHC Medicaid,UHC Medicaid,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,UMR CPD,UMR CPD,224.01,,,,,,,per diem,224.01,224.01,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,UHC Medicare,UHC Medicare,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38201260,CDM,306,RC,87210,CPT,,,,Inpatient,,,224.01,224.01,Wellcare,Wellcare,224.01,,,,,,,case rate,224.01,224.01,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Meritain Health PPO CPD,Meritain Health PPO CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Aetna/Commercial Product,Aetna/Commercial Product,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Meritain Health CPD,Meritain Health CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Starmark CPD,Starmark CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Aetna Medicare,Aetna Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Ambetter ,Ambetter ,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Access,Anthem Blue Access,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Access Choice,Anthem Blue Access Choice,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Preferred,Anthem Blue Preferred,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Pathway,Anthem Pathway,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Alliance,Anthem Alliance,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Anthem Medicare,Anthem Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Cigna,Cigna,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Cigna PPO,Cigna PPO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Cigna Medicare Advantage,Cigna Medicare Advantage,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Essence,Essence,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Healthlink HMO,Healthlink HMO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Healthlink PPO,Healthlink PPO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,HomeState Health Plan,HomeState Health Plan,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Humana Gold,Humana Gold,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Medicaid MO,Medicaid MO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Medica,Medica,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Tricare,Tricare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,UHC All Payer,UHC All Payer,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,UHC Exchange,UHC Exchange,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,UHC Medicaid,UHC Medicaid,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,UMR CPD,UMR CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,UHC Medicare,UHC Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GAMMA GT (GGT)                ,38201270,CDM,301,RC,82977,CPT,,,,Inpatient,,,97.6,97.6,Wellcare,Wellcare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Meritain Health PPO CPD,Meritain Health PPO CPD,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Aetna/Commercial Product,Aetna/Commercial Product,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Meritain Health CPD,Meritain Health CPD,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Starmark CPD,Starmark CPD,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Aetna Medicare,Aetna Medicare,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Ambetter ,Ambetter ,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Blue Access,Anthem Blue Access,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Blue Access Choice,Anthem Blue Access Choice,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Blue Preferred,Anthem Blue Preferred,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Pathway,Anthem Pathway,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Alliance,Anthem Alliance,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Anthem Medicare,Anthem Medicare,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Cigna,Cigna,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Cigna PPO,Cigna PPO,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Cigna Medicare Advantage,Cigna Medicare Advantage,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Essence,Essence,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Healthlink HMO,Healthlink HMO,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Healthlink PPO,Healthlink PPO,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,HomeState Health Plan,HomeState Health Plan,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Humana Gold,Humana Gold,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Medicaid MO,Medicaid MO,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Medica,Medica,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Tricare,Tricare,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,UHC All Payer,UHC All Payer,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,UHC Exchange,UHC Exchange,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,UHC Medicaid,UHC Medicaid,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,UMR CPD,UMR CPD,339.64,,,,,,,per diem,339.64,339.64,"Per diem rate, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,UHC Medicare,UHC Medicare,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GASTRIN                       ,38201280,CDM,301,RC,82941,CPT,,,,Inpatient,,,339.64,339.64,Wellcare,Wellcare,339.64,,,,,,,case rate,339.64,339.64,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Meritain Health PPO CPD,Meritain Health PPO CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Aetna/Commercial Product,Aetna/Commercial Product,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Meritain Health CPD,Meritain Health CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Starmark CPD,Starmark CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Aetna Medicare,Aetna Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Ambetter ,Ambetter ,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Access,Anthem Blue Access,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Access Choice,Anthem Blue Access Choice,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Preferred,Anthem Blue Preferred,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Pathway,Anthem Pathway,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Alliance,Anthem Alliance,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Anthem Medicare,Anthem Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Cigna,Cigna,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Cigna PPO,Cigna PPO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Cigna Medicare Advantage,Cigna Medicare Advantage,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Essence,Essence,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Healthlink HMO,Healthlink HMO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Healthlink PPO,Healthlink PPO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,HomeState Health Plan,HomeState Health Plan,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Humana Gold,Humana Gold,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Medicaid MO,Medicaid MO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Medica,Medica,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Tricare,Tricare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,UHC All Payer,UHC All Payer,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,UHC Exchange,UHC Exchange,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,UHC Medicaid,UHC Medicaid,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,UMR CPD,UMR CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,UHC Medicare,UHC Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38201290,CDM,301,RC,80170,CPT,,,,Inpatient,,,195.21,195.21,Wellcare,Wellcare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
GLUCAGON                      ,38201315,CDM,301,RC,82943,CPT,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Meritain Health PPO CPD,Meritain Health PPO CPD,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Aetna/Commercial Product,Aetna/Commercial Product,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Meritain Health CPD,Meritain Health CPD,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Starmark CPD,Starmark CPD,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Aetna Medicare,Aetna Medicare,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Ambetter ,Ambetter ,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Blue Access,Anthem Blue Access,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Blue Access Choice,Anthem Blue Access Choice,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Blue Preferred,Anthem Blue Preferred,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Pathway,Anthem Pathway,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Alliance,Anthem Alliance,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Anthem Medicare,Anthem Medicare,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Cigna,Cigna,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Cigna PPO,Cigna PPO,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Cigna Medicare Advantage,Cigna Medicare Advantage,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Essence,Essence,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Healthlink HMO,Healthlink HMO,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Healthlink PPO,Healthlink PPO,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,HomeState Health Plan,HomeState Health Plan,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Humana Gold,Humana Gold,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Medicaid MO,Medicaid MO,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Medica,Medica,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Tricare,Tricare,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,UHC All Payer,UHC All Payer,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,UHC Exchange,UHC Exchange,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,UHC Medicaid,UHC Medicaid,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,UMR CPD,UMR CPD,19.57,,,,,,,per diem,19.57,19.57,"Per diem rate, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,UHC Medicare,UHC Medicare,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE BLOOD, REAGENT STRIP  ",38201320,CDM,301,RC,82948,CPT,,,,Inpatient,,,19.57,19.57,Wellcare,Wellcare,19.57,,,,,,,case rate,19.57,19.57,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Meritain Health PPO CPD,Meritain Health PPO CPD,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Aetna/Commercial Product,Aetna/Commercial Product,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Meritain Health CPD,Meritain Health CPD,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Starmark CPD,Starmark CPD,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Aetna Medicare,Aetna Medicare,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Ambetter ,Ambetter ,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Blue Access,Anthem Blue Access,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Blue Access Choice,Anthem Blue Access Choice,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Blue Preferred,Anthem Blue Preferred,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Pathway,Anthem Pathway,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Alliance,Anthem Alliance,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Anthem Medicare,Anthem Medicare,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Cigna,Cigna,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Cigna PPO,Cigna PPO,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Cigna Medicare Advantage,Cigna Medicare Advantage,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Essence,Essence,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Healthlink HMO,Healthlink HMO,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Healthlink PPO,Healthlink PPO,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,HomeState Health Plan,HomeState Health Plan,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Humana Gold,Humana Gold,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Medicaid MO,Medicaid MO,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Medica,Medica,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Tricare,Tricare,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,UHC All Payer,UHC All Payer,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,UHC Exchange,UHC Exchange,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,UHC Medicaid,UHC Medicaid,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,UMR CPD,UMR CPD,50.93,,,,,,,per diem,50.93,50.93,"Per diem rate, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,UHC Medicare,UHC Medicare,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
"GLUCOSE,EXCEPT URINE          ",38201330,CDM,301,RC,82947,CPT,,,,Inpatient,,,50.93,50.93,Wellcare,Wellcare,50.93,,,,,,,case rate,50.93,50.93,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Meritain Health PPO CPD,Meritain Health PPO CPD,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Aetna/Commercial Product,Aetna/Commercial Product,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Meritain Health CPD,Meritain Health CPD,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Starmark CPD,Starmark CPD,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Aetna Medicare,Aetna Medicare,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Ambetter ,Ambetter ,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Blue Access,Anthem Blue Access,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Blue Access Choice,Anthem Blue Access Choice,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Blue Preferred,Anthem Blue Preferred,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Pathway,Anthem Pathway,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Alliance,Anthem Alliance,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Anthem Medicare,Anthem Medicare,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Cigna,Cigna,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Cigna PPO,Cigna PPO,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Cigna Medicare Advantage,Cigna Medicare Advantage,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Essence,Essence,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Healthlink HMO,Healthlink HMO,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Healthlink PPO,Healthlink PPO,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,HomeState Health Plan,HomeState Health Plan,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Humana Gold,Humana Gold,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Medicaid MO,Medicaid MO,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Medica,Medica,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Tricare,Tricare,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,UHC All Payer,UHC All Payer,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,UHC Exchange,UHC Exchange,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,UHC Medicaid,UHC Medicaid,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,UMR CPD,UMR CPD,161.72,,,,,,,per diem,161.72,161.72,"Per diem rate, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,UHC Medicare,UHC Medicare,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
GLUCOSE TOL - 3 SPECIMENS     ,38201350,CDM,301,RC,82951,CPT,,,,Inpatient,,,161.72,161.72,Wellcare,Wellcare,161.72,,,,,,,case rate,161.72,161.72,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Meritain Health PPO CPD,Meritain Health PPO CPD,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Aetna/Commercial Product,Aetna/Commercial Product,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Meritain Health CPD,Meritain Health CPD,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Starmark CPD,Starmark CPD,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Aetna Medicare,Aetna Medicare,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Ambetter ,Ambetter ,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Blue Access,Anthem Blue Access,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Blue Access Choice,Anthem Blue Access Choice,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Blue Preferred,Anthem Blue Preferred,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Pathway,Anthem Pathway,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Alliance,Anthem Alliance,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Anthem Medicare,Anthem Medicare,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Cigna,Cigna,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Cigna PPO,Cigna PPO,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Cigna Medicare Advantage,Cigna Medicare Advantage,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Essence,Essence,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Healthlink HMO,Healthlink HMO,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Healthlink PPO,Healthlink PPO,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,HomeState Health Plan,HomeState Health Plan,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Humana Gold,Humana Gold,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Medicaid MO,Medicaid MO,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Medica,Medica,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Tricare,Tricare,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,UHC All Payer,UHC All Payer,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,UHC Exchange,UHC Exchange,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,UHC Medicaid,UHC Medicaid,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,UMR CPD,UMR CPD,70.67,,,,,,,per diem,70.67,70.67,"Per diem rate, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,UHC Medicare,UHC Medicare,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
"GLUCOSE TOL, EACH ADD SPEC    ",38201360,CDM,301,RC,82952,CPT,,,,Inpatient,,,70.67,70.67,Wellcare,Wellcare,70.67,,,,,,,case rate,70.67,70.67,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health PPO CPD,Meritain Health PPO CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Aetna/Commercial Product,Aetna/Commercial Product,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health CPD,Meritain Health CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Starmark CPD,Starmark CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Aetna Medicare,Aetna Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Ambetter ,Ambetter ,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access,Anthem Blue Access,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access Choice,Anthem Blue Access Choice,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Preferred,Anthem Blue Preferred,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Pathway,Anthem Pathway,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Alliance,Anthem Alliance,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Anthem Medicare,Anthem Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Cigna,Cigna,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Cigna PPO,Cigna PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Cigna Medicare Advantage,Cigna Medicare Advantage,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Essence,Essence,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Healthlink HMO,Healthlink HMO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Healthlink PPO,Healthlink PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,HomeState Health Plan,HomeState Health Plan,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Humana Gold,Humana Gold,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Medicaid MO,Medicaid MO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Medica,Medica,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Tricare,Tricare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,UHC All Payer,UHC All Payer,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,UHC Exchange,UHC Exchange,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicaid,UHC Medicaid,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,UMR CPD,UMR CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicare,UHC Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GLYCOHEMOGLOBIN  (HGB A1)     ,38201380,CDM,301,RC,83036,CPT,,,,Inpatient,,,137.92,137.92,Wellcare,Wellcare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Meritain Health PPO CPD,Meritain Health PPO CPD,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Aetna/Commercial Product,Aetna/Commercial Product,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Meritain Health CPD,Meritain Health CPD,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Starmark CPD,Starmark CPD,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Aetna Medicare,Aetna Medicare,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Ambetter ,Ambetter ,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Blue Access,Anthem Blue Access,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Blue Access Choice,Anthem Blue Access Choice,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Blue Preferred,Anthem Blue Preferred,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Pathway,Anthem Pathway,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Alliance,Anthem Alliance,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Anthem Medicare,Anthem Medicare,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Cigna,Cigna,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Cigna PPO,Cigna PPO,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Cigna Medicare Advantage,Cigna Medicare Advantage,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Essence,Essence,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Healthlink HMO,Healthlink HMO,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Healthlink PPO,Healthlink PPO,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,HomeState Health Plan,HomeState Health Plan,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Humana Gold,Humana Gold,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Medicaid MO,Medicaid MO,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Medica,Medica,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Tricare,Tricare,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,UHC All Payer,UHC All Payer,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,UHC Exchange,UHC Exchange,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,UHC Medicaid,UHC Medicaid,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,UMR CPD,UMR CPD,269.75,,,,,,,per diem,269.75,269.75,"Per diem rate, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,UHC Medicare,UHC Medicare,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GONORRHEA DNA PROBE           ,38201385,CDM,306,RC,87800,CPT,,,,Inpatient,,,269.75,269.75,Wellcare,Wellcare,269.75,,,,,,,case rate,269.75,269.75,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM/GIESMA SMEAR             ,38201390,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Meritain Health PPO CPD,Meritain Health PPO CPD,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Aetna/Commercial Product,Aetna/Commercial Product,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Meritain Health CPD,Meritain Health CPD,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Starmark CPD,Starmark CPD,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Aetna Medicare,Aetna Medicare,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Ambetter ,Ambetter ,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Blue Access,Anthem Blue Access,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Blue Access Choice,Anthem Blue Access Choice,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Blue Preferred,Anthem Blue Preferred,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Pathway,Anthem Pathway,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Alliance,Anthem Alliance,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Anthem Medicare,Anthem Medicare,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Cigna,Cigna,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Cigna PPO,Cigna PPO,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Cigna Medicare Advantage,Cigna Medicare Advantage,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Essence,Essence,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Healthlink HMO,Healthlink HMO,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Healthlink PPO,Healthlink PPO,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,HomeState Health Plan,HomeState Health Plan,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Humana Gold,Humana Gold,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Medicaid MO,Medicaid MO,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Medica,Medica,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Tricare,Tricare,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,UHC All Payer,UHC All Payer,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,UHC Exchange,UHC Exchange,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,UHC Medicaid,UHC Medicaid,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,UMR CPD,UMR CPD,272.13,,,,,,,per diem,272.13,272.13,"Per diem rate, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,UHC Medicare,UHC Medicare,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
POST GLUCOSE DOSE (GTT)       ,38201399,CDM,301,RC,82950,CPT,,,,Inpatient,,,272.13,272.13,Wellcare,Wellcare,272.13,,,,,,,case rate,272.13,272.13,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Meritain Health PPO CPD,Meritain Health PPO CPD,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Aetna/Commercial Product,Aetna/Commercial Product,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Meritain Health CPD,Meritain Health CPD,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Starmark CPD,Starmark CPD,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Aetna Medicare,Aetna Medicare,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Ambetter ,Ambetter ,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Blue Access,Anthem Blue Access,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Blue Access Choice,Anthem Blue Access Choice,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Blue Preferred,Anthem Blue Preferred,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Pathway,Anthem Pathway,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Alliance,Anthem Alliance,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Anthem Medicare,Anthem Medicare,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Cigna,Cigna,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Cigna PPO,Cigna PPO,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Cigna Medicare Advantage,Cigna Medicare Advantage,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Essence,Essence,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Healthlink HMO,Healthlink HMO,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Healthlink PPO,Healthlink PPO,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,HomeState Health Plan,HomeState Health Plan,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Humana Gold,Humana Gold,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Medicaid MO,Medicaid MO,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Medica,Medica,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Tricare,Tricare,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,UHC All Payer,UHC All Payer,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,UHC Exchange,UHC Exchange,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,UHC Medicaid,UHC Medicaid,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,UMR CPD,UMR CPD,179.29,,,,,,,per diem,179.29,179.29,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,UHC Medicare,UHC Medicare,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38201400,CDM,301,RC,83010,CPT,,,,Inpatient,,,179.29,179.29,Wellcare,Wellcare,179.29,,,,,,,case rate,179.29,179.29,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Meritain Health PPO CPD,Meritain Health PPO CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Aetna/Commercial Product,Aetna/Commercial Product,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Meritain Health CPD,Meritain Health CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Starmark CPD,Starmark CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Aetna Medicare,Aetna Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Ambetter ,Ambetter ,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Access,Anthem Blue Access,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Access Choice,Anthem Blue Access Choice,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Preferred,Anthem Blue Preferred,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Pathway,Anthem Pathway,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Alliance,Anthem Alliance,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Anthem Medicare,Anthem Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Cigna,Cigna,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Cigna PPO,Cigna PPO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Cigna Medicare Advantage,Cigna Medicare Advantage,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Essence,Essence,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Healthlink HMO,Healthlink HMO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Healthlink PPO,Healthlink PPO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,HomeState Health Plan,HomeState Health Plan,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Humana Gold,Humana Gold,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Medicaid MO,Medicaid MO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Medica,Medica,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Tricare,Tricare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,UHC All Payer,UHC All Payer,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,UHC Exchange,UHC Exchange,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,UHC Medicaid,UHC Medicaid,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,UMR CPD,UMR CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,UHC Medicare,UHC Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HCG QUAL URINE                ,38201410,CDM,307,RC,84703,CPT,,,,Inpatient,,,114.58,114.58,Wellcare,Wellcare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Meritain Health PPO CPD,Meritain Health PPO CPD,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Aetna/Commercial Product,Aetna/Commercial Product,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Meritain Health CPD,Meritain Health CPD,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Starmark CPD,Starmark CPD,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Aetna Medicare,Aetna Medicare,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Ambetter ,Ambetter ,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Blue Access,Anthem Blue Access,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Blue Access Choice,Anthem Blue Access Choice,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Blue Preferred,Anthem Blue Preferred,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Pathway,Anthem Pathway,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Alliance,Anthem Alliance,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Anthem Medicare,Anthem Medicare,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Cigna,Cigna,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Cigna PPO,Cigna PPO,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Cigna Medicare Advantage,Cigna Medicare Advantage,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Essence,Essence,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Healthlink HMO,Healthlink HMO,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Healthlink PPO,Healthlink PPO,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,HomeState Health Plan,HomeState Health Plan,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Humana Gold,Humana Gold,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Medicaid MO,Medicaid MO,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Medica,Medica,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Tricare,Tricare,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,UHC All Payer,UHC All Payer,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,UHC Exchange,UHC Exchange,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,UHC Medicaid,UHC Medicaid,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,UMR CPD,UMR CPD,79.46,,,,,,,per diem,79.46,79.46,"Per diem rate, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,UHC Medicare,UHC Medicare,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HELICOBACTER PYLORI AB        ,38201415,CDM,302,RC,86677,CPT,,,,Inpatient,,,79.46,79.46,Wellcare,Wellcare,79.46,,,,,,,case rate,79.46,79.46,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health PPO CPD,Meritain Health PPO CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/Commercial Product,Aetna/Commercial Product,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health CPD,Meritain Health CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Starmark CPD,Starmark CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna Medicare,Aetna Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Ambetter ,Ambetter ,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access,Anthem Blue Access,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access Choice,Anthem Blue Access Choice,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Preferred,Anthem Blue Preferred,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Pathway,Anthem Pathway,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Alliance,Anthem Alliance,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Medicare,Anthem Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna,Cigna,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna PPO,Cigna PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna Medicare Advantage,Cigna Medicare Advantage,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Essence,Essence,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink HMO,Healthlink HMO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink PPO,Healthlink PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,HomeState Health Plan,HomeState Health Plan,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Humana Gold,Humana Gold,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medicaid MO,Medicaid MO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medica,Medica,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Tricare,Tricare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC All Payer,UHC All Payer,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Exchange,UHC Exchange,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicaid,UHC Medicaid,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UMR CPD,UMR CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicare,UHC Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HEMATOCRIT                    ,38201420,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Wellcare,Wellcare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health PPO CPD,Meritain Health PPO CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/Commercial Product,Aetna/Commercial Product,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health CPD,Meritain Health CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Starmark CPD,Starmark CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna Medicare,Aetna Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Ambetter ,Ambetter ,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access,Anthem Blue Access,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access Choice,Anthem Blue Access Choice,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Preferred,Anthem Blue Preferred,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Pathway,Anthem Pathway,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Alliance,Anthem Alliance,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Medicare,Anthem Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna,Cigna,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna PPO,Cigna PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna Medicare Advantage,Cigna Medicare Advantage,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Essence,Essence,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink HMO,Healthlink HMO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink PPO,Healthlink PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,HomeState Health Plan,HomeState Health Plan,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Humana Gold,Humana Gold,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medicaid MO,Medicaid MO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medica,Medica,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Tricare,Tricare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC All Payer,UHC All Payer,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Exchange,UHC Exchange,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicaid,UHC Medicaid,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UMR CPD,UMR CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicare,UHC Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38201425,CDM,300,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Wellcare,Wellcare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Meritain Health PPO CPD,Meritain Health PPO CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Aetna/Commercial Product,Aetna/Commercial Product,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Meritain Health CPD,Meritain Health CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Starmark CPD,Starmark CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Aetna Medicare,Aetna Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Ambetter ,Ambetter ,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Access,Anthem Blue Access,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Access Choice,Anthem Blue Access Choice,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Preferred,Anthem Blue Preferred,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Pathway,Anthem Pathway,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Alliance,Anthem Alliance,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Anthem Medicare,Anthem Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Cigna,Cigna,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Cigna PPO,Cigna PPO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Cigna Medicare Advantage,Cigna Medicare Advantage,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Essence,Essence,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Healthlink HMO,Healthlink HMO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Healthlink PPO,Healthlink PPO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,HomeState Health Plan,HomeState Health Plan,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Humana Gold,Humana Gold,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Medicaid MO,Medicaid MO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Medica,Medica,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Tricare,Tricare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,UHC All Payer,UHC All Payer,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,UHC Exchange,UHC Exchange,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,UHC Medicaid,UHC Medicaid,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,UMR CPD,UMR CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,UHC Medicare,UHC Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"CBC, AUTO W/O DIFF            ",38201439,CDM,305,RC,85027,CPT,,,,Inpatient,,,117.76,117.76,Wellcare,Wellcare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Meritain Health PPO CPD,Meritain Health PPO CPD,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Aetna/Commercial Product,Aetna/Commercial Product,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Meritain Health CPD,Meritain Health CPD,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Starmark CPD,Starmark CPD,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Aetna Medicare,Aetna Medicare,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Ambetter ,Ambetter ,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Blue Access,Anthem Blue Access,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Blue Access Choice,Anthem Blue Access Choice,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Blue Preferred,Anthem Blue Preferred,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Pathway,Anthem Pathway,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Alliance,Anthem Alliance,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Anthem Medicare,Anthem Medicare,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Cigna,Cigna,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Cigna PPO,Cigna PPO,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Cigna Medicare Advantage,Cigna Medicare Advantage,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Essence,Essence,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Healthlink HMO,Healthlink HMO,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Healthlink PPO,Healthlink PPO,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,HomeState Health Plan,HomeState Health Plan,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Humana Gold,Humana Gold,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Medicaid MO,Medicaid MO,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Medica,Medica,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Tricare,Tricare,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,UHC All Payer,UHC All Payer,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,UHC Exchange,UHC Exchange,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,UHC Medicaid,UHC Medicaid,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,UMR CPD,UMR CPD,38.7,,,,,,,per diem,38.7,38.7,"Per diem rate, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,UHC Medicare,UHC Medicare,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEMOSIDERIN                   ,38201441,CDM,301,RC,83070,CPT,,,,Inpatient,,,38.7,38.7,Wellcare,Wellcare,38.7,,,,,,,case rate,38.7,38.7,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Meritain Health PPO CPD,Meritain Health PPO CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Aetna/Commercial Product,Aetna/Commercial Product,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Meritain Health CPD,Meritain Health CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Starmark CPD,Starmark CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Aetna Medicare,Aetna Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Ambetter ,Ambetter ,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Access,Anthem Blue Access,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Access Choice,Anthem Blue Access Choice,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Blue Preferred,Anthem Blue Preferred,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Pathway,Anthem Pathway,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Alliance,Anthem Alliance,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Anthem Medicare,Anthem Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Cigna,Cigna,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Cigna PPO,Cigna PPO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Cigna Medicare Advantage,Cigna Medicare Advantage,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Essence,Essence,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Healthlink HMO,Healthlink HMO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Healthlink PPO,Healthlink PPO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,HomeState Health Plan,HomeState Health Plan,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Humana Gold,Humana Gold,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Medicaid MO,Medicaid MO,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Medica,Medica,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Tricare,Tricare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,UHC All Payer,UHC All Payer,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,UHC Exchange,UHC Exchange,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,UHC Medicaid,UHC Medicaid,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,UMR CPD,UMR CPD,195.21,,,,,,,per diem,195.21,195.21,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,UHC Medicare,UHC Medicare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY          ,38201450,CDM,302,RC,86708,CPT,,,,Inpatient,,,195.21,195.21,Wellcare,Wellcare,195.21,,,,,,,case rate,195.21,195.21,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health PPO CPD,Meritain Health PPO CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Aetna/Commercial Product,Aetna/Commercial Product,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health CPD,Meritain Health CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Starmark CPD,Starmark CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Aetna Medicare,Aetna Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Ambetter ,Ambetter ,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access,Anthem Blue Access,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access Choice,Anthem Blue Access Choice,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Preferred,Anthem Blue Preferred,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Pathway,Anthem Pathway,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Alliance,Anthem Alliance,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Anthem Medicare,Anthem Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Cigna,Cigna,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Cigna PPO,Cigna PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Cigna Medicare Advantage,Cigna Medicare Advantage,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Essence,Essence,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Healthlink HMO,Healthlink HMO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Healthlink PPO,Healthlink PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,HomeState Health Plan,HomeState Health Plan,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Humana Gold,Humana Gold,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Medicaid MO,Medicaid MO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Medica,Medica,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Tricare,Tricare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,UHC All Payer,UHC All Payer,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,UHC Exchange,UHC Exchange,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicaid,UHC Medicaid,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,UMR CPD,UMR CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicare,UHC Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38201455,CDM,302,RC,86709,CPT,,,,Inpatient,,,147.47,147.47,Wellcare,Wellcare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Meritain Health PPO CPD,Meritain Health PPO CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Aetna/Commercial Product,Aetna/Commercial Product,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Meritain Health CPD,Meritain Health CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Starmark CPD,Starmark CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Aetna Medicare,Aetna Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Ambetter ,Ambetter ,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Access,Anthem Blue Access,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Access Choice,Anthem Blue Access Choice,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Preferred,Anthem Blue Preferred,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Pathway,Anthem Pathway,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Alliance,Anthem Alliance,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Anthem Medicare,Anthem Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Cigna,Cigna,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Cigna PPO,Cigna PPO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Cigna Medicare Advantage,Cigna Medicare Advantage,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Essence,Essence,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Healthlink HMO,Healthlink HMO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Healthlink PPO,Healthlink PPO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,HomeState Health Plan,HomeState Health Plan,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Humana Gold,Humana Gold,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Medicaid MO,Medicaid MO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Medica,Medica,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Tricare,Tricare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,UHC All Payer,UHC All Payer,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,UHC Exchange,UHC Exchange,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,UHC Medicaid,UHC Medicaid,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,UMR CPD,UMR CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,UHC Medicare,UHC Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38201460,CDM,302,RC,86706,CPT,,,,Inpatient,,,165.5,165.5,Wellcare,Wellcare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Meritain Health PPO CPD,Meritain Health PPO CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Aetna/Commercial Product,Aetna/Commercial Product,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Meritain Health CPD,Meritain Health CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Starmark CPD,Starmark CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Aetna Medicare,Aetna Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Ambetter ,Ambetter ,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Access,Anthem Blue Access,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Access Choice,Anthem Blue Access Choice,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Preferred,Anthem Blue Preferred,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Pathway,Anthem Pathway,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Alliance,Anthem Alliance,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Anthem Medicare,Anthem Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Cigna,Cigna,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Cigna PPO,Cigna PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Cigna Medicare Advantage,Cigna Medicare Advantage,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Essence,Essence,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Healthlink HMO,Healthlink HMO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Healthlink PPO,Healthlink PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,HomeState Health Plan,HomeState Health Plan,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Humana Gold,Humana Gold,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Medicaid MO,Medicaid MO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Medica,Medica,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Tricare,Tricare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,UHC All Payer,UHC All Payer,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,UHC Exchange,UHC Exchange,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,UHC Medicaid,UHC Medicaid,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,UMR CPD,UMR CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,UHC Medicare,UHC Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38201465,CDM,302,RC,86707,CPT,,,,Inpatient,,,152.77,152.77,Wellcare,Wellcare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health PPO CPD,Meritain Health PPO CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Aetna/Commercial Product,Aetna/Commercial Product,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health CPD,Meritain Health CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Starmark CPD,Starmark CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Aetna Medicare,Aetna Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Ambetter ,Ambetter ,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access,Anthem Blue Access,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access Choice,Anthem Blue Access Choice,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Preferred,Anthem Blue Preferred,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Pathway,Anthem Pathway,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Alliance,Anthem Alliance,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Anthem Medicare,Anthem Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Cigna,Cigna,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Cigna PPO,Cigna PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Cigna Medicare Advantage,Cigna Medicare Advantage,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Essence,Essence,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Healthlink HMO,Healthlink HMO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Healthlink PPO,Healthlink PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,HomeState Health Plan,HomeState Health Plan,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Humana Gold,Humana Gold,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Medicaid MO,Medicaid MO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Medica,Medica,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Tricare,Tricare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,UHC All Payer,UHC All Payer,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,UHC Exchange,UHC Exchange,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicaid,UHC Medicaid,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,UMR CPD,UMR CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicare,UHC Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38201470,CDM,306,RC,87340,CPT,,,,Inpatient,,,159.14,159.14,Wellcare,Wellcare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Meritain Health PPO CPD,Meritain Health PPO CPD,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Aetna/Commercial Product,Aetna/Commercial Product,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Meritain Health CPD,Meritain Health CPD,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Starmark CPD,Starmark CPD,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Aetna Medicare,Aetna Medicare,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Ambetter ,Ambetter ,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Blue Access,Anthem Blue Access,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Blue Access Choice,Anthem Blue Access Choice,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Blue Preferred,Anthem Blue Preferred,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Pathway,Anthem Pathway,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Alliance,Anthem Alliance,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Anthem Medicare,Anthem Medicare,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Cigna,Cigna,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Cigna PPO,Cigna PPO,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Cigna Medicare Advantage,Cigna Medicare Advantage,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Essence,Essence,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Healthlink HMO,Healthlink HMO,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Healthlink PPO,Healthlink PPO,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,HomeState Health Plan,HomeState Health Plan,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Humana Gold,Humana Gold,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Medicaid MO,Medicaid MO,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Medica,Medica,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Tricare,Tricare,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,UHC All Payer,UHC All Payer,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,UHC Exchange,UHC Exchange,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,UHC Medicaid,UHC Medicaid,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,UMR CPD,UMR CPD,157.01,,,,,,,per diem,157.01,157.01,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,UHC Medicare,UHC Medicare,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38201472,CDM,302,RC,86704,CPT,,,,Inpatient,,,157.01,157.01,Wellcare,Wellcare,157.01,,,,,,,case rate,157.01,157.01,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Meritain Health PPO CPD,Meritain Health PPO CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Aetna/Commercial Product,Aetna/Commercial Product,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Meritain Health CPD,Meritain Health CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Starmark CPD,Starmark CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Aetna Medicare,Aetna Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Ambetter ,Ambetter ,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Access,Anthem Blue Access,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Access Choice,Anthem Blue Access Choice,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Blue Preferred,Anthem Blue Preferred,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Pathway,Anthem Pathway,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Alliance,Anthem Alliance,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Anthem Medicare,Anthem Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Cigna,Cigna,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Cigna PPO,Cigna PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Cigna Medicare Advantage,Cigna Medicare Advantage,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Essence,Essence,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Healthlink HMO,Healthlink HMO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Healthlink PPO,Healthlink PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,HomeState Health Plan,HomeState Health Plan,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Humana Gold,Humana Gold,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Medicaid MO,Medicaid MO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Medica,Medica,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Tricare,Tricare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,UHC All Payer,UHC All Payer,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,UHC Exchange,UHC Exchange,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,UHC Medicaid,UHC Medicaid,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,UMR CPD,UMR CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,UHC Medicare,UHC Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38201475,CDM,306,RC,87350,CPT,,,,Inpatient,,,152.77,152.77,Wellcare,Wellcare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health PPO CPD,Meritain Health PPO CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Aetna/Commercial Product,Aetna/Commercial Product,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health CPD,Meritain Health CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Starmark CPD,Starmark CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Aetna Medicare,Aetna Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Ambetter ,Ambetter ,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access,Anthem Blue Access,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access Choice,Anthem Blue Access Choice,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Preferred,Anthem Blue Preferred,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Pathway,Anthem Pathway,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Alliance,Anthem Alliance,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Anthem Medicare,Anthem Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Cigna,Cigna,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Cigna PPO,Cigna PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Cigna Medicare Advantage,Cigna Medicare Advantage,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Essence,Essence,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Healthlink HMO,Healthlink HMO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Healthlink PPO,Healthlink PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,HomeState Health Plan,HomeState Health Plan,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Humana Gold,Humana Gold,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Medicaid MO,Medicaid MO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Medica,Medica,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Tricare,Tricare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,UHC All Payer,UHC All Payer,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,UHC Exchange,UHC Exchange,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicaid,UHC Medicaid,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,UMR CPD,UMR CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicare,UHC Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38201480,CDM,302,RC,86803,CPT,,,,Inpatient,,,198.39,198.39,Wellcare,Wellcare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Meritain Health PPO CPD,Meritain Health PPO CPD,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Aetna/Commercial Product,Aetna/Commercial Product,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Meritain Health CPD,Meritain Health CPD,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Starmark CPD,Starmark CPD,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Aetna Medicare,Aetna Medicare,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Ambetter ,Ambetter ,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Blue Access,Anthem Blue Access,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Blue Access Choice,Anthem Blue Access Choice,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Blue Preferred,Anthem Blue Preferred,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Pathway,Anthem Pathway,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Alliance,Anthem Alliance,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Anthem Medicare,Anthem Medicare,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Cigna,Cigna,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Cigna PPO,Cigna PPO,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Cigna Medicare Advantage,Cigna Medicare Advantage,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Essence,Essence,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Healthlink HMO,Healthlink HMO,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Healthlink PPO,Healthlink PPO,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,HomeState Health Plan,HomeState Health Plan,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Humana Gold,Humana Gold,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Medicaid MO,Medicaid MO,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Medica,Medica,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Tricare,Tricare,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,UHC All Payer,UHC All Payer,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,UHC Exchange,UHC Exchange,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,UHC Medicaid,UHC Medicaid,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,UMR CPD,UMR CPD,150.72,,,,,,,per diem,150.72,150.72,"Per diem rate, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,UHC Medicare,UHC Medicare,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
HEPATITIS C AMP. PROBE TECH   ,38201481,CDM,306,RC,87521,CPT,,,,Inpatient,,,150.72,150.72,Wellcare,Wellcare,150.72,,,,,,,case rate,150.72,150.72,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Meritain Health PPO CPD,Meritain Health PPO CPD,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Aetna/Commercial Product,Aetna/Commercial Product,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Meritain Health CPD,Meritain Health CPD,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Starmark CPD,Starmark CPD,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Aetna Medicare,Aetna Medicare,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Ambetter ,Ambetter ,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Blue Access,Anthem Blue Access,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Blue Access Choice,Anthem Blue Access Choice,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Blue Preferred,Anthem Blue Preferred,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Pathway,Anthem Pathway,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Alliance,Anthem Alliance,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Anthem Medicare,Anthem Medicare,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Cigna,Cigna,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Cigna PPO,Cigna PPO,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Cigna Medicare Advantage,Cigna Medicare Advantage,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Essence,Essence,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Healthlink HMO,Healthlink HMO,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Healthlink PPO,Healthlink PPO,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,HomeState Health Plan,HomeState Health Plan,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Humana Gold,Humana Gold,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Medicaid MO,Medicaid MO,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Medica,Medica,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Tricare,Tricare,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,UHC All Payer,UHC All Payer,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,UHC Exchange,UHC Exchange,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,UHC Medicaid,UHC Medicaid,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,UMR CPD,UMR CPD,161.95,,,,,,,per diem,161.95,161.95,"Per diem rate, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,UHC Medicare,UHC Medicare,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
"HEPATITIS C AB, CONFIRM       ",38201482,CDM,302,RC,86804,CPT,,,,Inpatient,,,161.95,161.95,Wellcare,Wellcare,161.95,,,,,,,case rate,161.95,161.95,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Meritain Health PPO CPD,Meritain Health PPO CPD,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Aetna/Commercial Product,Aetna/Commercial Product,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Meritain Health CPD,Meritain Health CPD,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Starmark CPD,Starmark CPD,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Aetna Medicare,Aetna Medicare,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Ambetter ,Ambetter ,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Blue Access,Anthem Blue Access,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Blue Access Choice,Anthem Blue Access Choice,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Blue Preferred,Anthem Blue Preferred,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Pathway,Anthem Pathway,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Alliance,Anthem Alliance,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Anthem Medicare,Anthem Medicare,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Cigna,Cigna,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Cigna PPO,Cigna PPO,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Cigna Medicare Advantage,Cigna Medicare Advantage,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Essence,Essence,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Healthlink HMO,Healthlink HMO,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Healthlink PPO,Healthlink PPO,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,HomeState Health Plan,HomeState Health Plan,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Humana Gold,Humana Gold,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Medicaid MO,Medicaid MO,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Medica,Medica,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Tricare,Tricare,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,UHC All Payer,UHC All Payer,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,UHC Exchange,UHC Exchange,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,UHC Medicaid,UHC Medicaid,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,UMR CPD,UMR CPD,618.5,,,,,,,per diem,618.5,618.5,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,UHC Medicare,UHC Medicare,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38201498,CDM,301,RC,80074,CPT,,,,Inpatient,,,618.5,618.5,Wellcare,Wellcare,618.5,,,,,,,case rate,618.5,618.5,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Meritain Health PPO CPD,Meritain Health PPO CPD,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Aetna/Commercial Product,Aetna/Commercial Product,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Meritain Health CPD,Meritain Health CPD,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Starmark CPD,Starmark CPD,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Aetna Medicare,Aetna Medicare,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Ambetter ,Ambetter ,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Blue Access,Anthem Blue Access,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Blue Access Choice,Anthem Blue Access Choice,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Blue Preferred,Anthem Blue Preferred,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Pathway,Anthem Pathway,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Alliance,Anthem Alliance,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Anthem Medicare,Anthem Medicare,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Cigna,Cigna,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Cigna PPO,Cigna PPO,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Cigna Medicare Advantage,Cigna Medicare Advantage,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Essence,Essence,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Healthlink HMO,Healthlink HMO,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Healthlink PPO,Healthlink PPO,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,HomeState Health Plan,HomeState Health Plan,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Humana Gold,Humana Gold,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Medicaid MO,Medicaid MO,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Medica,Medica,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Tricare,Tricare,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,UHC All Payer,UHC All Payer,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,UHC Exchange,UHC Exchange,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,UHC Medicaid,UHC Medicaid,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,UMR CPD,UMR CPD,41.2,,,,,,,per diem,41.2,41.2,"Per diem rate, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,UHC Medicare,UHC Medicare,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
HEPATITIS DELTA VIRUS AB      ,38201499,CDM,302,RC,86692,CPT,,,,Inpatient,,,41.2,41.2,Wellcare,Wellcare,41.2,,,,,,,case rate,41.2,41.2,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Meritain Health PPO CPD,Meritain Health PPO CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna/Commercial Product,Aetna/Commercial Product,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Meritain Health CPD,Meritain Health CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Starmark CPD,Starmark CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna Medicare,Aetna Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Ambetter ,Ambetter ,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Access,Anthem Blue Access,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Access Choice,Anthem Blue Access Choice,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Preferred,Anthem Blue Preferred,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Pathway,Anthem Pathway,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Alliance,Anthem Alliance,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Medicare,Anthem Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna,Cigna,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna PPO,Cigna PPO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna Medicare Advantage,Cigna Medicare Advantage,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Essence,Essence,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthlink HMO,Healthlink HMO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthlink PPO,Healthlink PPO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,HomeState Health Plan,HomeState Health Plan,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Humana Gold,Humana Gold,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Medicaid MO,Medicaid MO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Medica,Medica,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Tricare,Tricare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC All Payer,UHC All Payer,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Exchange,UHC Exchange,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Medicaid,UHC Medicaid,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UMR CPD,UMR CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Medicare,UHC Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38201501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Wellcare,Wellcare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CULTURE HERPES                ,38201505,CDM,306,RC,87254,CPT,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Meritain Health PPO CPD,Meritain Health PPO CPD,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Aetna/Commercial Product,Aetna/Commercial Product,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Meritain Health CPD,Meritain Health CPD,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Starmark CPD,Starmark CPD,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Aetna Medicare,Aetna Medicare,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Ambetter ,Ambetter ,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Blue Access,Anthem Blue Access,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Blue Access Choice,Anthem Blue Access Choice,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Blue Preferred,Anthem Blue Preferred,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Pathway,Anthem Pathway,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Alliance,Anthem Alliance,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Anthem Medicare,Anthem Medicare,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Cigna,Cigna,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Cigna PPO,Cigna PPO,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Cigna Medicare Advantage,Cigna Medicare Advantage,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Essence,Essence,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Healthlink HMO,Healthlink HMO,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Healthlink PPO,Healthlink PPO,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,HomeState Health Plan,HomeState Health Plan,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Humana Gold,Humana Gold,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Medicaid MO,Medicaid MO,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Medica,Medica,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Tricare,Tricare,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,UHC All Payer,UHC All Payer,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,UHC Exchange,UHC Exchange,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,UHC Medicaid,UHC Medicaid,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,UMR CPD,UMR CPD,352.97,,,,,,,per diem,352.97,352.97,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,UHC Medicare,UHC Medicare,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38201540,CDM,302,RC,86701,CPT,,,,Inpatient,,,352.97,352.97,Wellcare,Wellcare,352.97,,,,,,,case rate,352.97,352.97,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Meritain Health PPO CPD,Meritain Health PPO CPD,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Aetna/Commercial Product,Aetna/Commercial Product,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Meritain Health CPD,Meritain Health CPD,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Starmark CPD,Starmark CPD,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Aetna Medicare,Aetna Medicare,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Ambetter ,Ambetter ,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Blue Access,Anthem Blue Access,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Blue Access Choice,Anthem Blue Access Choice,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Blue Preferred,Anthem Blue Preferred,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Pathway,Anthem Pathway,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Alliance,Anthem Alliance,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Anthem Medicare,Anthem Medicare,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Cigna,Cigna,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Cigna PPO,Cigna PPO,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Cigna Medicare Advantage,Cigna Medicare Advantage,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Essence,Essence,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Healthlink HMO,Healthlink HMO,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Healthlink PPO,Healthlink PPO,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,HomeState Health Plan,HomeState Health Plan,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Humana Gold,Humana Gold,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Medicaid MO,Medicaid MO,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Medica,Medica,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Tricare,Tricare,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,UHC All Payer,UHC All Payer,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,UHC Exchange,UHC Exchange,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,UHC Medicaid,UHC Medicaid,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,UMR CPD,UMR CPD,68.73,,,,,,,per diem,68.73,68.73,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,UHC Medicare,UHC Medicare,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 2 ABY     ,38201541,CDM,302,RC,86696,CPT,,,,Inpatient,,,68.73,68.73,Wellcare,Wellcare,68.73,,,,,,,case rate,68.73,68.73,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Meritain Health PPO CPD,Meritain Health PPO CPD,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Aetna/Commercial Product,Aetna/Commercial Product,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Meritain Health CPD,Meritain Health CPD,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Starmark CPD,Starmark CPD,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Aetna Medicare,Aetna Medicare,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Ambetter ,Ambetter ,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Blue Access,Anthem Blue Access,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Blue Access Choice,Anthem Blue Access Choice,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Blue Preferred,Anthem Blue Preferred,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Pathway,Anthem Pathway,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Alliance,Anthem Alliance,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Anthem Medicare,Anthem Medicare,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Cigna,Cigna,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Cigna PPO,Cigna PPO,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Cigna Medicare Advantage,Cigna Medicare Advantage,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Essence,Essence,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Healthlink HMO,Healthlink HMO,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Healthlink PPO,Healthlink PPO,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,HomeState Health Plan,HomeState Health Plan,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Humana Gold,Humana Gold,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Medicaid MO,Medicaid MO,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Medica,Medica,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Tricare,Tricare,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,UHC All Payer,UHC All Payer,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,UHC Exchange,UHC Exchange,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,UHC Medicaid,UHC Medicaid,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,UMR CPD,UMR CPD,184.6,,,,,,,per diem,184.6,184.6,"Per diem rate, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,UHC Medicare,UHC Medicare,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
T-CELLS-CD4COUNT              ,38201545,CDM,302,RC,86361,CPT,,,,Inpatient,,,184.6,184.6,Wellcare,Wellcare,184.6,,,,,,,case rate,184.6,184.6,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
PROTOZOA AB                   ,38201547,CDM,302,RC,86753,CPT,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Meritain Health PPO CPD,Meritain Health PPO CPD,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Aetna/Commercial Product,Aetna/Commercial Product,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Meritain Health CPD,Meritain Health CPD,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Starmark CPD,Starmark CPD,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Aetna Medicare,Aetna Medicare,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Ambetter ,Ambetter ,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Blue Access,Anthem Blue Access,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Blue Access Choice,Anthem Blue Access Choice,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Blue Preferred,Anthem Blue Preferred,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Pathway,Anthem Pathway,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Alliance,Anthem Alliance,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Anthem Medicare,Anthem Medicare,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Cigna,Cigna,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Cigna PPO,Cigna PPO,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Cigna Medicare Advantage,Cigna Medicare Advantage,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Essence,Essence,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Healthlink HMO,Healthlink HMO,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Healthlink PPO,Healthlink PPO,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,HomeState Health Plan,HomeState Health Plan,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Humana Gold,Humana Gold,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Medicaid MO,Medicaid MO,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Medica,Medica,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Tricare,Tricare,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,UHC All Payer,UHC All Payer,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,UHC Exchange,UHC Exchange,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,UHC Medicaid,UHC Medicaid,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,UMR CPD,UMR CPD,374.27,,,,,,,per diem,374.27,374.27,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,UHC Medicare,UHC Medicare,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38201555,CDM,306,RC,87536,CPT,,,,Inpatient,,,374.27,374.27,Wellcare,Wellcare,374.27,,,,,,,case rate,374.27,374.27,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Meritain Health PPO CPD,Meritain Health PPO CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Aetna/Commercial Product,Aetna/Commercial Product,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Meritain Health CPD,Meritain Health CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Starmark CPD,Starmark CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Aetna Medicare,Aetna Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Ambetter ,Ambetter ,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Blue Access,Anthem Blue Access,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Blue Access Choice,Anthem Blue Access Choice,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Blue Preferred,Anthem Blue Preferred,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Pathway,Anthem Pathway,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Alliance,Anthem Alliance,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Anthem Medicare,Anthem Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Cigna,Cigna,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Cigna PPO,Cigna PPO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Cigna Medicare Advantage,Cigna Medicare Advantage,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Essence,Essence,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Healthlink HMO,Healthlink HMO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Healthlink PPO,Healthlink PPO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,HomeState Health Plan,HomeState Health Plan,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Humana Gold,Humana Gold,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Medicaid MO,Medicaid MO,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Medica,Medica,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Tricare,Tricare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,UHC All Payer,UHC All Payer,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,UHC Exchange,UHC Exchange,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,UHC Medicaid,UHC Medicaid,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,UMR CPD,UMR CPD,128.75,,,,,,,per diem,128.75,128.75,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,UHC Medicare,UHC Medicare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38201570,CDM,302,RC,86320,CPT,,,,Inpatient,,,128.75,128.75,Wellcare,Wellcare,128.75,,,,,,,case rate,128.75,128.75,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Meritain Health PPO CPD,Meritain Health PPO CPD,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Aetna/Commercial Product,Aetna/Commercial Product,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Meritain Health CPD,Meritain Health CPD,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Starmark CPD,Starmark CPD,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Aetna Medicare,Aetna Medicare,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Ambetter ,Ambetter ,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Blue Access,Anthem Blue Access,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Blue Access Choice,Anthem Blue Access Choice,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Blue Preferred,Anthem Blue Preferred,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Pathway,Anthem Pathway,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Alliance,Anthem Alliance,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Anthem Medicare,Anthem Medicare,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Cigna,Cigna,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Cigna PPO,Cigna PPO,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Cigna Medicare Advantage,Cigna Medicare Advantage,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Essence,Essence,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Healthlink HMO,Healthlink HMO,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Healthlink PPO,Healthlink PPO,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,HomeState Health Plan,HomeState Health Plan,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Humana Gold,Humana Gold,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Medicaid MO,Medicaid MO,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Medica,Medica,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Tricare,Tricare,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,UHC All Payer,UHC All Payer,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,UHC Exchange,UHC Exchange,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,UHC Medicaid,UHC Medicaid,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,UMR CPD,UMR CPD,63.27,,,,,,,per diem,63.27,63.27,"Per diem rate, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,UHC Medicare,UHC Medicare,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
INSULIN                       ,38201580,CDM,301,RC,83525,CPT,,,,Inpatient,,,63.27,63.27,Wellcare,Wellcare,63.27,,,,,,,case rate,63.27,63.27,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
ASPERGILLUS                   ,38201590,CDM,306,RC,87305,CPT,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health PPO CPD,Meritain Health PPO CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Aetna/Commercial Product,Aetna/Commercial Product,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health CPD,Meritain Health CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Starmark CPD,Starmark CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Aetna Medicare,Aetna Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Ambetter ,Ambetter ,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access,Anthem Blue Access,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access Choice,Anthem Blue Access Choice,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Preferred,Anthem Blue Preferred,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Pathway,Anthem Pathway,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Alliance,Anthem Alliance,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Anthem Medicare,Anthem Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Cigna,Cigna,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Cigna PPO,Cigna PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Cigna Medicare Advantage,Cigna Medicare Advantage,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Essence,Essence,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Healthlink HMO,Healthlink HMO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Healthlink PPO,Healthlink PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,HomeState Health Plan,HomeState Health Plan,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Humana Gold,Humana Gold,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Medicaid MO,Medicaid MO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Medica,Medica,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Tricare,Tricare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,UHC All Payer,UHC All Payer,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,UHC Exchange,UHC Exchange,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicaid,UHC Medicaid,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,UMR CPD,UMR CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicare,UHC Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"IRON,SERUM,CHEMICAL           ",38201600,CDM,301,RC,83540,CPT,,,,Inpatient,,,120.94,120.94,Wellcare,Wellcare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Meritain Health PPO CPD,Meritain Health PPO CPD,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Aetna/Commercial Product,Aetna/Commercial Product,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Meritain Health CPD,Meritain Health CPD,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Starmark CPD,Starmark CPD,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Aetna Medicare,Aetna Medicare,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Ambetter ,Ambetter ,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Blue Access,Anthem Blue Access,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Blue Access Choice,Anthem Blue Access Choice,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Blue Preferred,Anthem Blue Preferred,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Pathway,Anthem Pathway,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Alliance,Anthem Alliance,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Anthem Medicare,Anthem Medicare,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Cigna,Cigna,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Cigna PPO,Cigna PPO,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Cigna Medicare Advantage,Cigna Medicare Advantage,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Essence,Essence,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Healthlink HMO,Healthlink HMO,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Healthlink PPO,Healthlink PPO,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,HomeState Health Plan,HomeState Health Plan,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Humana Gold,Humana Gold,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Medicaid MO,Medicaid MO,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Medica,Medica,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Tricare,Tricare,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,UHC All Payer,UHC All Payer,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,UHC Exchange,UHC Exchange,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,UHC Medicaid,UHC Medicaid,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,UMR CPD,UMR CPD,100.79,,,,,,,per diem,100.79,100.79,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,UHC Medicare,UHC Medicare,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38201610,CDM,301,RC,83550,CPT,,,,Inpatient,,,100.79,100.79,Wellcare,Wellcare,100.79,,,,,,,case rate,100.79,100.79,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Meritain Health PPO CPD,Meritain Health PPO CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Aetna/Commercial Product,Aetna/Commercial Product,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Meritain Health CPD,Meritain Health CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Starmark CPD,Starmark CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Aetna Medicare,Aetna Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Ambetter ,Ambetter ,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Blue Access,Anthem Blue Access,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Blue Access Choice,Anthem Blue Access Choice,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Blue Preferred,Anthem Blue Preferred,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Pathway,Anthem Pathway,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Alliance,Anthem Alliance,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Anthem Medicare,Anthem Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Cigna,Cigna,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Cigna PPO,Cigna PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Cigna Medicare Advantage,Cigna Medicare Advantage,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Essence,Essence,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Healthlink HMO,Healthlink HMO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Healthlink PPO,Healthlink PPO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,HomeState Health Plan,HomeState Health Plan,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Humana Gold,Humana Gold,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Medicaid MO,Medicaid MO,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Medica,Medica,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Tricare,Tricare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,UHC All Payer,UHC All Payer,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,UHC Exchange,UHC Exchange,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,UHC Medicaid,UHC Medicaid,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,UMR CPD,UMR CPD,92.7,,,,,,,per diem,92.7,92.7,"Per diem rate, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,UHC Medicare,UHC Medicare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETONES (ACETONE),QUAL        ",38201620,CDM,301,RC,82009,CPT,,,,Inpatient,,,92.7,92.7,Wellcare,Wellcare,92.7,,,,,,,case rate,92.7,92.7,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Meritain Health PPO CPD,Meritain Health PPO CPD,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Aetna/Commercial Product,Aetna/Commercial Product,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Meritain Health CPD,Meritain Health CPD,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Starmark CPD,Starmark CPD,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Aetna Medicare,Aetna Medicare,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Ambetter ,Ambetter ,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Blue Access,Anthem Blue Access,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Blue Access Choice,Anthem Blue Access Choice,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Blue Preferred,Anthem Blue Preferred,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Pathway,Anthem Pathway,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Alliance,Anthem Alliance,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Anthem Medicare,Anthem Medicare,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Cigna,Cigna,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Cigna PPO,Cigna PPO,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Cigna Medicare Advantage,Cigna Medicare Advantage,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Essence,Essence,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Healthlink HMO,Healthlink HMO,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Healthlink PPO,Healthlink PPO,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,HomeState Health Plan,HomeState Health Plan,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Humana Gold,Humana Gold,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Medicaid MO,Medicaid MO,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Medica,Medica,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Tricare,Tricare,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,UHC All Payer,UHC All Payer,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,UHC Exchange,UHC Exchange,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,UHC Medicaid,UHC Medicaid,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,UMR CPD,UMR CPD,187.38,,,,,,,per diem,187.38,187.38,"Per diem rate, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,UHC Medicare,UHC Medicare,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
"KETOSTEROIDS 17, TOTAL        ",38201625,CDM,301,RC,83586,CPT,,,,Inpatient,,,187.38,187.38,Wellcare,Wellcare,187.38,,,,,,,case rate,187.38,187.38,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38201630,CDM,301,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Meritain Health PPO CPD,Meritain Health PPO CPD,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Aetna/Commercial Product,Aetna/Commercial Product,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Meritain Health CPD,Meritain Health CPD,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Starmark CPD,Starmark CPD,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Aetna Medicare,Aetna Medicare,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Ambetter ,Ambetter ,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Blue Access,Anthem Blue Access,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Blue Access Choice,Anthem Blue Access Choice,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Blue Preferred,Anthem Blue Preferred,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Pathway,Anthem Pathway,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Alliance,Anthem Alliance,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Anthem Medicare,Anthem Medicare,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Cigna,Cigna,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Cigna PPO,Cigna PPO,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Cigna Medicare Advantage,Cigna Medicare Advantage,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Essence,Essence,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Healthlink HMO,Healthlink HMO,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Healthlink PPO,Healthlink PPO,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,HomeState Health Plan,HomeState Health Plan,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Humana Gold,Humana Gold,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Medicaid MO,Medicaid MO,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Medica,Medica,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Tricare,Tricare,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,UHC All Payer,UHC All Payer,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,UHC Exchange,UHC Exchange,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,UHC Medicaid,UHC Medicaid,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,UMR CPD,UMR CPD,185.66,,,,,,,per diem,185.66,185.66,"Per diem rate, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,UHC Medicare,UHC Medicare,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LAMICTAL/LAMOTRIGINE          ,38201639,CDM,301,RC,80175,CPT,,,,Inpatient,,,185.66,185.66,Wellcare,Wellcare,185.66,,,,,,,case rate,185.66,185.66,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38201650,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Meritain Health PPO CPD,Meritain Health PPO CPD,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Aetna/Commercial Product,Aetna/Commercial Product,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Meritain Health CPD,Meritain Health CPD,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Starmark CPD,Starmark CPD,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Aetna Medicare,Aetna Medicare,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Ambetter ,Ambetter ,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Blue Access,Anthem Blue Access,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Blue Access Choice,Anthem Blue Access Choice,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Blue Preferred,Anthem Blue Preferred,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Pathway,Anthem Pathway,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Alliance,Anthem Alliance,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Anthem Medicare,Anthem Medicare,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Cigna,Cigna,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Cigna PPO,Cigna PPO,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Cigna Medicare Advantage,Cigna Medicare Advantage,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Essence,Essence,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Healthlink HMO,Healthlink HMO,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Healthlink PPO,Healthlink PPO,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,HomeState Health Plan,HomeState Health Plan,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Humana Gold,Humana Gold,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Medicaid MO,Medicaid MO,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Medica,Medica,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Tricare,Tricare,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,UHC All Payer,UHC All Payer,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,UHC Exchange,UHC Exchange,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,UHC Medicaid,UHC Medicaid,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,UMR CPD,UMR CPD,180.55,,,,,,,per diem,180.55,180.55,"Per diem rate, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,UHC Medicare,UHC Medicare,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
LDH ISOENZYMES                ,38201660,CDM,301,RC,83625,CPT,,,,Inpatient,,,180.55,180.55,Wellcare,Wellcare,180.55,,,,,,,case rate,180.55,180.55,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE LEGIONELLA            ,38201680,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Meritain Health PPO CPD,Meritain Health PPO CPD,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Aetna/Commercial Product,Aetna/Commercial Product,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Meritain Health CPD,Meritain Health CPD,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Starmark CPD,Starmark CPD,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Aetna Medicare,Aetna Medicare,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Ambetter ,Ambetter ,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Blue Access,Anthem Blue Access,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Blue Access Choice,Anthem Blue Access Choice,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Blue Preferred,Anthem Blue Preferred,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Pathway,Anthem Pathway,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Alliance,Anthem Alliance,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Anthem Medicare,Anthem Medicare,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Cigna,Cigna,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Cigna PPO,Cigna PPO,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Cigna Medicare Advantage,Cigna Medicare Advantage,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Essence,Essence,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Healthlink HMO,Healthlink HMO,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Healthlink PPO,Healthlink PPO,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,HomeState Health Plan,HomeState Health Plan,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Humana Gold,Humana Gold,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Medicaid MO,Medicaid MO,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Medica,Medica,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Tricare,Tricare,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,UHC All Payer,UHC All Payer,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,UHC Exchange,UHC Exchange,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,UHC Medicaid,UHC Medicaid,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,UMR CPD,UMR CPD,522.15,,,,,,,per diem,522.15,522.15,"Per diem rate, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,UHC Medicare,UHC Medicare,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA AG-DFA             ,38201685,CDM,306,RC,87278,CPT,,,,Inpatient,,,522.15,522.15,Wellcare,Wellcare,522.15,,,,,,,case rate,522.15,522.15,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Meritain Health PPO CPD,Meritain Health PPO CPD,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Aetna/Commercial Product,Aetna/Commercial Product,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Meritain Health CPD,Meritain Health CPD,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Starmark CPD,Starmark CPD,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Aetna Medicare,Aetna Medicare,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Ambetter ,Ambetter ,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Blue Access,Anthem Blue Access,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Blue Access Choice,Anthem Blue Access Choice,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Blue Preferred,Anthem Blue Preferred,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Pathway,Anthem Pathway,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Alliance,Anthem Alliance,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Anthem Medicare,Anthem Medicare,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Cigna,Cigna,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Cigna PPO,Cigna PPO,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Cigna Medicare Advantage,Cigna Medicare Advantage,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Essence,Essence,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Healthlink HMO,Healthlink HMO,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Healthlink PPO,Healthlink PPO,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,HomeState Health Plan,HomeState Health Plan,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Humana Gold,Humana Gold,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Medicaid MO,Medicaid MO,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Medica,Medica,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Tricare,Tricare,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,UHC All Payer,UHC All Payer,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,UHC Exchange,UHC Exchange,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,UHC Medicaid,UHC Medicaid,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,UMR CPD,UMR CPD,331.78,,,,,,,per diem,331.78,331.78,"Per diem rate, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,UHC Medicare,UHC Medicare,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEGIONELLA TITER              ,38201690,CDM,302,RC,86713,CPT,,,,Inpatient,,,331.78,331.78,Wellcare,Wellcare,331.78,,,,,,,case rate,331.78,331.78,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Meritain Health PPO CPD,Meritain Health PPO CPD,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Aetna/Commercial Product,Aetna/Commercial Product,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Meritain Health CPD,Meritain Health CPD,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Starmark CPD,Starmark CPD,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Aetna Medicare,Aetna Medicare,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Ambetter ,Ambetter ,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Blue Access,Anthem Blue Access,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Blue Access Choice,Anthem Blue Access Choice,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Blue Preferred,Anthem Blue Preferred,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Pathway,Anthem Pathway,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Alliance,Anthem Alliance,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Anthem Medicare,Anthem Medicare,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Cigna,Cigna,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Cigna PPO,Cigna PPO,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Cigna Medicare Advantage,Cigna Medicare Advantage,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Essence,Essence,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Healthlink HMO,Healthlink HMO,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Healthlink PPO,Healthlink PPO,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,HomeState Health Plan,HomeState Health Plan,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Humana Gold,Humana Gold,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Medicaid MO,Medicaid MO,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Medica,Medica,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Tricare,Tricare,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,UHC All Payer,UHC All Payer,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,UHC Exchange,UHC Exchange,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,UHC Medicaid,UHC Medicaid,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,UMR CPD,UMR CPD,279.04,,,,,,,per diem,279.04,279.04,"Per diem rate, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,UHC Medicare,UHC Medicare,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LEUKOCYTE ALK.PHOS            ,38201695,CDM,305,RC,85540,CPT,,,,Inpatient,,,279.04,279.04,Wellcare,Wellcare,279.04,,,,,,,case rate,279.04,279.04,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health PPO CPD,Meritain Health PPO CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Aetna/Commercial Product,Aetna/Commercial Product,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health CPD,Meritain Health CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Starmark CPD,Starmark CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Aetna Medicare,Aetna Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Ambetter ,Ambetter ,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access,Anthem Blue Access,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access Choice,Anthem Blue Access Choice,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Preferred,Anthem Blue Preferred,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Pathway,Anthem Pathway,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Alliance,Anthem Alliance,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Anthem Medicare,Anthem Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Cigna,Cigna,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Cigna PPO,Cigna PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Cigna Medicare Advantage,Cigna Medicare Advantage,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Essence,Essence,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Healthlink HMO,Healthlink HMO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Healthlink PPO,Healthlink PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,HomeState Health Plan,HomeState Health Plan,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Humana Gold,Humana Gold,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Medicaid MO,Medicaid MO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Medica,Medica,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Tricare,Tricare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,UHC All Payer,UHC All Payer,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,UHC Exchange,UHC Exchange,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicaid,UHC Medicaid,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,UMR CPD,UMR CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicare,UHC Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LUTEINIZING HORMONE           ,38201700,CDM,301,RC,83002,CPT,,,,Inpatient,,,245.07,245.07,Wellcare,Wellcare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Meritain Health PPO CPD,Meritain Health PPO CPD,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Aetna/Commercial Product,Aetna/Commercial Product,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Meritain Health CPD,Meritain Health CPD,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Starmark CPD,Starmark CPD,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Aetna Medicare,Aetna Medicare,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Ambetter ,Ambetter ,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Blue Access,Anthem Blue Access,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Blue Access Choice,Anthem Blue Access Choice,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Blue Preferred,Anthem Blue Preferred,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Pathway,Anthem Pathway,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Alliance,Anthem Alliance,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Anthem Medicare,Anthem Medicare,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Cigna,Cigna,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Cigna PPO,Cigna PPO,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Cigna Medicare Advantage,Cigna Medicare Advantage,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Essence,Essence,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Healthlink HMO,Healthlink HMO,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Healthlink PPO,Healthlink PPO,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,HomeState Health Plan,HomeState Health Plan,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Humana Gold,Humana Gold,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Medicaid MO,Medicaid MO,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Medica,Medica,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Tricare,Tricare,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,UHC All Payer,UHC All Payer,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,UHC Exchange,UHC Exchange,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,UHC Medicaid,UHC Medicaid,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,UMR CPD,UMR CPD,161.91,,,,,,,per diem,161.91,161.91,"Per diem rate, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,UHC Medicare,UHC Medicare,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIDOCAINE                     ,38201710,CDM,301,RC,80176,CPT,,,,Inpatient,,,161.91,161.91,Wellcare,Wellcare,161.91,,,,,,,case rate,161.91,161.91,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health PPO CPD,Meritain Health PPO CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna/Commercial Product,Aetna/Commercial Product,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health CPD,Meritain Health CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Starmark CPD,Starmark CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna Medicare,Aetna Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Ambetter ,Ambetter ,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access,Anthem Blue Access,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access Choice,Anthem Blue Access Choice,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Preferred,Anthem Blue Preferred,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Pathway,Anthem Pathway,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Alliance,Anthem Alliance,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Medicare,Anthem Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna,Cigna,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna PPO,Cigna PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna Medicare Advantage,Cigna Medicare Advantage,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Essence,Essence,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthlink HMO,Healthlink HMO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthlink PPO,Healthlink PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,HomeState Health Plan,HomeState Health Plan,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Humana Gold,Humana Gold,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Medicaid MO,Medicaid MO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Medica,Medica,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Tricare,Tricare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC All Payer,UHC All Payer,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Exchange,UHC Exchange,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicaid,UHC Medicaid,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UMR CPD,UMR CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicare,UHC Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
LIPASE                        ,38201720,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Wellcare,Wellcare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Meritain Health PPO CPD,Meritain Health PPO CPD,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Aetna/Commercial Product,Aetna/Commercial Product,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Meritain Health CPD,Meritain Health CPD,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Starmark CPD,Starmark CPD,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Aetna Medicare,Aetna Medicare,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Ambetter ,Ambetter ,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Blue Access,Anthem Blue Access,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Blue Access Choice,Anthem Blue Access Choice,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Blue Preferred,Anthem Blue Preferred,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Pathway,Anthem Pathway,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Alliance,Anthem Alliance,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Anthem Medicare,Anthem Medicare,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Cigna,Cigna,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Cigna PPO,Cigna PPO,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Cigna Medicare Advantage,Cigna Medicare Advantage,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Essence,Essence,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Healthlink HMO,Healthlink HMO,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Healthlink PPO,Healthlink PPO,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,HomeState Health Plan,HomeState Health Plan,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Humana Gold,Humana Gold,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Medicaid MO,Medicaid MO,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Medica,Medica,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Tricare,Tricare,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,UHC All Payer,UHC All Payer,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,UHC Exchange,UHC Exchange,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,UHC Medicaid,UHC Medicaid,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,UMR CPD,UMR CPD,361.77,,,,,,,per diem,361.77,361.77,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,UHC Medicare,UHC Medicare,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38201722,CDM,301,RC,80197,CPT,,,,Inpatient,,,361.77,361.77,Wellcare,Wellcare,361.77,,,,,,,case rate,361.77,361.77,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health PPO CPD,Meritain Health PPO CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Aetna/Commercial Product,Aetna/Commercial Product,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health CPD,Meritain Health CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Starmark CPD,Starmark CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Aetna Medicare,Aetna Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Ambetter ,Ambetter ,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access,Anthem Blue Access,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access Choice,Anthem Blue Access Choice,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Preferred,Anthem Blue Preferred,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Pathway,Anthem Pathway,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Alliance,Anthem Alliance,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Anthem Medicare,Anthem Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Cigna,Cigna,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Cigna PPO,Cigna PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Cigna Medicare Advantage,Cigna Medicare Advantage,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Essence,Essence,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Healthlink HMO,Healthlink HMO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Healthlink PPO,Healthlink PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,HomeState Health Plan,HomeState Health Plan,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Humana Gold,Humana Gold,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Medicaid MO,Medicaid MO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Medica,Medica,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Tricare,Tricare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,UHC All Payer,UHC All Payer,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,UHC Exchange,UHC Exchange,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicaid,UHC Medicaid,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,UMR CPD,UMR CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicare,UHC Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38201730,CDM,301,RC,80178,CPT,,,,Inpatient,,,137.92,137.92,Wellcare,Wellcare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38201740,CDM,301,RC,80076,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Meritain Health PPO CPD,Meritain Health PPO CPD,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Aetna/Commercial Product,Aetna/Commercial Product,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Meritain Health CPD,Meritain Health CPD,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Starmark CPD,Starmark CPD,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Aetna Medicare,Aetna Medicare,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Ambetter ,Ambetter ,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Blue Access,Anthem Blue Access,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Blue Access Choice,Anthem Blue Access Choice,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Blue Preferred,Anthem Blue Preferred,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Pathway,Anthem Pathway,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Alliance,Anthem Alliance,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Anthem Medicare,Anthem Medicare,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Cigna,Cigna,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Cigna PPO,Cigna PPO,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Cigna Medicare Advantage,Cigna Medicare Advantage,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Essence,Essence,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Healthlink HMO,Healthlink HMO,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Healthlink PPO,Healthlink PPO,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,HomeState Health Plan,HomeState Health Plan,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Humana Gold,Humana Gold,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Medicaid MO,Medicaid MO,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Medica,Medica,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Tricare,Tricare,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,UHC All Payer,UHC All Payer,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,UHC Exchange,UHC Exchange,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,UHC Medicaid,UHC Medicaid,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,UMR CPD,UMR CPD,223.85,,,,,,,per diem,223.85,223.85,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,UHC Medicare,UHC Medicare,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38201750,CDM,302,RC,86618,CPT,,,,Inpatient,,,223.85,223.85,Wellcare,Wellcare,223.85,,,,,,,case rate,223.85,223.85,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health PPO CPD,Meritain Health PPO CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Aetna/Commercial Product,Aetna/Commercial Product,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health CPD,Meritain Health CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Starmark CPD,Starmark CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Aetna Medicare,Aetna Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Ambetter ,Ambetter ,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access,Anthem Blue Access,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access Choice,Anthem Blue Access Choice,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Preferred,Anthem Blue Preferred,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Pathway,Anthem Pathway,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Alliance,Anthem Alliance,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Anthem Medicare,Anthem Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Cigna,Cigna,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Cigna PPO,Cigna PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Cigna Medicare Advantage,Cigna Medicare Advantage,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Essence,Essence,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Healthlink HMO,Healthlink HMO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Healthlink PPO,Healthlink PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,HomeState Health Plan,HomeState Health Plan,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Humana Gold,Humana Gold,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Medicaid MO,Medicaid MO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Medica,Medica,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Tricare,Tricare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,UHC All Payer,UHC All Payer,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,UHC Exchange,UHC Exchange,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicaid,UHC Medicaid,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,UMR CPD,UMR CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicare,UHC Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38201760,CDM,301,RC,83735,CPT,,,,Inpatient,,,120.94,120.94,Wellcare,Wellcare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Meritain Health PPO CPD,Meritain Health PPO CPD,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Aetna/Commercial Product,Aetna/Commercial Product,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Meritain Health CPD,Meritain Health CPD,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Starmark CPD,Starmark CPD,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Aetna Medicare,Aetna Medicare,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Ambetter ,Ambetter ,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Blue Access,Anthem Blue Access,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Blue Access Choice,Anthem Blue Access Choice,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Blue Preferred,Anthem Blue Preferred,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Pathway,Anthem Pathway,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Alliance,Anthem Alliance,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Anthem Medicare,Anthem Medicare,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Cigna,Cigna,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Cigna PPO,Cigna PPO,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Cigna Medicare Advantage,Cigna Medicare Advantage,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Essence,Essence,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Healthlink HMO,Healthlink HMO,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Healthlink PPO,Healthlink PPO,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,HomeState Health Plan,HomeState Health Plan,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Humana Gold,Humana Gold,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Medicaid MO,Medicaid MO,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Medica,Medica,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Tricare,Tricare,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,UHC All Payer,UHC All Payer,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,UHC Exchange,UHC Exchange,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,UHC Medicaid,UHC Medicaid,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,UMR CPD,UMR CPD,169.05,,,,,,,per diem,169.05,169.05,"Per diem rate, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,UHC Medicare,UHC Medicare,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
MICROALBUMIN URINE QUANT      ,38201770,CDM,301,RC,82043,CPT,,,,Inpatient,,,169.05,169.05,Wellcare,Wellcare,169.05,,,,,,,case rate,169.05,169.05,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Meritain Health PPO CPD,Meritain Health PPO CPD,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Aetna/Commercial Product,Aetna/Commercial Product,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Meritain Health CPD,Meritain Health CPD,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Starmark CPD,Starmark CPD,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Aetna Medicare,Aetna Medicare,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Ambetter ,Ambetter ,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Blue Access,Anthem Blue Access,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Blue Access Choice,Anthem Blue Access Choice,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Blue Preferred,Anthem Blue Preferred,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Pathway,Anthem Pathway,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Alliance,Anthem Alliance,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Anthem Medicare,Anthem Medicare,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Cigna,Cigna,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Cigna PPO,Cigna PPO,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Cigna Medicare Advantage,Cigna Medicare Advantage,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Essence,Essence,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Healthlink HMO,Healthlink HMO,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Healthlink PPO,Healthlink PPO,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,HomeState Health Plan,HomeState Health Plan,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Humana Gold,Humana Gold,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Medicaid MO,Medicaid MO,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Medica,Medica,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Tricare,Tricare,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,UHC All Payer,UHC All Payer,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,UHC Exchange,UHC Exchange,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,UHC Medicaid,UHC Medicaid,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,UMR CPD,UMR CPD,128.22,,,,,,,per diem,128.22,128.22,"Per diem rate, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,UHC Medicare,UHC Medicare,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
HETEROPHILE ANTIBODY SCREEN   ,38201780,CDM,302,RC,86308,CPT,,,,Inpatient,,,128.22,128.22,Wellcare,Wellcare,128.22,,,,,,,case rate,128.22,128.22,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Meritain Health PPO CPD,Meritain Health PPO CPD,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Aetna/Commercial Product,Aetna/Commercial Product,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Meritain Health CPD,Meritain Health CPD,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Starmark CPD,Starmark CPD,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Aetna Medicare,Aetna Medicare,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Ambetter ,Ambetter ,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Blue Access,Anthem Blue Access,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Blue Access Choice,Anthem Blue Access Choice,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Blue Preferred,Anthem Blue Preferred,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Pathway,Anthem Pathway,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Alliance,Anthem Alliance,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Anthem Medicare,Anthem Medicare,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Cigna,Cigna,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Cigna PPO,Cigna PPO,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Cigna Medicare Advantage,Cigna Medicare Advantage,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Essence,Essence,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Healthlink HMO,Healthlink HMO,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Healthlink PPO,Healthlink PPO,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,HomeState Health Plan,HomeState Health Plan,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Humana Gold,Humana Gold,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Medicaid MO,Medicaid MO,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Medica,Medica,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Tricare,Tricare,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,UHC All Payer,UHC All Payer,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,UHC Exchange,UHC Exchange,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,UHC Medicaid,UHC Medicaid,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,UMR CPD,UMR CPD,73.13,,,,,,,per diem,73.13,73.13,"Per diem rate, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,UHC Medicare,UHC Medicare,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
FLUORESCENT AB SCREEN         ,38201790,CDM,302,RC,86255,CPT,,,,Inpatient,,,73.13,73.13,Wellcare,Wellcare,73.13,,,,,,,case rate,73.13,73.13,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Meritain Health PPO CPD,Meritain Health PPO CPD,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Aetna/Commercial Product,Aetna/Commercial Product,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Meritain Health CPD,Meritain Health CPD,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Starmark CPD,Starmark CPD,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Aetna Medicare,Aetna Medicare,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Ambetter ,Ambetter ,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Blue Access,Anthem Blue Access,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Blue Access Choice,Anthem Blue Access Choice,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Blue Preferred,Anthem Blue Preferred,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Pathway,Anthem Pathway,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Alliance,Anthem Alliance,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Anthem Medicare,Anthem Medicare,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Cigna,Cigna,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Cigna PPO,Cigna PPO,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Cigna Medicare Advantage,Cigna Medicare Advantage,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Essence,Essence,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Healthlink HMO,Healthlink HMO,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Healthlink PPO,Healthlink PPO,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,HomeState Health Plan,HomeState Health Plan,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Humana Gold,Humana Gold,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Medicaid MO,Medicaid MO,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Medica,Medica,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Tricare,Tricare,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,UHC All Payer,UHC All Payer,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,UHC Exchange,UHC Exchange,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,UHC Medicaid,UHC Medicaid,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,UMR CPD,UMR CPD,41.1,,,,,,,per diem,41.1,41.1,"Per diem rate, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,UHC Medicare,UHC Medicare,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OCCULT BLOOD, FECAL           ",38201800,CDM,301,RC,82270,CPT,,,,Inpatient,,,41.1,41.1,Wellcare,Wellcare,41.1,,,,,,,case rate,41.1,41.1,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
"OUCHTERLONY GEL DIFFUSION, EA ",38201805,CDM,302,RC,86331,CPT,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health PPO CPD,Meritain Health PPO CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Aetna/Commercial Product,Aetna/Commercial Product,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health CPD,Meritain Health CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Starmark CPD,Starmark CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Aetna Medicare,Aetna Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Ambetter ,Ambetter ,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access,Anthem Blue Access,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access Choice,Anthem Blue Access Choice,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Preferred,Anthem Blue Preferred,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Pathway,Anthem Pathway,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Alliance,Anthem Alliance,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Anthem Medicare,Anthem Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Cigna,Cigna,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Cigna PPO,Cigna PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Cigna Medicare Advantage,Cigna Medicare Advantage,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Essence,Essence,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Healthlink HMO,Healthlink HMO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Healthlink PPO,Healthlink PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,HomeState Health Plan,HomeState Health Plan,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Humana Gold,Humana Gold,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Medicaid MO,Medicaid MO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Medica,Medica,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Tricare,Tricare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,UHC All Payer,UHC All Payer,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,UHC Exchange,UHC Exchange,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicaid,UHC Medicaid,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,UMR CPD,UMR CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicare,UHC Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38201810,CDM,301,RC,83930,CPT,,,,Inpatient,,,109.27,109.27,Wellcare,Wellcare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health PPO CPD,Meritain Health PPO CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna/Commercial Product,Aetna/Commercial Product,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health CPD,Meritain Health CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Starmark CPD,Starmark CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna Medicare,Aetna Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Ambetter ,Ambetter ,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access,Anthem Blue Access,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access Choice,Anthem Blue Access Choice,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Preferred,Anthem Blue Preferred,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Pathway,Anthem Pathway,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Alliance,Anthem Alliance,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Medicare,Anthem Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna,Cigna,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna PPO,Cigna PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna Medicare Advantage,Cigna Medicare Advantage,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Essence,Essence,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthlink HMO,Healthlink HMO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthlink PPO,Healthlink PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,HomeState Health Plan,HomeState Health Plan,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Humana Gold,Humana Gold,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Medicaid MO,Medicaid MO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Medica,Medica,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Tricare,Tricare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC All Payer,UHC All Payer,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Exchange,UHC Exchange,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicaid,UHC Medicaid,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UMR CPD,UMR CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicare,UHC Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URINE              ,38201820,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Wellcare,Wellcare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health PPO CPD,Meritain Health PPO CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Aetna/Commercial Product,Aetna/Commercial Product,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health CPD,Meritain Health CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Starmark CPD,Starmark CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Aetna Medicare,Aetna Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Ambetter ,Ambetter ,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access,Anthem Blue Access,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access Choice,Anthem Blue Access Choice,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Preferred,Anthem Blue Preferred,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Pathway,Anthem Pathway,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Alliance,Anthem Alliance,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Anthem Medicare,Anthem Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Cigna,Cigna,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Cigna PPO,Cigna PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Cigna Medicare Advantage,Cigna Medicare Advantage,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Essence,Essence,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Healthlink HMO,Healthlink HMO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Healthlink PPO,Healthlink PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,HomeState Health Plan,HomeState Health Plan,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Humana Gold,Humana Gold,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Medicaid MO,Medicaid MO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Medica,Medica,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Tricare,Tricare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,UHC All Payer,UHC All Payer,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,UHC Exchange,UHC Exchange,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicaid,UHC Medicaid,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,UMR CPD,UMR CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicare,UHC Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38201830,CDM,306,RC,87177,CPT,,,,Inpatient,,,147.47,147.47,Wellcare,Wellcare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health PPO CPD,Meritain Health PPO CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Aetna/Commercial Product,Aetna/Commercial Product,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health CPD,Meritain Health CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Starmark CPD,Starmark CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Aetna Medicare,Aetna Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Ambetter ,Ambetter ,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access,Anthem Blue Access,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access Choice,Anthem Blue Access Choice,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Preferred,Anthem Blue Preferred,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Pathway,Anthem Pathway,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Alliance,Anthem Alliance,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Anthem Medicare,Anthem Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Cigna,Cigna,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Cigna PPO,Cigna PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Cigna Medicare Advantage,Cigna Medicare Advantage,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Essence,Essence,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Healthlink HMO,Healthlink HMO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Healthlink PPO,Healthlink PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,HomeState Health Plan,HomeState Health Plan,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Humana Gold,Humana Gold,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Medicaid MO,Medicaid MO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Medica,Medica,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Tricare,Tricare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,UHC All Payer,UHC All Payer,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,UHC Exchange,UHC Exchange,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicaid,UHC Medicaid,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,UMR CPD,UMR CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicare,UHC Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38201880,CDM,301,RC,80184,CPT,,,,Inpatient,,,194.14,194.14,Wellcare,Wellcare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health PPO CPD,Meritain Health PPO CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Aetna/Commercial Product,Aetna/Commercial Product,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health CPD,Meritain Health CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Starmark CPD,Starmark CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Aetna Medicare,Aetna Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Ambetter ,Ambetter ,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access,Anthem Blue Access,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access Choice,Anthem Blue Access Choice,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Preferred,Anthem Blue Preferred,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Pathway,Anthem Pathway,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Alliance,Anthem Alliance,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Anthem Medicare,Anthem Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Cigna,Cigna,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Cigna PPO,Cigna PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Cigna Medicare Advantage,Cigna Medicare Advantage,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Essence,Essence,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Healthlink HMO,Healthlink HMO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Healthlink PPO,Healthlink PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,HomeState Health Plan,HomeState Health Plan,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Humana Gold,Humana Gold,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Medicaid MO,Medicaid MO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Medica,Medica,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Tricare,Tricare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,UHC All Payer,UHC All Payer,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,UHC Exchange,UHC Exchange,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicaid,UHC Medicaid,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,UMR CPD,UMR CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicare,UHC Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38201882,CDM,301,RC,84300,CPT,,,,Inpatient,,,78.51,78.51,Wellcare,Wellcare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health PPO CPD,Meritain Health PPO CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Aetna/Commercial Product,Aetna/Commercial Product,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Meritain Health CPD,Meritain Health CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Starmark CPD,Starmark CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Aetna Medicare,Aetna Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Ambetter ,Ambetter ,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access,Anthem Blue Access,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Access Choice,Anthem Blue Access Choice,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Blue Preferred,Anthem Blue Preferred,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Pathway,Anthem Pathway,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Alliance,Anthem Alliance,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Anthem Medicare,Anthem Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Cigna,Cigna,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Cigna PPO,Cigna PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Cigna Medicare Advantage,Cigna Medicare Advantage,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Essence,Essence,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Healthlink HMO,Healthlink HMO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Healthlink PPO,Healthlink PPO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,HomeState Health Plan,HomeState Health Plan,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Humana Gold,Humana Gold,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Medicaid MO,Medicaid MO,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Medica,Medica,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Tricare,Tricare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,UHC All Payer,UHC All Payer,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,UHC Exchange,UHC Exchange,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicaid,UHC Medicaid,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,UMR CPD,UMR CPD,80.63,,,,,,,per diem,80.63,80.63,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,UHC Medicare,UHC Medicare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38201883,CDM,301,RC,82436,CPT,,,,Inpatient,,,80.63,80.63,Wellcare,Wellcare,80.63,,,,,,,case rate,80.63,80.63,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Meritain Health PPO CPD,Meritain Health PPO CPD,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Aetna/Commercial Product,Aetna/Commercial Product,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Meritain Health CPD,Meritain Health CPD,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Starmark CPD,Starmark CPD,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Aetna Medicare,Aetna Medicare,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Ambetter ,Ambetter ,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Blue Access,Anthem Blue Access,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Blue Access Choice,Anthem Blue Access Choice,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Blue Preferred,Anthem Blue Preferred,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Pathway,Anthem Pathway,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Alliance,Anthem Alliance,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Anthem Medicare,Anthem Medicare,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Cigna,Cigna,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Cigna PPO,Cigna PPO,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Cigna Medicare Advantage,Cigna Medicare Advantage,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Essence,Essence,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Healthlink HMO,Healthlink HMO,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Healthlink PPO,Healthlink PPO,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,HomeState Health Plan,HomeState Health Plan,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Humana Gold,Humana Gold,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Medicaid MO,Medicaid MO,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Medica,Medica,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Tricare,Tricare,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,UHC All Payer,UHC All Payer,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,UHC Exchange,UHC Exchange,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,UHC Medicaid,UHC Medicaid,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,UMR CPD,UMR CPD,61.23,,,,,,,per diem,61.23,61.23,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,UHC Medicare,UHC Medicare,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38201890,CDM,301,RC,83986,CPT,,,,Inpatient,,,61.23,61.23,Wellcare,Wellcare,61.23,,,,,,,case rate,61.23,61.23,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
PHOSPHOROUS SERUM             ,38201910,CDM,301,RC,84100,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Meritain Health PPO CPD,Meritain Health PPO CPD,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Aetna/Commercial Product,Aetna/Commercial Product,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Meritain Health CPD,Meritain Health CPD,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Starmark CPD,Starmark CPD,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Aetna Medicare,Aetna Medicare,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Ambetter ,Ambetter ,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Blue Access,Anthem Blue Access,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Blue Access Choice,Anthem Blue Access Choice,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Blue Preferred,Anthem Blue Preferred,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Pathway,Anthem Pathway,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Alliance,Anthem Alliance,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Anthem Medicare,Anthem Medicare,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Cigna,Cigna,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Cigna PPO,Cigna PPO,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Cigna Medicare Advantage,Cigna Medicare Advantage,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Essence,Essence,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Healthlink HMO,Healthlink HMO,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Healthlink PPO,Healthlink PPO,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,HomeState Health Plan,HomeState Health Plan,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Humana Gold,Humana Gold,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Medicaid MO,Medicaid MO,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Medica,Medica,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Tricare,Tricare,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,UHC All Payer,UHC All Payer,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,UHC Exchange,UHC Exchange,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,UHC Medicaid,UHC Medicaid,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,UMR CPD,UMR CPD,120.82,,,,,,,per diem,120.82,120.82,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,UHC Medicare,UHC Medicare,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38201928,CDM,301,RC,80201,CPT,,,,Inpatient,,,120.82,120.82,Wellcare,Wellcare,120.82,,,,,,,case rate,120.82,120.82,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health PPO CPD,Meritain Health PPO CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna/Commercial Product,Aetna/Commercial Product,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health CPD,Meritain Health CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Starmark CPD,Starmark CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna Medicare,Aetna Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Ambetter ,Ambetter ,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access,Anthem Blue Access,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access Choice,Anthem Blue Access Choice,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Preferred,Anthem Blue Preferred,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Pathway,Anthem Pathway,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Alliance,Anthem Alliance,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Medicare,Anthem Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna,Cigna,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna PPO,Cigna PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna Medicare Advantage,Cigna Medicare Advantage,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Essence,Essence,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthlink HMO,Healthlink HMO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthlink PPO,Healthlink PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,HomeState Health Plan,HomeState Health Plan,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Humana Gold,Humana Gold,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Medicaid MO,Medicaid MO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Medica,Medica,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Tricare,Tricare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC All Payer,UHC All Payer,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Exchange,UHC Exchange,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicaid,UHC Medicaid,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UMR CPD,UMR CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicare,UHC Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM               ,38201930,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Wellcare,Wellcare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Meritain Health PPO CPD,Meritain Health PPO CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Aetna/Commercial Product,Aetna/Commercial Product,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Meritain Health CPD,Meritain Health CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Starmark CPD,Starmark CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Aetna Medicare,Aetna Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Ambetter ,Ambetter ,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Access,Anthem Blue Access,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Access Choice,Anthem Blue Access Choice,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Preferred,Anthem Blue Preferred,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Pathway,Anthem Pathway,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Alliance,Anthem Alliance,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Anthem Medicare,Anthem Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Cigna,Cigna,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Cigna PPO,Cigna PPO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Cigna Medicare Advantage,Cigna Medicare Advantage,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Essence,Essence,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Healthlink HMO,Healthlink HMO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Healthlink PPO,Healthlink PPO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,HomeState Health Plan,HomeState Health Plan,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Humana Gold,Humana Gold,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Medicaid MO,Medicaid MO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Medica,Medica,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Tricare,Tricare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,UHC All Payer,UHC All Payer,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,UHC Exchange,UHC Exchange,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,UHC Medicaid,UHC Medicaid,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,UMR CPD,UMR CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,UHC Medicare,UHC Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38201940,CDM,301,RC,84133,CPT,,,,Inpatient,,,76.38,76.38,Wellcare,Wellcare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Meritain Health PPO CPD,Meritain Health PPO CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Aetna/Commercial Product,Aetna/Commercial Product,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Meritain Health CPD,Meritain Health CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Starmark CPD,Starmark CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Aetna Medicare,Aetna Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Ambetter ,Ambetter ,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Blue Access,Anthem Blue Access,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Blue Access Choice,Anthem Blue Access Choice,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Blue Preferred,Anthem Blue Preferred,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Pathway,Anthem Pathway,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Alliance,Anthem Alliance,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Anthem Medicare,Anthem Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Cigna,Cigna,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Cigna PPO,Cigna PPO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Cigna Medicare Advantage,Cigna Medicare Advantage,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Essence,Essence,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Healthlink HMO,Healthlink HMO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Healthlink PPO,Healthlink PPO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,HomeState Health Plan,HomeState Health Plan,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Humana Gold,Humana Gold,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Medicaid MO,Medicaid MO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Medica,Medica,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Tricare,Tricare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,UHC All Payer,UHC All Payer,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,UHC Exchange,UHC Exchange,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,UHC Medicaid,UHC Medicaid,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,UMR CPD,UMR CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,UHC Medicare,UHC Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREGNENOLONE LEVEL            ,38201977,CDM,301,RC,84140,CPT,,,,Inpatient,,,81.95,81.95,Wellcare,Wellcare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN                    ,38201978,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Meritain Health PPO CPD,Meritain Health PPO CPD,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Aetna/Commercial Product,Aetna/Commercial Product,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Meritain Health CPD,Meritain Health CPD,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Starmark CPD,Starmark CPD,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Aetna Medicare,Aetna Medicare,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Ambetter ,Ambetter ,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Blue Access,Anthem Blue Access,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Blue Access Choice,Anthem Blue Access Choice,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Blue Preferred,Anthem Blue Preferred,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Pathway,Anthem Pathway,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Alliance,Anthem Alliance,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Anthem Medicare,Anthem Medicare,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Cigna,Cigna,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Cigna PPO,Cigna PPO,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Cigna Medicare Advantage,Cigna Medicare Advantage,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Essence,Essence,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Healthlink HMO,Healthlink HMO,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Healthlink PPO,Healthlink PPO,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,HomeState Health Plan,HomeState Health Plan,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Humana Gold,Humana Gold,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Medicaid MO,Medicaid MO,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Medica,Medica,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Tricare,Tricare,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,UHC All Payer,UHC All Payer,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,UHC Exchange,UHC Exchange,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,UHC Medicaid,UHC Medicaid,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,UMR CPD,UMR CPD,429.47,,,,,,,per diem,429.47,429.47,"Per diem rate, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,UHC Medicare,UHC Medicare,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROGESTERONE                  ,38201985,CDM,301,RC,84144,CPT,,,,Inpatient,,,429.47,429.47,Wellcare,Wellcare,429.47,,,,,,,case rate,429.47,429.47,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Meritain Health PPO CPD,Meritain Health PPO CPD,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Aetna/Commercial Product,Aetna/Commercial Product,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Meritain Health CPD,Meritain Health CPD,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Starmark CPD,Starmark CPD,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Aetna Medicare,Aetna Medicare,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Ambetter ,Ambetter ,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Blue Access,Anthem Blue Access,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Blue Access Choice,Anthem Blue Access Choice,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Blue Preferred,Anthem Blue Preferred,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Pathway,Anthem Pathway,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Alliance,Anthem Alliance,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Anthem Medicare,Anthem Medicare,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Cigna,Cigna,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Cigna PPO,Cigna PPO,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Cigna Medicare Advantage,Cigna Medicare Advantage,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Essence,Essence,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Healthlink HMO,Healthlink HMO,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Healthlink PPO,Healthlink PPO,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,HomeState Health Plan,HomeState Health Plan,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Humana Gold,Humana Gold,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Medicaid MO,Medicaid MO,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Medica,Medica,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Tricare,Tricare,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,UHC All Payer,UHC All Payer,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,UHC Exchange,UHC Exchange,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,UHC Medicaid,UHC Medicaid,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,UMR CPD,UMR CPD,258.86,,,,,,,per diem,258.86,258.86,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,UHC Medicare,UHC Medicare,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38201990,CDM,301,RC,84146,CPT,,,,Inpatient,,,258.86,258.86,Wellcare,Wellcare,258.86,,,,,,,case rate,258.86,258.86,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROLIXIN LEVEL                ,38201992,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Meritain Health PPO CPD,Meritain Health PPO CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Aetna/Commercial Product,Aetna/Commercial Product,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Meritain Health CPD,Meritain Health CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Starmark CPD,Starmark CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Aetna Medicare,Aetna Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Ambetter ,Ambetter ,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Access,Anthem Blue Access,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Access Choice,Anthem Blue Access Choice,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Blue Preferred,Anthem Blue Preferred,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Pathway,Anthem Pathway,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Alliance,Anthem Alliance,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Anthem Medicare,Anthem Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Cigna,Cigna,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Cigna PPO,Cigna PPO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Cigna Medicare Advantage,Cigna Medicare Advantage,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Essence,Essence,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Healthlink HMO,Healthlink HMO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Healthlink PPO,Healthlink PPO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,HomeState Health Plan,HomeState Health Plan,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Humana Gold,Humana Gold,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Medicaid MO,Medicaid MO,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Medica,Medica,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Tricare,Tricare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,UHC All Payer,UHC All Payer,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,UHC Exchange,UHC Exchange,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,UHC Medicaid,UHC Medicaid,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,UMR CPD,UMR CPD,171.87,,,,,,,per diem,171.87,171.87,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,UHC Medicare,UHC Medicare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (TOTAL) ,38202000,CDM,301,RC,84153,CPT,,,,Inpatient,,,171.87,171.87,Wellcare,Wellcare,171.87,,,,,,,case rate,171.87,171.87,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Meritain Health PPO CPD,Meritain Health PPO CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Aetna/Commercial Product,Aetna/Commercial Product,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Meritain Health CPD,Meritain Health CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Starmark CPD,Starmark CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Aetna Medicare,Aetna Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Ambetter ,Ambetter ,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Access,Anthem Blue Access,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Access Choice,Anthem Blue Access Choice,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Preferred,Anthem Blue Preferred,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Pathway,Anthem Pathway,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Alliance,Anthem Alliance,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Anthem Medicare,Anthem Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Cigna,Cigna,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Cigna PPO,Cigna PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Cigna Medicare Advantage,Cigna Medicare Advantage,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Essence,Essence,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Healthlink HMO,Healthlink HMO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Healthlink PPO,Healthlink PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,HomeState Health Plan,HomeState Health Plan,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Humana Gold,Humana Gold,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Medicaid MO,Medicaid MO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Medica,Medica,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Tricare,Tricare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,UHC All Payer,UHC All Payer,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,UHC Exchange,UHC Exchange,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,UHC Medicaid,UHC Medicaid,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,UMR CPD,UMR CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,UHC Medicare,UHC Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
PROTEIN TOTAL                 ,38202010,CDM,301,RC,84155,CPT,,,,Inpatient,,,92.3,92.3,Wellcare,Wellcare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Meritain Health PPO CPD,Meritain Health PPO CPD,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Aetna/Commercial Product,Aetna/Commercial Product,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Meritain Health CPD,Meritain Health CPD,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Starmark CPD,Starmark CPD,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Aetna Medicare,Aetna Medicare,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Ambetter ,Ambetter ,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Blue Access,Anthem Blue Access,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Blue Access Choice,Anthem Blue Access Choice,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Blue Preferred,Anthem Blue Preferred,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Pathway,Anthem Pathway,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Alliance,Anthem Alliance,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Anthem Medicare,Anthem Medicare,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Cigna,Cigna,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Cigna PPO,Cigna PPO,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Cigna Medicare Advantage,Cigna Medicare Advantage,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Essence,Essence,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Healthlink HMO,Healthlink HMO,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Healthlink PPO,Healthlink PPO,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,HomeState Health Plan,HomeState Health Plan,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Humana Gold,Humana Gold,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Medicaid MO,Medicaid MO,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Medica,Medica,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Tricare,Tricare,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,UHC All Payer,UHC All Payer,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,UHC Exchange,UHC Exchange,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,UHC Medicaid,UHC Medicaid,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,UMR CPD,UMR CPD,139.67,,,,,,,per diem,139.67,139.67,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,UHC Medicare,UHC Medicare,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38202011,CDM,301,RC,84157,CPT,,,,Inpatient,,,139.67,139.67,Wellcare,Wellcare,139.67,,,,,,,case rate,139.67,139.67,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health PPO CPD,Meritain Health PPO CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Aetna/Commercial Product,Aetna/Commercial Product,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health CPD,Meritain Health CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Starmark CPD,Starmark CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Aetna Medicare,Aetna Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Ambetter ,Ambetter ,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access,Anthem Blue Access,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access Choice,Anthem Blue Access Choice,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Preferred,Anthem Blue Preferred,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Pathway,Anthem Pathway,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Alliance,Anthem Alliance,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Anthem Medicare,Anthem Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Cigna,Cigna,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Cigna PPO,Cigna PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Cigna Medicare Advantage,Cigna Medicare Advantage,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Essence,Essence,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Healthlink HMO,Healthlink HMO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Healthlink PPO,Healthlink PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,HomeState Health Plan,HomeState Health Plan,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Humana Gold,Humana Gold,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Medicaid MO,Medicaid MO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Medica,Medica,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Tricare,Tricare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,UHC All Payer,UHC All Payer,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,UHC Exchange,UHC Exchange,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicaid,UHC Medicaid,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,UMR CPD,UMR CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicare,UHC Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPHORESIS       ,38202015,CDM,301,RC,84165,CPT,,,,Inpatient,,,213.24,213.24,Wellcare,Wellcare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health PPO CPD,Meritain Health PPO CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/Commercial Product,Aetna/Commercial Product,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health CPD,Meritain Health CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Starmark CPD,Starmark CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna Medicare,Aetna Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Ambetter ,Ambetter ,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access,Anthem Blue Access,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access Choice,Anthem Blue Access Choice,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Preferred,Anthem Blue Preferred,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Pathway,Anthem Pathway,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Alliance,Anthem Alliance,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Medicare,Anthem Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna,Cigna,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna PPO,Cigna PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna Medicare Advantage,Cigna Medicare Advantage,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Essence,Essence,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink HMO,Healthlink HMO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink PPO,Healthlink PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,HomeState Health Plan,HomeState Health Plan,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Humana Gold,Humana Gold,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medicaid MO,Medicaid MO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medica,Medica,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Tricare,Tricare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC All Payer,UHC All Payer,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Exchange,UHC Exchange,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicaid,UHC Medicaid,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UMR CPD,UMR CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicare,UHC Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38202040,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Wellcare,Wellcare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health PPO CPD,Meritain Health PPO CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/Commercial Product,Aetna/Commercial Product,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health CPD,Meritain Health CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Starmark CPD,Starmark CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna Medicare,Aetna Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Ambetter ,Ambetter ,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access,Anthem Blue Access,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access Choice,Anthem Blue Access Choice,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Preferred,Anthem Blue Preferred,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Pathway,Anthem Pathway,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Alliance,Anthem Alliance,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Medicare,Anthem Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna,Cigna,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna PPO,Cigna PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna Medicare Advantage,Cigna Medicare Advantage,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Essence,Essence,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink HMO,Healthlink HMO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink PPO,Healthlink PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,HomeState Health Plan,HomeState Health Plan,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Humana Gold,Humana Gold,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medicaid MO,Medicaid MO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medica,Medica,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Tricare,Tricare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC All Payer,UHC All Payer,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Exchange,UHC Exchange,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicaid,UHC Medicaid,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UMR CPD,UMR CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicare,UHC Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONES INTACT   ,38202045,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Wellcare,Wellcare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health PPO CPD,Meritain Health PPO CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/Commercial Product,Aetna/Commercial Product,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health CPD,Meritain Health CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Starmark CPD,Starmark CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna Medicare,Aetna Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Ambetter ,Ambetter ,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access,Anthem Blue Access,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access Choice,Anthem Blue Access Choice,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Preferred,Anthem Blue Preferred,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Pathway,Anthem Pathway,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Alliance,Anthem Alliance,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Medicare,Anthem Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna,Cigna,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna PPO,Cigna PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna Medicare Advantage,Cigna Medicare Advantage,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Essence,Essence,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink HMO,Healthlink HMO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink PPO,Healthlink PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,HomeState Health Plan,HomeState Health Plan,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Humana Gold,Humana Gold,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medicaid MO,Medicaid MO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medica,Medica,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Tricare,Tricare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC All Payer,UHC All Payer,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Exchange,UHC Exchange,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicaid,UHC Medicaid,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UMR CPD,UMR CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicare,UHC Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARA THYROID INTACT C TERMINAL,38202048,CDM,300,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Wellcare,Wellcare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health PPO CPD,Meritain Health PPO CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna/Commercial Product,Aetna/Commercial Product,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Meritain Health CPD,Meritain Health CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Starmark CPD,Starmark CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Aetna Medicare,Aetna Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Ambetter ,Ambetter ,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access,Anthem Blue Access,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Access Choice,Anthem Blue Access Choice,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Blue Preferred,Anthem Blue Preferred,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Pathway,Anthem Pathway,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Alliance,Anthem Alliance,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Anthem Medicare,Anthem Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna,Cigna,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna PPO,Cigna PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Cigna Medicare Advantage,Cigna Medicare Advantage,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Essence,Essence,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink HMO,Healthlink HMO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Healthlink PPO,Healthlink PPO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,HomeState Health Plan,HomeState Health Plan,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Humana Gold,Humana Gold,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medicaid MO,Medicaid MO,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Medica,Medica,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Tricare,Tricare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC All Payer,UHC All Payer,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Exchange,UHC Exchange,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicaid,UHC Medicaid,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UMR CPD,UMR CPD,373.44,,,,,,,per diem,373.44,373.44,"Per diem rate, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,UHC Medicare,UHC Medicare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PARATHYROID HORMONE           ,38202049,CDM,301,RC,83970,CPT,,,,Inpatient,,,373.44,373.44,Wellcare,Wellcare,373.44,,,,,,,case rate,373.44,373.44,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Meritain Health PPO CPD,Meritain Health PPO CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna/Commercial Product,Aetna/Commercial Product,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Meritain Health CPD,Meritain Health CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Starmark CPD,Starmark CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna Medicare,Aetna Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Ambetter ,Ambetter ,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Access,Anthem Blue Access,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Access Choice,Anthem Blue Access Choice,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Preferred,Anthem Blue Preferred,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Pathway,Anthem Pathway,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Alliance,Anthem Alliance,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Medicare,Anthem Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna,Cigna,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna PPO,Cigna PPO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna Medicare Advantage,Cigna Medicare Advantage,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Essence,Essence,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthlink HMO,Healthlink HMO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthlink PPO,Healthlink PPO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,HomeState Health Plan,HomeState Health Plan,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Humana Gold,Humana Gold,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Medicaid MO,Medicaid MO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Medica,Medica,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Tricare,Tricare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC All Payer,UHC All Payer,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Exchange,UHC Exchange,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Medicaid,UHC Medicaid,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UMR CPD,UMR CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Medicare,UHC Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
PTT                           ,38202050,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Wellcare,Wellcare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health PPO CPD,Meritain Health PPO CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna/Commercial Product,Aetna/Commercial Product,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health CPD,Meritain Health CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Starmark CPD,Starmark CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna Medicare,Aetna Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Ambetter ,Ambetter ,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access,Anthem Blue Access,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access Choice,Anthem Blue Access Choice,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Preferred,Anthem Blue Preferred,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Pathway,Anthem Pathway,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Alliance,Anthem Alliance,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Medicare,Anthem Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna,Cigna,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna PPO,Cigna PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna Medicare Advantage,Cigna Medicare Advantage,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Essence,Essence,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthlink HMO,Healthlink HMO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthlink PPO,Healthlink PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,HomeState Health Plan,HomeState Health Plan,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Humana Gold,Humana Gold,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Medicaid MO,Medicaid MO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Medica,Medica,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Tricare,Tricare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC All Payer,UHC All Payer,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Exchange,UHC Exchange,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicaid,UHC Medicaid,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UMR CPD,UMR CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicare,UHC Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38202055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Wellcare,Wellcare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Meritain Health PPO CPD,Meritain Health PPO CPD,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Aetna/Commercial Product,Aetna/Commercial Product,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Meritain Health CPD,Meritain Health CPD,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Starmark CPD,Starmark CPD,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Aetna Medicare,Aetna Medicare,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Ambetter ,Ambetter ,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Blue Access,Anthem Blue Access,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Blue Access Choice,Anthem Blue Access Choice,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Blue Preferred,Anthem Blue Preferred,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Pathway,Anthem Pathway,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Alliance,Anthem Alliance,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Anthem Medicare,Anthem Medicare,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Cigna,Cigna,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Cigna PPO,Cigna PPO,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Cigna Medicare Advantage,Cigna Medicare Advantage,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Essence,Essence,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Healthlink HMO,Healthlink HMO,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Healthlink PPO,Healthlink PPO,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,HomeState Health Plan,HomeState Health Plan,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Humana Gold,Humana Gold,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Medicaid MO,Medicaid MO,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Medica,Medica,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Tricare,Tricare,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,UHC All Payer,UHC All Payer,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,UHC Exchange,UHC Exchange,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,UHC Medicaid,UHC Medicaid,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,UMR CPD,UMR CPD,287.21,,,,,,,per diem,287.21,287.21,"Per diem rate, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,UHC Medicare,UHC Medicare,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
QUINIDINE                     ,38202070,CDM,301,RC,80194,CPT,,,,Inpatient,,,287.21,287.21,Wellcare,Wellcare,287.21,,,,,,,case rate,287.21,287.21,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
CMV BY PCR                    ,38202073,CDM,306,RC,87496,CPT,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health PPO CPD,Meritain Health PPO CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Aetna/Commercial Product,Aetna/Commercial Product,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health CPD,Meritain Health CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Starmark CPD,Starmark CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Aetna Medicare,Aetna Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Ambetter ,Ambetter ,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access,Anthem Blue Access,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access Choice,Anthem Blue Access Choice,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Preferred,Anthem Blue Preferred,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Pathway,Anthem Pathway,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Alliance,Anthem Alliance,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Anthem Medicare,Anthem Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Cigna,Cigna,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Cigna PPO,Cigna PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Cigna Medicare Advantage,Cigna Medicare Advantage,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Essence,Essence,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Healthlink HMO,Healthlink HMO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Healthlink PPO,Healthlink PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,HomeState Health Plan,HomeState Health Plan,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Humana Gold,Humana Gold,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Medicaid MO,Medicaid MO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Medica,Medica,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Tricare,Tricare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,UHC All Payer,UHC All Payer,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,UHC Exchange,UHC Exchange,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicaid,UHC Medicaid,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,UMR CPD,UMR CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicare,UHC Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
RAPAMYCIN (SIROLIMUS)         ,38202080,CDM,301,RC,80195,CPT,,,,Inpatient,,,224.91,224.91,Wellcare,Wellcare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Meritain Health PPO CPD,Meritain Health PPO CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Aetna/Commercial Product,Aetna/Commercial Product,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Meritain Health CPD,Meritain Health CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Starmark CPD,Starmark CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Aetna Medicare,Aetna Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Ambetter ,Ambetter ,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Blue Access,Anthem Blue Access,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Blue Access Choice,Anthem Blue Access Choice,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Blue Preferred,Anthem Blue Preferred,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Pathway,Anthem Pathway,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Alliance,Anthem Alliance,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Anthem Medicare,Anthem Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Cigna,Cigna,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Cigna PPO,Cigna PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Cigna Medicare Advantage,Cigna Medicare Advantage,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Essence,Essence,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Healthlink HMO,Healthlink HMO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Healthlink PPO,Healthlink PPO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,HomeState Health Plan,HomeState Health Plan,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Humana Gold,Humana Gold,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Medicaid MO,Medicaid MO,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Medica,Medica,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Tricare,Tricare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,UHC All Payer,UHC All Payer,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,UHC Exchange,UHC Exchange,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,UHC Medicaid,UHC Medicaid,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,UMR CPD,UMR CPD,7.21,,,,,,,per diem,7.21,7.21,"Per diem rate, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,UHC Medicare,UHC Medicare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"RBC COUNT, AUTO               ",38202090,CDM,305,RC,85041,CPT,,,,Inpatient,,,7.21,7.21,Wellcare,Wellcare,7.21,,,,,,,case rate,7.21,7.21,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"FOLIC ACID, RBC               ",38202095,CDM,301,RC,82747,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Meritain Health PPO CPD,Meritain Health PPO CPD,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Aetna/Commercial Product,Aetna/Commercial Product,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Meritain Health CPD,Meritain Health CPD,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Starmark CPD,Starmark CPD,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Aetna Medicare,Aetna Medicare,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Ambetter ,Ambetter ,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Blue Access,Anthem Blue Access,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Blue Access Choice,Anthem Blue Access Choice,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Blue Preferred,Anthem Blue Preferred,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Pathway,Anthem Pathway,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Alliance,Anthem Alliance,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Anthem Medicare,Anthem Medicare,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Cigna,Cigna,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Cigna PPO,Cigna PPO,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Cigna Medicare Advantage,Cigna Medicare Advantage,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Essence,Essence,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Healthlink HMO,Healthlink HMO,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Healthlink PPO,Healthlink PPO,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,HomeState Health Plan,HomeState Health Plan,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Humana Gold,Humana Gold,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Medicaid MO,Medicaid MO,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Medica,Medica,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Tricare,Tricare,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,UHC All Payer,UHC All Payer,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,UHC Exchange,UHC Exchange,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,UHC Medicaid,UHC Medicaid,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,UMR CPD,UMR CPD,244.01,,,,,,,per diem,244.01,244.01,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,UHC Medicare,UHC Medicare,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38202115,CDM,301,RC,84244,CPT,,,,Inpatient,,,244.01,244.01,Wellcare,Wellcare,244.01,,,,,,,case rate,244.01,244.01,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Meritain Health PPO CPD,Meritain Health PPO CPD,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Aetna/Commercial Product,Aetna/Commercial Product,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Meritain Health CPD,Meritain Health CPD,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Starmark CPD,Starmark CPD,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Aetna Medicare,Aetna Medicare,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Ambetter ,Ambetter ,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Blue Access,Anthem Blue Access,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Blue Access Choice,Anthem Blue Access Choice,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Blue Preferred,Anthem Blue Preferred,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Pathway,Anthem Pathway,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Alliance,Anthem Alliance,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Anthem Medicare,Anthem Medicare,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Cigna,Cigna,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Cigna PPO,Cigna PPO,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Cigna Medicare Advantage,Cigna Medicare Advantage,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Essence,Essence,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Healthlink HMO,Healthlink HMO,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Healthlink PPO,Healthlink PPO,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,HomeState Health Plan,HomeState Health Plan,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Humana Gold,Humana Gold,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Medicaid MO,Medicaid MO,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Medica,Medica,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Tricare,Tricare,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,UHC All Payer,UHC All Payer,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,UHC Exchange,UHC Exchange,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,UHC Medicaid,UHC Medicaid,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,UMR CPD,UMR CPD,64.11,,,,,,,per diem,64.11,64.11,"Per diem rate, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,UHC Medicare,UHC Medicare,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
RETICULOCYTE (MANUAL)         ,38202120,CDM,305,RC,85044,CPT,,,,Inpatient,,,64.11,64.11,Wellcare,Wellcare,64.11,,,,,,,case rate,64.11,64.11,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Meritain Health PPO CPD,Meritain Health PPO CPD,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Aetna/Commercial Product,Aetna/Commercial Product,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Meritain Health CPD,Meritain Health CPD,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Starmark CPD,Starmark CPD,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Aetna Medicare,Aetna Medicare,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Ambetter ,Ambetter ,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Blue Access,Anthem Blue Access,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Blue Access Choice,Anthem Blue Access Choice,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Blue Preferred,Anthem Blue Preferred,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Pathway,Anthem Pathway,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Alliance,Anthem Alliance,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Anthem Medicare,Anthem Medicare,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Cigna,Cigna,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Cigna PPO,Cigna PPO,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Cigna Medicare Advantage,Cigna Medicare Advantage,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Essence,Essence,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Healthlink HMO,Healthlink HMO,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Healthlink PPO,Healthlink PPO,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,HomeState Health Plan,HomeState Health Plan,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Humana Gold,Humana Gold,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Medicaid MO,Medicaid MO,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Medica,Medica,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Tricare,Tricare,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,UHC All Payer,UHC All Payer,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,UHC Exchange,UHC Exchange,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,UHC Medicaid,UHC Medicaid,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,UMR CPD,UMR CPD,260.75,,,,,,,per diem,260.75,260.75,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,UHC Medicare,UHC Medicare,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUAL       ",38202130,CDM,302,RC,86430,CPT,,,,Inpatient,,,260.75,260.75,Wellcare,Wellcare,260.75,,,,,,,case rate,260.75,260.75,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE VRE SCREEN            ,38202138,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Meritain Health PPO CPD,Meritain Health PPO CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Aetna/Commercial Product,Aetna/Commercial Product,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Meritain Health CPD,Meritain Health CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Starmark CPD,Starmark CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Aetna Medicare,Aetna Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Ambetter ,Ambetter ,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Access,Anthem Blue Access,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Access Choice,Anthem Blue Access Choice,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Preferred,Anthem Blue Preferred,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Pathway,Anthem Pathway,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Alliance,Anthem Alliance,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Anthem Medicare,Anthem Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Cigna,Cigna,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Cigna PPO,Cigna PPO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Cigna Medicare Advantage,Cigna Medicare Advantage,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Essence,Essence,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Healthlink HMO,Healthlink HMO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Healthlink PPO,Healthlink PPO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,HomeState Health Plan,HomeState Health Plan,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Humana Gold,Humana Gold,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Medicaid MO,Medicaid MO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Medica,Medica,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Tricare,Tricare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,UHC All Payer,UHC All Payer,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,UHC Exchange,UHC Exchange,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,UHC Medicaid,UHC Medicaid,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,UMR CPD,UMR CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,UHC Medicare,UHC Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RPR                           ,38202140,CDM,302,RC,86592,CPT,,,,Inpatient,,,93.36,93.36,Wellcare,Wellcare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Meritain Health PPO CPD,Meritain Health PPO CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Aetna/Commercial Product,Aetna/Commercial Product,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Meritain Health CPD,Meritain Health CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Starmark CPD,Starmark CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Aetna Medicare,Aetna Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Ambetter ,Ambetter ,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Blue Access,Anthem Blue Access,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Blue Access Choice,Anthem Blue Access Choice,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Blue Preferred,Anthem Blue Preferred,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Pathway,Anthem Pathway,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Alliance,Anthem Alliance,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Anthem Medicare,Anthem Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Cigna,Cigna,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Cigna PPO,Cigna PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Cigna Medicare Advantage,Cigna Medicare Advantage,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Essence,Essence,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Healthlink HMO,Healthlink HMO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Healthlink PPO,Healthlink PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,HomeState Health Plan,HomeState Health Plan,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Humana Gold,Humana Gold,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Medicaid MO,Medicaid MO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Medica,Medica,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Tricare,Tricare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,UHC All Payer,UHC All Payer,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,UHC Exchange,UHC Exchange,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,UHC Medicaid,UHC Medicaid,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,UMR CPD,UMR CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,UHC Medicare,UHC Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBELLA ANTIBODY              ,38202145,CDM,302,RC,86762,CPT,,,,Inpatient,,,317.28,317.28,Wellcare,Wellcare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
RUBEOLA ANTIBODY              ,38202146,CDM,302,RC,86765,CPT,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Meritain Health PPO CPD,Meritain Health PPO CPD,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Aetna/Commercial Product,Aetna/Commercial Product,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Meritain Health CPD,Meritain Health CPD,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Starmark CPD,Starmark CPD,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Aetna Medicare,Aetna Medicare,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Ambetter ,Ambetter ,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Blue Access,Anthem Blue Access,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Blue Access Choice,Anthem Blue Access Choice,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Blue Preferred,Anthem Blue Preferred,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Pathway,Anthem Pathway,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Alliance,Anthem Alliance,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Anthem Medicare,Anthem Medicare,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Cigna,Cigna,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Cigna PPO,Cigna PPO,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Cigna Medicare Advantage,Cigna Medicare Advantage,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Essence,Essence,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Healthlink HMO,Healthlink HMO,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Healthlink PPO,Healthlink PPO,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,HomeState Health Plan,HomeState Health Plan,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Humana Gold,Humana Gold,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Medicaid MO,Medicaid MO,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Medica,Medica,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Tricare,Tricare,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,UHC All Payer,UHC All Payer,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,UHC Exchange,UHC Exchange,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,UHC Medicaid,UHC Medicaid,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,UMR CPD,UMR CPD,79.99,,,,,,,per diem,79.99,79.99,"Per diem rate, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,UHC Medicare,UHC Medicare,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
PSA SCREENING                 ,38202151,CDM,300,RC,G0103,HCPCS,,,,Inpatient,,,79.99,79.99,Wellcare,Wellcare,79.99,,,,,,,case rate,79.99,79.99,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SENSITIVITY (MIC)             ,38202160,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"SENSITIVITY, ANTIBIOTIC-K     ",38202161,CDM,300,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Meritain Health PPO CPD,Meritain Health PPO CPD,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Aetna/Commercial Product,Aetna/Commercial Product,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Meritain Health CPD,Meritain Health CPD,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Starmark CPD,Starmark CPD,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Aetna Medicare,Aetna Medicare,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Ambetter ,Ambetter ,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Blue Access,Anthem Blue Access,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Blue Access Choice,Anthem Blue Access Choice,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Blue Preferred,Anthem Blue Preferred,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Pathway,Anthem Pathway,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Alliance,Anthem Alliance,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Anthem Medicare,Anthem Medicare,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Cigna,Cigna,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Cigna PPO,Cigna PPO,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Cigna Medicare Advantage,Cigna Medicare Advantage,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Essence,Essence,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Healthlink HMO,Healthlink HMO,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Healthlink PPO,Healthlink PPO,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,HomeState Health Plan,HomeState Health Plan,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Humana Gold,Humana Gold,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Medicaid MO,Medicaid MO,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Medica,Medica,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Tricare,Tricare,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,UHC All Payer,UHC All Payer,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,UHC Exchange,UHC Exchange,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,UHC Medicaid,UHC Medicaid,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,UMR CPD,UMR CPD,118.56,,,,,,,per diem,118.56,118.56,"Per diem rate, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,UHC Medicare,UHC Medicare,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGOT (AST)                    ,38202170,CDM,301,RC,84450,CPT,,,,Inpatient,,,118.56,118.56,Wellcare,Wellcare,118.56,,,,,,,case rate,118.56,118.56,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SGPT (ALT)                    ,38202180,CDM,301,RC,84460,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Meritain Health PPO CPD,Meritain Health PPO CPD,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Aetna/Commercial Product,Aetna/Commercial Product,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Meritain Health CPD,Meritain Health CPD,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Starmark CPD,Starmark CPD,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Aetna Medicare,Aetna Medicare,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Ambetter ,Ambetter ,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Blue Access,Anthem Blue Access,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Blue Access Choice,Anthem Blue Access Choice,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Blue Preferred,Anthem Blue Preferred,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Pathway,Anthem Pathway,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Alliance,Anthem Alliance,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Anthem Medicare,Anthem Medicare,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Cigna,Cigna,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Cigna PPO,Cigna PPO,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Cigna Medicare Advantage,Cigna Medicare Advantage,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Essence,Essence,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Healthlink HMO,Healthlink HMO,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Healthlink PPO,Healthlink PPO,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,HomeState Health Plan,HomeState Health Plan,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Humana Gold,Humana Gold,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Medicaid MO,Medicaid MO,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Medica,Medica,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Tricare,Tricare,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,UHC All Payer,UHC All Payer,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,UHC Exchange,UHC Exchange,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,UHC Medicaid,UHC Medicaid,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,UMR CPD,UMR CPD,21.88,,,,,,,per diem,21.88,21.88,"Per diem rate, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,UHC Medicare,UHC Medicare,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SICKLE CELL SCREEN            ,38202190,CDM,305,RC,85660,CPT,,,,Inpatient,,,21.88,21.88,Wellcare,Wellcare,21.88,,,,,,,case rate,21.88,21.88,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Meritain Health PPO CPD,Meritain Health PPO CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Aetna/Commercial Product,Aetna/Commercial Product,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Meritain Health CPD,Meritain Health CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Starmark CPD,Starmark CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Aetna Medicare,Aetna Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Ambetter ,Ambetter ,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Blue Access,Anthem Blue Access,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Blue Access Choice,Anthem Blue Access Choice,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Blue Preferred,Anthem Blue Preferred,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Pathway,Anthem Pathway,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Alliance,Anthem Alliance,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Anthem Medicare,Anthem Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Cigna,Cigna,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Cigna PPO,Cigna PPO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Cigna Medicare Advantage,Cigna Medicare Advantage,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Essence,Essence,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Healthlink HMO,Healthlink HMO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Healthlink PPO,Healthlink PPO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,HomeState Health Plan,HomeState Health Plan,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Humana Gold,Humana Gold,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Medicaid MO,Medicaid MO,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Medica,Medica,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Tricare,Tricare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,UHC All Payer,UHC All Payer,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,UHC Exchange,UHC Exchange,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,UHC Medicaid,UHC Medicaid,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,UMR CPD,UMR CPD,61.53,,,,,,,per diem,61.53,61.53,"Per diem rate, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,UHC Medicare,UHC Medicare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
SODIUM SERUM                  ,38202200,CDM,301,RC,84295,CPT,,,,Inpatient,,,61.53,61.53,Wellcare,Wellcare,61.53,,,,,,,case rate,61.53,61.53,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Meritain Health PPO CPD,Meritain Health PPO CPD,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Aetna/Commercial Product,Aetna/Commercial Product,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Meritain Health CPD,Meritain Health CPD,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Starmark CPD,Starmark CPD,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Aetna Medicare,Aetna Medicare,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Ambetter ,Ambetter ,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Blue Access,Anthem Blue Access,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Blue Access Choice,Anthem Blue Access Choice,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Blue Preferred,Anthem Blue Preferred,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Pathway,Anthem Pathway,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Alliance,Anthem Alliance,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Anthem Medicare,Anthem Medicare,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Cigna,Cigna,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Cigna PPO,Cigna PPO,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Cigna Medicare Advantage,Cigna Medicare Advantage,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Essence,Essence,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Healthlink HMO,Healthlink HMO,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Healthlink PPO,Healthlink PPO,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,HomeState Health Plan,HomeState Health Plan,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Humana Gold,Humana Gold,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Medicaid MO,Medicaid MO,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Medica,Medica,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Tricare,Tricare,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,UHC All Payer,UHC All Payer,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,UHC Exchange,UHC Exchange,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,UHC Medicaid,UHC Medicaid,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,UMR CPD,UMR CPD,740.51,,,,,,,per diem,740.51,740.51,"Per diem rate, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,UHC Medicare,UHC Medicare,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
RSV PCR QUALITATIVE           ,38202208,CDM,300,RC,87798,CPT,,,,Inpatient,,,740.51,740.51,Wellcare,Wellcare,740.51,,,,,,,case rate,740.51,740.51,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Meritain Health PPO CPD,Meritain Health PPO CPD,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Aetna/Commercial Product,Aetna/Commercial Product,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Meritain Health CPD,Meritain Health CPD,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Starmark CPD,Starmark CPD,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Aetna Medicare,Aetna Medicare,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Ambetter ,Ambetter ,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Blue Access,Anthem Blue Access,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Blue Access Choice,Anthem Blue Access Choice,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Blue Preferred,Anthem Blue Preferred,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Pathway,Anthem Pathway,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Alliance,Anthem Alliance,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Anthem Medicare,Anthem Medicare,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Cigna,Cigna,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Cigna PPO,Cigna PPO,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Cigna Medicare Advantage,Cigna Medicare Advantage,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Essence,Essence,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Healthlink HMO,Healthlink HMO,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Healthlink PPO,Healthlink PPO,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,HomeState Health Plan,HomeState Health Plan,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Humana Gold,Humana Gold,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Medicaid MO,Medicaid MO,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Medica,Medica,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Tricare,Tricare,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,UHC All Payer,UHC All Payer,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,UHC Exchange,UHC Exchange,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,UHC Medicaid,UHC Medicaid,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,UMR CPD,UMR CPD,35.16,,,,,,,per diem,35.16,35.16,"Per diem rate, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,UHC Medicare,UHC Medicare,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
SODIUM NON-URINE/NON-BLOOD    ,38202211,CDM,301,RC,84302,CPT,,,,Inpatient,,,35.16,35.16,Wellcare,Wellcare,35.16,,,,,,,case rate,35.16,35.16,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health PPO CPD,Meritain Health PPO CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Aetna/Commercial Product,Aetna/Commercial Product,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health CPD,Meritain Health CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Starmark CPD,Starmark CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Aetna Medicare,Aetna Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Ambetter ,Ambetter ,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access,Anthem Blue Access,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access Choice,Anthem Blue Access Choice,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Preferred,Anthem Blue Preferred,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Pathway,Anthem Pathway,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Alliance,Anthem Alliance,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Anthem Medicare,Anthem Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Cigna,Cigna,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Cigna PPO,Cigna PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Cigna Medicare Advantage,Cigna Medicare Advantage,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Essence,Essence,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Healthlink HMO,Healthlink HMO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Healthlink PPO,Healthlink PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,HomeState Health Plan,HomeState Health Plan,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Humana Gold,Humana Gold,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Medicaid MO,Medicaid MO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Medica,Medica,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Tricare,Tricare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,UHC All Payer,UHC All Payer,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,UHC Exchange,UHC Exchange,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicaid,UHC Medicaid,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,UMR CPD,UMR CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicare,UHC Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38202212,CDM,305,RC,85049,CPT,,,,Inpatient,,,74.26,74.26,Wellcare,Wellcare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Meritain Health PPO CPD,Meritain Health PPO CPD,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Aetna/Commercial Product,Aetna/Commercial Product,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Meritain Health CPD,Meritain Health CPD,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Starmark CPD,Starmark CPD,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Aetna Medicare,Aetna Medicare,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Ambetter ,Ambetter ,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Blue Access,Anthem Blue Access,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Blue Access Choice,Anthem Blue Access Choice,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Blue Preferred,Anthem Blue Preferred,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Pathway,Anthem Pathway,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Alliance,Anthem Alliance,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Anthem Medicare,Anthem Medicare,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Cigna,Cigna,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Cigna PPO,Cigna PPO,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Cigna Medicare Advantage,Cigna Medicare Advantage,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Essence,Essence,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Healthlink HMO,Healthlink HMO,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Healthlink PPO,Healthlink PPO,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,HomeState Health Plan,HomeState Health Plan,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Humana Gold,Humana Gold,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Medicaid MO,Medicaid MO,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Medica,Medica,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Tricare,Tricare,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,UHC All Payer,UHC All Payer,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,UHC Exchange,UHC Exchange,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,UHC Medicaid,UHC Medicaid,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,UMR CPD,UMR CPD,71.55,,,,,,,per diem,71.55,71.55,"Per diem rate, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,UHC Medicare,UHC Medicare,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
BLOOD SMR W/O MAN DIFF WBC CNT,38202213,CDM,305,RC,85008,CPT,,,,Inpatient,,,71.55,71.55,Wellcare,Wellcare,71.55,,,,,,,case rate,71.55,71.55,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Meritain Health PPO CPD,Meritain Health PPO CPD,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Aetna/Commercial Product,Aetna/Commercial Product,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Meritain Health CPD,Meritain Health CPD,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Starmark CPD,Starmark CPD,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Aetna Medicare,Aetna Medicare,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Ambetter ,Ambetter ,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Blue Access,Anthem Blue Access,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Blue Access Choice,Anthem Blue Access Choice,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Blue Preferred,Anthem Blue Preferred,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Pathway,Anthem Pathway,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Alliance,Anthem Alliance,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Anthem Medicare,Anthem Medicare,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Cigna,Cigna,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Cigna PPO,Cigna PPO,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Cigna Medicare Advantage,Cigna Medicare Advantage,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Essence,Essence,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Healthlink HMO,Healthlink HMO,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Healthlink PPO,Healthlink PPO,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,HomeState Health Plan,HomeState Health Plan,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Humana Gold,Humana Gold,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Medicaid MO,Medicaid MO,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Medica,Medica,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Tricare,Tricare,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,UHC All Payer,UHC All Payer,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,UHC Exchange,UHC Exchange,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,UHC Medicaid,UHC Medicaid,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,UMR CPD,UMR CPD,37.08,,,,,,,per diem,37.08,37.08,"Per diem rate, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,UHC Medicare,UHC Medicare,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
MAN DIFF WBC CNT BUFFY COAT   ,38202214,CDM,305,RC,85009,CPT,,,,Inpatient,,,37.08,37.08,Wellcare,Wellcare,37.08,,,,,,,case rate,37.08,37.08,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Meritain Health PPO CPD,Meritain Health PPO CPD,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Aetna/Commercial Product,Aetna/Commercial Product,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Meritain Health CPD,Meritain Health CPD,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Starmark CPD,Starmark CPD,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Aetna Medicare,Aetna Medicare,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Ambetter ,Ambetter ,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Blue Access,Anthem Blue Access,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Blue Access Choice,Anthem Blue Access Choice,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Blue Preferred,Anthem Blue Preferred,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Pathway,Anthem Pathway,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Alliance,Anthem Alliance,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Anthem Medicare,Anthem Medicare,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Cigna,Cigna,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Cigna PPO,Cigna PPO,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Cigna Medicare Advantage,Cigna Medicare Advantage,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Essence,Essence,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Healthlink HMO,Healthlink HMO,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Healthlink PPO,Healthlink PPO,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,HomeState Health Plan,HomeState Health Plan,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Humana Gold,Humana Gold,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Medicaid MO,Medicaid MO,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Medica,Medica,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Tricare,Tricare,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,UHC All Payer,UHC All Payer,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,UHC Exchange,UHC Exchange,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,UHC Medicaid,UHC Medicaid,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,UMR CPD,UMR CPD,56.72,,,,,,,per diem,56.72,56.72,"Per diem rate, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,UHC Medicare,UHC Medicare,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
RETICULOCYTE (AUTO)           ,38202215,CDM,305,RC,85045,CPT,,,,Inpatient,,,56.72,56.72,Wellcare,Wellcare,56.72,,,,,,,case rate,56.72,56.72,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Meritain Health PPO CPD,Meritain Health PPO CPD,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Aetna/Commercial Product,Aetna/Commercial Product,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Meritain Health CPD,Meritain Health CPD,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Starmark CPD,Starmark CPD,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Aetna Medicare,Aetna Medicare,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Ambetter ,Ambetter ,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Blue Access,Anthem Blue Access,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Blue Access Choice,Anthem Blue Access Choice,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Blue Preferred,Anthem Blue Preferred,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Pathway,Anthem Pathway,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Alliance,Anthem Alliance,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Anthem Medicare,Anthem Medicare,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Cigna,Cigna,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Cigna PPO,Cigna PPO,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Cigna Medicare Advantage,Cigna Medicare Advantage,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Essence,Essence,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Healthlink HMO,Healthlink HMO,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Healthlink PPO,Healthlink PPO,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,HomeState Health Plan,HomeState Health Plan,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Humana Gold,Humana Gold,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Medicaid MO,Medicaid MO,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Medica,Medica,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Tricare,Tricare,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,UHC All Payer,UHC All Payer,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,UHC Exchange,UHC Exchange,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,UHC Medicaid,UHC Medicaid,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,UMR CPD,UMR CPD,98.91,,,,,,,per diem,98.91,98.91,"Per diem rate, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,UHC Medicare,UHC Medicare,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
"LEUKOCYTE COUNT, FECAL        ",38202216,CDM,300,RC,89055,CPT,,,,Inpatient,,,98.91,98.91,Wellcare,Wellcare,98.91,,,,,,,case rate,98.91,98.91,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Meritain Health PPO CPD,Meritain Health PPO CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Aetna/Commercial Product,Aetna/Commercial Product,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Meritain Health CPD,Meritain Health CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Starmark CPD,Starmark CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Aetna Medicare,Aetna Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Ambetter ,Ambetter ,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Access,Anthem Blue Access,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Access Choice,Anthem Blue Access Choice,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Preferred,Anthem Blue Preferred,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Pathway,Anthem Pathway,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Alliance,Anthem Alliance,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Anthem Medicare,Anthem Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Cigna,Cigna,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Cigna PPO,Cigna PPO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Cigna Medicare Advantage,Cigna Medicare Advantage,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Essence,Essence,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Healthlink HMO,Healthlink HMO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Healthlink PPO,Healthlink PPO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,HomeState Health Plan,HomeState Health Plan,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Humana Gold,Humana Gold,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Medicaid MO,Medicaid MO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Medica,Medica,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Tricare,Tricare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,UHC All Payer,UHC All Payer,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,UHC Exchange,UHC Exchange,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,UHC Medicaid,UHC Medicaid,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,UMR CPD,UMR CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,UHC Medicare,UHC Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
SPECIFIC GRAVITY (NON-URINE)  ,38202229,CDM,301,RC,84315,CPT,,,,Inpatient,,,22.06,22.06,Wellcare,Wellcare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
STREP A SCREEN (EIA)          ,38202270,CDM,306,RC,87880,CPT,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP B STREP SC     ",38202271,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Meritain Health PPO CPD,Meritain Health PPO CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Aetna/Commercial Product,Aetna/Commercial Product,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Meritain Health CPD,Meritain Health CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Starmark CPD,Starmark CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Aetna Medicare,Aetna Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Ambetter ,Ambetter ,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Blue Access,Anthem Blue Access,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Blue Access Choice,Anthem Blue Access Choice,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Blue Preferred,Anthem Blue Preferred,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Pathway,Anthem Pathway,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Alliance,Anthem Alliance,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Anthem Medicare,Anthem Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Cigna,Cigna,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Cigna PPO,Cigna PPO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Cigna Medicare Advantage,Cigna Medicare Advantage,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Essence,Essence,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Healthlink HMO,Healthlink HMO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Healthlink PPO,Healthlink PPO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,HomeState Health Plan,HomeState Health Plan,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Humana Gold,Humana Gold,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Medicaid MO,Medicaid MO,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Medica,Medica,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Tricare,Tricare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,UHC All Payer,UHC All Payer,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,UHC Exchange,UHC Exchange,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,UHC Medicaid,UHC Medicaid,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,UMR CPD,UMR CPD,204.75,,,,,,,per diem,204.75,204.75,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,UHC Medicare,UHC Medicare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38202290,CDM,301,RC,84481,CPT,,,,Inpatient,,,204.75,204.75,Wellcare,Wellcare,204.75,,,,,,,case rate,204.75,204.75,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Meritain Health PPO CPD,Meritain Health PPO CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Aetna/Commercial Product,Aetna/Commercial Product,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Meritain Health CPD,Meritain Health CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Starmark CPD,Starmark CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Aetna Medicare,Aetna Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Ambetter ,Ambetter ,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Blue Access,Anthem Blue Access,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Blue Access Choice,Anthem Blue Access Choice,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Blue Preferred,Anthem Blue Preferred,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Pathway,Anthem Pathway,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Alliance,Anthem Alliance,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Anthem Medicare,Anthem Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Cigna,Cigna,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Cigna PPO,Cigna PPO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Cigna Medicare Advantage,Cigna Medicare Advantage,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Essence,Essence,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Healthlink HMO,Healthlink HMO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Healthlink PPO,Healthlink PPO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,HomeState Health Plan,HomeState Health Plan,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Humana Gold,Humana Gold,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Medicaid MO,Medicaid MO,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Medica,Medica,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Tricare,Tricare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,UHC All Payer,UHC All Payer,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,UHC Exchange,UHC Exchange,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,UHC Medicaid,UHC Medicaid,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,UMR CPD,UMR CPD,239.54,,,,,,,per diem,239.54,239.54,"Per diem rate, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,UHC Medicare,UHC Medicare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T-3 UPTAKE                    ,38202300,CDM,301,RC,84479,CPT,,,,Inpatient,,,239.54,239.54,Wellcare,Wellcare,239.54,,,,,,,case rate,239.54,239.54,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Meritain Health PPO CPD,Meritain Health PPO CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna/Commercial Product,Aetna/Commercial Product,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Meritain Health CPD,Meritain Health CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Starmark CPD,Starmark CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna Medicare,Aetna Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Ambetter ,Ambetter ,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Access,Anthem Blue Access,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Access Choice,Anthem Blue Access Choice,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Preferred,Anthem Blue Preferred,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Pathway,Anthem Pathway,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Alliance,Anthem Alliance,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Medicare,Anthem Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna,Cigna,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna PPO,Cigna PPO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna Medicare Advantage,Cigna Medicare Advantage,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Essence,Essence,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthlink HMO,Healthlink HMO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthlink PPO,Healthlink PPO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,HomeState Health Plan,HomeState Health Plan,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Humana Gold,Humana Gold,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Medicaid MO,Medicaid MO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Medica,Medica,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Tricare,Tricare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC All Payer,UHC All Payer,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Exchange,UHC Exchange,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Medicaid,UHC Medicaid,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UMR CPD,UMR CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Medicare,UHC Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38202303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Wellcare,Wellcare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Meritain Health PPO CPD,Meritain Health PPO CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Aetna/Commercial Product,Aetna/Commercial Product,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Meritain Health CPD,Meritain Health CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Starmark CPD,Starmark CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Aetna Medicare,Aetna Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Ambetter ,Ambetter ,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Blue Access,Anthem Blue Access,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Blue Access Choice,Anthem Blue Access Choice,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Blue Preferred,Anthem Blue Preferred,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Pathway,Anthem Pathway,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Alliance,Anthem Alliance,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Anthem Medicare,Anthem Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Cigna,Cigna,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Cigna PPO,Cigna PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Cigna Medicare Advantage,Cigna Medicare Advantage,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Essence,Essence,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Healthlink HMO,Healthlink HMO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Healthlink PPO,Healthlink PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,HomeState Health Plan,HomeState Health Plan,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Humana Gold,Humana Gold,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Medicaid MO,Medicaid MO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Medica,Medica,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Tricare,Tricare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,UHC All Payer,UHC All Payer,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,UHC Exchange,UHC Exchange,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,UHC Medicaid,UHC Medicaid,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,UMR CPD,UMR CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,UHC Medicare,UHC Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
REVERSE T3                    ,38202304,CDM,301,RC,84482,CPT,,,,Inpatient,,,485.38,485.38,Wellcare,Wellcare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Meritain Health PPO CPD,Meritain Health PPO CPD,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Aetna/Commercial Product,Aetna/Commercial Product,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Meritain Health CPD,Meritain Health CPD,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Starmark CPD,Starmark CPD,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Aetna Medicare,Aetna Medicare,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Ambetter ,Ambetter ,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Blue Access,Anthem Blue Access,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Blue Access Choice,Anthem Blue Access Choice,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Blue Preferred,Anthem Blue Preferred,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Pathway,Anthem Pathway,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Alliance,Anthem Alliance,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Anthem Medicare,Anthem Medicare,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Cigna,Cigna,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Cigna PPO,Cigna PPO,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Cigna Medicare Advantage,Cigna Medicare Advantage,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Essence,Essence,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Healthlink HMO,Healthlink HMO,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Healthlink PPO,Healthlink PPO,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,HomeState Health Plan,HomeState Health Plan,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Humana Gold,Humana Gold,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Medicaid MO,Medicaid MO,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Medica,Medica,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Tricare,Tricare,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,UHC All Payer,UHC All Payer,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,UHC Exchange,UHC Exchange,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,UHC Medicaid,UHC Medicaid,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,UMR CPD,UMR CPD,180.68,,,,,,,per diem,180.68,180.68,"Per diem rate, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,UHC Medicare,UHC Medicare,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
T-4 TOTAL (THYROXINE)         ,38202310,CDM,301,RC,84436,CPT,,,,Inpatient,,,180.68,180.68,Wellcare,Wellcare,180.68,,,,,,,case rate,180.68,180.68,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Meritain Health PPO CPD,Meritain Health PPO CPD,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Aetna/Commercial Product,Aetna/Commercial Product,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Meritain Health CPD,Meritain Health CPD,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Starmark CPD,Starmark CPD,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Aetna Medicare,Aetna Medicare,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Ambetter ,Ambetter ,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Blue Access,Anthem Blue Access,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Blue Access Choice,Anthem Blue Access Choice,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Blue Preferred,Anthem Blue Preferred,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Pathway,Anthem Pathway,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Alliance,Anthem Alliance,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Anthem Medicare,Anthem Medicare,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Cigna,Cigna,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Cigna PPO,Cigna PPO,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Cigna Medicare Advantage,Cigna Medicare Advantage,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Essence,Essence,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Healthlink HMO,Healthlink HMO,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Healthlink PPO,Healthlink PPO,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,HomeState Health Plan,HomeState Health Plan,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Humana Gold,Humana Gold,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Medicaid MO,Medicaid MO,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Medica,Medica,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Tricare,Tricare,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,UHC All Payer,UHC All Payer,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,UHC Exchange,UHC Exchange,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,UHC Medicaid,UHC Medicaid,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,UMR CPD,UMR CPD,188.05,,,,,,,per diem,188.05,188.05,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,UHC Medicare,UHC Medicare,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38202330,CDM,301,RC,80156,CPT,,,,Inpatient,,,188.05,188.05,Wellcare,Wellcare,188.05,,,,,,,case rate,188.05,188.05,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Meritain Health PPO CPD,Meritain Health PPO CPD,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Aetna/Commercial Product,Aetna/Commercial Product,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Meritain Health CPD,Meritain Health CPD,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Starmark CPD,Starmark CPD,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Aetna Medicare,Aetna Medicare,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Ambetter ,Ambetter ,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Blue Access,Anthem Blue Access,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Blue Access Choice,Anthem Blue Access Choice,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Blue Preferred,Anthem Blue Preferred,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Pathway,Anthem Pathway,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Alliance,Anthem Alliance,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Anthem Medicare,Anthem Medicare,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Cigna,Cigna,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Cigna PPO,Cigna PPO,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Cigna Medicare Advantage,Cigna Medicare Advantage,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Essence,Essence,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Healthlink HMO,Healthlink HMO,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Healthlink PPO,Healthlink PPO,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,HomeState Health Plan,HomeState Health Plan,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Humana Gold,Humana Gold,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Medicaid MO,Medicaid MO,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Medica,Medica,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Tricare,Tricare,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,UHC All Payer,UHC All Payer,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,UHC Exchange,UHC Exchange,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,UHC Medicaid,UHC Medicaid,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,UMR CPD,UMR CPD,240.82,,,,,,,per diem,240.82,240.82,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,UHC Medicare,UHC Medicare,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38202340,CDM,301,RC,84403,CPT,,,,Inpatient,,,240.82,240.82,Wellcare,Wellcare,240.82,,,,,,,case rate,240.82,240.82,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Meritain Health PPO CPD,Meritain Health PPO CPD,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Aetna/Commercial Product,Aetna/Commercial Product,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Meritain Health CPD,Meritain Health CPD,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Starmark CPD,Starmark CPD,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Aetna Medicare,Aetna Medicare,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Ambetter ,Ambetter ,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Blue Access,Anthem Blue Access,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Blue Access Choice,Anthem Blue Access Choice,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Blue Preferred,Anthem Blue Preferred,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Pathway,Anthem Pathway,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Alliance,Anthem Alliance,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Anthem Medicare,Anthem Medicare,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Cigna,Cigna,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Cigna PPO,Cigna PPO,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Cigna Medicare Advantage,Cigna Medicare Advantage,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Essence,Essence,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Healthlink HMO,Healthlink HMO,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Healthlink PPO,Healthlink PPO,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,HomeState Health Plan,HomeState Health Plan,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Humana Gold,Humana Gold,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Medicaid MO,Medicaid MO,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Medica,Medica,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Tricare,Tricare,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,UHC All Payer,UHC All Payer,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,UHC Exchange,UHC Exchange,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,UHC Medicaid,UHC Medicaid,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,UMR CPD,UMR CPD,243.37,,,,,,,per diem,243.37,243.37,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,UHC Medicare,UHC Medicare,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38202350,CDM,301,RC,80198,CPT,,,,Inpatient,,,243.37,243.37,Wellcare,Wellcare,243.37,,,,,,,case rate,243.37,243.37,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Meritain Health PPO CPD,Meritain Health PPO CPD,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Aetna/Commercial Product,Aetna/Commercial Product,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Meritain Health CPD,Meritain Health CPD,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Starmark CPD,Starmark CPD,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Aetna Medicare,Aetna Medicare,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Ambetter ,Ambetter ,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Blue Access,Anthem Blue Access,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Blue Access Choice,Anthem Blue Access Choice,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Blue Preferred,Anthem Blue Preferred,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Pathway,Anthem Pathway,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Alliance,Anthem Alliance,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Anthem Medicare,Anthem Medicare,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Cigna,Cigna,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Cigna PPO,Cigna PPO,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Cigna Medicare Advantage,Cigna Medicare Advantage,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Essence,Essence,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Healthlink HMO,Healthlink HMO,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Healthlink PPO,Healthlink PPO,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,HomeState Health Plan,HomeState Health Plan,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Humana Gold,Humana Gold,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Medicaid MO,Medicaid MO,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Medica,Medica,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Tricare,Tricare,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,UHC All Payer,UHC All Payer,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,UHC Exchange,UHC Exchange,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,UHC Medicaid,UHC Medicaid,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,UMR CPD,UMR CPD,439.32,,,,,,,per diem,439.32,439.32,"Per diem rate, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,UHC Medicare,UHC Medicare,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THROMBIN TIME                 ,38202370,CDM,305,RC,85670,CPT,,,,Inpatient,,,439.32,439.32,Wellcare,Wellcare,439.32,,,,,,,case rate,439.32,439.32,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Meritain Health PPO CPD,Meritain Health PPO CPD,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Aetna/Commercial Product,Aetna/Commercial Product,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Meritain Health CPD,Meritain Health CPD,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Starmark CPD,Starmark CPD,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Aetna Medicare,Aetna Medicare,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Ambetter ,Ambetter ,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Blue Access,Anthem Blue Access,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Blue Access Choice,Anthem Blue Access Choice,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Blue Preferred,Anthem Blue Preferred,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Pathway,Anthem Pathway,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Alliance,Anthem Alliance,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Anthem Medicare,Anthem Medicare,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Cigna,Cigna,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Cigna PPO,Cigna PPO,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Cigna Medicare Advantage,Cigna Medicare Advantage,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Essence,Essence,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Healthlink HMO,Healthlink HMO,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Healthlink PPO,Healthlink PPO,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,HomeState Health Plan,HomeState Health Plan,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Humana Gold,Humana Gold,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Medicaid MO,Medicaid MO,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Medica,Medica,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Tricare,Tricare,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,UHC All Payer,UHC All Payer,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,UHC Exchange,UHC Exchange,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,UHC Medicaid,UHC Medicaid,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,UMR CPD,UMR CPD,258.33,,,,,,,per diem,258.33,258.33,"Per diem rate, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,UHC Medicare,UHC Medicare,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
THYROID STIMULATING IMM GLOB  ,38202384,CDM,301,RC,84445,CPT,,,,Inpatient,,,258.33,258.33,Wellcare,Wellcare,258.33,,,,,,,case rate,258.33,258.33,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Meritain Health PPO CPD,Meritain Health PPO CPD,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Aetna/Commercial Product,Aetna/Commercial Product,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Meritain Health CPD,Meritain Health CPD,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Starmark CPD,Starmark CPD,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Aetna Medicare,Aetna Medicare,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Ambetter ,Ambetter ,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Blue Access,Anthem Blue Access,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Blue Access Choice,Anthem Blue Access Choice,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Blue Preferred,Anthem Blue Preferred,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Pathway,Anthem Pathway,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Alliance,Anthem Alliance,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Anthem Medicare,Anthem Medicare,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Cigna,Cigna,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Cigna PPO,Cigna PPO,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Cigna Medicare Advantage,Cigna Medicare Advantage,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Essence,Essence,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Healthlink HMO,Healthlink HMO,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Healthlink PPO,Healthlink PPO,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,HomeState Health Plan,HomeState Health Plan,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Humana Gold,Humana Gold,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Medicaid MO,Medicaid MO,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Medica,Medica,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Tricare,Tricare,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,UHC All Payer,UHC All Payer,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,UHC Exchange,UHC Exchange,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,UHC Medicaid,UHC Medicaid,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,UMR CPD,UMR CPD,351.58,,,,,,,per diem,351.58,351.58,"Per diem rate, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,UHC Medicare,UHC Medicare,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TOBRAMYCIN                    ,38202390,CDM,301,RC,80200,CPT,,,,Inpatient,,,351.58,351.58,Wellcare,Wellcare,351.58,,,,,,,case rate,351.58,351.58,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health PPO CPD,Meritain Health PPO CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Aetna/Commercial Product,Aetna/Commercial Product,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health CPD,Meritain Health CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Starmark CPD,Starmark CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Aetna Medicare,Aetna Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Ambetter ,Ambetter ,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access,Anthem Blue Access,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access Choice,Anthem Blue Access Choice,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Preferred,Anthem Blue Preferred,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Pathway,Anthem Pathway,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Alliance,Anthem Alliance,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Anthem Medicare,Anthem Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Cigna,Cigna,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Cigna PPO,Cigna PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Cigna Medicare Advantage,Cigna Medicare Advantage,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Essence,Essence,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Healthlink HMO,Healthlink HMO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Healthlink PPO,Healthlink PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,HomeState Health Plan,HomeState Health Plan,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Humana Gold,Humana Gold,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Medicaid MO,Medicaid MO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Medica,Medica,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Tricare,Tricare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,UHC All Payer,UHC All Payer,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,UHC Exchange,UHC Exchange,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicaid,UHC Medicaid,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,UMR CPD,UMR CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicare,UHC Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38202400,CDM,301,RC,84466,CPT,,,,Inpatient,,,154.89,154.89,Wellcare,Wellcare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Meritain Health PPO CPD,Meritain Health PPO CPD,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Aetna/Commercial Product,Aetna/Commercial Product,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Meritain Health CPD,Meritain Health CPD,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Starmark CPD,Starmark CPD,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Aetna Medicare,Aetna Medicare,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Ambetter ,Ambetter ,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Blue Access,Anthem Blue Access,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Blue Access Choice,Anthem Blue Access Choice,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Blue Preferred,Anthem Blue Preferred,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Pathway,Anthem Pathway,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Alliance,Anthem Alliance,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Anthem Medicare,Anthem Medicare,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Cigna,Cigna,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Cigna PPO,Cigna PPO,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Cigna Medicare Advantage,Cigna Medicare Advantage,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Essence,Essence,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Healthlink HMO,Healthlink HMO,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Healthlink PPO,Healthlink PPO,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,HomeState Health Plan,HomeState Health Plan,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Humana Gold,Humana Gold,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Medicaid MO,Medicaid MO,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Medica,Medica,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Tricare,Tricare,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,UHC All Payer,UHC All Payer,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,UHC Exchange,UHC Exchange,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,UHC Medicaid,UHC Medicaid,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,UMR CPD,UMR CPD,96.91,,,,,,,per diem,96.91,96.91,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,UHC Medicare,UHC Medicare,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38202410,CDM,301,RC,84478,CPT,,,,Inpatient,,,96.91,96.91,Wellcare,Wellcare,96.91,,,,,,,case rate,96.91,96.91,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Meritain Health PPO CPD,Meritain Health PPO CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Aetna/Commercial Product,Aetna/Commercial Product,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Meritain Health CPD,Meritain Health CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Starmark CPD,Starmark CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Aetna Medicare,Aetna Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Ambetter ,Ambetter ,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Access,Anthem Blue Access,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Access Choice,Anthem Blue Access Choice,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Preferred,Anthem Blue Preferred,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Pathway,Anthem Pathway,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Alliance,Anthem Alliance,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Anthem Medicare,Anthem Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Cigna,Cigna,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Cigna PPO,Cigna PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Cigna Medicare Advantage,Cigna Medicare Advantage,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Essence,Essence,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Healthlink HMO,Healthlink HMO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Healthlink PPO,Healthlink PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,HomeState Health Plan,HomeState Health Plan,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Humana Gold,Humana Gold,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Medicaid MO,Medicaid MO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Medica,Medica,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Tricare,Tricare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,UHC All Payer,UHC All Payer,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,UHC Exchange,UHC Exchange,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,UHC Medicaid,UHC Medicaid,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,UMR CPD,UMR CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,UHC Medicare,UHC Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDE FLUID            ,38202412,CDM,300,RC,84478,CPT,,,,Inpatient,,,101.97,101.97,Wellcare,Wellcare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN (QUANTITATIVE)       ,38202415,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health PPO CPD,Meritain Health PPO CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna/Commercial Product,Aetna/Commercial Product,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Meritain Health CPD,Meritain Health CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Starmark CPD,Starmark CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Aetna Medicare,Aetna Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Ambetter ,Ambetter ,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access,Anthem Blue Access,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Access Choice,Anthem Blue Access Choice,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Blue Preferred,Anthem Blue Preferred,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Pathway,Anthem Pathway,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Alliance,Anthem Alliance,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Anthem Medicare,Anthem Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna,Cigna,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna PPO,Cigna PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Cigna Medicare Advantage,Cigna Medicare Advantage,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Essence,Essence,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthlink HMO,Healthlink HMO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Healthlink PPO,Healthlink PPO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,HomeState Health Plan,HomeState Health Plan,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Humana Gold,Humana Gold,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Medicaid MO,Medicaid MO,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Medica,Medica,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Tricare,Tricare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC All Payer,UHC All Payer,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Exchange,UHC Exchange,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicaid,UHC Medicaid,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UMR CPD,UMR CPD,193.08,,,,,,,per diem,193.08,193.08,"Per diem rate, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,UHC Medicare,UHC Medicare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TROPONIN T (QUANTITATIVE)     ,38202416,CDM,301,RC,84484,CPT,,,,Inpatient,,,193.08,193.08,Wellcare,Wellcare,193.08,,,,,,,case rate,193.08,193.08,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health PPO CPD,Meritain Health PPO CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/Commercial Product,Aetna/Commercial Product,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health CPD,Meritain Health CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Starmark CPD,Starmark CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna Medicare,Aetna Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Ambetter ,Ambetter ,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access,Anthem Blue Access,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access Choice,Anthem Blue Access Choice,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Preferred,Anthem Blue Preferred,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Pathway,Anthem Pathway,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Alliance,Anthem Alliance,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Medicare,Anthem Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna,Cigna,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna PPO,Cigna PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna Medicare Advantage,Cigna Medicare Advantage,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Essence,Essence,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink HMO,Healthlink HMO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink PPO,Healthlink PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,HomeState Health Plan,HomeState Health Plan,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Humana Gold,Humana Gold,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medicaid MO,Medicaid MO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medica,Medica,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Tricare,Tricare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC All Payer,UHC All Payer,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Exchange,UHC Exchange,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicaid,UHC Medicaid,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UMR CPD,UMR CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicare,UHC Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH                           ,38202420,CDM,301,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Wellcare,Wellcare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & CROSSMATCH             ,38202429,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
TYPE & SCREEN                 ,38202430,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Meritain Health PPO CPD,Meritain Health PPO CPD,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Aetna/Commercial Product,Aetna/Commercial Product,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Meritain Health CPD,Meritain Health CPD,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Starmark CPD,Starmark CPD,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Aetna Medicare,Aetna Medicare,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Ambetter ,Ambetter ,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Blue Access,Anthem Blue Access,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Blue Access Choice,Anthem Blue Access Choice,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Blue Preferred,Anthem Blue Preferred,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Pathway,Anthem Pathway,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Alliance,Anthem Alliance,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Anthem Medicare,Anthem Medicare,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Cigna,Cigna,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Cigna PPO,Cigna PPO,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Cigna Medicare Advantage,Cigna Medicare Advantage,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Essence,Essence,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Healthlink HMO,Healthlink HMO,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Healthlink PPO,Healthlink PPO,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,HomeState Health Plan,HomeState Health Plan,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Humana Gold,Humana Gold,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Medicaid MO,Medicaid MO,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Medica,Medica,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Tricare,Tricare,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,UHC All Payer,UHC All Payer,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,UHC Exchange,UHC Exchange,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,UHC Medicaid,UHC Medicaid,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,UMR CPD,UMR CPD,106.09,,,,,,,per diem,106.09,106.09,"Per diem rate, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,UHC Medicare,UHC Medicare,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"URIC ACID, BLOOD              ",38202440,CDM,301,RC,84550,CPT,,,,Inpatient,,,106.09,106.09,Wellcare,Wellcare,106.09,,,,,,,case rate,106.09,106.09,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Meritain Health PPO CPD,Meritain Health PPO CPD,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Aetna/Commercial Product,Aetna/Commercial Product,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Meritain Health CPD,Meritain Health CPD,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Starmark CPD,Starmark CPD,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Aetna Medicare,Aetna Medicare,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Ambetter ,Ambetter ,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Blue Access,Anthem Blue Access,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Blue Access Choice,Anthem Blue Access Choice,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Blue Preferred,Anthem Blue Preferred,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Pathway,Anthem Pathway,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Alliance,Anthem Alliance,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Anthem Medicare,Anthem Medicare,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Cigna,Cigna,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Cigna PPO,Cigna PPO,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Cigna Medicare Advantage,Cigna Medicare Advantage,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Essence,Essence,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Healthlink HMO,Healthlink HMO,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Healthlink PPO,Healthlink PPO,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,HomeState Health Plan,HomeState Health Plan,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Humana Gold,Humana Gold,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Medicaid MO,Medicaid MO,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Medica,Medica,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Tricare,Tricare,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,UHC All Payer,UHC All Payer,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,UHC Exchange,UHC Exchange,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,UHC Medicaid,UHC Medicaid,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,UMR CPD,UMR CPD,357.52,,,,,,,per diem,357.52,357.52,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,UHC Medicare,UHC Medicare,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25 HYDROXY         ",38202456,CDM,301,RC,82306,CPT,,,,Inpatient,,,357.52,357.52,Wellcare,Wellcare,357.52,,,,,,,case rate,357.52,357.52,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health PPO CPD,Meritain Health PPO CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna/Commercial Product,Aetna/Commercial Product,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health CPD,Meritain Health CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Starmark CPD,Starmark CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna Medicare,Aetna Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Ambetter ,Ambetter ,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access,Anthem Blue Access,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access Choice,Anthem Blue Access Choice,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Preferred,Anthem Blue Preferred,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Pathway,Anthem Pathway,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Alliance,Anthem Alliance,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Medicare,Anthem Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna,Cigna,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna PPO,Cigna PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna Medicare Advantage,Cigna Medicare Advantage,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Essence,Essence,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthlink HMO,Healthlink HMO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthlink PPO,Healthlink PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,HomeState Health Plan,HomeState Health Plan,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Humana Gold,Humana Gold,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Medicaid MO,Medicaid MO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Medica,Medica,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Tricare,Tricare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC All Payer,UHC All Payer,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Exchange,UHC Exchange,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicaid,UHC Medicaid,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UMR CPD,UMR CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicare,UHC Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/O MICRO     ,38202460,CDM,307,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Wellcare,Wellcare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health PPO CPD,Meritain Health PPO CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Aetna/Commercial Product,Aetna/Commercial Product,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health CPD,Meritain Health CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Starmark CPD,Starmark CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Aetna Medicare,Aetna Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Ambetter ,Ambetter ,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access,Anthem Blue Access,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access Choice,Anthem Blue Access Choice,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Preferred,Anthem Blue Preferred,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Pathway,Anthem Pathway,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Alliance,Anthem Alliance,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Anthem Medicare,Anthem Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Cigna,Cigna,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Cigna PPO,Cigna PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Cigna Medicare Advantage,Cigna Medicare Advantage,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Essence,Essence,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Healthlink HMO,Healthlink HMO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Healthlink PPO,Healthlink PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,HomeState Health Plan,HomeState Health Plan,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Humana Gold,Humana Gold,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Medicaid MO,Medicaid MO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Medica,Medica,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Tricare,Tricare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,UHC All Payer,UHC All Payer,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,UHC Exchange,UHC Exchange,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicaid,UHC Medicaid,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,UMR CPD,UMR CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicare,UHC Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
URINALYSIS AUTO W/MICROSCOPIC ,38202470,CDM,307,RC,81001,CPT,,,,Inpatient,,,109.27,109.27,Wellcare,Wellcare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health PPO CPD,Meritain Health PPO CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Aetna/Commercial Product,Aetna/Commercial Product,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health CPD,Meritain Health CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Starmark CPD,Starmark CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Aetna Medicare,Aetna Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Ambetter ,Ambetter ,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access,Anthem Blue Access,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access Choice,Anthem Blue Access Choice,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Preferred,Anthem Blue Preferred,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Pathway,Anthem Pathway,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Alliance,Anthem Alliance,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Anthem Medicare,Anthem Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Cigna,Cigna,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Cigna PPO,Cigna PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Cigna Medicare Advantage,Cigna Medicare Advantage,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Essence,Essence,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Healthlink HMO,Healthlink HMO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Healthlink PPO,Healthlink PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,HomeState Health Plan,HomeState Health Plan,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Humana Gold,Humana Gold,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Medicaid MO,Medicaid MO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Medica,Medica,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Tricare,Tricare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,UHC All Payer,UHC All Payer,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,UHC Exchange,UHC Exchange,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicaid,UHC Medicaid,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,UMR CPD,UMR CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicare,UHC Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38202480,CDM,301,RC,84540,CPT,,,,Inpatient,,,137.92,137.92,Wellcare,Wellcare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Meritain Health PPO CPD,Meritain Health PPO CPD,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Aetna/Commercial Product,Aetna/Commercial Product,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Meritain Health CPD,Meritain Health CPD,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Starmark CPD,Starmark CPD,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Aetna Medicare,Aetna Medicare,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Ambetter ,Ambetter ,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Blue Access,Anthem Blue Access,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Blue Access Choice,Anthem Blue Access Choice,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Blue Preferred,Anthem Blue Preferred,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Pathway,Anthem Pathway,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Alliance,Anthem Alliance,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Anthem Medicare,Anthem Medicare,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Cigna,Cigna,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Cigna PPO,Cigna PPO,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Cigna Medicare Advantage,Cigna Medicare Advantage,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Essence,Essence,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Healthlink HMO,Healthlink HMO,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Healthlink PPO,Healthlink PPO,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,HomeState Health Plan,HomeState Health Plan,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Humana Gold,Humana Gold,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Medicaid MO,Medicaid MO,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Medica,Medica,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Tricare,Tricare,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,UHC All Payer,UHC All Payer,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,UHC Exchange,UHC Exchange,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,UHC Medicaid,UHC Medicaid,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,UMR CPD,UMR CPD,350.57,,,,,,,per diem,350.57,350.57,"Per diem rate, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,UHC Medicare,UHC Medicare,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
HISTOPLASMA ANTIGEN           ,38202481,CDM,306,RC,87385,CPT,,,,Inpatient,,,350.57,350.57,Wellcare,Wellcare,350.57,,,,,,,case rate,350.57,350.57,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38202500,CDM,301,RC,80164,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VALPROIC ACID FREE            ,38202505,CDM,301,RC,80165,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Meritain Health PPO CPD,Meritain Health PPO CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Aetna/Commercial Product,Aetna/Commercial Product,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Meritain Health CPD,Meritain Health CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Starmark CPD,Starmark CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Aetna Medicare,Aetna Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Ambetter ,Ambetter ,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Access,Anthem Blue Access,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Access Choice,Anthem Blue Access Choice,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Preferred,Anthem Blue Preferred,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Pathway,Anthem Pathway,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Alliance,Anthem Alliance,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Anthem Medicare,Anthem Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Cigna,Cigna,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Cigna PPO,Cigna PPO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Cigna Medicare Advantage,Cigna Medicare Advantage,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Essence,Essence,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Healthlink HMO,Healthlink HMO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Healthlink PPO,Healthlink PPO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,HomeState Health Plan,HomeState Health Plan,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Humana Gold,Humana Gold,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Medicaid MO,Medicaid MO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Medica,Medica,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Tricare,Tricare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,UHC All Payer,UHC All Payer,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,UHC Exchange,UHC Exchange,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,UHC Medicaid,UHC Medicaid,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,UMR CPD,UMR CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,UHC Medicare,UHC Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VANCOMYCIN                    ,38202510,CDM,301,RC,80202,CPT,,,,Inpatient,,,242.95,242.95,Wellcare,Wellcare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Meritain Health PPO CPD,Meritain Health PPO CPD,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Aetna/Commercial Product,Aetna/Commercial Product,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Meritain Health CPD,Meritain Health CPD,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Starmark CPD,Starmark CPD,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Aetna Medicare,Aetna Medicare,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Ambetter ,Ambetter ,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Blue Access,Anthem Blue Access,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Blue Access Choice,Anthem Blue Access Choice,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Blue Preferred,Anthem Blue Preferred,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Pathway,Anthem Pathway,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Alliance,Anthem Alliance,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Anthem Medicare,Anthem Medicare,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Cigna,Cigna,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Cigna PPO,Cigna PPO,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Cigna Medicare Advantage,Cigna Medicare Advantage,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Essence,Essence,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Healthlink HMO,Healthlink HMO,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Healthlink PPO,Healthlink PPO,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,HomeState Health Plan,HomeState Health Plan,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Humana Gold,Humana Gold,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Medicaid MO,Medicaid MO,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Medica,Medica,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Tricare,Tricare,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,UHC All Payer,UHC All Payer,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,UHC Exchange,UHC Exchange,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,UHC Medicaid,UHC Medicaid,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,UMR CPD,UMR CPD,181.4,,,,,,,per diem,181.4,181.4,"Per diem rate, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,UHC Medicare,UHC Medicare,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VDRL QUANTITATIVE             ,38202530,CDM,302,RC,86593,CPT,,,,Inpatient,,,181.4,181.4,Wellcare,Wellcare,181.4,,,,,,,case rate,181.4,181.4,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VENLAFAXINE LEVEL             ,38202533,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Meritain Health PPO CPD,Meritain Health PPO CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Aetna/Commercial Product,Aetna/Commercial Product,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Meritain Health CPD,Meritain Health CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Starmark CPD,Starmark CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Aetna Medicare,Aetna Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Ambetter ,Ambetter ,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Blue Access,Anthem Blue Access,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Blue Access Choice,Anthem Blue Access Choice,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Blue Preferred,Anthem Blue Preferred,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Pathway,Anthem Pathway,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Alliance,Anthem Alliance,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Anthem Medicare,Anthem Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Cigna,Cigna,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Cigna PPO,Cigna PPO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Cigna Medicare Advantage,Cigna Medicare Advantage,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Essence,Essence,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Healthlink HMO,Healthlink HMO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Healthlink PPO,Healthlink PPO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,HomeState Health Plan,HomeState Health Plan,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Humana Gold,Humana Gold,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Medicaid MO,Medicaid MO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Medica,Medica,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Tricare,Tricare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,UHC All Payer,UHC All Payer,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,UHC Exchange,UHC Exchange,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,UHC Medicaid,UHC Medicaid,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,UMR CPD,UMR CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,UHC Medicare,UHC Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VISCOSITY                     ,38202535,CDM,305,RC,85810,CPT,,,,Inpatient,,,135.53,135.53,Wellcare,Wellcare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Meritain Health PPO CPD,Meritain Health PPO CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Aetna/Commercial Product,Aetna/Commercial Product,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Meritain Health CPD,Meritain Health CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Starmark CPD,Starmark CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Aetna Medicare,Aetna Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Ambetter ,Ambetter ,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Blue Access,Anthem Blue Access,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Blue Access Choice,Anthem Blue Access Choice,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Blue Preferred,Anthem Blue Preferred,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Pathway,Anthem Pathway,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Alliance,Anthem Alliance,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Anthem Medicare,Anthem Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Cigna,Cigna,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Cigna PPO,Cigna PPO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Cigna Medicare Advantage,Cigna Medicare Advantage,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Essence,Essence,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Healthlink HMO,Healthlink HMO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Healthlink PPO,Healthlink PPO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,HomeState Health Plan,HomeState Health Plan,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Humana Gold,Humana Gold,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Medicaid MO,Medicaid MO,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Medica,Medica,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Tricare,Tricare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,UHC All Payer,UHC All Payer,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,UHC Exchange,UHC Exchange,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,UHC Medicaid,UHC Medicaid,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,UMR CPD,UMR CPD,19.2,,,,,,,per diem,19.2,19.2,"Per diem rate, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,UHC Medicare,UHC Medicare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
VORICONAZOLE QNT              ,38202536,CDM,300,RC,80299,CPT,,,,Inpatient,,,19.2,19.2,Wellcare,Wellcare,19.2,,,,,,,case rate,19.2,19.2,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Meritain Health PPO CPD,Meritain Health PPO CPD,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Aetna/Commercial Product,Aetna/Commercial Product,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Meritain Health CPD,Meritain Health CPD,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Starmark CPD,Starmark CPD,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Aetna Medicare,Aetna Medicare,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Ambetter ,Ambetter ,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Blue Access,Anthem Blue Access,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Blue Access Choice,Anthem Blue Access Choice,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Blue Preferred,Anthem Blue Preferred,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Pathway,Anthem Pathway,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Alliance,Anthem Alliance,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Anthem Medicare,Anthem Medicare,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Cigna,Cigna,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Cigna PPO,Cigna PPO,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Cigna Medicare Advantage,Cigna Medicare Advantage,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Essence,Essence,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Healthlink HMO,Healthlink HMO,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Healthlink PPO,Healthlink PPO,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,HomeState Health Plan,HomeState Health Plan,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Humana Gold,Humana Gold,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Medicaid MO,Medicaid MO,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Medica,Medica,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Tricare,Tricare,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,UHC All Payer,UHC All Payer,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,UHC Exchange,UHC Exchange,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,UHC Medicaid,UHC Medicaid,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,UMR CPD,UMR CPD,101.88,,,,,,,per diem,101.88,101.88,"Per diem rate, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,UHC Medicare,UHC Medicare,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
FUNGITELL QUAL/SEMIQNT        ,38202537,CDM,300,RC,87449,CPT,,,,Inpatient,,,101.88,101.88,Wellcare,Wellcare,101.88,,,,,,,case rate,101.88,101.88,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health PPO CPD,Meritain Health PPO CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna/Commercial Product,Aetna/Commercial Product,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health CPD,Meritain Health CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Starmark CPD,Starmark CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna Medicare,Aetna Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Ambetter ,Ambetter ,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access,Anthem Blue Access,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access Choice,Anthem Blue Access Choice,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Preferred,Anthem Blue Preferred,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Pathway,Anthem Pathway,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Alliance,Anthem Alliance,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Medicare,Anthem Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna,Cigna,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna PPO,Cigna PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna Medicare Advantage,Cigna Medicare Advantage,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Essence,Essence,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthlink HMO,Healthlink HMO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthlink PPO,Healthlink PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,HomeState Health Plan,HomeState Health Plan,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Humana Gold,Humana Gold,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Medicaid MO,Medicaid MO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Medica,Medica,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Tricare,Tricare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC All Payer,UHC All Payer,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Exchange,UHC Exchange,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicaid,UHC Medicaid,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UMR CPD,UMR CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicare,UHC Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 (THIAMINE)         ,38202539,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Wellcare,Wellcare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health PPO CPD,Meritain Health PPO CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna/Commercial Product,Aetna/Commercial Product,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health CPD,Meritain Health CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Starmark CPD,Starmark CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna Medicare,Aetna Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Ambetter ,Ambetter ,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access,Anthem Blue Access,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access Choice,Anthem Blue Access Choice,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Preferred,Anthem Blue Preferred,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Pathway,Anthem Pathway,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Alliance,Anthem Alliance,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Medicare,Anthem Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna,Cigna,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna PPO,Cigna PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna Medicare Advantage,Cigna Medicare Advantage,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Essence,Essence,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthlink HMO,Healthlink HMO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthlink PPO,Healthlink PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,HomeState Health Plan,HomeState Health Plan,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Humana Gold,Humana Gold,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Medicaid MO,Medicaid MO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Medica,Medica,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Tricare,Tricare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC All Payer,UHC All Payer,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Exchange,UHC Exchange,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicaid,UHC Medicaid,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UMR CPD,UMR CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicare,UHC Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38202540,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Wellcare,Wellcare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Meritain Health PPO CPD,Meritain Health PPO CPD,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Aetna/Commercial Product,Aetna/Commercial Product,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Meritain Health CPD,Meritain Health CPD,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Starmark CPD,Starmark CPD,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Aetna Medicare,Aetna Medicare,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Ambetter ,Ambetter ,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Blue Access,Anthem Blue Access,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Blue Access Choice,Anthem Blue Access Choice,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Blue Preferred,Anthem Blue Preferred,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Pathway,Anthem Pathway,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Alliance,Anthem Alliance,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Anthem Medicare,Anthem Medicare,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Cigna,Cigna,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Cigna PPO,Cigna PPO,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Cigna Medicare Advantage,Cigna Medicare Advantage,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Essence,Essence,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Healthlink HMO,Healthlink HMO,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Healthlink PPO,Healthlink PPO,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,HomeState Health Plan,HomeState Health Plan,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Humana Gold,Humana Gold,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Medicaid MO,Medicaid MO,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Medica,Medica,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Tricare,Tricare,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,UHC All Payer,UHC All Payer,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,UHC Exchange,UHC Exchange,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,UHC Medicaid,UHC Medicaid,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,UMR CPD,UMR CPD,590.44,,,,,,,per diem,590.44,590.44,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,UHC Medicare,UHC Medicare,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38202545,CDM,301,RC,84585,CPT,,,,Inpatient,,,590.44,590.44,Wellcare,Wellcare,590.44,,,,,,,case rate,590.44,590.44,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Meritain Health PPO CPD,Meritain Health PPO CPD,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Aetna/Commercial Product,Aetna/Commercial Product,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Meritain Health CPD,Meritain Health CPD,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Starmark CPD,Starmark CPD,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Aetna Medicare,Aetna Medicare,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Ambetter ,Ambetter ,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Blue Access,Anthem Blue Access,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Blue Access Choice,Anthem Blue Access Choice,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Blue Preferred,Anthem Blue Preferred,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Pathway,Anthem Pathway,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Alliance,Anthem Alliance,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Anthem Medicare,Anthem Medicare,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Cigna,Cigna,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Cigna PPO,Cigna PPO,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Cigna Medicare Advantage,Cigna Medicare Advantage,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Essence,Essence,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Healthlink HMO,Healthlink HMO,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Healthlink PPO,Healthlink PPO,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,HomeState Health Plan,HomeState Health Plan,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Humana Gold,Humana Gold,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Medicaid MO,Medicaid MO,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Medica,Medica,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Tricare,Tricare,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,UHC All Payer,UHC All Payer,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,UHC Exchange,UHC Exchange,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,UHC Medicaid,UHC Medicaid,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,UMR CPD,UMR CPD,47.22,,,,,,,per diem,47.22,47.22,"Per diem rate, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,UHC Medicare,UHC Medicare,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
"LEUKOCYTE WBC, AUTO           ",38202550,CDM,305,RC,85048,CPT,,,,Inpatient,,,47.22,47.22,Wellcare,Wellcare,47.22,,,,,,,case rate,47.22,47.22,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Meritain Health PPO CPD,Meritain Health PPO CPD,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Aetna/Commercial Product,Aetna/Commercial Product,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Meritain Health CPD,Meritain Health CPD,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Starmark CPD,Starmark CPD,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Aetna Medicare,Aetna Medicare,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Ambetter ,Ambetter ,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Blue Access,Anthem Blue Access,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Blue Access Choice,Anthem Blue Access Choice,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Blue Preferred,Anthem Blue Preferred,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Pathway,Anthem Pathway,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Alliance,Anthem Alliance,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Anthem Medicare,Anthem Medicare,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Cigna,Cigna,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Cigna PPO,Cigna PPO,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Cigna Medicare Advantage,Cigna Medicare Advantage,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Essence,Essence,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Healthlink HMO,Healthlink HMO,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Healthlink PPO,Healthlink PPO,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,HomeState Health Plan,HomeState Health Plan,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Humana Gold,Humana Gold,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Medicaid MO,Medicaid MO,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Medica,Medica,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Tricare,Tricare,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,UHC All Payer,UHC All Payer,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,UHC Exchange,UHC Exchange,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,UHC Medicaid,UHC Medicaid,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,UMR CPD,UMR CPD,336.16,,,,,,,per diem,336.16,336.16,"Per diem rate, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,UHC Medicare,UHC Medicare,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
WEST NILE VIRUS TITER         ,38202575,CDM,302,RC,86790,CPT,,,,Inpatient,,,336.16,336.16,Wellcare,Wellcare,336.16,,,,,,,case rate,336.16,336.16,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Meritain Health PPO CPD,Meritain Health PPO CPD,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Aetna/Commercial Product,Aetna/Commercial Product,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Meritain Health CPD,Meritain Health CPD,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Starmark CPD,Starmark CPD,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Aetna Medicare,Aetna Medicare,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Ambetter ,Ambetter ,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Blue Access,Anthem Blue Access,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Blue Access Choice,Anthem Blue Access Choice,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Blue Preferred,Anthem Blue Preferred,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Pathway,Anthem Pathway,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Alliance,Anthem Alliance,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Anthem Medicare,Anthem Medicare,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Cigna,Cigna,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Cigna PPO,Cigna PPO,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Cigna Medicare Advantage,Cigna Medicare Advantage,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Essence,Essence,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Healthlink HMO,Healthlink HMO,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Healthlink PPO,Healthlink PPO,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,HomeState Health Plan,HomeState Health Plan,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Humana Gold,Humana Gold,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Medicaid MO,Medicaid MO,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Medica,Medica,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Tricare,Tricare,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,UHC All Payer,UHC All Payer,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,UHC Exchange,UHC Exchange,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,UHC Medicaid,UHC Medicaid,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,UMR CPD,UMR CPD,166.13,,,,,,,per diem,166.13,166.13,"Per diem rate, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,UHC Medicare,UHC Medicare,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ZINC                          ,38202590,CDM,301,RC,84630,CPT,,,,Inpatient,,,166.13,166.13,Wellcare,Wellcare,166.13,,,,,,,case rate,166.13,166.13,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ADENOVIRUS AB                 ,38202610,CDM,302,RC,86603,CPT,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Meritain Health PPO CPD,Meritain Health PPO CPD,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Aetna/Commercial Product,Aetna/Commercial Product,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Meritain Health CPD,Meritain Health CPD,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Starmark CPD,Starmark CPD,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Aetna Medicare,Aetna Medicare,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Ambetter ,Ambetter ,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Blue Access,Anthem Blue Access,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Blue Access Choice,Anthem Blue Access Choice,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Blue Preferred,Anthem Blue Preferred,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Pathway,Anthem Pathway,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Alliance,Anthem Alliance,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Anthem Medicare,Anthem Medicare,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Cigna,Cigna,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Cigna PPO,Cigna PPO,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Cigna Medicare Advantage,Cigna Medicare Advantage,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Essence,Essence,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Healthlink HMO,Healthlink HMO,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Healthlink PPO,Healthlink PPO,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,HomeState Health Plan,HomeState Health Plan,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Humana Gold,Humana Gold,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Medicaid MO,Medicaid MO,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Medica,Medica,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Tricare,Tricare,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,UHC All Payer,UHC All Payer,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,UHC Exchange,UHC Exchange,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,UHC Medicaid,UHC Medicaid,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,UMR CPD,UMR CPD,219.34,,,,,,,per diem,219.34,219.34,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,UHC Medicare,UHC Medicare,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI CULTURE     ,38202615,CDM,306,RC,87116,CPT,,,,Inpatient,,,219.34,219.34,Wellcare,Wellcare,219.34,,,,,,,case rate,219.34,219.34,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Meritain Health PPO CPD,Meritain Health PPO CPD,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Aetna/Commercial Product,Aetna/Commercial Product,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Meritain Health CPD,Meritain Health CPD,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Starmark CPD,Starmark CPD,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Aetna Medicare,Aetna Medicare,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Ambetter ,Ambetter ,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Blue Access,Anthem Blue Access,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Blue Access Choice,Anthem Blue Access Choice,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Blue Preferred,Anthem Blue Preferred,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Pathway,Anthem Pathway,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Alliance,Anthem Alliance,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Anthem Medicare,Anthem Medicare,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Cigna,Cigna,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Cigna PPO,Cigna PPO,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Cigna Medicare Advantage,Cigna Medicare Advantage,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Essence,Essence,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Healthlink HMO,Healthlink HMO,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Healthlink PPO,Healthlink PPO,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,HomeState Health Plan,HomeState Health Plan,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Humana Gold,Humana Gold,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Medicaid MO,Medicaid MO,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Medica,Medica,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Tricare,Tricare,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,UHC All Payer,UHC All Payer,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,UHC Exchange,UHC Exchange,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,UHC Medicaid,UHC Medicaid,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,UMR CPD,UMR CPD,280.39,,,,,,,per diem,280.39,280.39,"Per diem rate, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,UHC Medicare,UHC Medicare,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALK PHOS ISOENZYMES           ,38202620,CDM,301,RC,84080,CPT,,,,Inpatient,,,280.39,280.39,Wellcare,Wellcare,280.39,,,,,,,case rate,280.39,280.39,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
ALUMINUM                      ,38202625,CDM,301,RC,82108,CPT,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMPHETAMINES SCRN 1-2         ,38202641,CDM,301,RC,80324,CPT,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE FLD                   ,38202645,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health PPO CPD,Meritain Health PPO CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna/Commercial Product,Aetna/Commercial Product,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health CPD,Meritain Health CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Starmark CPD,Starmark CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna Medicare,Aetna Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Ambetter ,Ambetter ,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access,Anthem Blue Access,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access Choice,Anthem Blue Access Choice,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Preferred,Anthem Blue Preferred,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Pathway,Anthem Pathway,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Alliance,Anthem Alliance,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Medicare,Anthem Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna,Cigna,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna PPO,Cigna PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna Medicare Advantage,Cigna Medicare Advantage,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Essence,Essence,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthlink HMO,Healthlink HMO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthlink PPO,Healthlink PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,HomeState Health Plan,HomeState Health Plan,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Humana Gold,Humana Gold,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Medicaid MO,Medicaid MO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Medica,Medica,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Tricare,Tricare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC All Payer,UHC All Payer,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Exchange,UHC Exchange,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicaid,UHC Medicaid,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UMR CPD,UMR CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicare,UHC Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38202650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Wellcare,Wellcare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Meritain Health PPO CPD,Meritain Health PPO CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Aetna/Commercial Product,Aetna/Commercial Product,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Meritain Health CPD,Meritain Health CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Starmark CPD,Starmark CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Aetna Medicare,Aetna Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Ambetter ,Ambetter ,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Blue Access,Anthem Blue Access,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Blue Access Choice,Anthem Blue Access Choice,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Blue Preferred,Anthem Blue Preferred,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Pathway,Anthem Pathway,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Alliance,Anthem Alliance,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Anthem Medicare,Anthem Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Cigna,Cigna,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Cigna PPO,Cigna PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Cigna Medicare Advantage,Cigna Medicare Advantage,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Essence,Essence,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Healthlink HMO,Healthlink HMO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Healthlink PPO,Healthlink PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,HomeState Health Plan,HomeState Health Plan,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Humana Gold,Humana Gold,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Medicaid MO,Medicaid MO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Medica,Medica,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Tricare,Tricare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,UHC All Payer,UHC All Payer,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,UHC Exchange,UHC Exchange,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,UHC Medicaid,UHC Medicaid,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,UMR CPD,UMR CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,UHC Medicare,UHC Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38202670,CDM,301,RC,82175,CPT,,,,Inpatient,,,423.39,423.39,Wellcare,Wellcare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Meritain Health PPO CPD,Meritain Health PPO CPD,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Aetna/Commercial Product,Aetna/Commercial Product,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Meritain Health CPD,Meritain Health CPD,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Starmark CPD,Starmark CPD,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Aetna Medicare,Aetna Medicare,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Ambetter ,Ambetter ,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Blue Access,Anthem Blue Access,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Blue Access Choice,Anthem Blue Access Choice,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Blue Preferred,Anthem Blue Preferred,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Pathway,Anthem Pathway,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Alliance,Anthem Alliance,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Anthem Medicare,Anthem Medicare,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Cigna,Cigna,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Cigna PPO,Cigna PPO,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Cigna Medicare Advantage,Cigna Medicare Advantage,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Essence,Essence,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Healthlink HMO,Healthlink HMO,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Healthlink PPO,Healthlink PPO,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,HomeState Health Plan,HomeState Health Plan,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Humana Gold,Humana Gold,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Medicaid MO,Medicaid MO,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Medica,Medica,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Tricare,Tricare,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,UHC All Payer,UHC All Payer,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,UHC Exchange,UHC Exchange,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,UHC Medicaid,UHC Medicaid,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,UMR CPD,UMR CPD,226.75,,,,,,,per diem,226.75,226.75,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,UHC Medicare,UHC Medicare,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38202693,CDM,301,RC,83825,CPT,,,,Inpatient,,,226.75,226.75,Wellcare,Wellcare,226.75,,,,,,,case rate,226.75,226.75,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Meritain Health PPO CPD,Meritain Health PPO CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Aetna/Commercial Product,Aetna/Commercial Product,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Meritain Health CPD,Meritain Health CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Starmark CPD,Starmark CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Aetna Medicare,Aetna Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Ambetter ,Ambetter ,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Blue Access,Anthem Blue Access,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Blue Access Choice,Anthem Blue Access Choice,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Blue Preferred,Anthem Blue Preferred,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Pathway,Anthem Pathway,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Alliance,Anthem Alliance,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Anthem Medicare,Anthem Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Cigna,Cigna,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Cigna PPO,Cigna PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Cigna Medicare Advantage,Cigna Medicare Advantage,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Essence,Essence,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Healthlink HMO,Healthlink HMO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Healthlink PPO,Healthlink PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,HomeState Health Plan,HomeState Health Plan,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Humana Gold,Humana Gold,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Medicaid MO,Medicaid MO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Medica,Medica,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Tricare,Tricare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,UHC All Payer,UHC All Payer,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,UHC Exchange,UHC Exchange,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,UHC Medicaid,UHC Medicaid,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,UMR CPD,UMR CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,UHC Medicare,UHC Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BARBITURATE SCREEN            ,38202706,CDM,301,RC,80345,CPT,,,,Inpatient,,,208.02,208.02,Wellcare,Wellcare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Meritain Health PPO CPD,Meritain Health PPO CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Aetna/Commercial Product,Aetna/Commercial Product,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Meritain Health CPD,Meritain Health CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Starmark CPD,Starmark CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Aetna Medicare,Aetna Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Ambetter ,Ambetter ,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Access,Anthem Blue Access,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Access Choice,Anthem Blue Access Choice,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Blue Preferred,Anthem Blue Preferred,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Pathway,Anthem Pathway,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Alliance,Anthem Alliance,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Anthem Medicare,Anthem Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Cigna,Cigna,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Cigna PPO,Cigna PPO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Cigna Medicare Advantage,Cigna Medicare Advantage,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Essence,Essence,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Healthlink HMO,Healthlink HMO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Healthlink PPO,Healthlink PPO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,HomeState Health Plan,HomeState Health Plan,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Humana Gold,Humana Gold,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Medicaid MO,Medicaid MO,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Medica,Medica,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Tricare,Tricare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,UHC All Payer,UHC All Payer,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,UHC Exchange,UHC Exchange,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,UHC Medicaid,UHC Medicaid,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,UMR CPD,UMR CPD,119.77,,,,,,,per diem,119.77,119.77,"Per diem rate, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,UHC Medicare,UHC Medicare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
BRUCELLA ANTIBODY             ,38202730,CDM,302,RC,86622,CPT,,,,Inpatient,,,119.77,119.77,Wellcare,Wellcare,119.77,,,,,,,case rate,119.77,119.77,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Meritain Health PPO CPD,Meritain Health PPO CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna/Commercial Product,Aetna/Commercial Product,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Meritain Health CPD,Meritain Health CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Starmark CPD,Starmark CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna Medicare,Aetna Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Ambetter ,Ambetter ,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Access,Anthem Blue Access,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Access Choice,Anthem Blue Access Choice,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Preferred,Anthem Blue Preferred,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Pathway,Anthem Pathway,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Alliance,Anthem Alliance,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Medicare,Anthem Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna,Cigna,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna PPO,Cigna PPO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna Medicare Advantage,Cigna Medicare Advantage,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Essence,Essence,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthlink HMO,Healthlink HMO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthlink PPO,Healthlink PPO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,HomeState Health Plan,HomeState Health Plan,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Humana Gold,Humana Gold,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Medicaid MO,Medicaid MO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Medica,Medica,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Tricare,Tricare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC All Payer,UHC All Payer,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Exchange,UHC Exchange,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Medicaid,UHC Medicaid,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UMR CPD,UMR CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Medicare,UHC Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38202745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Wellcare,Wellcare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Meritain Health PPO CPD,Meritain Health PPO CPD,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Aetna/Commercial Product,Aetna/Commercial Product,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Meritain Health CPD,Meritain Health CPD,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Starmark CPD,Starmark CPD,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Aetna Medicare,Aetna Medicare,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Ambetter ,Ambetter ,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Blue Access,Anthem Blue Access,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Blue Access Choice,Anthem Blue Access Choice,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Blue Preferred,Anthem Blue Preferred,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Pathway,Anthem Pathway,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Alliance,Anthem Alliance,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Anthem Medicare,Anthem Medicare,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Cigna,Cigna,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Cigna PPO,Cigna PPO,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Cigna Medicare Advantage,Cigna Medicare Advantage,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Essence,Essence,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Healthlink HMO,Healthlink HMO,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Healthlink PPO,Healthlink PPO,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,HomeState Health Plan,HomeState Health Plan,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Humana Gold,Humana Gold,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Medicaid MO,Medicaid MO,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Medica,Medica,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Tricare,Tricare,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,UHC All Payer,UHC All Payer,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,UHC Exchange,UHC Exchange,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,UHC Medicaid,UHC Medicaid,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,UMR CPD,UMR CPD,376.72,,,,,,,per diem,376.72,376.72,"Per diem rate, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,UHC Medicare,UHC Medicare,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CA-19-9                       ,38202750,CDM,302,RC,86301,CPT,,,,Inpatient,,,376.72,376.72,Wellcare,Wellcare,376.72,,,,,,,case rate,376.72,376.72,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Meritain Health PPO CPD,Meritain Health PPO CPD,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Aetna/Commercial Product,Aetna/Commercial Product,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Meritain Health CPD,Meritain Health CPD,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Starmark CPD,Starmark CPD,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Aetna Medicare,Aetna Medicare,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Ambetter ,Ambetter ,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Blue Access,Anthem Blue Access,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Blue Access Choice,Anthem Blue Access Choice,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Blue Preferred,Anthem Blue Preferred,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Pathway,Anthem Pathway,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Alliance,Anthem Alliance,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Anthem Medicare,Anthem Medicare,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Cigna,Cigna,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Cigna PPO,Cigna PPO,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Cigna Medicare Advantage,Cigna Medicare Advantage,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Essence,Essence,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Healthlink HMO,Healthlink HMO,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Healthlink PPO,Healthlink PPO,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,HomeState Health Plan,HomeState Health Plan,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Humana Gold,Humana Gold,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Medicaid MO,Medicaid MO,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Medica,Medica,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Tricare,Tricare,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,UHC All Payer,UHC All Payer,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,UHC Exchange,UHC Exchange,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,UHC Medicaid,UHC Medicaid,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,UMR CPD,UMR CPD,216.38,,,,,,,per diem,216.38,216.38,"Per diem rate, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,UHC Medicare,UHC Medicare,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CANNABINOIDS NATURAL          ,38202751,CDM,301,RC,80349,CPT,G0480,HCPCS,,Inpatient,,,216.38,216.38,Wellcare,Wellcare,216.38,,,,,,,case rate,216.38,216.38,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Meritain Health PPO CPD,Meritain Health PPO CPD,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Aetna/Commercial Product,Aetna/Commercial Product,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Meritain Health CPD,Meritain Health CPD,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Starmark CPD,Starmark CPD,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Aetna Medicare,Aetna Medicare,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Ambetter ,Ambetter ,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Blue Access,Anthem Blue Access,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Blue Access Choice,Anthem Blue Access Choice,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Blue Preferred,Anthem Blue Preferred,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Pathway,Anthem Pathway,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Alliance,Anthem Alliance,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Anthem Medicare,Anthem Medicare,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Cigna,Cigna,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Cigna PPO,Cigna PPO,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Cigna Medicare Advantage,Cigna Medicare Advantage,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Essence,Essence,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Healthlink HMO,Healthlink HMO,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Healthlink PPO,Healthlink PPO,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,HomeState Health Plan,HomeState Health Plan,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Humana Gold,Humana Gold,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Medicaid MO,Medicaid MO,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Medica,Medica,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Tricare,Tricare,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,UHC All Payer,UHC All Payer,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,UHC Exchange,UHC Exchange,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,UHC Medicaid,UHC Medicaid,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,UMR CPD,UMR CPD,862.54,,,,,,,per diem,862.54,862.54,"Per diem rate, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,UHC Medicare,UHC Medicare,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CYTOGENETICS PHILADELPHIA     ,38202769,CDM,310,RC,88262,CPT,,,,Inpatient,,,862.54,862.54,Wellcare,Wellcare,862.54,,,,,,,case rate,862.54,862.54,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Meritain Health PPO CPD,Meritain Health PPO CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna/Commercial Product,Aetna/Commercial Product,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Meritain Health CPD,Meritain Health CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Starmark CPD,Starmark CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna Medicare,Aetna Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Ambetter ,Ambetter ,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Access,Anthem Blue Access,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Access Choice,Anthem Blue Access Choice,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Preferred,Anthem Blue Preferred,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Pathway,Anthem Pathway,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Alliance,Anthem Alliance,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Medicare,Anthem Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna,Cigna,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna PPO,Cigna PPO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna Medicare Advantage,Cigna Medicare Advantage,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Essence,Essence,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthlink HMO,Healthlink HMO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthlink PPO,Healthlink PPO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,HomeState Health Plan,HomeState Health Plan,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Humana Gold,Humana Gold,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Medicaid MO,Medicaid MO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Medica,Medica,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Tricare,Tricare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC All Payer,UHC All Payer,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Exchange,UHC Exchange,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Medicaid,UHC Medicaid,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UMR CPD,UMR CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Medicare,UHC Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38202774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Wellcare,Wellcare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Meritain Health PPO CPD,Meritain Health PPO CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Aetna/Commercial Product,Aetna/Commercial Product,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Meritain Health CPD,Meritain Health CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Starmark CPD,Starmark CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Aetna Medicare,Aetna Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Ambetter ,Ambetter ,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Access,Anthem Blue Access,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Access Choice,Anthem Blue Access Choice,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Preferred,Anthem Blue Preferred,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Pathway,Anthem Pathway,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Alliance,Anthem Alliance,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Anthem Medicare,Anthem Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Cigna,Cigna,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Cigna PPO,Cigna PPO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Cigna Medicare Advantage,Cigna Medicare Advantage,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Essence,Essence,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Healthlink HMO,Healthlink HMO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Healthlink PPO,Healthlink PPO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,HomeState Health Plan,HomeState Health Plan,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Humana Gold,Humana Gold,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Medicaid MO,Medicaid MO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Medica,Medica,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Tricare,Tricare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,UHC All Payer,UHC All Payer,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,UHC Exchange,UHC Exchange,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,UHC Medicaid,UHC Medicaid,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,UMR CPD,UMR CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,UHC Medicare,UHC Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
PLASMINOGEN                   ,38202778,CDM,305,RC,85420,CPT,,,,Inpatient,,,513.74,513.74,Wellcare,Wellcare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Meritain Health PPO CPD,Meritain Health PPO CPD,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Aetna/Commercial Product,Aetna/Commercial Product,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Meritain Health CPD,Meritain Health CPD,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Starmark CPD,Starmark CPD,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Aetna Medicare,Aetna Medicare,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Ambetter ,Ambetter ,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Blue Access,Anthem Blue Access,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Blue Access Choice,Anthem Blue Access Choice,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Blue Preferred,Anthem Blue Preferred,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Pathway,Anthem Pathway,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Alliance,Anthem Alliance,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Anthem Medicare,Anthem Medicare,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Cigna,Cigna,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Cigna PPO,Cigna PPO,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Cigna Medicare Advantage,Cigna Medicare Advantage,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Essence,Essence,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Healthlink HMO,Healthlink HMO,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Healthlink PPO,Healthlink PPO,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,HomeState Health Plan,HomeState Health Plan,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Humana Gold,Humana Gold,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Medicaid MO,Medicaid MO,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Medica,Medica,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Tricare,Tricare,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,UHC All Payer,UHC All Payer,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,UHC Exchange,UHC Exchange,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,UHC Medicaid,UHC Medicaid,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,UMR CPD,UMR CPD,88.81,,,,,,,per diem,88.81,88.81,"Per diem rate, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,UHC Medicare,UHC Medicare,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
CK-MB PANEL                   ,38202790,CDM,301,RC,82553,CPT,,,,Inpatient,,,88.81,88.81,Wellcare,Wellcare,88.81,,,,,,,case rate,88.81,88.81,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
"CHLORIDE, OTHER SOURCE        ",38202795,CDM,301,RC,82438,CPT,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Meritain Health PPO CPD,Meritain Health PPO CPD,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Aetna/Commercial Product,Aetna/Commercial Product,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Meritain Health CPD,Meritain Health CPD,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Starmark CPD,Starmark CPD,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Aetna Medicare,Aetna Medicare,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Ambetter ,Ambetter ,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Blue Access,Anthem Blue Access,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Blue Access Choice,Anthem Blue Access Choice,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Blue Preferred,Anthem Blue Preferred,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Pathway,Anthem Pathway,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Alliance,Anthem Alliance,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Anthem Medicare,Anthem Medicare,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Cigna,Cigna,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Cigna PPO,Cigna PPO,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Cigna Medicare Advantage,Cigna Medicare Advantage,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Essence,Essence,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Healthlink HMO,Healthlink HMO,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Healthlink PPO,Healthlink PPO,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,HomeState Health Plan,HomeState Health Plan,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Humana Gold,Humana Gold,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Medicaid MO,Medicaid MO,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Medica,Medica,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Tricare,Tricare,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,UHC All Payer,UHC All Payer,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,UHC Exchange,UHC Exchange,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,UHC Medicaid,UHC Medicaid,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,UMR CPD,UMR CPD,17.32,,,,,,,per diem,17.32,17.32,"Per diem rate, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,UHC Medicare,UHC Medicare,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
INF AGT AG DET EIA RSV        ,38202797,CDM,300,RC,87807,CPT,,,,Inpatient,,,17.32,17.32,Wellcare,Wellcare,17.32,,,,,,,case rate,17.32,17.32,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOMIPRAMINE                  ,38202800,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Meritain Health PPO CPD,Meritain Health PPO CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Aetna/Commercial Product,Aetna/Commercial Product,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Meritain Health CPD,Meritain Health CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Starmark CPD,Starmark CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Aetna Medicare,Aetna Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Ambetter ,Ambetter ,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Blue Access,Anthem Blue Access,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Blue Access Choice,Anthem Blue Access Choice,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Blue Preferred,Anthem Blue Preferred,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Pathway,Anthem Pathway,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Alliance,Anthem Alliance,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Anthem Medicare,Anthem Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Cigna,Cigna,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Cigna PPO,Cigna PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Cigna Medicare Advantage,Cigna Medicare Advantage,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Essence,Essence,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Healthlink HMO,Healthlink HMO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Healthlink PPO,Healthlink PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,HomeState Health Plan,HomeState Health Plan,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Humana Gold,Humana Gold,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Medicaid MO,Medicaid MO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Medica,Medica,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Tricare,Tricare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,UHC All Payer,UHC All Payer,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,UHC Exchange,UHC Exchange,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,UHC Medicaid,UHC Medicaid,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,UMR CPD,UMR CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,UHC Medicare,UHC Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCAINE SCREEN                ,38202831,CDM,301,RC,80353,CPT,,,,Inpatient,,,209.07,209.07,Wellcare,Wellcare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Meritain Health PPO CPD,Meritain Health PPO CPD,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Aetna/Commercial Product,Aetna/Commercial Product,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Meritain Health CPD,Meritain Health CPD,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Starmark CPD,Starmark CPD,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Aetna Medicare,Aetna Medicare,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Ambetter ,Ambetter ,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Blue Access,Anthem Blue Access,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Blue Access Choice,Anthem Blue Access Choice,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Blue Preferred,Anthem Blue Preferred,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Pathway,Anthem Pathway,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Alliance,Anthem Alliance,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Anthem Medicare,Anthem Medicare,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Cigna,Cigna,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Cigna PPO,Cigna PPO,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Cigna Medicare Advantage,Cigna Medicare Advantage,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Essence,Essence,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Healthlink HMO,Healthlink HMO,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Healthlink PPO,Healthlink PPO,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,HomeState Health Plan,HomeState Health Plan,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Humana Gold,Humana Gold,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Medicaid MO,Medicaid MO,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Medica,Medica,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Tricare,Tricare,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,UHC All Payer,UHC All Payer,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,UHC Exchange,UHC Exchange,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,UHC Medicaid,UHC Medicaid,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,UMR CPD,UMR CPD,422.4,,,,,,,per diem,422.4,422.4,"Per diem rate, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,UHC Medicare,UHC Medicare,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COCCIDIOIDES ANTIBODY         ,38202835,CDM,302,RC,86635,CPT,,,,Inpatient,,,422.4,422.4,Wellcare,Wellcare,422.4,,,,,,,case rate,422.4,422.4,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Meritain Health PPO CPD,Meritain Health PPO CPD,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Aetna/Commercial Product,Aetna/Commercial Product,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Meritain Health CPD,Meritain Health CPD,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Starmark CPD,Starmark CPD,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Aetna Medicare,Aetna Medicare,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Ambetter ,Ambetter ,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Blue Access,Anthem Blue Access,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Blue Access Choice,Anthem Blue Access Choice,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Blue Preferred,Anthem Blue Preferred,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Pathway,Anthem Pathway,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Alliance,Anthem Alliance,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Anthem Medicare,Anthem Medicare,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Cigna,Cigna,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Cigna PPO,Cigna PPO,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Cigna Medicare Advantage,Cigna Medicare Advantage,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Essence,Essence,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Healthlink HMO,Healthlink HMO,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Healthlink PPO,Healthlink PPO,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,HomeState Health Plan,HomeState Health Plan,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Humana Gold,Humana Gold,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Medicaid MO,Medicaid MO,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Medica,Medica,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Tricare,Tricare,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,UHC All Payer,UHC All Payer,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,UHC Exchange,UHC Exchange,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,UHC Medicaid,UHC Medicaid,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,UMR CPD,UMR CPD,21.63,,,,,,,per diem,21.63,21.63,"Per diem rate, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,UHC Medicare,UHC Medicare,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
COMPLEMENT C-1                ,38202840,CDM,302,RC,86160,CPT,,,,Inpatient,,,21.63,21.63,Wellcare,Wellcare,21.63,,,,,,,case rate,21.63,21.63,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Meritain Health PPO CPD,Meritain Health PPO CPD,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Aetna/Commercial Product,Aetna/Commercial Product,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Meritain Health CPD,Meritain Health CPD,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Starmark CPD,Starmark CPD,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Aetna Medicare,Aetna Medicare,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Ambetter ,Ambetter ,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Blue Access,Anthem Blue Access,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Blue Access Choice,Anthem Blue Access Choice,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Blue Preferred,Anthem Blue Preferred,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Pathway,Anthem Pathway,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Alliance,Anthem Alliance,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Anthem Medicare,Anthem Medicare,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Cigna,Cigna,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Cigna PPO,Cigna PPO,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Cigna Medicare Advantage,Cigna Medicare Advantage,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Essence,Essence,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Healthlink HMO,Healthlink HMO,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Healthlink PPO,Healthlink PPO,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,HomeState Health Plan,HomeState Health Plan,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Humana Gold,Humana Gold,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Medicaid MO,Medicaid MO,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Medica,Medica,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Tricare,Tricare,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,UHC All Payer,UHC All Payer,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,UHC Exchange,UHC Exchange,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,UHC Medicaid,UHC Medicaid,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,UMR CPD,UMR CPD,125.94,,,,,,,per diem,125.94,125.94,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,UHC Medicare,UHC Medicare,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38202850,CDM,301,RC,82530,CPT,,,,Inpatient,,,125.94,125.94,Wellcare,Wellcare,125.94,,,,,,,case rate,125.94,125.94,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Meritain Health PPO CPD,Meritain Health PPO CPD,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Aetna/Commercial Product,Aetna/Commercial Product,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Meritain Health CPD,Meritain Health CPD,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Starmark CPD,Starmark CPD,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Aetna Medicare,Aetna Medicare,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Ambetter ,Ambetter ,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Blue Access,Anthem Blue Access,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Blue Access Choice,Anthem Blue Access Choice,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Blue Preferred,Anthem Blue Preferred,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Pathway,Anthem Pathway,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Alliance,Anthem Alliance,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Anthem Medicare,Anthem Medicare,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Cigna,Cigna,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Cigna PPO,Cigna PPO,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Cigna Medicare Advantage,Cigna Medicare Advantage,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Essence,Essence,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Healthlink HMO,Healthlink HMO,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Healthlink PPO,Healthlink PPO,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,HomeState Health Plan,HomeState Health Plan,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Humana Gold,Humana Gold,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Medicaid MO,Medicaid MO,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Medica,Medica,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Tricare,Tricare,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,UHC All Payer,UHC All Payer,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,UHC Exchange,UHC Exchange,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,UHC Medicaid,UHC Medicaid,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,UMR CPD,UMR CPD,45.82,,,,,,,per diem,45.82,45.82,"Per diem rate, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,UHC Medicare,UHC Medicare,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
COXSACKIE B                   ,38202855,CDM,302,RC,86658,CPT,,,,Inpatient,,,45.82,45.82,Wellcare,Wellcare,45.82,,,,,,,case rate,45.82,45.82,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Meritain Health PPO CPD,Meritain Health PPO CPD,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Aetna/Commercial Product,Aetna/Commercial Product,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Meritain Health CPD,Meritain Health CPD,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Starmark CPD,Starmark CPD,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Aetna Medicare,Aetna Medicare,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Ambetter ,Ambetter ,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Blue Access,Anthem Blue Access,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Blue Access Choice,Anthem Blue Access Choice,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Blue Preferred,Anthem Blue Preferred,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Pathway,Anthem Pathway,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Alliance,Anthem Alliance,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Anthem Medicare,Anthem Medicare,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Cigna,Cigna,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Cigna PPO,Cigna PPO,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Cigna Medicare Advantage,Cigna Medicare Advantage,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Essence,Essence,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Healthlink HMO,Healthlink HMO,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Healthlink PPO,Healthlink PPO,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,HomeState Health Plan,HomeState Health Plan,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Humana Gold,Humana Gold,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Medicaid MO,Medicaid MO,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Medica,Medica,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Tricare,Tricare,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,UHC All Payer,UHC All Payer,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,UHC Exchange,UHC Exchange,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,UHC Medicaid,UHC Medicaid,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,UMR CPD,UMR CPD,141.74,,,,,,,per diem,141.74,141.74,"Per diem rate, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,UHC Medicare,UHC Medicare,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CRYOGLOBULIN                  ,38202865,CDM,301,RC,82595,CPT,,,,Inpatient,,,141.74,141.74,Wellcare,Wellcare,141.74,,,,,,,case rate,141.74,141.74,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE FLUID/OTHER (NON CSF) ,38202885,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Meritain Health PPO CPD,Meritain Health PPO CPD,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Aetna/Commercial Product,Aetna/Commercial Product,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Meritain Health CPD,Meritain Health CPD,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Starmark CPD,Starmark CPD,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Aetna Medicare,Aetna Medicare,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Ambetter ,Ambetter ,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Blue Access,Anthem Blue Access,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Blue Access Choice,Anthem Blue Access Choice,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Blue Preferred,Anthem Blue Preferred,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Pathway,Anthem Pathway,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Alliance,Anthem Alliance,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Anthem Medicare,Anthem Medicare,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Cigna,Cigna,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Cigna PPO,Cigna PPO,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Cigna Medicare Advantage,Cigna Medicare Advantage,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Essence,Essence,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Healthlink HMO,Healthlink HMO,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Healthlink PPO,Healthlink PPO,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,HomeState Health Plan,HomeState Health Plan,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Humana Gold,Humana Gold,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Medicaid MO,Medicaid MO,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Medica,Medica,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Tricare,Tricare,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,UHC All Payer,UHC All Payer,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,UHC Exchange,UHC Exchange,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,UHC Medicaid,UHC Medicaid,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,UMR CPD,UMR CPD,263.7,,,,,,,per diem,263.7,263.7,"Per diem rate, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,UHC Medicare,UHC Medicare,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
CYCSTATIN C                   ,38202892,CDM,301,RC,82610,CPT,,,,Inpatient,,,263.7,263.7,Wellcare,Wellcare,263.7,,,,,,,case rate,263.7,263.7,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Meritain Health PPO CPD,Meritain Health PPO CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Aetna/Commercial Product,Aetna/Commercial Product,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Meritain Health CPD,Meritain Health CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Starmark CPD,Starmark CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Aetna Medicare,Aetna Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Ambetter ,Ambetter ,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Blue Access,Anthem Blue Access,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Blue Access Choice,Anthem Blue Access Choice,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Blue Preferred,Anthem Blue Preferred,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Pathway,Anthem Pathway,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Alliance,Anthem Alliance,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Anthem Medicare,Anthem Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Cigna,Cigna,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Cigna PPO,Cigna PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Cigna Medicare Advantage,Cigna Medicare Advantage,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Essence,Essence,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Healthlink HMO,Healthlink HMO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Healthlink PPO,Healthlink PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,HomeState Health Plan,HomeState Health Plan,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Humana Gold,Humana Gold,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Medicaid MO,Medicaid MO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Medica,Medica,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Tricare,Tricare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,UHC All Payer,UHC All Payer,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,UHC Exchange,UHC Exchange,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,UHC Medicaid,UHC Medicaid,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,UMR CPD,UMR CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,UHC Medicare,UHC Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DELTA ALA                     ,38202905,CDM,301,RC,82135,CPT,,,,Inpatient,,,74.59,74.59,Wellcare,Wellcare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DISOPYRAMIDE                  ,38202920,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38202935,CDM,302,RC,86664,CPT,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Meritain Health PPO CPD,Meritain Health PPO CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Aetna/Commercial Product,Aetna/Commercial Product,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Meritain Health CPD,Meritain Health CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Starmark CPD,Starmark CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Aetna Medicare,Aetna Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Ambetter ,Ambetter ,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Access,Anthem Blue Access,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Access Choice,Anthem Blue Access Choice,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Preferred,Anthem Blue Preferred,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Pathway,Anthem Pathway,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Alliance,Anthem Alliance,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Anthem Medicare,Anthem Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Cigna,Cigna,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Cigna PPO,Cigna PPO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Cigna Medicare Advantage,Cigna Medicare Advantage,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Essence,Essence,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Healthlink HMO,Healthlink HMO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Healthlink PPO,Healthlink PPO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,HomeState Health Plan,HomeState Health Plan,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Humana Gold,Humana Gold,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Medicaid MO,Medicaid MO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Medica,Medica,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Tricare,Tricare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,UHC All Payer,UHC All Payer,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,UHC Exchange,UHC Exchange,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,UHC Medicaid,UHC Medicaid,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,UMR CPD,UMR CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,UHC Medicare,UHC Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGG (EBNA),38202955,CDM,302,RC,86664,CPT,,,,Inpatient,,,84.46,84.46,Wellcare,Wellcare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health PPO CPD,Meritain Health PPO CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Aetna/Commercial Product,Aetna/Commercial Product,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health CPD,Meritain Health CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Starmark CPD,Starmark CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Aetna Medicare,Aetna Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Ambetter ,Ambetter ,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access,Anthem Blue Access,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access Choice,Anthem Blue Access Choice,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Preferred,Anthem Blue Preferred,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Pathway,Anthem Pathway,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Alliance,Anthem Alliance,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Anthem Medicare,Anthem Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Cigna,Cigna,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Cigna PPO,Cigna PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Cigna Medicare Advantage,Cigna Medicare Advantage,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Essence,Essence,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Healthlink HMO,Healthlink HMO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Healthlink PPO,Healthlink PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,HomeState Health Plan,HomeState Health Plan,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Humana Gold,Humana Gold,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Medicaid MO,Medicaid MO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Medica,Medica,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Tricare,Tricare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,UHC All Payer,UHC All Payer,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,UHC Exchange,UHC Exchange,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicaid,UHC Medicaid,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,UMR CPD,UMR CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicare,UHC Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
"FECAL FAT TOTAL, QUANT        ",38202990,CDM,301,RC,82710,CPT,,,,Inpatient,,,189.9,189.9,Wellcare,Wellcare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLECAINIDE                    ,38203000,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FLUOXETINE- PROZAC            ,38203010,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health PPO CPD,Meritain Health PPO CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna/Commercial Product,Aetna/Commercial Product,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health CPD,Meritain Health CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Starmark CPD,Starmark CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna Medicare,Aetna Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Ambetter ,Ambetter ,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access,Anthem Blue Access,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access Choice,Anthem Blue Access Choice,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Preferred,Anthem Blue Preferred,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Pathway,Anthem Pathway,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Alliance,Anthem Alliance,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Medicare,Anthem Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna,Cigna,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna PPO,Cigna PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna Medicare Advantage,Cigna Medicare Advantage,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Essence,Essence,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthlink HMO,Healthlink HMO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthlink PPO,Healthlink PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,HomeState Health Plan,HomeState Health Plan,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Humana Gold,Humana Gold,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Medicaid MO,Medicaid MO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Medica,Medica,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Tricare,Tricare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC All Payer,UHC All Payer,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Exchange,UHC Exchange,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicaid,UHC Medicaid,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UMR CPD,UMR CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicare,UHC Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
T4 FREE (THYROXINE)           ,38203015,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Wellcare,Wellcare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health PPO CPD,Meritain Health PPO CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna/Commercial Product,Aetna/Commercial Product,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health CPD,Meritain Health CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Starmark CPD,Starmark CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna Medicare,Aetna Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Ambetter ,Ambetter ,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access,Anthem Blue Access,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access Choice,Anthem Blue Access Choice,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Preferred,Anthem Blue Preferred,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Pathway,Anthem Pathway,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Alliance,Anthem Alliance,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Medicare,Anthem Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna,Cigna,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna PPO,Cigna PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna Medicare Advantage,Cigna Medicare Advantage,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Essence,Essence,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthlink HMO,Healthlink HMO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthlink PPO,Healthlink PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,HomeState Health Plan,HomeState Health Plan,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Humana Gold,Humana Gold,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Medicaid MO,Medicaid MO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Medica,Medica,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Tricare,Tricare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC All Payer,UHC All Payer,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Exchange,UHC Exchange,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicaid,UHC Medicaid,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UMR CPD,UMR CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicare,UHC Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38203030,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Wellcare,Wellcare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Meritain Health PPO CPD,Meritain Health PPO CPD,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Aetna/Commercial Product,Aetna/Commercial Product,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Meritain Health CPD,Meritain Health CPD,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Starmark CPD,Starmark CPD,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Aetna Medicare,Aetna Medicare,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Ambetter ,Ambetter ,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Blue Access,Anthem Blue Access,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Blue Access Choice,Anthem Blue Access Choice,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Blue Preferred,Anthem Blue Preferred,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Pathway,Anthem Pathway,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Alliance,Anthem Alliance,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Anthem Medicare,Anthem Medicare,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Cigna,Cigna,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Cigna PPO,Cigna PPO,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Cigna Medicare Advantage,Cigna Medicare Advantage,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Essence,Essence,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Healthlink HMO,Healthlink HMO,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Healthlink PPO,Healthlink PPO,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,HomeState Health Plan,HomeState Health Plan,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Humana Gold,Humana Gold,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Medicaid MO,Medicaid MO,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Medica,Medica,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Tricare,Tricare,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,UHC All Payer,UHC All Payer,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,UHC Exchange,UHC Exchange,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,UHC Medicaid,UHC Medicaid,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,UMR CPD,UMR CPD,344.67,,,,,,,per diem,344.67,344.67,"Per diem rate, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,UHC Medicare,UHC Medicare,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
GROWTH HORMONE                ,38203055,CDM,301,RC,83003,CPT,,,,Inpatient,,,344.67,344.67,Wellcare,Wellcare,344.67,,,,,,,case rate,344.67,344.67,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Meritain Health PPO CPD,Meritain Health PPO CPD,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Aetna/Commercial Product,Aetna/Commercial Product,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Meritain Health CPD,Meritain Health CPD,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Starmark CPD,Starmark CPD,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Aetna Medicare,Aetna Medicare,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Ambetter ,Ambetter ,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Blue Access,Anthem Blue Access,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Blue Access Choice,Anthem Blue Access Choice,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Blue Preferred,Anthem Blue Preferred,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Pathway,Anthem Pathway,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Alliance,Anthem Alliance,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Anthem Medicare,Anthem Medicare,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Cigna,Cigna,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Cigna PPO,Cigna PPO,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Cigna Medicare Advantage,Cigna Medicare Advantage,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Essence,Essence,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Healthlink HMO,Healthlink HMO,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Healthlink PPO,Healthlink PPO,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,HomeState Health Plan,HomeState Health Plan,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Humana Gold,Humana Gold,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Medicaid MO,Medicaid MO,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Medica,Medica,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Tricare,Tricare,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,UHC All Payer,UHC All Payer,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,UHC Exchange,UHC Exchange,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,UHC Medicaid,UHC Medicaid,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,UMR CPD,UMR CPD,468.08,,,,,,,per diem,468.08,468.08,"Per diem rate, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,UHC Medicare,UHC Medicare,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
G6-PD                         ,38203085,CDM,301,RC,82955,CPT,,,,Inpatient,,,468.08,468.08,Wellcare,Wellcare,468.08,,,,,,,case rate,468.08,468.08,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Meritain Health PPO CPD,Meritain Health PPO CPD,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Aetna/Commercial Product,Aetna/Commercial Product,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Meritain Health CPD,Meritain Health CPD,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Starmark CPD,Starmark CPD,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Aetna Medicare,Aetna Medicare,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Ambetter ,Ambetter ,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Blue Access,Anthem Blue Access,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Blue Access Choice,Anthem Blue Access Choice,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Blue Preferred,Anthem Blue Preferred,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Pathway,Anthem Pathway,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Alliance,Anthem Alliance,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Anthem Medicare,Anthem Medicare,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Cigna,Cigna,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Cigna PPO,Cigna PPO,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Cigna Medicare Advantage,Cigna Medicare Advantage,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Essence,Essence,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Healthlink HMO,Healthlink HMO,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Healthlink PPO,Healthlink PPO,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,HomeState Health Plan,HomeState Health Plan,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Humana Gold,Humana Gold,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Medicaid MO,Medicaid MO,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Medica,Medica,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Tricare,Tricare,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,UHC All Payer,UHC All Payer,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,UHC Exchange,UHC Exchange,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,UHC Medicaid,UHC Medicaid,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,UMR CPD,UMR CPD,113.3,,,,,,,per diem,113.3,113.3,"Per diem rate, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,UHC Medicare,UHC Medicare,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HEAVY METAL SCREEN            ,38203095,CDM,301,RC,83015,CPT,,,,Inpatient,,,113.3,113.3,Wellcare,Wellcare,113.3,,,,,,,case rate,113.3,113.3,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Meritain Health PPO CPD,Meritain Health PPO CPD,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Aetna/Commercial Product,Aetna/Commercial Product,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Meritain Health CPD,Meritain Health CPD,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Starmark CPD,Starmark CPD,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Aetna Medicare,Aetna Medicare,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Ambetter ,Ambetter ,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Blue Access,Anthem Blue Access,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Blue Access Choice,Anthem Blue Access Choice,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Blue Preferred,Anthem Blue Preferred,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Pathway,Anthem Pathway,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Alliance,Anthem Alliance,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Anthem Medicare,Anthem Medicare,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Cigna,Cigna,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Cigna PPO,Cigna PPO,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Cigna Medicare Advantage,Cigna Medicare Advantage,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Essence,Essence,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Healthlink HMO,Healthlink HMO,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Healthlink PPO,Healthlink PPO,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,HomeState Health Plan,HomeState Health Plan,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Humana Gold,Humana Gold,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Medicaid MO,Medicaid MO,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Medica,Medica,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Tricare,Tricare,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,UHC All Payer,UHC All Payer,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,UHC Exchange,UHC Exchange,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,UHC Medicaid,UHC Medicaid,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,UMR CPD,UMR CPD,58.16,,,,,,,per diem,58.16,58.16,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,UHC Medicare,UHC Medicare,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX TYPE 1 ABY     ,38203110,CDM,302,RC,86695,CPT,,,,Inpatient,,,58.16,58.16,Wellcare,Wellcare,58.16,,,,,,,case rate,58.16,58.16,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Meritain Health PPO CPD,Meritain Health PPO CPD,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Aetna/Commercial Product,Aetna/Commercial Product,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Meritain Health CPD,Meritain Health CPD,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Starmark CPD,Starmark CPD,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Aetna Medicare,Aetna Medicare,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Ambetter ,Ambetter ,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Blue Access,Anthem Blue Access,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Blue Access Choice,Anthem Blue Access Choice,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Blue Preferred,Anthem Blue Preferred,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Pathway,Anthem Pathway,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Alliance,Anthem Alliance,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Anthem Medicare,Anthem Medicare,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Cigna,Cigna,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Cigna PPO,Cigna PPO,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Cigna Medicare Advantage,Cigna Medicare Advantage,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Essence,Essence,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Healthlink HMO,Healthlink HMO,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Healthlink PPO,Healthlink PPO,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,HomeState Health Plan,HomeState Health Plan,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Humana Gold,Humana Gold,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Medicaid MO,Medicaid MO,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Medica,Medica,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Tricare,Tricare,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,UHC All Payer,UHC All Payer,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,UHC Exchange,UHC Exchange,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,UHC Medicaid,UHC Medicaid,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,UMR CPD,UMR CPD,203.82,,,,,,,per diem,203.82,203.82,"Per diem rate, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,UHC Medicare,UHC Medicare,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
HGB-FETAL MATERNAL SCREEN     ,38203125,CDM,305,RC,85461,CPT,,,,Inpatient,,,203.82,203.82,Wellcare,Wellcare,203.82,,,,,,,case rate,203.82,203.82,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Meritain Health PPO CPD,Meritain Health PPO CPD,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Aetna/Commercial Product,Aetna/Commercial Product,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Meritain Health CPD,Meritain Health CPD,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Starmark CPD,Starmark CPD,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Aetna Medicare,Aetna Medicare,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Ambetter ,Ambetter ,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Blue Access,Anthem Blue Access,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Blue Access Choice,Anthem Blue Access Choice,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Blue Preferred,Anthem Blue Preferred,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Pathway,Anthem Pathway,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Alliance,Anthem Alliance,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Anthem Medicare,Anthem Medicare,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Cigna,Cigna,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Cigna PPO,Cigna PPO,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Cigna Medicare Advantage,Cigna Medicare Advantage,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Essence,Essence,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Healthlink HMO,Healthlink HMO,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Healthlink PPO,Healthlink PPO,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,HomeState Health Plan,HomeState Health Plan,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Humana Gold,Humana Gold,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Medicaid MO,Medicaid MO,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Medica,Medica,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Tricare,Tricare,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,UHC All Payer,UHC All Payer,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,UHC Exchange,UHC Exchange,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,UHC Medicaid,UHC Medicaid,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,UMR CPD,UMR CPD,426.42,,,,,,,per diem,426.42,426.42,"Per diem rate, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,UHC Medicare,UHC Medicare,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
"HIV1 ANTIGEN,EIA              ",38203135,CDM,306,RC,87390,CPT,,,,Inpatient,,,426.42,426.42,Wellcare,Wellcare,426.42,,,,,,,case rate,426.42,426.42,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Meritain Health PPO CPD,Meritain Health PPO CPD,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Aetna/Commercial Product,Aetna/Commercial Product,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Meritain Health CPD,Meritain Health CPD,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Starmark CPD,Starmark CPD,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Aetna Medicare,Aetna Medicare,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Ambetter ,Ambetter ,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Blue Access,Anthem Blue Access,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Blue Access Choice,Anthem Blue Access Choice,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Blue Preferred,Anthem Blue Preferred,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Pathway,Anthem Pathway,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Alliance,Anthem Alliance,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Anthem Medicare,Anthem Medicare,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Cigna,Cigna,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Cigna PPO,Cigna PPO,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Cigna Medicare Advantage,Cigna Medicare Advantage,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Essence,Essence,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Healthlink HMO,Healthlink HMO,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Healthlink PPO,Healthlink PPO,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,HomeState Health Plan,HomeState Health Plan,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Humana Gold,Humana Gold,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Medicaid MO,Medicaid MO,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Medica,Medica,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Tricare,Tricare,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,UHC All Payer,UHC All Payer,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,UHC Exchange,UHC Exchange,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,UHC Medicaid,UHC Medicaid,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,UMR CPD,UMR CPD,451.03,,,,,,,per diem,451.03,451.03,"Per diem rate, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,UHC Medicare,UHC Medicare,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
HLA-B27                       ,38203140,CDM,302,RC,86812,CPT,,,,Inpatient,,,451.03,451.03,Wellcare,Wellcare,451.03,,,,,,,case rate,451.03,451.03,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health PPO CPD,Meritain Health PPO CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna/Commercial Product,Aetna/Commercial Product,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health CPD,Meritain Health CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Starmark CPD,Starmark CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna Medicare,Aetna Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Ambetter ,Ambetter ,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access,Anthem Blue Access,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access Choice,Anthem Blue Access Choice,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Preferred,Anthem Blue Preferred,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Pathway,Anthem Pathway,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Alliance,Anthem Alliance,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Medicare,Anthem Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna,Cigna,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna PPO,Cigna PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna Medicare Advantage,Cigna Medicare Advantage,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Essence,Essence,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthlink HMO,Healthlink HMO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthlink PPO,Healthlink PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,HomeState Health Plan,HomeState Health Plan,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Humana Gold,Humana Gold,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Medicaid MO,Medicaid MO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Medica,Medica,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Tricare,Tricare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC All Payer,UHC All Payer,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Exchange,UHC Exchange,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicaid,UHC Medicaid,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UMR CPD,UMR CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicare,UHC Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGG             ,38203150,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Wellcare,Wellcare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health PPO CPD,Meritain Health PPO CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna/Commercial Product,Aetna/Commercial Product,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health CPD,Meritain Health CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Starmark CPD,Starmark CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Aetna Medicare,Aetna Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Ambetter ,Ambetter ,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access,Anthem Blue Access,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access Choice,Anthem Blue Access Choice,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Preferred,Anthem Blue Preferred,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Pathway,Anthem Pathway,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Alliance,Anthem Alliance,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Anthem Medicare,Anthem Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna,Cigna,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna PPO,Cigna PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Cigna Medicare Advantage,Cigna Medicare Advantage,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Essence,Essence,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthlink HMO,Healthlink HMO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Healthlink PPO,Healthlink PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,HomeState Health Plan,HomeState Health Plan,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Humana Gold,Humana Gold,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Medicaid MO,Medicaid MO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Medica,Medica,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Tricare,Tricare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC All Payer,UHC All Payer,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Exchange,UHC Exchange,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicaid,UHC Medicaid,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UMR CPD,UMR CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicare,UHC Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGA             ,38203155,CDM,301,RC,82784,CPT,,,,Inpatient,,,305.91,305.91,Wellcare,Wellcare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Meritain Health PPO CPD,Meritain Health PPO CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Aetna/Commercial Product,Aetna/Commercial Product,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Meritain Health CPD,Meritain Health CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Starmark CPD,Starmark CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Aetna Medicare,Aetna Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Ambetter ,Ambetter ,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Access,Anthem Blue Access,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Access Choice,Anthem Blue Access Choice,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Preferred,Anthem Blue Preferred,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Pathway,Anthem Pathway,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Alliance,Anthem Alliance,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Anthem Medicare,Anthem Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Cigna,Cigna,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Cigna PPO,Cigna PPO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Cigna Medicare Advantage,Cigna Medicare Advantage,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Essence,Essence,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Healthlink HMO,Healthlink HMO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Healthlink PPO,Healthlink PPO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,HomeState Health Plan,HomeState Health Plan,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Humana Gold,Humana Gold,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Medicaid MO,Medicaid MO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Medica,Medica,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Tricare,Tricare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,UHC All Payer,UHC All Payer,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,UHC Exchange,UHC Exchange,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,UHC Medicaid,UHC Medicaid,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,UMR CPD,UMR CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,UHC Medicare,UHC Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38203160,CDM,302,RC,86334,CPT,,,,Inpatient,,,263.1,263.1,Wellcare,Wellcare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
KANAMYCIN                     ,38203170,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH FL                        ,38203175,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38203180,CDM,301,RC,83655,CPT,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
LEPTOSPIRA ANTIBODY           ,38203195,CDM,302,RC,86720,CPT,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Meritain Health PPO CPD,Meritain Health PPO CPD,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Aetna/Commercial Product,Aetna/Commercial Product,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Meritain Health CPD,Meritain Health CPD,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Starmark CPD,Starmark CPD,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Aetna Medicare,Aetna Medicare,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Ambetter ,Ambetter ,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Blue Access,Anthem Blue Access,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Blue Access Choice,Anthem Blue Access Choice,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Blue Preferred,Anthem Blue Preferred,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Pathway,Anthem Pathway,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Alliance,Anthem Alliance,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Anthem Medicare,Anthem Medicare,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Cigna,Cigna,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Cigna PPO,Cigna PPO,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Cigna Medicare Advantage,Cigna Medicare Advantage,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Essence,Essence,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Healthlink HMO,Healthlink HMO,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Healthlink PPO,Healthlink PPO,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,HomeState Health Plan,HomeState Health Plan,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Humana Gold,Humana Gold,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Medicaid MO,Medicaid MO,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Medica,Medica,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Tricare,Tricare,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,UHC All Payer,UHC All Payer,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,UHC Exchange,UHC Exchange,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,UHC Medicaid,UHC Medicaid,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,UMR CPD,UMR CPD,166.87,,,,,,,per diem,166.87,166.87,"Per diem rate, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,UHC Medicare,UHC Medicare,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
INCLUSION_BODY/PARASITE STAIN ,38203215,CDM,306,RC,87207,CPT,,,,Inpatient,,,166.87,166.87,Wellcare,Wellcare,166.87,,,,,,,case rate,166.87,166.87,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Meritain Health PPO CPD,Meritain Health PPO CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Aetna/Commercial Product,Aetna/Commercial Product,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Meritain Health CPD,Meritain Health CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Starmark CPD,Starmark CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Aetna Medicare,Aetna Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Ambetter ,Ambetter ,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Blue Access,Anthem Blue Access,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Blue Access Choice,Anthem Blue Access Choice,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Blue Preferred,Anthem Blue Preferred,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Pathway,Anthem Pathway,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Alliance,Anthem Alliance,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Anthem Medicare,Anthem Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Cigna,Cigna,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Cigna PPO,Cigna PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Cigna Medicare Advantage,Cigna Medicare Advantage,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Essence,Essence,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Healthlink HMO,Healthlink HMO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Healthlink PPO,Healthlink PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,HomeState Health Plan,HomeState Health Plan,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Humana Gold,Humana Gold,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Medicaid MO,Medicaid MO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Medica,Medica,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Tricare,Tricare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,UHC All Payer,UHC All Payer,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,UHC Exchange,UHC Exchange,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,UHC Medicaid,UHC Medicaid,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,UMR CPD,UMR CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,UHC Medicare,UHC Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
MANGANESE                     ,38203217,CDM,301,RC,83785,CPT,,,,Inpatient,,,100.86,100.86,Wellcare,Wellcare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Meritain Health PPO CPD,Meritain Health PPO CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna/Commercial Product,Aetna/Commercial Product,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Meritain Health CPD,Meritain Health CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Starmark CPD,Starmark CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna Medicare,Aetna Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Ambetter ,Ambetter ,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Access,Anthem Blue Access,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Access Choice,Anthem Blue Access Choice,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Preferred,Anthem Blue Preferred,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Pathway,Anthem Pathway,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Alliance,Anthem Alliance,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Medicare,Anthem Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna,Cigna,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna PPO,Cigna PPO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna Medicare Advantage,Cigna Medicare Advantage,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Essence,Essence,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthlink HMO,Healthlink HMO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthlink PPO,Healthlink PPO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,HomeState Health Plan,HomeState Health Plan,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Humana Gold,Humana Gold,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Medicaid MO,Medicaid MO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Medica,Medica,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Tricare,Tricare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC All Payer,UHC All Payer,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Exchange,UHC Exchange,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Medicaid,UHC Medicaid,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UMR CPD,UMR CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Medicare,UHC Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38203220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Wellcare,Wellcare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MEXILETINE                    ,38203245,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Meritain Health PPO CPD,Meritain Health PPO CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Aetna/Commercial Product,Aetna/Commercial Product,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Meritain Health CPD,Meritain Health CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Starmark CPD,Starmark CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Aetna Medicare,Aetna Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Ambetter ,Ambetter ,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Access,Anthem Blue Access,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Access Choice,Anthem Blue Access Choice,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Blue Preferred,Anthem Blue Preferred,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Pathway,Anthem Pathway,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Alliance,Anthem Alliance,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Anthem Medicare,Anthem Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Cigna,Cigna,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Cigna PPO,Cigna PPO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Cigna Medicare Advantage,Cigna Medicare Advantage,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Essence,Essence,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Healthlink HMO,Healthlink HMO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Healthlink PPO,Healthlink PPO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,HomeState Health Plan,HomeState Health Plan,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Humana Gold,Humana Gold,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Medicaid MO,Medicaid MO,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Medica,Medica,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Tricare,Tricare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,UHC All Payer,UHC All Payer,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,UHC Exchange,UHC Exchange,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,UHC Medicaid,UHC Medicaid,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,UMR CPD,UMR CPD,138.98,,,,,,,per diem,138.98,138.98,"Per diem rate, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,UHC Medicare,UHC Medicare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MUMPS ANTIBODY                ,38203265,CDM,302,RC,86735,CPT,,,,Inpatient,,,138.98,138.98,Wellcare,Wellcare,138.98,,,,,,,case rate,138.98,138.98,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Meritain Health PPO CPD,Meritain Health PPO CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Aetna/Commercial Product,Aetna/Commercial Product,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Meritain Health CPD,Meritain Health CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Starmark CPD,Starmark CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Aetna Medicare,Aetna Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Ambetter ,Ambetter ,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Blue Access,Anthem Blue Access,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Blue Access Choice,Anthem Blue Access Choice,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Blue Preferred,Anthem Blue Preferred,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Pathway,Anthem Pathway,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Alliance,Anthem Alliance,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Anthem Medicare,Anthem Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Cigna,Cigna,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Cigna PPO,Cigna PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Cigna Medicare Advantage,Cigna Medicare Advantage,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Essence,Essence,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Healthlink HMO,Healthlink HMO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Healthlink PPO,Healthlink PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,HomeState Health Plan,HomeState Health Plan,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Humana Gold,Humana Gold,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Medicaid MO,Medicaid MO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Medica,Medica,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Tricare,Tricare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,UHC All Payer,UHC All Payer,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,UHC Exchange,UHC Exchange,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,UHC Medicaid,UHC Medicaid,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,UMR CPD,UMR CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,UHC Medicare,UHC Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
MYCOPLASMA ANTIBODY           ,38203275,CDM,302,RC,86738,CPT,,,,Inpatient,,,243.74,243.74,Wellcare,Wellcare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Meritain Health PPO CPD,Meritain Health PPO CPD,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Aetna/Commercial Product,Aetna/Commercial Product,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Meritain Health CPD,Meritain Health CPD,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Starmark CPD,Starmark CPD,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Aetna Medicare,Aetna Medicare,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Ambetter ,Ambetter ,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Blue Access,Anthem Blue Access,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Blue Access Choice,Anthem Blue Access Choice,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Blue Preferred,Anthem Blue Preferred,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Pathway,Anthem Pathway,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Alliance,Anthem Alliance,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Anthem Medicare,Anthem Medicare,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Cigna,Cigna,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Cigna PPO,Cigna PPO,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Cigna Medicare Advantage,Cigna Medicare Advantage,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Essence,Essence,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Healthlink HMO,Healthlink HMO,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Healthlink PPO,Healthlink PPO,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,HomeState Health Plan,HomeState Health Plan,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Humana Gold,Humana Gold,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Medicaid MO,Medicaid MO,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Medica,Medica,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Tricare,Tricare,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,UHC All Payer,UHC All Payer,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,UHC Exchange,UHC Exchange,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,UHC Medicaid,UHC Medicaid,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,UMR CPD,UMR CPD,210.22,,,,,,,per diem,210.22,210.22,"Per diem rate, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,UHC Medicare,UHC Medicare,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
"C DIFFICILE, PCR              ",38203286,CDM,306,RC,87798,CPT,,,,Inpatient,,,210.22,210.22,Wellcare,Wellcare,210.22,,,,,,,case rate,210.22,210.22,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Meritain Health PPO CPD,Meritain Health PPO CPD,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Aetna/Commercial Product,Aetna/Commercial Product,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Meritain Health CPD,Meritain Health CPD,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Starmark CPD,Starmark CPD,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Aetna Medicare,Aetna Medicare,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Ambetter ,Ambetter ,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Blue Access,Anthem Blue Access,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Blue Access Choice,Anthem Blue Access Choice,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Blue Preferred,Anthem Blue Preferred,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Pathway,Anthem Pathway,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Alliance,Anthem Alliance,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Anthem Medicare,Anthem Medicare,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Cigna,Cigna,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Cigna PPO,Cigna PPO,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Cigna Medicare Advantage,Cigna Medicare Advantage,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Essence,Essence,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Healthlink HMO,Healthlink HMO,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Healthlink PPO,Healthlink PPO,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,HomeState Health Plan,HomeState Health Plan,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Humana Gold,Humana Gold,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Medicaid MO,Medicaid MO,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Medica,Medica,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Tricare,Tricare,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,UHC All Payer,UHC All Payer,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,UHC Exchange,UHC Exchange,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,UHC Medicaid,UHC Medicaid,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,UMR CPD,UMR CPD,675.54,,,,,,,per diem,675.54,675.54,"Per diem rate, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,UHC Medicare,UHC Medicare,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYELIN BASIC CSF              ,38203290,CDM,301,RC,83873,CPT,,,,Inpatient,,,675.54,675.54,Wellcare,Wellcare,675.54,,,,,,,case rate,675.54,675.54,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Meritain Health PPO CPD,Meritain Health PPO CPD,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Aetna/Commercial Product,Aetna/Commercial Product,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Meritain Health CPD,Meritain Health CPD,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Starmark CPD,Starmark CPD,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Aetna Medicare,Aetna Medicare,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Ambetter ,Ambetter ,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Blue Access,Anthem Blue Access,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Blue Access Choice,Anthem Blue Access Choice,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Blue Preferred,Anthem Blue Preferred,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Pathway,Anthem Pathway,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Alliance,Anthem Alliance,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Anthem Medicare,Anthem Medicare,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Cigna,Cigna,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Cigna PPO,Cigna PPO,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Cigna Medicare Advantage,Cigna Medicare Advantage,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Essence,Essence,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Healthlink HMO,Healthlink HMO,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Healthlink PPO,Healthlink PPO,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,HomeState Health Plan,HomeState Health Plan,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Humana Gold,Humana Gold,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Medicaid MO,Medicaid MO,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Medica,Medica,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Tricare,Tricare,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,UHC All Payer,UHC All Payer,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,UHC Exchange,UHC Exchange,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,UHC Medicaid,UHC Medicaid,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,UMR CPD,UMR CPD,301.42,,,,,,,per diem,301.42,301.42,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,UHC Medicare,UHC Medicare,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38203295,CDM,301,RC,83874,CPT,,,,Inpatient,,,301.42,301.42,Wellcare,Wellcare,301.42,,,,,,,case rate,301.42,301.42,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Meritain Health PPO CPD,Meritain Health PPO CPD,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Aetna/Commercial Product,Aetna/Commercial Product,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Meritain Health CPD,Meritain Health CPD,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Starmark CPD,Starmark CPD,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Aetna Medicare,Aetna Medicare,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Ambetter ,Ambetter ,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Blue Access,Anthem Blue Access,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Blue Access Choice,Anthem Blue Access Choice,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Blue Preferred,Anthem Blue Preferred,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Pathway,Anthem Pathway,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Alliance,Anthem Alliance,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Anthem Medicare,Anthem Medicare,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Cigna,Cigna,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Cigna PPO,Cigna PPO,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Cigna Medicare Advantage,Cigna Medicare Advantage,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Essence,Essence,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Healthlink HMO,Healthlink HMO,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Healthlink PPO,Healthlink PPO,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,HomeState Health Plan,HomeState Health Plan,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Humana Gold,Humana Gold,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Medicaid MO,Medicaid MO,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Medica,Medica,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Tricare,Tricare,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,UHC All Payer,UHC All Payer,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,UHC Exchange,UHC Exchange,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,UHC Medicaid,UHC Medicaid,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,UMR CPD,UMR CPD,342.96,,,,,,,per diem,342.96,342.96,"Per diem rate, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,UHC Medicare,UHC Medicare,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
PROCAINAMIDE & NAPA LEVEL     ,38203305,CDM,301,RC,80192,CPT,,,,Inpatient,,,342.96,342.96,Wellcare,Wellcare,342.96,,,,,,,case rate,342.96,342.96,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Meritain Health PPO CPD,Meritain Health PPO CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Aetna/Commercial Product,Aetna/Commercial Product,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Meritain Health CPD,Meritain Health CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Starmark CPD,Starmark CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Aetna Medicare,Aetna Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Ambetter ,Ambetter ,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Access,Anthem Blue Access,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Access Choice,Anthem Blue Access Choice,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Preferred,Anthem Blue Preferred,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Pathway,Anthem Pathway,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Alliance,Anthem Alliance,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Anthem Medicare,Anthem Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Cigna,Cigna,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Cigna PPO,Cigna PPO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Cigna Medicare Advantage,Cigna Medicare Advantage,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Essence,Essence,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Healthlink HMO,Healthlink HMO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Healthlink PPO,Healthlink PPO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,HomeState Health Plan,HomeState Health Plan,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Humana Gold,Humana Gold,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Medicaid MO,Medicaid MO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Medica,Medica,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Tricare,Tricare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,UHC All Payer,UHC All Payer,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,UHC Exchange,UHC Exchange,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,UHC Medicaid,UHC Medicaid,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,UMR CPD,UMR CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,UHC Medicare,UHC Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38203310,CDM,301,RC,82652,CPT,,,,Inpatient,,,397.84,397.84,Wellcare,Wellcare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Meritain Health PPO CPD,Meritain Health PPO CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Aetna/Commercial Product,Aetna/Commercial Product,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Meritain Health CPD,Meritain Health CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Starmark CPD,Starmark CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Aetna Medicare,Aetna Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Ambetter ,Ambetter ,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Blue Access,Anthem Blue Access,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Blue Access Choice,Anthem Blue Access Choice,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Blue Preferred,Anthem Blue Preferred,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Pathway,Anthem Pathway,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Alliance,Anthem Alliance,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Anthem Medicare,Anthem Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Cigna,Cigna,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Cigna PPO,Cigna PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Cigna Medicare Advantage,Cigna Medicare Advantage,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Essence,Essence,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Healthlink HMO,Healthlink HMO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Healthlink PPO,Healthlink PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,HomeState Health Plan,HomeState Health Plan,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Humana Gold,Humana Gold,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Medicaid MO,Medicaid MO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Medica,Medica,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Tricare,Tricare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,UHC All Payer,UHC All Payer,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,UHC Exchange,UHC Exchange,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,UHC Medicaid,UHC Medicaid,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,UMR CPD,UMR CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,UHC Medicare,UHC Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OLIGOCLONAL BANDS             ,38203315,CDM,301,RC,83916,CPT,,,,Inpatient,,,97.71,97.71,Wellcare,Wellcare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OPIATES 1 OR MORE             ,38203326,CDM,301,RC,80361,CPT,G0480,HCPCS,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
OXALATE                       ,38203330,CDM,301,RC,83945,CPT,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Meritain Health PPO CPD,Meritain Health PPO CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Aetna/Commercial Product,Aetna/Commercial Product,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Meritain Health CPD,Meritain Health CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Starmark CPD,Starmark CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Aetna Medicare,Aetna Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Ambetter ,Ambetter ,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Blue Access,Anthem Blue Access,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Blue Access Choice,Anthem Blue Access Choice,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Blue Preferred,Anthem Blue Preferred,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Pathway,Anthem Pathway,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Alliance,Anthem Alliance,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Anthem Medicare,Anthem Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Cigna,Cigna,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Cigna PPO,Cigna PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Cigna Medicare Advantage,Cigna Medicare Advantage,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Essence,Essence,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Healthlink HMO,Healthlink HMO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Healthlink PPO,Healthlink PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,HomeState Health Plan,HomeState Health Plan,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Humana Gold,Humana Gold,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Medicaid MO,Medicaid MO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Medica,Medica,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Tricare,Tricare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,UHC All Payer,UHC All Payer,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,UHC Exchange,UHC Exchange,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,UHC Medicaid,UHC Medicaid,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,UMR CPD,UMR CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,UHC Medicare,UHC Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHENCYCLIDINE (PCP)           ,38203340,CDM,301,RC,83992,CPT,,,,Inpatient,,,200.66,200.66,Wellcare,Wellcare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Meritain Health PPO CPD,Meritain Health PPO CPD,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Aetna/Commercial Product,Aetna/Commercial Product,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Meritain Health CPD,Meritain Health CPD,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Starmark CPD,Starmark CPD,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Aetna Medicare,Aetna Medicare,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Ambetter ,Ambetter ,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Blue Access,Anthem Blue Access,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Blue Access Choice,Anthem Blue Access Choice,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Blue Preferred,Anthem Blue Preferred,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Pathway,Anthem Pathway,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Alliance,Anthem Alliance,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Anthem Medicare,Anthem Medicare,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Cigna,Cigna,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Cigna PPO,Cigna PPO,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Cigna Medicare Advantage,Cigna Medicare Advantage,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Essence,Essence,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Healthlink HMO,Healthlink HMO,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Healthlink PPO,Healthlink PPO,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,HomeState Health Plan,HomeState Health Plan,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Humana Gold,Humana Gold,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Medicaid MO,Medicaid MO,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Medica,Medica,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Tricare,Tricare,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,UHC All Payer,UHC All Payer,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,UHC Exchange,UHC Exchange,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,UHC Medicaid,UHC Medicaid,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,UMR CPD,UMR CPD,18.08,,,,,,,per diem,18.08,18.08,"Per diem rate, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,UHC Medicare,UHC Medicare,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PHOSPHORUS UR                 ,38203345,CDM,301,RC,84105,CPT,,,,Inpatient,,,18.08,18.08,Wellcare,Wellcare,18.08,,,,,,,case rate,18.08,18.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Meritain Health PPO CPD,Meritain Health PPO CPD,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Aetna/Commercial Product,Aetna/Commercial Product,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Meritain Health CPD,Meritain Health CPD,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Starmark CPD,Starmark CPD,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Aetna Medicare,Aetna Medicare,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Ambetter ,Ambetter ,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Blue Access,Anthem Blue Access,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Blue Access Choice,Anthem Blue Access Choice,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Blue Preferred,Anthem Blue Preferred,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Pathway,Anthem Pathway,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Alliance,Anthem Alliance,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Anthem Medicare,Anthem Medicare,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Cigna,Cigna,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Cigna PPO,Cigna PPO,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Cigna Medicare Advantage,Cigna Medicare Advantage,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Essence,Essence,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Healthlink HMO,Healthlink HMO,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Healthlink PPO,Healthlink PPO,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,HomeState Health Plan,HomeState Health Plan,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Humana Gold,Humana Gold,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Medicaid MO,Medicaid MO,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Medica,Medica,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Tricare,Tricare,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,UHC All Payer,UHC All Payer,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,UHC Exchange,UHC Exchange,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,UHC Medicaid,UHC Medicaid,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,UMR CPD,UMR CPD,230.08,,,,,,,per diem,230.08,230.08,"Per diem rate, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,UHC Medicare,UHC Medicare,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PINWORM PREP                  ,38203355,CDM,306,RC,87172,CPT,,,,Inpatient,,,230.08,230.08,Wellcare,Wellcare,230.08,,,,,,,case rate,230.08,230.08,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Meritain Health PPO CPD,Meritain Health PPO CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Aetna/Commercial Product,Aetna/Commercial Product,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Meritain Health CPD,Meritain Health CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Starmark CPD,Starmark CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Aetna Medicare,Aetna Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Ambetter ,Ambetter ,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Blue Access,Anthem Blue Access,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Blue Access Choice,Anthem Blue Access Choice,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Blue Preferred,Anthem Blue Preferred,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Pathway,Anthem Pathway,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Alliance,Anthem Alliance,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Anthem Medicare,Anthem Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Cigna,Cigna,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Cigna PPO,Cigna PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Cigna Medicare Advantage,Cigna Medicare Advantage,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Essence,Essence,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Healthlink HMO,Healthlink HMO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Healthlink PPO,Healthlink PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,HomeState Health Plan,HomeState Health Plan,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Humana Gold,Humana Gold,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Medicaid MO,Medicaid MO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Medica,Medica,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Tricare,Tricare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,UHC All Payer,UHC All Payer,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,UHC Exchange,UHC Exchange,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,UHC Medicaid,UHC Medicaid,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,UMR CPD,UMR CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,UHC Medicare,UHC Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
PORPHYRIN (QUANTITATIVE)      ,38203365,CDM,301,RC,84120,CPT,,,,Inpatient,,,434.95,434.95,Wellcare,Wellcare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
"PORPHOBILINOGEN URINE,QNT     ",38203375,CDM,301,RC,84110,CPT,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Meritain Health PPO CPD,Meritain Health PPO CPD,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Aetna/Commercial Product,Aetna/Commercial Product,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Meritain Health CPD,Meritain Health CPD,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Starmark CPD,Starmark CPD,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Aetna Medicare,Aetna Medicare,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Ambetter ,Ambetter ,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Blue Access,Anthem Blue Access,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Blue Access Choice,Anthem Blue Access Choice,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Blue Preferred,Anthem Blue Preferred,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Pathway,Anthem Pathway,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Alliance,Anthem Alliance,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Anthem Medicare,Anthem Medicare,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Cigna,Cigna,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Cigna PPO,Cigna PPO,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Cigna Medicare Advantage,Cigna Medicare Advantage,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Essence,Essence,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Healthlink HMO,Healthlink HMO,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Healthlink PPO,Healthlink PPO,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,HomeState Health Plan,HomeState Health Plan,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Humana Gold,Humana Gold,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Medicaid MO,Medicaid MO,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Medica,Medica,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Tricare,Tricare,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,UHC All Payer,UHC All Payer,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,UHC Exchange,UHC Exchange,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,UHC Medicaid,UHC Medicaid,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,UMR CPD,UMR CPD,227.55,,,,,,,per diem,227.55,227.55,"Per diem rate, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,UHC Medicare,UHC Medicare,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PRIMIDONE                     ,38203380,CDM,301,RC,80188,CPT,,,,Inpatient,,,227.55,227.55,Wellcare,Wellcare,227.55,,,,,,,case rate,227.55,227.55,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Meritain Health PPO CPD,Meritain Health PPO CPD,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Aetna/Commercial Product,Aetna/Commercial Product,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Meritain Health CPD,Meritain Health CPD,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Starmark CPD,Starmark CPD,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Aetna Medicare,Aetna Medicare,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Ambetter ,Ambetter ,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Blue Access,Anthem Blue Access,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Blue Access Choice,Anthem Blue Access Choice,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Blue Preferred,Anthem Blue Preferred,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Pathway,Anthem Pathway,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Alliance,Anthem Alliance,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Anthem Medicare,Anthem Medicare,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Cigna,Cigna,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Cigna PPO,Cigna PPO,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Cigna Medicare Advantage,Cigna Medicare Advantage,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Essence,Essence,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Healthlink HMO,Healthlink HMO,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Healthlink PPO,Healthlink PPO,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,HomeState Health Plan,HomeState Health Plan,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Humana Gold,Humana Gold,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Medicaid MO,Medicaid MO,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Medica,Medica,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Tricare,Tricare,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,UHC All Payer,UHC All Payer,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,UHC Exchange,UHC Exchange,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,UHC Medicaid,UHC Medicaid,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,UMR CPD,UMR CPD,235.87,,,,,,,per diem,235.87,235.87,"Per diem rate, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,UHC Medicare,UHC Medicare,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
PROCAINAMIDE                  ,38203385,CDM,301,RC,80190,CPT,,,,Inpatient,,,235.87,235.87,Wellcare,Wellcare,235.87,,,,,,,case rate,235.87,235.87,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Meritain Health PPO CPD,Meritain Health PPO CPD,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Aetna/Commercial Product,Aetna/Commercial Product,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Meritain Health CPD,Meritain Health CPD,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Starmark CPD,Starmark CPD,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Aetna Medicare,Aetna Medicare,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Ambetter ,Ambetter ,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Blue Access,Anthem Blue Access,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Blue Access Choice,Anthem Blue Access Choice,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Blue Preferred,Anthem Blue Preferred,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Pathway,Anthem Pathway,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Alliance,Anthem Alliance,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Anthem Medicare,Anthem Medicare,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Cigna,Cigna,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Cigna PPO,Cigna PPO,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Cigna Medicare Advantage,Cigna Medicare Advantage,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Essence,Essence,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Healthlink HMO,Healthlink HMO,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Healthlink PPO,Healthlink PPO,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,HomeState Health Plan,HomeState Health Plan,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Humana Gold,Humana Gold,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Medicaid MO,Medicaid MO,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Medica,Medica,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Tricare,Tricare,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,UHC All Payer,UHC All Payer,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,UHC Exchange,UHC Exchange,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,UHC Medicaid,UHC Medicaid,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,UMR CPD,UMR CPD,14.71,,,,,,,per diem,14.71,14.71,"Per diem rate, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,UHC Medicare,UHC Medicare,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
REDUCING SUBSTANCES (GLUCOSE) ,38203415,CDM,301,RC,84376,CPT,,,,Inpatient,,,14.71,14.71,Wellcare,Wellcare,14.71,,,,,,,case rate,14.71,14.71,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Meritain Health PPO CPD,Meritain Health PPO CPD,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Aetna/Commercial Product,Aetna/Commercial Product,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Meritain Health CPD,Meritain Health CPD,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Starmark CPD,Starmark CPD,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Aetna Medicare,Aetna Medicare,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Ambetter ,Ambetter ,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Blue Access,Anthem Blue Access,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Blue Access Choice,Anthem Blue Access Choice,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Blue Preferred,Anthem Blue Preferred,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Pathway,Anthem Pathway,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Alliance,Anthem Alliance,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Anthem Medicare,Anthem Medicare,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Cigna,Cigna,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Cigna PPO,Cigna PPO,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Cigna Medicare Advantage,Cigna Medicare Advantage,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Essence,Essence,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Healthlink HMO,Healthlink HMO,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Healthlink PPO,Healthlink PPO,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,HomeState Health Plan,HomeState Health Plan,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Humana Gold,Humana Gold,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Medicaid MO,Medicaid MO,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Medica,Medica,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Tricare,Tricare,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,UHC All Payer,UHC All Payer,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,UHC Exchange,UHC Exchange,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,UHC Medicaid,UHC Medicaid,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,UMR CPD,UMR CPD,134.96,,,,,,,per diem,134.96,134.96,"Per diem rate, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,UHC Medicare,UHC Medicare,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
RICKETTSIA ANTIBODY           ,38203425,CDM,302,RC,86757,CPT,,,,Inpatient,,,134.96,134.96,Wellcare,Wellcare,134.96,,,,,,,case rate,134.96,134.96,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Meritain Health PPO CPD,Meritain Health PPO CPD,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Aetna/Commercial Product,Aetna/Commercial Product,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Meritain Health CPD,Meritain Health CPD,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Starmark CPD,Starmark CPD,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Aetna Medicare,Aetna Medicare,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Ambetter ,Ambetter ,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Blue Access,Anthem Blue Access,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Blue Access Choice,Anthem Blue Access Choice,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Blue Preferred,Anthem Blue Preferred,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Pathway,Anthem Pathway,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Alliance,Anthem Alliance,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Anthem Medicare,Anthem Medicare,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Cigna,Cigna,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Cigna PPO,Cigna PPO,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Cigna Medicare Advantage,Cigna Medicare Advantage,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Essence,Essence,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Healthlink HMO,Healthlink HMO,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Healthlink PPO,Healthlink PPO,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,HomeState Health Plan,HomeState Health Plan,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Humana Gold,Humana Gold,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Medicaid MO,Medicaid MO,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Medica,Medica,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Tricare,Tricare,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,UHC All Payer,UHC All Payer,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,UHC Exchange,UHC Exchange,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,UHC Medicaid,UHC Medicaid,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,UMR CPD,UMR CPD,501.17,,,,,,,per diem,501.17,501.17,"Per diem rate, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,UHC Medicare,UHC Medicare,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
SEROTONIN                     ,38203455,CDM,301,RC,84260,CPT,,,,Inpatient,,,501.17,501.17,Wellcare,Wellcare,501.17,,,,,,,case rate,501.17,501.17,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Meritain Health PPO CPD,Meritain Health PPO CPD,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Aetna/Commercial Product,Aetna/Commercial Product,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Meritain Health CPD,Meritain Health CPD,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Starmark CPD,Starmark CPD,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Aetna Medicare,Aetna Medicare,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Ambetter ,Ambetter ,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Blue Access,Anthem Blue Access,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Blue Access Choice,Anthem Blue Access Choice,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Blue Preferred,Anthem Blue Preferred,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Pathway,Anthem Pathway,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Alliance,Anthem Alliance,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Anthem Medicare,Anthem Medicare,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Cigna,Cigna,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Cigna PPO,Cigna PPO,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Cigna Medicare Advantage,Cigna Medicare Advantage,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Essence,Essence,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Healthlink HMO,Healthlink HMO,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Healthlink PPO,Healthlink PPO,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,HomeState Health Plan,HomeState Health Plan,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Humana Gold,Humana Gold,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Medicaid MO,Medicaid MO,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Medica,Medica,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Tricare,Tricare,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,UHC All Payer,UHC All Payer,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,UHC Exchange,UHC Exchange,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,UHC Medicaid,UHC Medicaid,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,UMR CPD,UMR CPD,129.9,,,,,,,per diem,129.9,129.9,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,UHC Medicare,UHC Medicare,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38203500,CDM,301,RC,84402,CPT,,,,Inpatient,,,129.9,129.9,Wellcare,Wellcare,129.9,,,,,,,case rate,129.9,129.9,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Meritain Health PPO CPD,Meritain Health PPO CPD,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Aetna/Commercial Product,Aetna/Commercial Product,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Meritain Health CPD,Meritain Health CPD,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Starmark CPD,Starmark CPD,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Aetna Medicare,Aetna Medicare,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Ambetter ,Ambetter ,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Blue Access,Anthem Blue Access,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Blue Access Choice,Anthem Blue Access Choice,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Blue Preferred,Anthem Blue Preferred,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Pathway,Anthem Pathway,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Alliance,Anthem Alliance,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Anthem Medicare,Anthem Medicare,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Cigna,Cigna,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Cigna PPO,Cigna PPO,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Cigna Medicare Advantage,Cigna Medicare Advantage,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Essence,Essence,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Healthlink HMO,Healthlink HMO,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Healthlink PPO,Healthlink PPO,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,HomeState Health Plan,HomeState Health Plan,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Humana Gold,Humana Gold,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Medicaid MO,Medicaid MO,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Medica,Medica,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Tricare,Tricare,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,UHC All Payer,UHC All Payer,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,UHC Exchange,UHC Exchange,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,UHC Medicaid,UHC Medicaid,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,UMR CPD,UMR CPD,440.2,,,,,,,per diem,440.2,440.2,"Per diem rate, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,UHC Medicare,UHC Medicare,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
THIOCYANATE                   ,38203520,CDM,301,RC,84430,CPT,,,,Inpatient,,,440.2,440.2,Wellcare,Wellcare,440.2,,,,,,,case rate,440.2,440.2,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Meritain Health PPO CPD,Meritain Health PPO CPD,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Aetna/Commercial Product,Aetna/Commercial Product,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Meritain Health CPD,Meritain Health CPD,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Starmark CPD,Starmark CPD,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Aetna Medicare,Aetna Medicare,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Ambetter ,Ambetter ,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Blue Access,Anthem Blue Access,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Blue Access Choice,Anthem Blue Access Choice,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Blue Preferred,Anthem Blue Preferred,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Pathway,Anthem Pathway,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Alliance,Anthem Alliance,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Anthem Medicare,Anthem Medicare,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Cigna,Cigna,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Cigna PPO,Cigna PPO,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Cigna Medicare Advantage,Cigna Medicare Advantage,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Essence,Essence,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Healthlink HMO,Healthlink HMO,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Healthlink PPO,Healthlink PPO,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,HomeState Health Plan,HomeState Health Plan,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Humana Gold,Humana Gold,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Medicaid MO,Medicaid MO,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Medica,Medica,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Tricare,Tricare,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,UHC All Payer,UHC All Payer,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,UHC Exchange,UHC Exchange,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,UHC Medicaid,UHC Medicaid,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,UMR CPD,UMR CPD,141.11,,,,,,,per diem,141.11,141.11,"Per diem rate, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,UHC Medicare,UHC Medicare,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
ANTIPSYCHOTICS NOS 1-3        ,38203527,CDM,301,RC,80342,CPT,,,,Inpatient,,,141.11,141.11,Wellcare,Wellcare,141.11,,,,,,,case rate,141.11,141.11,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Meritain Health PPO CPD,Meritain Health PPO CPD,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Aetna/Commercial Product,Aetna/Commercial Product,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Meritain Health CPD,Meritain Health CPD,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Starmark CPD,Starmark CPD,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Aetna Medicare,Aetna Medicare,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Ambetter ,Ambetter ,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Blue Access,Anthem Blue Access,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Blue Access Choice,Anthem Blue Access Choice,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Blue Preferred,Anthem Blue Preferred,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Pathway,Anthem Pathway,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Alliance,Anthem Alliance,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Anthem Medicare,Anthem Medicare,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Cigna,Cigna,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Cigna PPO,Cigna PPO,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Cigna Medicare Advantage,Cigna Medicare Advantage,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Essence,Essence,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Healthlink HMO,Healthlink HMO,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Healthlink PPO,Healthlink PPO,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,HomeState Health Plan,HomeState Health Plan,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Humana Gold,Humana Gold,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Medicaid MO,Medicaid MO,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Medica,Medica,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Tricare,Tricare,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,UHC All Payer,UHC All Payer,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,UHC Exchange,UHC Exchange,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,UHC Medicaid,UHC Medicaid,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,UMR CPD,UMR CPD,245.55,,,,,,,per diem,245.55,245.55,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,UHC Medicare,UHC Medicare,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38203533,CDM,302,RC,86376,CPT,,,,Inpatient,,,245.55,245.55,Wellcare,Wellcare,245.55,,,,,,,case rate,245.55,245.55,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGG)            ,38203555,CDM,302,RC,86777,CPT,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
TOXOPLASM AB (IGM)            ,38203560,CDM,302,RC,86778,CPT,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Meritain Health PPO CPD,Meritain Health PPO CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna/Commercial Product,Aetna/Commercial Product,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Meritain Health CPD,Meritain Health CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Starmark CPD,Starmark CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna Medicare,Aetna Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Ambetter ,Ambetter ,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Access,Anthem Blue Access,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Access Choice,Anthem Blue Access Choice,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Preferred,Anthem Blue Preferred,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Pathway,Anthem Pathway,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Alliance,Anthem Alliance,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Medicare,Anthem Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna,Cigna,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna PPO,Cigna PPO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna Medicare Advantage,Cigna Medicare Advantage,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Essence,Essence,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthlink HMO,Healthlink HMO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthlink PPO,Healthlink PPO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,HomeState Health Plan,HomeState Health Plan,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Humana Gold,Humana Gold,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Medicaid MO,Medicaid MO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Medica,Medica,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Tricare,Tricare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC All Payer,UHC All Payer,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Exchange,UHC Exchange,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Medicaid,UHC Medicaid,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UMR CPD,UMR CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Medicare,UHC Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38203580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Wellcare,Wellcare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Meritain Health PPO CPD,Meritain Health PPO CPD,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Aetna/Commercial Product,Aetna/Commercial Product,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Meritain Health CPD,Meritain Health CPD,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Starmark CPD,Starmark CPD,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Aetna Medicare,Aetna Medicare,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Ambetter ,Ambetter ,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Blue Access,Anthem Blue Access,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Blue Access Choice,Anthem Blue Access Choice,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Blue Preferred,Anthem Blue Preferred,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Pathway,Anthem Pathway,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Alliance,Anthem Alliance,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Anthem Medicare,Anthem Medicare,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Cigna,Cigna,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Cigna PPO,Cigna PPO,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Cigna Medicare Advantage,Cigna Medicare Advantage,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Essence,Essence,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Healthlink HMO,Healthlink HMO,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Healthlink PPO,Healthlink PPO,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,HomeState Health Plan,HomeState Health Plan,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Humana Gold,Humana Gold,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Medicaid MO,Medicaid MO,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Medica,Medica,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Tricare,Tricare,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,UHC All Payer,UHC All Payer,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,UHC Exchange,UHC Exchange,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,UHC Medicaid,UHC Medicaid,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,UMR CPD,UMR CPD,8.87,,,,,,,per diem,8.87,8.87,"Per diem rate, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,UHC Medicare,UHC Medicare,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
"PREGNANCY TEST,VISUAL COLOR   ",38203581,CDM,307,RC,81025,CPT,,,,Inpatient,,,8.87,8.87,Wellcare,Wellcare,8.87,,,,,,,case rate,8.87,8.87,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Meritain Health PPO CPD,Meritain Health PPO CPD,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Aetna/Commercial Product,Aetna/Commercial Product,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Meritain Health CPD,Meritain Health CPD,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Starmark CPD,Starmark CPD,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Aetna Medicare,Aetna Medicare,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Ambetter ,Ambetter ,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Blue Access,Anthem Blue Access,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Blue Access Choice,Anthem Blue Access Choice,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Blue Preferred,Anthem Blue Preferred,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Pathway,Anthem Pathway,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Alliance,Anthem Alliance,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Anthem Medicare,Anthem Medicare,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Cigna,Cigna,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Cigna PPO,Cigna PPO,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Cigna Medicare Advantage,Cigna Medicare Advantage,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Essence,Essence,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Healthlink HMO,Healthlink HMO,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Healthlink PPO,Healthlink PPO,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,HomeState Health Plan,HomeState Health Plan,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Humana Gold,Humana Gold,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Medicaid MO,Medicaid MO,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Medica,Medica,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Tricare,Tricare,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,UHC All Payer,UHC All Payer,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,UHC Exchange,UHC Exchange,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,UHC Medicaid,UHC Medicaid,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,UMR CPD,UMR CPD,27.58,,,,,,,per diem,27.58,27.58,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,UHC Medicare,UHC Medicare,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38203585,CDM,307,RC,81050,CPT,,,,Inpatient,,,27.58,27.58,Wellcare,Wellcare,27.58,,,,,,,case rate,27.58,27.58,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Meritain Health PPO CPD,Meritain Health PPO CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Aetna/Commercial Product,Aetna/Commercial Product,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Meritain Health CPD,Meritain Health CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Starmark CPD,Starmark CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Aetna Medicare,Aetna Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Ambetter ,Ambetter ,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Access,Anthem Blue Access,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Access Choice,Anthem Blue Access Choice,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Blue Preferred,Anthem Blue Preferred,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Pathway,Anthem Pathway,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Alliance,Anthem Alliance,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Anthem Medicare,Anthem Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Cigna,Cigna,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Cigna PPO,Cigna PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Cigna Medicare Advantage,Cigna Medicare Advantage,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Essence,Essence,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Healthlink HMO,Healthlink HMO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Healthlink PPO,Healthlink PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,HomeState Health Plan,HomeState Health Plan,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Humana Gold,Humana Gold,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Medicaid MO,Medicaid MO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Medica,Medica,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Tricare,Tricare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,UHC All Payer,UHC All Payer,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,UHC Exchange,UHC Exchange,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,UHC Medicaid,UHC Medicaid,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,UMR CPD,UMR CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,UHC Medicare,UHC Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS LATEX AG SER     ,38203586,CDM,302,RC,86403,CPT,,,,Inpatient,,,134.48,134.48,Wellcare,Wellcare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Meritain Health PPO CPD,Meritain Health PPO CPD,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Aetna/Commercial Product,Aetna/Commercial Product,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Meritain Health CPD,Meritain Health CPD,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Starmark CPD,Starmark CPD,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Aetna Medicare,Aetna Medicare,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Ambetter ,Ambetter ,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Blue Access,Anthem Blue Access,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Blue Access Choice,Anthem Blue Access Choice,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Blue Preferred,Anthem Blue Preferred,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Pathway,Anthem Pathway,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Alliance,Anthem Alliance,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Anthem Medicare,Anthem Medicare,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Cigna,Cigna,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Cigna PPO,Cigna PPO,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Cigna Medicare Advantage,Cigna Medicare Advantage,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Essence,Essence,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Healthlink HMO,Healthlink HMO,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Healthlink PPO,Healthlink PPO,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,HomeState Health Plan,HomeState Health Plan,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Humana Gold,Humana Gold,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Medicaid MO,Medicaid MO,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Medica,Medica,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Tricare,Tricare,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,UHC All Payer,UHC All Payer,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,UHC Exchange,UHC Exchange,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,UHC Medicaid,UHC Medicaid,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,UMR CPD,UMR CPD,29.46,,,,,,,per diem,29.46,29.46,"Per diem rate, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,UHC Medicare,UHC Medicare,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
URIC ACID URINE               ,38203590,CDM,305,RC,84560,CPT,,,,Inpatient,,,29.46,29.46,Wellcare,Wellcare,29.46,,,,,,,case rate,29.46,29.46,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Meritain Health PPO CPD,Meritain Health PPO CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Aetna/Commercial Product,Aetna/Commercial Product,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Meritain Health CPD,Meritain Health CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Starmark CPD,Starmark CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Aetna Medicare,Aetna Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Ambetter ,Ambetter ,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Blue Access,Anthem Blue Access,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Blue Access Choice,Anthem Blue Access Choice,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Blue Preferred,Anthem Blue Preferred,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Pathway,Anthem Pathway,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Alliance,Anthem Alliance,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Anthem Medicare,Anthem Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Cigna,Cigna,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Cigna PPO,Cigna PPO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Cigna Medicare Advantage,Cigna Medicare Advantage,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Essence,Essence,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Healthlink HMO,Healthlink HMO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Healthlink PPO,Healthlink PPO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,HomeState Health Plan,HomeState Health Plan,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Humana Gold,Humana Gold,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Medicaid MO,Medicaid MO,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Medica,Medica,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Tricare,Tricare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,UHC All Payer,UHC All Payer,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,UHC Exchange,UHC Exchange,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,UHC Medicaid,UHC Medicaid,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,UMR CPD,UMR CPD,26.52,,,,,,,per diem,26.52,26.52,"Per diem rate, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,UHC Medicare,UHC Medicare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
VENIPUNCTURE                  ,38203610,CDM,300,RC,36415,CPT,,,,Inpatient,,,26.52,26.52,Wellcare,Wellcare,26.52,,,,,,,case rate,26.52,26.52,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
YERSINIA CULT                 ,38203620,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Meritain Health PPO CPD,Meritain Health PPO CPD,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Aetna/Commercial Product,Aetna/Commercial Product,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Meritain Health CPD,Meritain Health CPD,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Starmark CPD,Starmark CPD,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Aetna Medicare,Aetna Medicare,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Ambetter ,Ambetter ,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Blue Access,Anthem Blue Access,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Blue Access Choice,Anthem Blue Access Choice,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Blue Preferred,Anthem Blue Preferred,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Pathway,Anthem Pathway,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Alliance,Anthem Alliance,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Anthem Medicare,Anthem Medicare,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Cigna,Cigna,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Cigna PPO,Cigna PPO,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Cigna Medicare Advantage,Cigna Medicare Advantage,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Essence,Essence,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Healthlink HMO,Healthlink HMO,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Healthlink PPO,Healthlink PPO,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,HomeState Health Plan,HomeState Health Plan,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Humana Gold,Humana Gold,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Medicaid MO,Medicaid MO,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Medica,Medica,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Tricare,Tricare,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,UHC All Payer,UHC All Payer,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,UHC Exchange,UHC Exchange,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,UHC Medicaid,UHC Medicaid,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,UMR CPD,UMR CPD,90.52,,,,,,,per diem,90.52,90.52,"Per diem rate, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,UHC Medicare,UHC Medicare,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
17-HYDROXYCORTICOSTEROID      ,38203625,CDM,301,RC,83491,CPT,,,,Inpatient,,,90.52,90.52,Wellcare,Wellcare,90.52,,,,,,,case rate,90.52,90.52,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health PPO CPD,Meritain Health PPO CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Aetna/Commercial Product,Aetna/Commercial Product,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health CPD,Meritain Health CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Starmark CPD,Starmark CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Aetna Medicare,Aetna Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Ambetter ,Ambetter ,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access,Anthem Blue Access,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access Choice,Anthem Blue Access Choice,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Preferred,Anthem Blue Preferred,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Pathway,Anthem Pathway,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Alliance,Anthem Alliance,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Anthem Medicare,Anthem Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Cigna,Cigna,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Cigna PPO,Cigna PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Cigna Medicare Advantage,Cigna Medicare Advantage,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Essence,Essence,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Healthlink HMO,Healthlink HMO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Healthlink PPO,Healthlink PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,HomeState Health Plan,HomeState Health Plan,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Humana Gold,Humana Gold,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Medicaid MO,Medicaid MO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Medica,Medica,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Tricare,Tricare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,UHC All Payer,UHC All Payer,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,UHC Exchange,UHC Exchange,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicaid,UHC Medicaid,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,UMR CPD,UMR CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicare,UHC Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 HIAA                        ,38203640,CDM,301,RC,83497,CPT,,,,Inpatient,,,194.14,194.14,Wellcare,Wellcare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Meritain Health PPO CPD,Meritain Health PPO CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Aetna/Commercial Product,Aetna/Commercial Product,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Meritain Health CPD,Meritain Health CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Starmark CPD,Starmark CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Aetna Medicare,Aetna Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Ambetter ,Ambetter ,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Blue Access,Anthem Blue Access,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Blue Access Choice,Anthem Blue Access Choice,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Blue Preferred,Anthem Blue Preferred,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Pathway,Anthem Pathway,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Alliance,Anthem Alliance,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Anthem Medicare,Anthem Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Cigna,Cigna,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Cigna PPO,Cigna PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Cigna Medicare Advantage,Cigna Medicare Advantage,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Essence,Essence,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Healthlink HMO,Healthlink HMO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Healthlink PPO,Healthlink PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,HomeState Health Plan,HomeState Health Plan,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Humana Gold,Humana Gold,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Medicaid MO,Medicaid MO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Medica,Medica,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Tricare,Tricare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,UHC All Payer,UHC All Payer,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,UHC Exchange,UHC Exchange,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,UHC Medicaid,UHC Medicaid,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,UMR CPD,UMR CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,UHC Medicare,UHC Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
5 NUCLEOTIDASE                ,38203645,CDM,301,RC,83915,CPT,,,,Inpatient,,,211.17,211.17,Wellcare,Wellcare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Meritain Health PPO CPD,Meritain Health PPO CPD,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Aetna/Commercial Product,Aetna/Commercial Product,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Meritain Health CPD,Meritain Health CPD,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Starmark CPD,Starmark CPD,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Aetna Medicare,Aetna Medicare,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Ambetter ,Ambetter ,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Blue Access,Anthem Blue Access,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Blue Access Choice,Anthem Blue Access Choice,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Blue Preferred,Anthem Blue Preferred,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Pathway,Anthem Pathway,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Alliance,Anthem Alliance,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Anthem Medicare,Anthem Medicare,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Cigna,Cigna,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Cigna PPO,Cigna PPO,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Cigna Medicare Advantage,Cigna Medicare Advantage,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Essence,Essence,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Healthlink HMO,Healthlink HMO,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Healthlink PPO,Healthlink PPO,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,HomeState Health Plan,HomeState Health Plan,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Humana Gold,Humana Gold,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Medicaid MO,Medicaid MO,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Medica,Medica,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Tricare,Tricare,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,UHC All Payer,UHC All Payer,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,UHC Exchange,UHC Exchange,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,UHC Medicaid,UHC Medicaid,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,UMR CPD,UMR CPD,74.36,,,,,,,per diem,74.36,74.36,"Per diem rate, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,UHC Medicare,UHC Medicare,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
"GLUCOSE, QUANTITATIVE         ",38203690,CDM,301,RC,82947,CPT,,,,Inpatient,,,74.36,74.36,Wellcare,Wellcare,74.36,,,,,,,case rate,74.36,74.36,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Meritain Health PPO CPD,Meritain Health PPO CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna/Commercial Product,Aetna/Commercial Product,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Meritain Health CPD,Meritain Health CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Starmark CPD,Starmark CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna Medicare,Aetna Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Ambetter ,Ambetter ,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Access,Anthem Blue Access,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Access Choice,Anthem Blue Access Choice,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Preferred,Anthem Blue Preferred,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Pathway,Anthem Pathway,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Alliance,Anthem Alliance,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Medicare,Anthem Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna,Cigna,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna PPO,Cigna PPO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna Medicare Advantage,Cigna Medicare Advantage,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Essence,Essence,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthlink HMO,Healthlink HMO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthlink PPO,Healthlink PPO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,HomeState Health Plan,HomeState Health Plan,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Humana Gold,Humana Gold,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Medicaid MO,Medicaid MO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Medica,Medica,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Tricare,Tricare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC All Payer,UHC All Payer,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Exchange,UHC Exchange,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Medicaid,UHC Medicaid,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UMR CPD,UMR CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Medicare,UHC Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HEMOGLOBIN                    ,38203695,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Wellcare,Wellcare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Meritain Health PPO CPD,Meritain Health PPO CPD,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Aetna/Commercial Product,Aetna/Commercial Product,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Meritain Health CPD,Meritain Health CPD,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Starmark CPD,Starmark CPD,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Aetna Medicare,Aetna Medicare,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Ambetter ,Ambetter ,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Blue Access,Anthem Blue Access,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Blue Access Choice,Anthem Blue Access Choice,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Blue Preferred,Anthem Blue Preferred,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Pathway,Anthem Pathway,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Alliance,Anthem Alliance,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Anthem Medicare,Anthem Medicare,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Cigna,Cigna,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Cigna PPO,Cigna PPO,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Cigna Medicare Advantage,Cigna Medicare Advantage,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Essence,Essence,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Healthlink HMO,Healthlink HMO,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Healthlink PPO,Healthlink PPO,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,HomeState Health Plan,HomeState Health Plan,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Humana Gold,Humana Gold,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Medicaid MO,Medicaid MO,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Medica,Medica,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Tricare,Tricare,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,UHC All Payer,UHC All Payer,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,UHC Exchange,UHC Exchange,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,UHC Medicaid,UHC Medicaid,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,UMR CPD,UMR CPD,195.32,,,,,,,per diem,195.32,195.32,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,UHC Medicare,UHC Medicare,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGE             ,38203700,CDM,301,RC,82785,CPT,,,,Inpatient,,,195.32,195.32,Wellcare,Wellcare,195.32,,,,,,,case rate,195.32,195.32,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Meritain Health PPO CPD,Meritain Health PPO CPD,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Aetna/Commercial Product,Aetna/Commercial Product,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Meritain Health CPD,Meritain Health CPD,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Starmark CPD,Starmark CPD,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Aetna Medicare,Aetna Medicare,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Ambetter ,Ambetter ,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Blue Access,Anthem Blue Access,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Blue Access Choice,Anthem Blue Access Choice,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Blue Preferred,Anthem Blue Preferred,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Pathway,Anthem Pathway,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Alliance,Anthem Alliance,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Anthem Medicare,Anthem Medicare,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Cigna,Cigna,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Cigna PPO,Cigna PPO,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Cigna Medicare Advantage,Cigna Medicare Advantage,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Essence,Essence,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Healthlink HMO,Healthlink HMO,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Healthlink PPO,Healthlink PPO,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,HomeState Health Plan,HomeState Health Plan,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Humana Gold,Humana Gold,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Medicaid MO,Medicaid MO,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Medica,Medica,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Tricare,Tricare,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,UHC All Payer,UHC All Payer,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,UHC Exchange,UHC Exchange,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,UHC Medicaid,UHC Medicaid,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,UMR CPD,UMR CPD,43.29,,,,,,,per diem,43.29,43.29,"Per diem rate, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,UHC Medicare,UHC Medicare,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
SED RATE (MANUAL)             ,38203705,CDM,305,RC,85651,CPT,,,,Inpatient,,,43.29,43.29,Wellcare,Wellcare,43.29,,,,,,,case rate,43.29,43.29,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CULTURE ECOLI 0157            ,38203715,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Meritain Health PPO CPD,Meritain Health PPO CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Aetna/Commercial Product,Aetna/Commercial Product,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Meritain Health CPD,Meritain Health CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Starmark CPD,Starmark CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Aetna Medicare,Aetna Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Ambetter ,Ambetter ,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Access,Anthem Blue Access,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Access Choice,Anthem Blue Access Choice,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Preferred,Anthem Blue Preferred,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Pathway,Anthem Pathway,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Alliance,Anthem Alliance,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Anthem Medicare,Anthem Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Cigna,Cigna,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Cigna PPO,Cigna PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Cigna Medicare Advantage,Cigna Medicare Advantage,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Essence,Essence,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Healthlink HMO,Healthlink HMO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Healthlink PPO,Healthlink PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,HomeState Health Plan,HomeState Health Plan,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Humana Gold,Humana Gold,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Medicaid MO,Medicaid MO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Medica,Medica,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Tricare,Tricare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,UHC All Payer,UHC All Payer,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,UHC Exchange,UHC Exchange,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,UHC Medicaid,UHC Medicaid,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,UMR CPD,UMR CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,UHC Medicare,UHC Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
INTERLEUKIN 6                 ,38203721,CDM,300,RC,83520,CPT,,,,Inpatient,,,231.75,231.75,Wellcare,Wellcare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health PPO CPD,Meritain Health PPO CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Aetna/Commercial Product,Aetna/Commercial Product,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health CPD,Meritain Health CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Starmark CPD,Starmark CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Aetna Medicare,Aetna Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Ambetter ,Ambetter ,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access,Anthem Blue Access,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access Choice,Anthem Blue Access Choice,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Preferred,Anthem Blue Preferred,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Pathway,Anthem Pathway,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Alliance,Anthem Alliance,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Anthem Medicare,Anthem Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Cigna,Cigna,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Cigna PPO,Cigna PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Cigna Medicare Advantage,Cigna Medicare Advantage,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Essence,Essence,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Healthlink HMO,Healthlink HMO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Healthlink PPO,Healthlink PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,HomeState Health Plan,HomeState Health Plan,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Humana Gold,Humana Gold,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Medicaid MO,Medicaid MO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Medica,Medica,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Tricare,Tricare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,UHC All Payer,UHC All Payer,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,UHC Exchange,UHC Exchange,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicaid,UHC Medicaid,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,UMR CPD,UMR CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicare,UHC Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38203723,CDM,306,RC,87209,CPT,,,,Inpatient,,,116.7,116.7,Wellcare,Wellcare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Meritain Health PPO CPD,Meritain Health PPO CPD,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Aetna/Commercial Product,Aetna/Commercial Product,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Meritain Health CPD,Meritain Health CPD,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Starmark CPD,Starmark CPD,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Aetna Medicare,Aetna Medicare,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Ambetter ,Ambetter ,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Blue Access,Anthem Blue Access,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Blue Access Choice,Anthem Blue Access Choice,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Blue Preferred,Anthem Blue Preferred,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Pathway,Anthem Pathway,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Alliance,Anthem Alliance,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Anthem Medicare,Anthem Medicare,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Cigna,Cigna,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Cigna PPO,Cigna PPO,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Cigna Medicare Advantage,Cigna Medicare Advantage,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Essence,Essence,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Healthlink HMO,Healthlink HMO,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Healthlink PPO,Healthlink PPO,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,HomeState Health Plan,HomeState Health Plan,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Humana Gold,Humana Gold,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Medicaid MO,Medicaid MO,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Medica,Medica,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Tricare,Tricare,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,UHC All Payer,UHC All Payer,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,UHC Exchange,UHC Exchange,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,UHC Medicaid,UHC Medicaid,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,UMR CPD,UMR CPD,270,,,,,,,per diem,270,270,"Per diem rate, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,UHC Medicare,UHC Medicare,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
KOH PREP-HAIR-SKIN-NAILS      ,38203725,CDM,306,RC,87220,CPT,,,,Inpatient,,,270,270,Wellcare,Wellcare,270,,,,,,,case rate,270,270,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Meritain Health PPO CPD,Meritain Health PPO CPD,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Aetna/Commercial Product,Aetna/Commercial Product,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Meritain Health CPD,Meritain Health CPD,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Starmark CPD,Starmark CPD,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Aetna Medicare,Aetna Medicare,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Ambetter ,Ambetter ,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Blue Access,Anthem Blue Access,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Blue Access Choice,Anthem Blue Access Choice,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Blue Preferred,Anthem Blue Preferred,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Pathway,Anthem Pathway,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Alliance,Anthem Alliance,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Anthem Medicare,Anthem Medicare,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Cigna,Cigna,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Cigna PPO,Cigna PPO,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Cigna Medicare Advantage,Cigna Medicare Advantage,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Essence,Essence,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Healthlink HMO,Healthlink HMO,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Healthlink PPO,Healthlink PPO,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,HomeState Health Plan,HomeState Health Plan,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Humana Gold,Humana Gold,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Medicaid MO,Medicaid MO,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Medica,Medica,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Tricare,Tricare,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,UHC All Payer,UHC All Payer,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,UHC Exchange,UHC Exchange,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,UHC Medicaid,UHC Medicaid,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,UMR CPD,UMR CPD,53.88,,,,,,,per diem,53.88,53.88,"Per diem rate, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,UHC Medicare,UHC Medicare,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
OCCULT BLOOD- OTHER SOURCES   ,38203736,CDM,301,RC,82271,CPT,,,,Inpatient,,,53.88,53.88,Wellcare,Wellcare,53.88,,,,,,,case rate,53.88,53.88,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Meritain Health PPO CPD,Meritain Health PPO CPD,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Aetna/Commercial Product,Aetna/Commercial Product,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Meritain Health CPD,Meritain Health CPD,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Starmark CPD,Starmark CPD,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Aetna Medicare,Aetna Medicare,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Ambetter ,Ambetter ,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Blue Access,Anthem Blue Access,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Blue Access Choice,Anthem Blue Access Choice,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Blue Preferred,Anthem Blue Preferred,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Pathway,Anthem Pathway,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Alliance,Anthem Alliance,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Anthem Medicare,Anthem Medicare,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Cigna,Cigna,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Cigna PPO,Cigna PPO,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Cigna Medicare Advantage,Cigna Medicare Advantage,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Essence,Essence,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Healthlink HMO,Healthlink HMO,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Healthlink PPO,Healthlink PPO,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,HomeState Health Plan,HomeState Health Plan,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Humana Gold,Humana Gold,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Medicaid MO,Medicaid MO,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Medica,Medica,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Tricare,Tricare,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,UHC All Payer,UHC All Payer,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,UHC Exchange,UHC Exchange,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,UHC Medicaid,UHC Medicaid,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,UMR CPD,UMR CPD,162.09,,,,,,,per diem,162.09,162.09,"Per diem rate, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,UHC Medicare,UHC Medicare,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
PLASMA HEMOGLOBIN             ,38203737,CDM,301,RC,83051,CPT,,,,Inpatient,,,162.09,162.09,Wellcare,Wellcare,162.09,,,,,,,case rate,162.09,162.09,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Meritain Health PPO CPD,Meritain Health PPO CPD,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Aetna/Commercial Product,Aetna/Commercial Product,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Meritain Health CPD,Meritain Health CPD,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Starmark CPD,Starmark CPD,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Aetna Medicare,Aetna Medicare,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Ambetter ,Ambetter ,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Blue Access,Anthem Blue Access,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Blue Access Choice,Anthem Blue Access Choice,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Blue Preferred,Anthem Blue Preferred,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Pathway,Anthem Pathway,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Alliance,Anthem Alliance,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Anthem Medicare,Anthem Medicare,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Cigna,Cigna,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Cigna PPO,Cigna PPO,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Cigna Medicare Advantage,Cigna Medicare Advantage,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Essence,Essence,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Healthlink HMO,Healthlink HMO,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Healthlink PPO,Healthlink PPO,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,HomeState Health Plan,HomeState Health Plan,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Humana Gold,Humana Gold,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Medicaid MO,Medicaid MO,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Medica,Medica,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Tricare,Tricare,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,UHC All Payer,UHC All Payer,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,UHC Exchange,UHC Exchange,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,UHC Medicaid,UHC Medicaid,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,UMR CPD,UMR CPD,285.9,,,,,,,per diem,285.9,285.9,"Per diem rate, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,UHC Medicare,UHC Medicare,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
METHYLMALONIC ACID            ,38203741,CDM,301,RC,83921,CPT,,,,Inpatient,,,285.9,285.9,Wellcare,Wellcare,285.9,,,,,,,case rate,285.9,285.9,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health PPO CPD,Meritain Health PPO CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna/Commercial Product,Aetna/Commercial Product,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health CPD,Meritain Health CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Starmark CPD,Starmark CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Aetna Medicare,Aetna Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Ambetter ,Ambetter ,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access,Anthem Blue Access,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access Choice,Anthem Blue Access Choice,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Preferred,Anthem Blue Preferred,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Pathway,Anthem Pathway,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Alliance,Anthem Alliance,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Anthem Medicare,Anthem Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna,Cigna,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna PPO,Cigna PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Cigna Medicare Advantage,Cigna Medicare Advantage,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Essence,Essence,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthlink HMO,Healthlink HMO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Healthlink PPO,Healthlink PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,HomeState Health Plan,HomeState Health Plan,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Humana Gold,Humana Gold,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Medicaid MO,Medicaid MO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Medica,Medica,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Tricare,Tricare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC All Payer,UHC All Payer,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Exchange,UHC Exchange,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicaid,UHC Medicaid,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UMR CPD,UMR CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicare,UHC Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
FUNGUS/YEAST IDENTIFICATION   ,38203747,CDM,306,RC,87106,CPT,,,,Inpatient,,,102.91,102.91,Wellcare,Wellcare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
EOS SMEAR (URINE)             ,38203753,CDM,300,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
"POTASSIUM, STOOL              ",38203758,CDM,301,RC,84999,CPT,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Meritain Health PPO CPD,Meritain Health PPO CPD,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Aetna/Commercial Product,Aetna/Commercial Product,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Meritain Health CPD,Meritain Health CPD,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Starmark CPD,Starmark CPD,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Aetna Medicare,Aetna Medicare,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Ambetter ,Ambetter ,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Blue Access,Anthem Blue Access,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Blue Access Choice,Anthem Blue Access Choice,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Blue Preferred,Anthem Blue Preferred,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Pathway,Anthem Pathway,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Alliance,Anthem Alliance,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Anthem Medicare,Anthem Medicare,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Cigna,Cigna,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Cigna PPO,Cigna PPO,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Cigna Medicare Advantage,Cigna Medicare Advantage,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Essence,Essence,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Healthlink HMO,Healthlink HMO,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Healthlink PPO,Healthlink PPO,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,HomeState Health Plan,HomeState Health Plan,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Humana Gold,Humana Gold,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Medicaid MO,Medicaid MO,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Medica,Medica,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Tricare,Tricare,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,UHC All Payer,UHC All Payer,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,UHC Exchange,UHC Exchange,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,UHC Medicaid,UHC Medicaid,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,UMR CPD,UMR CPD,325.89,,,,,,,per diem,325.89,325.89,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,UHC Medicare,UHC Medicare,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XII           ,38203766,CDM,305,RC,85280,CPT,,,,Inpatient,,,325.89,325.89,Wellcare,Wellcare,325.89,,,,,,,case rate,325.89,325.89,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Meritain Health PPO CPD,Meritain Health PPO CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Aetna/Commercial Product,Aetna/Commercial Product,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Meritain Health CPD,Meritain Health CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Starmark CPD,Starmark CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Aetna Medicare,Aetna Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Ambetter ,Ambetter ,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Access,Anthem Blue Access,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Access Choice,Anthem Blue Access Choice,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Preferred,Anthem Blue Preferred,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Pathway,Anthem Pathway,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Alliance,Anthem Alliance,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Anthem Medicare,Anthem Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Cigna,Cigna,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Cigna PPO,Cigna PPO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Cigna Medicare Advantage,Cigna Medicare Advantage,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Essence,Essence,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Healthlink HMO,Healthlink HMO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Healthlink PPO,Healthlink PPO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,HomeState Health Plan,HomeState Health Plan,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Humana Gold,Humana Gold,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Medicaid MO,Medicaid MO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Medica,Medica,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Tricare,Tricare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,UHC All Payer,UHC All Payer,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,UHC Exchange,UHC Exchange,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,UHC Medicaid,UHC Medicaid,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,UMR CPD,UMR CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,UHC Medicare,UHC Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XI            ,38203767,CDM,305,RC,85270,CPT,,,,Inpatient,,,336.19,336.19,Wellcare,Wellcare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Meritain Health PPO CPD,Meritain Health PPO CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Aetna/Commercial Product,Aetna/Commercial Product,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Meritain Health CPD,Meritain Health CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Starmark CPD,Starmark CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Aetna Medicare,Aetna Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Ambetter ,Ambetter ,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Blue Access,Anthem Blue Access,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Blue Access Choice,Anthem Blue Access Choice,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Blue Preferred,Anthem Blue Preferred,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Pathway,Anthem Pathway,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Alliance,Anthem Alliance,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Anthem Medicare,Anthem Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Cigna,Cigna,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Cigna PPO,Cigna PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Cigna Medicare Advantage,Cigna Medicare Advantage,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Essence,Essence,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Healthlink HMO,Healthlink HMO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Healthlink PPO,Healthlink PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,HomeState Health Plan,HomeState Health Plan,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Humana Gold,Humana Gold,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Medicaid MO,Medicaid MO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Medica,Medica,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Tricare,Tricare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,UHC All Payer,UHC All Payer,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,UHC Exchange,UHC Exchange,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,UHC Medicaid,UHC Medicaid,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,UMR CPD,UMR CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,UHC Medicare,UHC Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR IX            ,38203769,CDM,305,RC,85250,CPT,,,,Inpatient,,,489.58,489.58,Wellcare,Wellcare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Meritain Health PPO CPD,Meritain Health PPO CPD,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Aetna/Commercial Product,Aetna/Commercial Product,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Meritain Health CPD,Meritain Health CPD,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Starmark CPD,Starmark CPD,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Aetna Medicare,Aetna Medicare,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Ambetter ,Ambetter ,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Blue Access,Anthem Blue Access,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Blue Access Choice,Anthem Blue Access Choice,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Blue Preferred,Anthem Blue Preferred,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Pathway,Anthem Pathway,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Alliance,Anthem Alliance,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Anthem Medicare,Anthem Medicare,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Cigna,Cigna,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Cigna PPO,Cigna PPO,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Cigna Medicare Advantage,Cigna Medicare Advantage,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Essence,Essence,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Healthlink HMO,Healthlink HMO,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Healthlink PPO,Healthlink PPO,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,HomeState Health Plan,HomeState Health Plan,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Humana Gold,Humana Gold,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Medicaid MO,Medicaid MO,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Medica,Medica,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Tricare,Tricare,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,UHC All Payer,UHC All Payer,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,UHC Exchange,UHC Exchange,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,UHC Medicaid,UHC Medicaid,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,UMR CPD,UMR CPD,166.77,,,,,,,per diem,166.77,166.77,"Per diem rate, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,UHC Medicare,UHC Medicare,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
CRYSTAL IDENTIFICATION        ,38203771,CDM,300,RC,89060,CPT,,,,Inpatient,,,166.77,166.77,Wellcare,Wellcare,166.77,,,,,,,case rate,166.77,166.77,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Meritain Health PPO CPD,Meritain Health PPO CPD,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Aetna/Commercial Product,Aetna/Commercial Product,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Meritain Health CPD,Meritain Health CPD,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Starmark CPD,Starmark CPD,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Aetna Medicare,Aetna Medicare,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Ambetter ,Ambetter ,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Blue Access,Anthem Blue Access,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Blue Access Choice,Anthem Blue Access Choice,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Blue Preferred,Anthem Blue Preferred,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Pathway,Anthem Pathway,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Alliance,Anthem Alliance,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Anthem Medicare,Anthem Medicare,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Cigna,Cigna,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Cigna PPO,Cigna PPO,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Cigna Medicare Advantage,Cigna Medicare Advantage,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Essence,Essence,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Healthlink HMO,Healthlink HMO,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Healthlink PPO,Healthlink PPO,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,HomeState Health Plan,HomeState Health Plan,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Humana Gold,Humana Gold,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Medicaid MO,Medicaid MO,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Medica,Medica,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Tricare,Tricare,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,UHC All Payer,UHC All Payer,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,UHC Exchange,UHC Exchange,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,UHC Medicaid,UHC Medicaid,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,UMR CPD,UMR CPD,255.31,,,,,,,per diem,255.31,255.31,"Per diem rate, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,UHC Medicare,UHC Medicare,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
HEPARIN INDUCED ANTIBODY      ,38203776,CDM,302,RC,86022,CPT,,,,Inpatient,,,255.31,255.31,Wellcare,Wellcare,255.31,,,,,,,case rate,255.31,255.31,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Meritain Health PPO CPD,Meritain Health PPO CPD,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Aetna/Commercial Product,Aetna/Commercial Product,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Meritain Health CPD,Meritain Health CPD,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Starmark CPD,Starmark CPD,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Aetna Medicare,Aetna Medicare,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Ambetter ,Ambetter ,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Blue Access,Anthem Blue Access,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Blue Access Choice,Anthem Blue Access Choice,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Blue Preferred,Anthem Blue Preferred,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Pathway,Anthem Pathway,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Alliance,Anthem Alliance,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Anthem Medicare,Anthem Medicare,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Cigna,Cigna,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Cigna PPO,Cigna PPO,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Cigna Medicare Advantage,Cigna Medicare Advantage,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Essence,Essence,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Healthlink HMO,Healthlink HMO,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Healthlink PPO,Healthlink PPO,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,HomeState Health Plan,HomeState Health Plan,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Humana Gold,Humana Gold,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Medicaid MO,Medicaid MO,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Medica,Medica,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Tricare,Tricare,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,UHC All Payer,UHC All Payer,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,UHC Exchange,UHC Exchange,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,UHC Medicaid,UHC Medicaid,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,UMR CPD,UMR CPD,142.89,,,,,,,per diem,142.89,142.89,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,UHC Medicare,UHC Medicare,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38203777,CDM,301,RC,82042,CPT,,,,Inpatient,,,142.89,142.89,Wellcare,Wellcare,142.89,,,,,,,case rate,142.89,142.89,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Meritain Health PPO CPD,Meritain Health PPO CPD,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Aetna/Commercial Product,Aetna/Commercial Product,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Meritain Health CPD,Meritain Health CPD,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Starmark CPD,Starmark CPD,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Aetna Medicare,Aetna Medicare,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Ambetter ,Ambetter ,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Blue Access,Anthem Blue Access,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Blue Access Choice,Anthem Blue Access Choice,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Blue Preferred,Anthem Blue Preferred,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Pathway,Anthem Pathway,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Alliance,Anthem Alliance,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Anthem Medicare,Anthem Medicare,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Cigna,Cigna,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Cigna PPO,Cigna PPO,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Cigna Medicare Advantage,Cigna Medicare Advantage,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Essence,Essence,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Healthlink HMO,Healthlink HMO,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Healthlink PPO,Healthlink PPO,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,HomeState Health Plan,HomeState Health Plan,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Humana Gold,Humana Gold,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Medicaid MO,Medicaid MO,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Medica,Medica,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Tricare,Tricare,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,UHC All Payer,UHC All Payer,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,UHC Exchange,UHC Exchange,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,UHC Medicaid,UHC Medicaid,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,UMR CPD,UMR CPD,339.77,,,,,,,per diem,339.77,339.77,"Per diem rate, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,UHC Medicare,UHC Medicare,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
HIV WESTERN BLOT              ,38203779,CDM,302,RC,86689,CPT,,,,Inpatient,,,339.77,339.77,Wellcare,Wellcare,339.77,,,,,,,case rate,339.77,339.77,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Meritain Health PPO CPD,Meritain Health PPO CPD,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Aetna/Commercial Product,Aetna/Commercial Product,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Meritain Health CPD,Meritain Health CPD,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Starmark CPD,Starmark CPD,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Aetna Medicare,Aetna Medicare,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Ambetter ,Ambetter ,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Blue Access,Anthem Blue Access,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Blue Access Choice,Anthem Blue Access Choice,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Blue Preferred,Anthem Blue Preferred,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Pathway,Anthem Pathway,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Alliance,Anthem Alliance,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Anthem Medicare,Anthem Medicare,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Cigna,Cigna,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Cigna PPO,Cigna PPO,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Cigna Medicare Advantage,Cigna Medicare Advantage,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Essence,Essence,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Healthlink HMO,Healthlink HMO,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Healthlink PPO,Healthlink PPO,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,HomeState Health Plan,HomeState Health Plan,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Humana Gold,Humana Gold,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Medicaid MO,Medicaid MO,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Medica,Medica,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Tricare,Tricare,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,UHC All Payer,UHC All Payer,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,UHC Exchange,UHC Exchange,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,UHC Medicaid,UHC Medicaid,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,UMR CPD,UMR CPD,200.79,,,,,,,per diem,200.79,200.79,"Per diem rate, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,UHC Medicare,UHC Medicare,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AB EXTRACT NUC ANTIGEN, EACH  ",38203804,CDM,302,RC,86235,CPT,,,,Inpatient,,,200.79,200.79,Wellcare,Wellcare,200.79,,,,,,,case rate,200.79,200.79,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Meritain Health PPO CPD,Meritain Health PPO CPD,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Aetna/Commercial Product,Aetna/Commercial Product,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Meritain Health CPD,Meritain Health CPD,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Starmark CPD,Starmark CPD,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Aetna Medicare,Aetna Medicare,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Ambetter ,Ambetter ,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Blue Access,Anthem Blue Access,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Blue Access Choice,Anthem Blue Access Choice,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Blue Preferred,Anthem Blue Preferred,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Pathway,Anthem Pathway,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Alliance,Anthem Alliance,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Anthem Medicare,Anthem Medicare,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Cigna,Cigna,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Cigna PPO,Cigna PPO,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Cigna Medicare Advantage,Cigna Medicare Advantage,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Essence,Essence,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Healthlink HMO,Healthlink HMO,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Healthlink PPO,Healthlink PPO,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,HomeState Health Plan,HomeState Health Plan,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Humana Gold,Humana Gold,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Medicaid MO,Medicaid MO,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Medica,Medica,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Tricare,Tricare,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,UHC All Payer,UHC All Payer,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,UHC Exchange,UHC Exchange,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,UHC Medicaid,UHC Medicaid,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,UMR CPD,UMR CPD,277.07,,,,,,,per diem,277.07,277.07,"Per diem rate, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,UHC Medicare,UHC Medicare,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
"AMINO ACID QUANT, EA          ",38203806,CDM,301,RC,82131,CPT,,,,Inpatient,,,277.07,277.07,Wellcare,Wellcare,277.07,,,,,,,case rate,277.07,277.07,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Meritain Health PPO CPD,Meritain Health PPO CPD,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Aetna/Commercial Product,Aetna/Commercial Product,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Meritain Health CPD,Meritain Health CPD,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Starmark CPD,Starmark CPD,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Aetna Medicare,Aetna Medicare,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Ambetter ,Ambetter ,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Blue Access,Anthem Blue Access,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Blue Access Choice,Anthem Blue Access Choice,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Blue Preferred,Anthem Blue Preferred,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Pathway,Anthem Pathway,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Alliance,Anthem Alliance,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Anthem Medicare,Anthem Medicare,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Cigna,Cigna,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Cigna PPO,Cigna PPO,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Cigna Medicare Advantage,Cigna Medicare Advantage,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Essence,Essence,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Healthlink HMO,Healthlink HMO,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Healthlink PPO,Healthlink PPO,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,HomeState Health Plan,HomeState Health Plan,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Humana Gold,Humana Gold,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Medicaid MO,Medicaid MO,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Medica,Medica,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Tricare,Tricare,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,UHC All Payer,UHC All Payer,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,UHC Exchange,UHC Exchange,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,UHC Medicaid,UHC Medicaid,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,UMR CPD,UMR CPD,74.13,,,,,,,per diem,74.13,74.13,"Per diem rate, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,UHC Medicare,UHC Medicare,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CALCULUS (STONE) SPECTROSCOPY ,38203812,CDM,301,RC,82365,CPT,,,,Inpatient,,,74.13,74.13,Wellcare,Wellcare,74.13,,,,,,,case rate,74.13,74.13,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Meritain Health PPO CPD,Meritain Health PPO CPD,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Aetna/Commercial Product,Aetna/Commercial Product,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Meritain Health CPD,Meritain Health CPD,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Starmark CPD,Starmark CPD,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Aetna Medicare,Aetna Medicare,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Ambetter ,Ambetter ,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Blue Access,Anthem Blue Access,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Blue Access Choice,Anthem Blue Access Choice,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Blue Preferred,Anthem Blue Preferred,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Pathway,Anthem Pathway,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Alliance,Anthem Alliance,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Anthem Medicare,Anthem Medicare,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Cigna,Cigna,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Cigna PPO,Cigna PPO,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Cigna Medicare Advantage,Cigna Medicare Advantage,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Essence,Essence,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Healthlink HMO,Healthlink HMO,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Healthlink PPO,Healthlink PPO,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,HomeState Health Plan,HomeState Health Plan,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Humana Gold,Humana Gold,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Medicaid MO,Medicaid MO,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Medica,Medica,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Tricare,Tricare,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,UHC All Payer,UHC All Payer,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,UHC Exchange,UHC Exchange,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,UHC Medicaid,UHC Medicaid,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,UMR CPD,UMR CPD,385.57,,,,,,,per diem,385.57,385.57,"Per diem rate, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,UHC Medicare,UHC Medicare,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
CYANIDE                       ,38203813,CDM,301,RC,82600,CPT,,,,Inpatient,,,385.57,385.57,Wellcare,Wellcare,385.57,,,,,,,case rate,385.57,385.57,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Meritain Health PPO CPD,Meritain Health PPO CPD,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Aetna/Commercial Product,Aetna/Commercial Product,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Meritain Health CPD,Meritain Health CPD,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Starmark CPD,Starmark CPD,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Aetna Medicare,Aetna Medicare,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Ambetter ,Ambetter ,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Blue Access,Anthem Blue Access,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Blue Access Choice,Anthem Blue Access Choice,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Blue Preferred,Anthem Blue Preferred,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Pathway,Anthem Pathway,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Alliance,Anthem Alliance,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Anthem Medicare,Anthem Medicare,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Cigna,Cigna,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Cigna PPO,Cigna PPO,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Cigna Medicare Advantage,Cigna Medicare Advantage,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Essence,Essence,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Healthlink HMO,Healthlink HMO,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Healthlink PPO,Healthlink PPO,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,HomeState Health Plan,HomeState Health Plan,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Humana Gold,Humana Gold,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Medicaid MO,Medicaid MO,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Medica,Medica,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Tricare,Tricare,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,UHC All Payer,UHC All Payer,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,UHC Exchange,UHC Exchange,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,UHC Medicaid,UHC Medicaid,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,UMR CPD,UMR CPD,160.75,,,,,,,per diem,160.75,160.75,"Per diem rate, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,UHC Medicare,UHC Medicare,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
MICROHEMATOCRIT-SPUN          ,38203819,CDM,305,RC,85013,CPT,,,,Inpatient,,,160.75,160.75,Wellcare,Wellcare,160.75,,,,,,,case rate,160.75,160.75,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Meritain Health PPO CPD,Meritain Health PPO CPD,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Aetna/Commercial Product,Aetna/Commercial Product,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Meritain Health CPD,Meritain Health CPD,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Starmark CPD,Starmark CPD,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Aetna Medicare,Aetna Medicare,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Ambetter ,Ambetter ,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Blue Access,Anthem Blue Access,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Blue Access Choice,Anthem Blue Access Choice,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Blue Preferred,Anthem Blue Preferred,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Pathway,Anthem Pathway,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Alliance,Anthem Alliance,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Anthem Medicare,Anthem Medicare,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Cigna,Cigna,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Cigna PPO,Cigna PPO,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Cigna Medicare Advantage,Cigna Medicare Advantage,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Essence,Essence,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Healthlink HMO,Healthlink HMO,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Healthlink PPO,Healthlink PPO,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,HomeState Health Plan,HomeState Health Plan,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Humana Gold,Humana Gold,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Medicaid MO,Medicaid MO,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Medica,Medica,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Tricare,Tricare,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,UHC All Payer,UHC All Payer,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,UHC Exchange,UHC Exchange,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,UHC Medicaid,UHC Medicaid,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,UMR CPD,UMR CPD,284.28,,,,,,,per diem,284.28,284.28,"Per diem rate, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,UHC Medicare,UHC Medicare,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
IMMUNOASSAY NONANTIBODY       ,38203825,CDM,301,RC,83520,CPT,,,,Inpatient,,,284.28,284.28,Wellcare,Wellcare,284.28,,,,,,,case rate,284.28,284.28,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
H.PYLORI RAPID UREASE TEST    ,38203856,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Meritain Health PPO CPD,Meritain Health PPO CPD,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Aetna/Commercial Product,Aetna/Commercial Product,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Meritain Health CPD,Meritain Health CPD,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Starmark CPD,Starmark CPD,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Aetna Medicare,Aetna Medicare,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Ambetter ,Ambetter ,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Blue Access,Anthem Blue Access,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Blue Access Choice,Anthem Blue Access Choice,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Blue Preferred,Anthem Blue Preferred,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Pathway,Anthem Pathway,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Alliance,Anthem Alliance,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Anthem Medicare,Anthem Medicare,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Cigna,Cigna,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Cigna PPO,Cigna PPO,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Cigna Medicare Advantage,Cigna Medicare Advantage,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Essence,Essence,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Healthlink HMO,Healthlink HMO,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Healthlink PPO,Healthlink PPO,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,HomeState Health Plan,HomeState Health Plan,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Humana Gold,Humana Gold,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Medicaid MO,Medicaid MO,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Medica,Medica,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Tricare,Tricare,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,UHC All Payer,UHC All Payer,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,UHC Exchange,UHC Exchange,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,UHC Medicaid,UHC Medicaid,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,UMR CPD,UMR CPD,47.63,,,,,,,per diem,47.63,47.63,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,UHC Medicare,UHC Medicare,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-SERUM     ,38203860,CDM,300,RC,84165,CPT,,,,Inpatient,,,47.63,47.63,Wellcare,Wellcare,47.63,,,,,,,case rate,47.63,47.63,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Meritain Health PPO CPD,Meritain Health PPO CPD,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Aetna/Commercial Product,Aetna/Commercial Product,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Meritain Health CPD,Meritain Health CPD,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Starmark CPD,Starmark CPD,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Aetna Medicare,Aetna Medicare,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Ambetter ,Ambetter ,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Blue Access,Anthem Blue Access,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Blue Access Choice,Anthem Blue Access Choice,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Blue Preferred,Anthem Blue Preferred,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Pathway,Anthem Pathway,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Alliance,Anthem Alliance,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Anthem Medicare,Anthem Medicare,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Cigna,Cigna,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Cigna PPO,Cigna PPO,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Cigna Medicare Advantage,Cigna Medicare Advantage,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Essence,Essence,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Healthlink HMO,Healthlink HMO,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Healthlink PPO,Healthlink PPO,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,HomeState Health Plan,HomeState Health Plan,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Humana Gold,Humana Gold,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Medicaid MO,Medicaid MO,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Medica,Medica,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Tricare,Tricare,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,UHC All Payer,UHC All Payer,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,UHC Exchange,UHC Exchange,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,UHC Medicaid,UHC Medicaid,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,UMR CPD,UMR CPD,201.57,,,,,,,per diem,201.57,201.57,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,UHC Medicare,UHC Medicare,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38203865,CDM,300,RC,84166,CPT,,,,Inpatient,,,201.57,201.57,Wellcare,Wellcare,201.57,,,,,,,case rate,201.57,201.57,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Meritain Health PPO CPD,Meritain Health PPO CPD,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Aetna/Commercial Product,Aetna/Commercial Product,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Meritain Health CPD,Meritain Health CPD,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Starmark CPD,Starmark CPD,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Aetna Medicare,Aetna Medicare,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Ambetter ,Ambetter ,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Blue Access,Anthem Blue Access,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Blue Access Choice,Anthem Blue Access Choice,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Blue Preferred,Anthem Blue Preferred,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Pathway,Anthem Pathway,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Alliance,Anthem Alliance,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Anthem Medicare,Anthem Medicare,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Cigna,Cigna,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Cigna PPO,Cigna PPO,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Cigna Medicare Advantage,Cigna Medicare Advantage,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Essence,Essence,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Healthlink HMO,Healthlink HMO,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Healthlink PPO,Healthlink PPO,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,HomeState Health Plan,HomeState Health Plan,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Humana Gold,Humana Gold,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Medicaid MO,Medicaid MO,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Medica,Medica,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Tricare,Tricare,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,UHC All Payer,UHC All Payer,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,UHC Exchange,UHC Exchange,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,UHC Medicaid,UHC Medicaid,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,UMR CPD,UMR CPD,68.94,,,,,,,per diem,68.94,68.94,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,UHC Medicare,UHC Medicare,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-SERUM   ,38203870,CDM,300,RC,86334,CPT,,,,Inpatient,,,68.94,68.94,Wellcare,Wellcare,68.94,,,,,,,case rate,68.94,68.94,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Meritain Health PPO CPD,Meritain Health PPO CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Aetna/Commercial Product,Aetna/Commercial Product,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Meritain Health CPD,Meritain Health CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Starmark CPD,Starmark CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Aetna Medicare,Aetna Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Ambetter ,Ambetter ,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Access,Anthem Blue Access,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Access Choice,Anthem Blue Access Choice,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Blue Preferred,Anthem Blue Preferred,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Pathway,Anthem Pathway,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Alliance,Anthem Alliance,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Anthem Medicare,Anthem Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Cigna,Cigna,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Cigna PPO,Cigna PPO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Cigna Medicare Advantage,Cigna Medicare Advantage,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Essence,Essence,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Healthlink HMO,Healthlink HMO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Healthlink PPO,Healthlink PPO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,HomeState Health Plan,HomeState Health Plan,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Humana Gold,Humana Gold,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Medicaid MO,Medicaid MO,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Medica,Medica,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Tricare,Tricare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,UHC All Payer,UHC All Payer,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,UHC Exchange,UHC Exchange,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,UHC Medicaid,UHC Medicaid,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,UMR CPD,UMR CPD,263.1,,,,,,,per diem,263.1,263.1,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,UHC Medicare,UHC Medicare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38203875,CDM,300,RC,86335,CPT,,,,Inpatient,,,263.1,263.1,Wellcare,Wellcare,263.1,,,,,,,case rate,263.1,263.1,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Meritain Health PPO CPD,Meritain Health PPO CPD,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Aetna/Commercial Product,Aetna/Commercial Product,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Meritain Health CPD,Meritain Health CPD,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Starmark CPD,Starmark CPD,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Aetna Medicare,Aetna Medicare,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Ambetter ,Ambetter ,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Blue Access,Anthem Blue Access,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Blue Access Choice,Anthem Blue Access Choice,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Blue Preferred,Anthem Blue Preferred,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Pathway,Anthem Pathway,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Alliance,Anthem Alliance,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Anthem Medicare,Anthem Medicare,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Cigna,Cigna,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Cigna PPO,Cigna PPO,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Cigna Medicare Advantage,Cigna Medicare Advantage,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Essence,Essence,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Healthlink HMO,Healthlink HMO,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Healthlink PPO,Healthlink PPO,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,HomeState Health Plan,HomeState Health Plan,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Humana Gold,Humana Gold,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Medicaid MO,Medicaid MO,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Medica,Medica,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Tricare,Tricare,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,UHC All Payer,UHC All Payer,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,UHC Exchange,UHC Exchange,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,UHC Medicaid,UHC Medicaid,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,UMR CPD,UMR CPD,269.47,,,,,,,per diem,269.47,269.47,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,UHC Medicare,UHC Medicare,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38203885,CDM,301,RC,82542,CPT,,,,Inpatient,,,269.47,269.47,Wellcare,Wellcare,269.47,,,,,,,case rate,269.47,269.47,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Meritain Health PPO CPD,Meritain Health PPO CPD,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Aetna/Commercial Product,Aetna/Commercial Product,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Meritain Health CPD,Meritain Health CPD,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Starmark CPD,Starmark CPD,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Aetna Medicare,Aetna Medicare,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Ambetter ,Ambetter ,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Blue Access,Anthem Blue Access,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Blue Access Choice,Anthem Blue Access Choice,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Blue Preferred,Anthem Blue Preferred,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Pathway,Anthem Pathway,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Alliance,Anthem Alliance,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Anthem Medicare,Anthem Medicare,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Cigna,Cigna,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Cigna PPO,Cigna PPO,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Cigna Medicare Advantage,Cigna Medicare Advantage,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Essence,Essence,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Healthlink HMO,Healthlink HMO,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Healthlink PPO,Healthlink PPO,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,HomeState Health Plan,HomeState Health Plan,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Humana Gold,Humana Gold,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Medicaid MO,Medicaid MO,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Medica,Medica,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Tricare,Tricare,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,UHC All Payer,UHC All Payer,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,UHC Exchange,UHC Exchange,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,UHC Medicaid,UHC Medicaid,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,UMR CPD,UMR CPD,86.28,,,,,,,per diem,86.28,86.28,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,UHC Medicare,UHC Medicare,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38203890,CDM,302,RC,86665,CPT,,,,Inpatient,,,86.28,86.28,Wellcare,Wellcare,86.28,,,,,,,case rate,86.28,86.28,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Meritain Health PPO CPD,Meritain Health PPO CPD,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Aetna/Commercial Product,Aetna/Commercial Product,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Meritain Health CPD,Meritain Health CPD,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Starmark CPD,Starmark CPD,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Aetna Medicare,Aetna Medicare,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Ambetter ,Ambetter ,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Blue Access,Anthem Blue Access,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Blue Access Choice,Anthem Blue Access Choice,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Blue Preferred,Anthem Blue Preferred,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Pathway,Anthem Pathway,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Alliance,Anthem Alliance,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Anthem Medicare,Anthem Medicare,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Cigna,Cigna,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Cigna PPO,Cigna PPO,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Cigna Medicare Advantage,Cigna Medicare Advantage,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Essence,Essence,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Healthlink HMO,Healthlink HMO,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Healthlink PPO,Healthlink PPO,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,HomeState Health Plan,HomeState Health Plan,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Humana Gold,Humana Gold,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Medicaid MO,Medicaid MO,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Medica,Medica,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Tricare,Tricare,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,UHC All Payer,UHC All Payer,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,UHC Exchange,UHC Exchange,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,UHC Medicaid,UHC Medicaid,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,UMR CPD,UMR CPD,284.97,,,,,,,per diem,284.97,284.97,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,UHC Medicare,UHC Medicare,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38203895,CDM,306,RC,87497,CPT,,,,Inpatient,,,284.97,284.97,Wellcare,Wellcare,284.97,,,,,,,case rate,284.97,284.97,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CARBIDOPA                     ,38203900,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Meritain Health PPO CPD,Meritain Health PPO CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Aetna/Commercial Product,Aetna/Commercial Product,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Meritain Health CPD,Meritain Health CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Starmark CPD,Starmark CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Aetna Medicare,Aetna Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Ambetter ,Ambetter ,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Access,Anthem Blue Access,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Access Choice,Anthem Blue Access Choice,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Blue Preferred,Anthem Blue Preferred,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Pathway,Anthem Pathway,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Alliance,Anthem Alliance,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Anthem Medicare,Anthem Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Cigna,Cigna,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Cigna PPO,Cigna PPO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Cigna Medicare Advantage,Cigna Medicare Advantage,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Essence,Essence,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Healthlink HMO,Healthlink HMO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Healthlink PPO,Healthlink PPO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,HomeState Health Plan,HomeState Health Plan,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Humana Gold,Humana Gold,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Medicaid MO,Medicaid MO,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Medica,Medica,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Tricare,Tricare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,UHC All Payer,UHC All Payer,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,UHC Exchange,UHC Exchange,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,UHC Medicaid,UHC Medicaid,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,UMR CPD,UMR CPD,93.36,,,,,,,per diem,93.36,93.36,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,UHC Medicare,UHC Medicare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38203910,CDM,302,RC,86921,CPT,,,,Inpatient,,,93.36,93.36,Wellcare,Wellcare,93.36,,,,,,,case rate,93.36,93.36,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Meritain Health PPO CPD,Meritain Health PPO CPD,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Aetna/Commercial Product,Aetna/Commercial Product,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Meritain Health CPD,Meritain Health CPD,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Starmark CPD,Starmark CPD,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Aetna Medicare,Aetna Medicare,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Ambetter ,Ambetter ,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Blue Access,Anthem Blue Access,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Blue Access Choice,Anthem Blue Access Choice,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Blue Preferred,Anthem Blue Preferred,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Pathway,Anthem Pathway,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Alliance,Anthem Alliance,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Anthem Medicare,Anthem Medicare,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Cigna,Cigna,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Cigna PPO,Cigna PPO,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Cigna Medicare Advantage,Cigna Medicare Advantage,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Essence,Essence,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Healthlink HMO,Healthlink HMO,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Healthlink PPO,Healthlink PPO,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,HomeState Health Plan,HomeState Health Plan,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Humana Gold,Humana Gold,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Medicaid MO,Medicaid MO,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Medica,Medica,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Tricare,Tricare,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,UHC All Payer,UHC All Payer,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,UHC Exchange,UHC Exchange,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,UHC Medicaid,UHC Medicaid,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,UMR CPD,UMR CPD,98.37,,,,,,,per diem,98.37,98.37,"Per diem rate, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,UHC Medicare,UHC Medicare,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
D-DIMER SEMI QUANT            ,38204121,CDM,305,RC,85378,CPT,,,,Inpatient,,,98.37,98.37,Wellcare,Wellcare,98.37,,,,,,,case rate,98.37,98.37,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Meritain Health PPO CPD,Meritain Health PPO CPD,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Aetna/Commercial Product,Aetna/Commercial Product,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Meritain Health CPD,Meritain Health CPD,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Starmark CPD,Starmark CPD,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Aetna Medicare,Aetna Medicare,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Ambetter ,Ambetter ,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Blue Access,Anthem Blue Access,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Blue Access Choice,Anthem Blue Access Choice,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Blue Preferred,Anthem Blue Preferred,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Pathway,Anthem Pathway,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Alliance,Anthem Alliance,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Anthem Medicare,Anthem Medicare,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Cigna,Cigna,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Cigna PPO,Cigna PPO,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Cigna Medicare Advantage,Cigna Medicare Advantage,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Essence,Essence,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Healthlink HMO,Healthlink HMO,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Healthlink PPO,Healthlink PPO,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,HomeState Health Plan,HomeState Health Plan,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Humana Gold,Humana Gold,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Medicaid MO,Medicaid MO,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Medica,Medica,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Tricare,Tricare,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,UHC All Payer,UHC All Payer,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,UHC Exchange,UHC Exchange,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,UHC Medicaid,UHC Medicaid,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,UMR CPD,UMR CPD,246.66,,,,,,,per diem,246.66,246.66,"Per diem rate, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,UHC Medicare,UHC Medicare,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
FOLLICLE STIMULATING HORMONE  ,38204150,CDM,301,RC,83001,CPT,,,,Inpatient,,,246.66,246.66,Wellcare,Wellcare,246.66,,,,,,,case rate,246.66,246.66,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Meritain Health PPO CPD,Meritain Health PPO CPD,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Aetna/Commercial Product,Aetna/Commercial Product,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Meritain Health CPD,Meritain Health CPD,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Starmark CPD,Starmark CPD,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Aetna Medicare,Aetna Medicare,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Ambetter ,Ambetter ,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Blue Access,Anthem Blue Access,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Blue Access Choice,Anthem Blue Access Choice,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Blue Preferred,Anthem Blue Preferred,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Pathway,Anthem Pathway,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Alliance,Anthem Alliance,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Anthem Medicare,Anthem Medicare,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Cigna,Cigna,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Cigna PPO,Cigna PPO,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Cigna Medicare Advantage,Cigna Medicare Advantage,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Essence,Essence,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Healthlink HMO,Healthlink HMO,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Healthlink PPO,Healthlink PPO,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,HomeState Health Plan,HomeState Health Plan,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Humana Gold,Humana Gold,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Medicaid MO,Medicaid MO,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Medica,Medica,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Tricare,Tricare,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,UHC All Payer,UHC All Payer,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,UHC Exchange,UHC Exchange,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,UHC Medicaid,UHC Medicaid,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,UMR CPD,UMR CPD,100.94,,,,,,,per diem,100.94,100.94,"Per diem rate, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,UHC Medicare,UHC Medicare,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
PTH RELATED TOTAL PROTEIN     ,38204300,CDM,301,RC,83519,CPT,,,,Inpatient,,,100.94,100.94,Wellcare,Wellcare,100.94,,,,,,,case rate,100.94,100.94,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Meritain Health PPO CPD,Meritain Health PPO CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Aetna/Commercial Product,Aetna/Commercial Product,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Meritain Health CPD,Meritain Health CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Starmark CPD,Starmark CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Aetna Medicare,Aetna Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Ambetter ,Ambetter ,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Blue Access,Anthem Blue Access,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Blue Access Choice,Anthem Blue Access Choice,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Blue Preferred,Anthem Blue Preferred,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Pathway,Anthem Pathway,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Alliance,Anthem Alliance,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Anthem Medicare,Anthem Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Cigna,Cigna,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Cigna PPO,Cigna PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Cigna Medicare Advantage,Cigna Medicare Advantage,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Essence,Essence,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Healthlink HMO,Healthlink HMO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Healthlink PPO,Healthlink PPO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,HomeState Health Plan,HomeState Health Plan,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Humana Gold,Humana Gold,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Medicaid MO,Medicaid MO,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Medica,Medica,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Tricare,Tricare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,UHC All Payer,UHC All Payer,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,UHC Exchange,UHC Exchange,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,UHC Medicaid,UHC Medicaid,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,UMR CPD,UMR CPD,61.8,,,,,,,per diem,61.8,61.8,"Per diem rate, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,UHC Medicare,UHC Medicare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
OBSTETRIC PANEL               ,38205040,CDM,301,RC,80055,CPT,,,,Inpatient,,,61.8,61.8,Wellcare,Wellcare,61.8,,,,,,,case rate,61.8,61.8,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Meritain Health PPO CPD,Meritain Health PPO CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Aetna/Commercial Product,Aetna/Commercial Product,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Meritain Health CPD,Meritain Health CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Starmark CPD,Starmark CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Aetna Medicare,Aetna Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Ambetter ,Ambetter ,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Access,Anthem Blue Access,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Access Choice,Anthem Blue Access Choice,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Preferred,Anthem Blue Preferred,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Pathway,Anthem Pathway,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Alliance,Anthem Alliance,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Anthem Medicare,Anthem Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Cigna,Cigna,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Cigna PPO,Cigna PPO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Cigna Medicare Advantage,Cigna Medicare Advantage,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Essence,Essence,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Healthlink HMO,Healthlink HMO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Healthlink PPO,Healthlink PPO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,HomeState Health Plan,HomeState Health Plan,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Humana Gold,Humana Gold,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Medicaid MO,Medicaid MO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Medica,Medica,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Tricare,Tricare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,UHC All Payer,UHC All Payer,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,UHC Exchange,UHC Exchange,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,UHC Medicaid,UHC Medicaid,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,UMR CPD,UMR CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,UHC Medicare,UHC Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38205066,CDM,301,RC,84446,CPT,,,,Inpatient,,,168.68,168.68,Wellcare,Wellcare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Meritain Health PPO CPD,Meritain Health PPO CPD,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Aetna/Commercial Product,Aetna/Commercial Product,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Meritain Health CPD,Meritain Health CPD,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Starmark CPD,Starmark CPD,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Aetna Medicare,Aetna Medicare,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Ambetter ,Ambetter ,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Blue Access,Anthem Blue Access,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Blue Access Choice,Anthem Blue Access Choice,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Blue Preferred,Anthem Blue Preferred,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Pathway,Anthem Pathway,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Alliance,Anthem Alliance,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Anthem Medicare,Anthem Medicare,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Cigna,Cigna,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Cigna PPO,Cigna PPO,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Cigna Medicare Advantage,Cigna Medicare Advantage,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Essence,Essence,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Healthlink HMO,Healthlink HMO,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Healthlink PPO,Healthlink PPO,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,HomeState Health Plan,HomeState Health Plan,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Humana Gold,Humana Gold,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Medicaid MO,Medicaid MO,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Medica,Medica,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Tricare,Tricare,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,UHC All Payer,UHC All Payer,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,UHC Exchange,UHC Exchange,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,UHC Medicaid,UHC Medicaid,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,UMR CPD,UMR CPD,514.43,,,,,,,per diem,514.43,514.43,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,UHC Medicare,UHC Medicare,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38205067,CDM,301,RC,84207,CPT,,,,Inpatient,,,514.43,514.43,Wellcare,Wellcare,514.43,,,,,,,case rate,514.43,514.43,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Meritain Health PPO CPD,Meritain Health PPO CPD,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Aetna/Commercial Product,Aetna/Commercial Product,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Meritain Health CPD,Meritain Health CPD,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Starmark CPD,Starmark CPD,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Aetna Medicare,Aetna Medicare,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Ambetter ,Ambetter ,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Blue Access,Anthem Blue Access,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Blue Access Choice,Anthem Blue Access Choice,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Blue Preferred,Anthem Blue Preferred,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Pathway,Anthem Pathway,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Alliance,Anthem Alliance,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Anthem Medicare,Anthem Medicare,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Cigna,Cigna,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Cigna PPO,Cigna PPO,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Cigna Medicare Advantage,Cigna Medicare Advantage,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Essence,Essence,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Healthlink HMO,Healthlink HMO,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Healthlink PPO,Healthlink PPO,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,HomeState Health Plan,HomeState Health Plan,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Humana Gold,Humana Gold,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Medicaid MO,Medicaid MO,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Medica,Medica,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Tricare,Tricare,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,UHC All Payer,UHC All Payer,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,UHC Exchange,UHC Exchange,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,UHC Medicaid,UHC Medicaid,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,UMR CPD,UMR CPD,219.63,,,,,,,per diem,219.63,219.63,"Per diem rate, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,UHC Medicare,UHC Medicare,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN C (ASCORBIC ACID)     ,38205068,CDM,301,RC,82180,CPT,,,,Inpatient,,,219.63,219.63,Wellcare,Wellcare,219.63,,,,,,,case rate,219.63,219.63,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Meritain Health PPO CPD,Meritain Health PPO CPD,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Aetna/Commercial Product,Aetna/Commercial Product,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Meritain Health CPD,Meritain Health CPD,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Starmark CPD,Starmark CPD,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Aetna Medicare,Aetna Medicare,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Ambetter ,Ambetter ,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Blue Access,Anthem Blue Access,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Blue Access Choice,Anthem Blue Access Choice,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Blue Preferred,Anthem Blue Preferred,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Pathway,Anthem Pathway,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Alliance,Anthem Alliance,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Anthem Medicare,Anthem Medicare,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Cigna,Cigna,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Cigna PPO,Cigna PPO,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Cigna Medicare Advantage,Cigna Medicare Advantage,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Essence,Essence,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Healthlink HMO,Healthlink HMO,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Healthlink PPO,Healthlink PPO,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,HomeState Health Plan,HomeState Health Plan,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Humana Gold,Humana Gold,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Medicaid MO,Medicaid MO,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Medica,Medica,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Tricare,Tricare,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,UHC All Payer,UHC All Payer,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,UHC Exchange,UHC Exchange,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,UHC Medicaid,UHC Medicaid,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,UMR CPD,UMR CPD,201.05,,,,,,,per diem,201.05,201.05,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,UHC Medicare,UHC Medicare,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38205069,CDM,301,RC,84590,CPT,,,,Inpatient,,,201.05,201.05,Wellcare,Wellcare,201.05,,,,,,,case rate,201.05,201.05,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
FELBAMATE                     ,38205076,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Meritain Health PPO CPD,Meritain Health PPO CPD,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Aetna/Commercial Product,Aetna/Commercial Product,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Meritain Health CPD,Meritain Health CPD,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Starmark CPD,Starmark CPD,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Aetna Medicare,Aetna Medicare,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Ambetter ,Ambetter ,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Blue Access,Anthem Blue Access,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Blue Access Choice,Anthem Blue Access Choice,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Blue Preferred,Anthem Blue Preferred,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Pathway,Anthem Pathway,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Alliance,Anthem Alliance,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Anthem Medicare,Anthem Medicare,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Cigna,Cigna,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Cigna PPO,Cigna PPO,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Cigna Medicare Advantage,Cigna Medicare Advantage,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Essence,Essence,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Healthlink HMO,Healthlink HMO,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Healthlink PPO,Healthlink PPO,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,HomeState Health Plan,HomeState Health Plan,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Humana Gold,Humana Gold,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Medicaid MO,Medicaid MO,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Medica,Medica,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Tricare,Tricare,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,UHC All Payer,UHC All Payer,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,UHC Exchange,UHC Exchange,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,UHC Medicaid,UHC Medicaid,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,UMR CPD,UMR CPD,11.53,,,,,,,per diem,11.53,11.53,"Per diem rate, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,UHC Medicare,UHC Medicare,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
NOCARDIA CULTURE              ,38205086,CDM,301,RC,87070,CPT,,,,Inpatient,,,11.53,11.53,Wellcare,Wellcare,11.53,,,,,,,case rate,11.53,11.53,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EAR                  ,38205087,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- EYE                  ,38205088,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- GENITAL              ,38205089,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- TISSUE               ,38205090,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Meritain Health PPO CPD,Meritain Health PPO CPD,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Aetna/Commercial Product,Aetna/Commercial Product,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Meritain Health CPD,Meritain Health CPD,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Starmark CPD,Starmark CPD,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Aetna Medicare,Aetna Medicare,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Ambetter ,Ambetter ,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Blue Access,Anthem Blue Access,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Blue Access Choice,Anthem Blue Access Choice,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Blue Preferred,Anthem Blue Preferred,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Pathway,Anthem Pathway,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Alliance,Anthem Alliance,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Anthem Medicare,Anthem Medicare,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Cigna,Cigna,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Cigna PPO,Cigna PPO,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Cigna Medicare Advantage,Cigna Medicare Advantage,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Essence,Essence,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Healthlink HMO,Healthlink HMO,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Healthlink PPO,Healthlink PPO,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,HomeState Health Plan,HomeState Health Plan,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Humana Gold,Humana Gold,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Medicaid MO,Medicaid MO,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Medica,Medica,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Tricare,Tricare,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,UHC All Payer,UHC All Payer,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,UHC Exchange,UHC Exchange,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,UHC Medicaid,UHC Medicaid,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,UMR CPD,UMR CPD,287.78,,,,,,,per diem,287.78,287.78,"Per diem rate, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,UHC Medicare,UHC Medicare,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
THYROXINE BINDING GLOBULIN    ,38205091,CDM,301,RC,84442,CPT,,,,Inpatient,,,287.78,287.78,Wellcare,Wellcare,287.78,,,,,,,case rate,287.78,287.78,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE- RESPIRATORY          ,38205100,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Meritain Health PPO CPD,Meritain Health PPO CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Aetna/Commercial Product,Aetna/Commercial Product,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Meritain Health CPD,Meritain Health CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Starmark CPD,Starmark CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Aetna Medicare,Aetna Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Ambetter ,Ambetter ,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Access,Anthem Blue Access,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Access Choice,Anthem Blue Access Choice,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Preferred,Anthem Blue Preferred,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Pathway,Anthem Pathway,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Alliance,Anthem Alliance,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Anthem Medicare,Anthem Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Cigna,Cigna,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Cigna PPO,Cigna PPO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Cigna Medicare Advantage,Cigna Medicare Advantage,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Essence,Essence,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Healthlink HMO,Healthlink HMO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Healthlink PPO,Healthlink PPO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,HomeState Health Plan,HomeState Health Plan,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Humana Gold,Humana Gold,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Medicaid MO,Medicaid MO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Medica,Medica,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Tricare,Tricare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,UHC All Payer,UHC All Payer,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,UHC Exchange,UHC Exchange,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,UHC Medicaid,UHC Medicaid,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,UMR CPD,UMR CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,UHC Medicare,UHC Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
"ASSAY, TOXIN OR ANTITOXIN     ",38205210,CDM,306,RC,87230,CPT,,,,Inpatient,,,115.36,115.36,Wellcare,Wellcare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
AMYLASE PROFILE               ,38205330,CDM,301,RC,82150,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
OXYCODNE SCREEN               ,38205402,CDM,301,RC,80365,CPT,G0480,HCPCS,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Meritain Health PPO CPD,Meritain Health PPO CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Aetna/Commercial Product,Aetna/Commercial Product,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Meritain Health CPD,Meritain Health CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Starmark CPD,Starmark CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Aetna Medicare,Aetna Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Ambetter ,Ambetter ,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Blue Access,Anthem Blue Access,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Blue Access Choice,Anthem Blue Access Choice,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Blue Preferred,Anthem Blue Preferred,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Pathway,Anthem Pathway,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Alliance,Anthem Alliance,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Anthem Medicare,Anthem Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Cigna,Cigna,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Cigna PPO,Cigna PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Cigna Medicare Advantage,Cigna Medicare Advantage,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Essence,Essence,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Healthlink HMO,Healthlink HMO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Healthlink PPO,Healthlink PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,HomeState Health Plan,HomeState Health Plan,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Humana Gold,Humana Gold,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Medicaid MO,Medicaid MO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Medica,Medica,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Tricare,Tricare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,UHC All Payer,UHC All Payer,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,UHC Exchange,UHC Exchange,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,UHC Medicaid,UHC Medicaid,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,UMR CPD,UMR CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,UHC Medicare,UHC Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZ0DIAZEPINES 1-12          ,38205405,CDM,301,RC,80346,CPT,,,,Inpatient,,,587.29,587.29,Wellcare,Wellcare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
BENZODIAZEPIINES 13+          ,38205406,CDM,301,RC,80347,CPT,,,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
METHYLENEDIOXYAMPHETAMINES    ,38205450,CDM,301,RC,80359,CPT,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Meritain Health PPO CPD,Meritain Health PPO CPD,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Aetna/Commercial Product,Aetna/Commercial Product,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Meritain Health CPD,Meritain Health CPD,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Starmark CPD,Starmark CPD,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Aetna Medicare,Aetna Medicare,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Ambetter ,Ambetter ,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Blue Access,Anthem Blue Access,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Blue Access Choice,Anthem Blue Access Choice,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Blue Preferred,Anthem Blue Preferred,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Pathway,Anthem Pathway,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Alliance,Anthem Alliance,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Anthem Medicare,Anthem Medicare,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Cigna,Cigna,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Cigna PPO,Cigna PPO,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Cigna Medicare Advantage,Cigna Medicare Advantage,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Essence,Essence,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Healthlink HMO,Healthlink HMO,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Healthlink PPO,Healthlink PPO,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,HomeState Health Plan,HomeState Health Plan,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Humana Gold,Humana Gold,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Medicaid MO,Medicaid MO,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Medica,Medica,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Tricare,Tricare,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,UHC All Payer,UHC All Payer,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,UHC Exchange,UHC Exchange,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,UHC Medicaid,UHC Medicaid,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,UMR CPD,UMR CPD,96.32,,,,,,,per diem,96.32,96.32,"Per diem rate, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,UHC Medicare,UHC Medicare,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
BILIRUBIN                     ,38205526,CDM,301,RC,82247,CPT,,,,Inpatient,,,96.32,96.32,Wellcare,Wellcare,96.32,,,,,,,case rate,96.32,96.32,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Meritain Health PPO CPD,Meritain Health PPO CPD,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Aetna/Commercial Product,Aetna/Commercial Product,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Meritain Health CPD,Meritain Health CPD,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Starmark CPD,Starmark CPD,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Aetna Medicare,Aetna Medicare,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Ambetter ,Ambetter ,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Blue Access,Anthem Blue Access,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Blue Access Choice,Anthem Blue Access Choice,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Blue Preferred,Anthem Blue Preferred,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Pathway,Anthem Pathway,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Alliance,Anthem Alliance,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Anthem Medicare,Anthem Medicare,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Cigna,Cigna,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Cigna PPO,Cigna PPO,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Cigna Medicare Advantage,Cigna Medicare Advantage,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Essence,Essence,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Healthlink HMO,Healthlink HMO,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Healthlink PPO,Healthlink PPO,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,HomeState Health Plan,HomeState Health Plan,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Humana Gold,Humana Gold,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Medicaid MO,Medicaid MO,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Medica,Medica,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Tricare,Tricare,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,UHC All Payer,UHC All Payer,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,UHC Exchange,UHC Exchange,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,UHC Medicaid,UHC Medicaid,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,UMR CPD,UMR CPD,21.72,,,,,,,per diem,21.72,21.72,"Per diem rate, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,UHC Medicare,UHC Medicare,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CALCIUM, MISC FLUID           ",38205530,CDM,301,RC,82310,CPT,,,,Inpatient,,,21.72,21.72,Wellcare,Wellcare,21.72,,,,,,,case rate,21.72,21.72,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Meritain Health PPO CPD,Meritain Health PPO CPD,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Aetna/Commercial Product,Aetna/Commercial Product,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Meritain Health CPD,Meritain Health CPD,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Starmark CPD,Starmark CPD,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Aetna Medicare,Aetna Medicare,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Ambetter ,Ambetter ,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Blue Access,Anthem Blue Access,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Blue Access Choice,Anthem Blue Access Choice,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Blue Preferred,Anthem Blue Preferred,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Pathway,Anthem Pathway,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Alliance,Anthem Alliance,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Anthem Medicare,Anthem Medicare,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Cigna,Cigna,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Cigna PPO,Cigna PPO,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Cigna Medicare Advantage,Cigna Medicare Advantage,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Essence,Essence,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Healthlink HMO,Healthlink HMO,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Healthlink PPO,Healthlink PPO,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,HomeState Health Plan,HomeState Health Plan,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Humana Gold,Humana Gold,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Medicaid MO,Medicaid MO,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Medica,Medica,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Tricare,Tricare,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,UHC All Payer,UHC All Payer,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,UHC Exchange,UHC Exchange,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,UHC Medicaid,UHC Medicaid,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,UMR CPD,UMR CPD,129.39,,,,,,,per diem,129.39,129.39,"Per diem rate, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,UHC Medicare,UHC Medicare,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
"CREATININE, MISC FLUID        ",38205534,CDM,301,RC,82570,CPT,,,,Inpatient,,,129.39,129.39,Wellcare,Wellcare,129.39,,,,,,,case rate,129.39,129.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health PPO CPD,Meritain Health PPO CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna/Commercial Product,Aetna/Commercial Product,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Meritain Health CPD,Meritain Health CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Starmark CPD,Starmark CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Aetna Medicare,Aetna Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Ambetter ,Ambetter ,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access,Anthem Blue Access,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Access Choice,Anthem Blue Access Choice,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Blue Preferred,Anthem Blue Preferred,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Pathway,Anthem Pathway,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Alliance,Anthem Alliance,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Anthem Medicare,Anthem Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna,Cigna,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna PPO,Cigna PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Cigna Medicare Advantage,Cigna Medicare Advantage,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Essence,Essence,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthlink HMO,Healthlink HMO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Healthlink PPO,Healthlink PPO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,HomeState Health Plan,HomeState Health Plan,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Humana Gold,Humana Gold,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Medicaid MO,Medicaid MO,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Medica,Medica,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Tricare,Tricare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC All Payer,UHC All Payer,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Exchange,UHC Exchange,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicaid,UHC Medicaid,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UMR CPD,UMR CPD,198.39,,,,,,,per diem,198.39,198.39,"Per diem rate, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,UHC Medicare,UHC Medicare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
VITAMIN B12 & FOLATE          ,38205535,CDM,301,RC,82607,CPT,,,,Inpatient,,,198.39,198.39,Wellcare,Wellcare,198.39,,,,,,,case rate,198.39,198.39,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Meritain Health PPO CPD,Meritain Health PPO CPD,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Aetna/Commercial Product,Aetna/Commercial Product,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Meritain Health CPD,Meritain Health CPD,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Starmark CPD,Starmark CPD,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Aetna Medicare,Aetna Medicare,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Ambetter ,Ambetter ,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Blue Access,Anthem Blue Access,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Blue Access Choice,Anthem Blue Access Choice,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Blue Preferred,Anthem Blue Preferred,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Pathway,Anthem Pathway,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Alliance,Anthem Alliance,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Anthem Medicare,Anthem Medicare,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Cigna,Cigna,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Cigna PPO,Cigna PPO,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Cigna Medicare Advantage,Cigna Medicare Advantage,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Essence,Essence,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Healthlink HMO,Healthlink HMO,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Healthlink PPO,Healthlink PPO,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,HomeState Health Plan,HomeState Health Plan,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Humana Gold,Humana Gold,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Medicaid MO,Medicaid MO,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Medica,Medica,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Tricare,Tricare,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,UHC All Payer,UHC All Payer,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,UHC Exchange,UHC Exchange,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,UHC Medicaid,UHC Medicaid,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,UMR CPD,UMR CPD,236.9,,,,,,,per diem,236.9,236.9,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,UHC Medicare,UHC Medicare,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN PROFILE        ,38205536,CDM,301,RC,82784,CPT,,,,Inpatient,,,236.9,236.9,Wellcare,Wellcare,236.9,,,,,,,case rate,236.9,236.9,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Meritain Health PPO CPD,Meritain Health PPO CPD,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Aetna/Commercial Product,Aetna/Commercial Product,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Meritain Health CPD,Meritain Health CPD,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Starmark CPD,Starmark CPD,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Aetna Medicare,Aetna Medicare,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Ambetter ,Ambetter ,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Blue Access,Anthem Blue Access,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Blue Access Choice,Anthem Blue Access Choice,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Blue Preferred,Anthem Blue Preferred,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Pathway,Anthem Pathway,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Alliance,Anthem Alliance,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Anthem Medicare,Anthem Medicare,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Cigna,Cigna,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Cigna PPO,Cigna PPO,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Cigna Medicare Advantage,Cigna Medicare Advantage,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Essence,Essence,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Healthlink HMO,Healthlink HMO,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Healthlink PPO,Healthlink PPO,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,HomeState Health Plan,HomeState Health Plan,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Humana Gold,Humana Gold,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Medicaid MO,Medicaid MO,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Medica,Medica,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Tricare,Tricare,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,UHC All Payer,UHC All Payer,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,UHC Exchange,UHC Exchange,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,UHC Medicaid,UHC Medicaid,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,UMR CPD,UMR CPD,33.54,,,,,,,per diem,33.54,33.54,"Per diem rate, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,UHC Medicare,UHC Medicare,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
IRON PANEL                    ,38205540,CDM,301,RC,83540,CPT,,,,Inpatient,,,33.54,33.54,Wellcare,Wellcare,33.54,,,,,,,case rate,33.54,33.54,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health PPO CPD,Meritain Health PPO CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna/Commercial Product,Aetna/Commercial Product,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Meritain Health CPD,Meritain Health CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Starmark CPD,Starmark CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Aetna Medicare,Aetna Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Ambetter ,Ambetter ,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access,Anthem Blue Access,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Access Choice,Anthem Blue Access Choice,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Blue Preferred,Anthem Blue Preferred,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Pathway,Anthem Pathway,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Alliance,Anthem Alliance,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Anthem Medicare,Anthem Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna,Cigna,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna PPO,Cigna PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Cigna Medicare Advantage,Cigna Medicare Advantage,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Essence,Essence,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthlink HMO,Healthlink HMO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Healthlink PPO,Healthlink PPO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,HomeState Health Plan,HomeState Health Plan,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Humana Gold,Humana Gold,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Medicaid MO,Medicaid MO,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Medica,Medica,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Tricare,Tricare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC All Payer,UHC All Payer,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Exchange,UHC Exchange,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicaid,UHC Medicaid,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UMR CPD,UMR CPD,141.1,,,,,,,per diem,141.1,141.1,"Per diem rate, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,UHC Medicare,UHC Medicare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
"LIPASE, MISC FLUID            ",38205542,CDM,301,RC,83690,CPT,,,,Inpatient,,,141.1,141.1,Wellcare,Wellcare,141.1,,,,,,,case rate,141.1,141.1,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Meritain Health PPO CPD,Meritain Health PPO CPD,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Aetna/Commercial Product,Aetna/Commercial Product,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Meritain Health CPD,Meritain Health CPD,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Starmark CPD,Starmark CPD,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Aetna Medicare,Aetna Medicare,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Ambetter ,Ambetter ,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Blue Access,Anthem Blue Access,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Blue Access Choice,Anthem Blue Access Choice,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Blue Preferred,Anthem Blue Preferred,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Pathway,Anthem Pathway,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Alliance,Anthem Alliance,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Anthem Medicare,Anthem Medicare,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Cigna,Cigna,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Cigna PPO,Cigna PPO,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Cigna Medicare Advantage,Cigna Medicare Advantage,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Essence,Essence,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Healthlink HMO,Healthlink HMO,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Healthlink PPO,Healthlink PPO,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,HomeState Health Plan,HomeState Health Plan,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Humana Gold,Humana Gold,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Medicaid MO,Medicaid MO,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Medica,Medica,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Tricare,Tricare,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,UHC All Payer,UHC All Payer,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,UHC Exchange,UHC Exchange,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,UHC Medicaid,UHC Medicaid,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,UMR CPD,UMR CPD,56.23,,,,,,,per diem,56.23,56.23,"Per diem rate, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,UHC Medicare,UHC Medicare,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
APO E GENOTYPING              ,38205545,CDM,301,RC,83891,CPT,,,,Inpatient,,,56.23,56.23,Wellcare,Wellcare,56.23,,,,,,,case rate,56.23,56.23,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Meritain Health PPO CPD,Meritain Health PPO CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Aetna/Commercial Product,Aetna/Commercial Product,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Meritain Health CPD,Meritain Health CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Starmark CPD,Starmark CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Aetna Medicare,Aetna Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Ambetter ,Ambetter ,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Blue Access,Anthem Blue Access,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Blue Access Choice,Anthem Blue Access Choice,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Blue Preferred,Anthem Blue Preferred,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Pathway,Anthem Pathway,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Alliance,Anthem Alliance,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Anthem Medicare,Anthem Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Cigna,Cigna,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Cigna PPO,Cigna PPO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Cigna Medicare Advantage,Cigna Medicare Advantage,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Essence,Essence,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Healthlink HMO,Healthlink HMO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Healthlink PPO,Healthlink PPO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,HomeState Health Plan,HomeState Health Plan,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Humana Gold,Humana Gold,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Medicaid MO,Medicaid MO,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Medica,Medica,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Tricare,Tricare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,UHC All Payer,UHC All Payer,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,UHC Exchange,UHC Exchange,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,UHC Medicaid,UHC Medicaid,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,UMR CPD,UMR CPD,394.65,,,,,,,per diem,394.65,394.65,"Per diem rate, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,UHC Medicare,UHC Medicare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
JAK2 V617 MUTATION            ,38205555,CDM,301,RC,81270,CPT,,,,Inpatient,,,394.65,394.65,Wellcare,Wellcare,394.65,,,,,,,case rate,394.65,394.65,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Meritain Health PPO CPD,Meritain Health PPO CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Aetna/Commercial Product,Aetna/Commercial Product,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Meritain Health CPD,Meritain Health CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Starmark CPD,Starmark CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Aetna Medicare,Aetna Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Ambetter ,Ambetter ,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Access,Anthem Blue Access,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Access Choice,Anthem Blue Access Choice,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Blue Preferred,Anthem Blue Preferred,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Pathway,Anthem Pathway,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Alliance,Anthem Alliance,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Anthem Medicare,Anthem Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Cigna,Cigna,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Cigna PPO,Cigna PPO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Cigna Medicare Advantage,Cigna Medicare Advantage,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Essence,Essence,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Healthlink HMO,Healthlink HMO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Healthlink PPO,Healthlink PPO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,HomeState Health Plan,HomeState Health Plan,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Humana Gold,Humana Gold,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Medicaid MO,Medicaid MO,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Medica,Medica,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Tricare,Tricare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,UHC All Payer,UHC All Payer,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,UHC Exchange,UHC Exchange,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,UHC Medicaid,UHC Medicaid,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,UMR CPD,UMR CPD,117.76,,,,,,,per diem,117.76,117.76,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,UHC Medicare,UHC Medicare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL 24 HR URINE    ",38205559,CDM,301,RC,84156,CPT,,,,Inpatient,,,117.76,117.76,Wellcare,Wellcare,117.76,,,,,,,case rate,117.76,117.76,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health PPO CPD,Meritain Health PPO CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna/Commercial Product,Aetna/Commercial Product,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Meritain Health CPD,Meritain Health CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Starmark CPD,Starmark CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Aetna Medicare,Aetna Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Ambetter ,Ambetter ,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access,Anthem Blue Access,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Access Choice,Anthem Blue Access Choice,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Blue Preferred,Anthem Blue Preferred,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Pathway,Anthem Pathway,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Alliance,Anthem Alliance,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Anthem Medicare,Anthem Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna,Cigna,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna PPO,Cigna PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Cigna Medicare Advantage,Cigna Medicare Advantage,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Essence,Essence,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthlink HMO,Healthlink HMO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Healthlink PPO,Healthlink PPO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,HomeState Health Plan,HomeState Health Plan,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Humana Gold,Humana Gold,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Medicaid MO,Medicaid MO,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Medica,Medica,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Tricare,Tricare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC All Payer,UHC All Payer,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Exchange,UHC Exchange,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicaid,UHC Medicaid,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UMR CPD,UMR CPD,178.23,,,,,,,per diem,178.23,178.23,"Per diem rate, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,UHC Medicare,UHC Medicare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
THYROID FUNCTION PANEL        ,38205563,CDM,301,RC,84439,CPT,,,,Inpatient,,,178.23,178.23,Wellcare,Wellcare,178.23,,,,,,,case rate,178.23,178.23,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health PPO CPD,Meritain Health PPO CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna/Commercial Product,Aetna/Commercial Product,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health CPD,Meritain Health CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Starmark CPD,Starmark CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Aetna Medicare,Aetna Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Ambetter ,Ambetter ,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access,Anthem Blue Access,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access Choice,Anthem Blue Access Choice,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Preferred,Anthem Blue Preferred,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Pathway,Anthem Pathway,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Alliance,Anthem Alliance,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Anthem Medicare,Anthem Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna,Cigna,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna PPO,Cigna PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Cigna Medicare Advantage,Cigna Medicare Advantage,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Essence,Essence,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthlink HMO,Healthlink HMO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Healthlink PPO,Healthlink PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,HomeState Health Plan,HomeState Health Plan,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Humana Gold,Humana Gold,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Medicaid MO,Medicaid MO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Medica,Medica,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Tricare,Tricare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC All Payer,UHC All Payer,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Exchange,UHC Exchange,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicaid,UHC Medicaid,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UMR CPD,UMR CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicare,UHC Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
"UREA NITRO, FLUID             ",38205565,CDM,301,RC,84520,CPT,,,,Inpatient,,,71.08,71.08,Wellcare,Wellcare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Meritain Health PPO CPD,Meritain Health PPO CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Aetna/Commercial Product,Aetna/Commercial Product,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Meritain Health CPD,Meritain Health CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Starmark CPD,Starmark CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Aetna Medicare,Aetna Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Ambetter ,Ambetter ,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Access,Anthem Blue Access,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Access Choice,Anthem Blue Access Choice,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Preferred,Anthem Blue Preferred,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Pathway,Anthem Pathway,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Alliance,Anthem Alliance,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Anthem Medicare,Anthem Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Cigna,Cigna,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Cigna PPO,Cigna PPO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Cigna Medicare Advantage,Cigna Medicare Advantage,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Essence,Essence,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Healthlink HMO,Healthlink HMO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Healthlink PPO,Healthlink PPO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,HomeState Health Plan,HomeState Health Plan,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Humana Gold,Humana Gold,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Medicaid MO,Medicaid MO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Medica,Medica,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Tricare,Tricare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,UHC All Payer,UHC All Payer,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,UHC Exchange,UHC Exchange,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,UHC Medicaid,UHC Medicaid,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,UMR CPD,UMR CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,UHC Medicare,UHC Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
UNFRACTIONATED HEPARIN        ,38205568,CDM,305,RC,85520,CPT,,,,Inpatient,,,374.5,374.5,Wellcare,Wellcare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Meritain Health PPO CPD,Meritain Health PPO CPD,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Aetna/Commercial Product,Aetna/Commercial Product,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Meritain Health CPD,Meritain Health CPD,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Starmark CPD,Starmark CPD,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Aetna Medicare,Aetna Medicare,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Ambetter ,Ambetter ,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Blue Access,Anthem Blue Access,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Blue Access Choice,Anthem Blue Access Choice,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Blue Preferred,Anthem Blue Preferred,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Pathway,Anthem Pathway,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Alliance,Anthem Alliance,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Anthem Medicare,Anthem Medicare,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Cigna,Cigna,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Cigna PPO,Cigna PPO,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Cigna Medicare Advantage,Cigna Medicare Advantage,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Essence,Essence,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Healthlink HMO,Healthlink HMO,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Healthlink PPO,Healthlink PPO,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,HomeState Health Plan,HomeState Health Plan,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Humana Gold,Humana Gold,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Medicaid MO,Medicaid MO,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Medica,Medica,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Tricare,Tricare,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,UHC All Payer,UHC All Payer,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,UHC Exchange,UHC Exchange,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,UHC Medicaid,UHC Medicaid,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,UMR CPD,UMR CPD,93.97,,,,,,,per diem,93.97,93.97,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,UHC Medicare,UHC Medicare,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38205569,CDM,305,RC,85576,CPT,,,,Inpatient,,,93.97,93.97,Wellcare,Wellcare,93.97,,,,,,,case rate,93.97,93.97,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health PPO CPD,Meritain Health PPO CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/Commercial Product,Aetna/Commercial Product,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health CPD,Meritain Health CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Starmark CPD,Starmark CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna Medicare,Aetna Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Ambetter ,Ambetter ,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access,Anthem Blue Access,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access Choice,Anthem Blue Access Choice,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Preferred,Anthem Blue Preferred,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Pathway,Anthem Pathway,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Alliance,Anthem Alliance,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Medicare,Anthem Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna,Cigna,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna PPO,Cigna PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna Medicare Advantage,Cigna Medicare Advantage,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Essence,Essence,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink HMO,Healthlink HMO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink PPO,Healthlink PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,HomeState Health Plan,HomeState Health Plan,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Humana Gold,Humana Gold,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medicaid MO,Medicaid MO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medica,Medica,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Tricare,Tricare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC All Payer,UHC All Payer,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Exchange,UHC Exchange,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicaid,UHC Medicaid,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UMR CPD,UMR CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicare,UHC Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
DIC SCREEN                    ,38205570,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Wellcare,Wellcare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health PPO CPD,Meritain Health PPO CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna/Commercial Product,Aetna/Commercial Product,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Meritain Health CPD,Meritain Health CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Starmark CPD,Starmark CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Aetna Medicare,Aetna Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Ambetter ,Ambetter ,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access,Anthem Blue Access,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Access Choice,Anthem Blue Access Choice,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Blue Preferred,Anthem Blue Preferred,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Pathway,Anthem Pathway,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Alliance,Anthem Alliance,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Anthem Medicare,Anthem Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna,Cigna,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna PPO,Cigna PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Cigna Medicare Advantage,Cigna Medicare Advantage,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Essence,Essence,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink HMO,Healthlink HMO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Healthlink PPO,Healthlink PPO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,HomeState Health Plan,HomeState Health Plan,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Humana Gold,Humana Gold,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medicaid MO,Medicaid MO,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Medica,Medica,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Tricare,Tricare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC All Payer,UHC All Payer,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Exchange,UHC Exchange,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicaid,UHC Medicaid,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UMR CPD,UMR CPD,78.51,,,,,,,per diem,78.51,78.51,"Per diem rate, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,UHC Medicare,UHC Medicare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
PT/PTT                        ,38205571,CDM,305,RC,85610,CPT,,,,Inpatient,,,78.51,78.51,Wellcare,Wellcare,78.51,,,,,,,case rate,78.51,78.51,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
ANTISMOOTH MUSCLE TITER       ,38205590,CDM,302,RC,86256,CPT,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Meritain Health PPO CPD,Meritain Health PPO CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Aetna/Commercial Product,Aetna/Commercial Product,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Meritain Health CPD,Meritain Health CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Starmark CPD,Starmark CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Aetna Medicare,Aetna Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Ambetter ,Ambetter ,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Access,Anthem Blue Access,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Access Choice,Anthem Blue Access Choice,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Preferred,Anthem Blue Preferred,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Pathway,Anthem Pathway,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Alliance,Anthem Alliance,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Anthem Medicare,Anthem Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Cigna,Cigna,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Cigna PPO,Cigna PPO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Cigna Medicare Advantage,Cigna Medicare Advantage,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Essence,Essence,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Healthlink HMO,Healthlink HMO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Healthlink PPO,Healthlink PPO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,HomeState Health Plan,HomeState Health Plan,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Humana Gold,Humana Gold,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Medicaid MO,Medicaid MO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Medica,Medica,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Tricare,Tricare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,UHC All Payer,UHC All Payer,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,UHC Exchange,UHC Exchange,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,UHC Medicaid,UHC Medicaid,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,UMR CPD,UMR CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,UHC Medicare,UHC Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS IGG & IGM     ,38205596,CDM,302,RC,86644,CPT,,,,Inpatient,,,283.25,283.25,Wellcare,Wellcare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Meritain Health PPO CPD,Meritain Health PPO CPD,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Aetna/Commercial Product,Aetna/Commercial Product,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Meritain Health CPD,Meritain Health CPD,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Starmark CPD,Starmark CPD,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Aetna Medicare,Aetna Medicare,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Ambetter ,Ambetter ,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Blue Access,Anthem Blue Access,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Blue Access Choice,Anthem Blue Access Choice,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Blue Preferred,Anthem Blue Preferred,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Pathway,Anthem Pathway,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Alliance,Anthem Alliance,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Anthem Medicare,Anthem Medicare,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Cigna,Cigna,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Cigna PPO,Cigna PPO,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Cigna Medicare Advantage,Cigna Medicare Advantage,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Essence,Essence,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Healthlink HMO,Healthlink HMO,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Healthlink PPO,Healthlink PPO,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,HomeState Health Plan,HomeState Health Plan,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Humana Gold,Humana Gold,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Medicaid MO,Medicaid MO,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Medica,Medica,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Tricare,Tricare,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,UHC All Payer,UHC All Payer,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,UHC Exchange,UHC Exchange,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,UHC Medicaid,UHC Medicaid,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,UMR CPD,UMR CPD,18.41,,,,,,,per diem,18.41,18.41,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,UHC Medicare,UHC Medicare,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38205601,CDM,302,RC,86703,CPT,,,,Inpatient,,,18.41,18.41,Wellcare,Wellcare,18.41,,,,,,,case rate,18.41,18.41,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
DIRECT & INDIRECT COOMBS      ,38205611,CDM,302,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38205612,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ABO & RH TYPE                 ,38205613,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
PRENATAL PANEL                ,38205614,CDM,302,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health PPO CPD,Meritain Health PPO CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Aetna/Commercial Product,Aetna/Commercial Product,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health CPD,Meritain Health CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Starmark CPD,Starmark CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Aetna Medicare,Aetna Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Ambetter ,Ambetter ,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access,Anthem Blue Access,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access Choice,Anthem Blue Access Choice,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Preferred,Anthem Blue Preferred,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Pathway,Anthem Pathway,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Alliance,Anthem Alliance,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Anthem Medicare,Anthem Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Cigna,Cigna,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Cigna PPO,Cigna PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Cigna Medicare Advantage,Cigna Medicare Advantage,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Essence,Essence,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Healthlink HMO,Healthlink HMO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Healthlink PPO,Healthlink PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,HomeState Health Plan,HomeState Health Plan,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Humana Gold,Humana Gold,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Medicaid MO,Medicaid MO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Medica,Medica,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Tricare,Tricare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,UHC All Payer,UHC All Payer,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,UHC Exchange,UHC Exchange,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicaid,UHC Medicaid,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,UMR CPD,UMR CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicare,UHC Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38205619,CDM,302,RC,86922,CPT,,,,Inpatient,,,177.17,177.17,Wellcare,Wellcare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Meritain Health PPO CPD,Meritain Health PPO CPD,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Aetna/Commercial Product,Aetna/Commercial Product,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Meritain Health CPD,Meritain Health CPD,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Starmark CPD,Starmark CPD,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Aetna Medicare,Aetna Medicare,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Ambetter ,Ambetter ,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Blue Access,Anthem Blue Access,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Blue Access Choice,Anthem Blue Access Choice,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Blue Preferred,Anthem Blue Preferred,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Pathway,Anthem Pathway,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Alliance,Anthem Alliance,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Anthem Medicare,Anthem Medicare,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Cigna,Cigna,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Cigna PPO,Cigna PPO,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Cigna Medicare Advantage,Cigna Medicare Advantage,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Essence,Essence,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Healthlink HMO,Healthlink HMO,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Healthlink PPO,Healthlink PPO,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,HomeState Health Plan,HomeState Health Plan,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Humana Gold,Humana Gold,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Medicaid MO,Medicaid MO,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Medica,Medica,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Tricare,Tricare,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,UHC All Payer,UHC All Payer,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,UHC Exchange,UHC Exchange,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,UHC Medicaid,UHC Medicaid,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,UMR CPD,UMR CPD,234.23,,,,,,,per diem,234.23,234.23,"Per diem rate, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,UHC Medicare,UHC Medicare,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
ENZYME PANEL                  ,38205621,CDM,302,RC,86971,CPT,,,,Inpatient,,,234.23,234.23,Wellcare,Wellcare,234.23,,,,,,,case rate,234.23,234.23,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health PPO CPD,Meritain Health PPO CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Aetna/Commercial Product,Aetna/Commercial Product,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health CPD,Meritain Health CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Starmark CPD,Starmark CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Aetna Medicare,Aetna Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Ambetter ,Ambetter ,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access,Anthem Blue Access,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access Choice,Anthem Blue Access Choice,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Preferred,Anthem Blue Preferred,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Pathway,Anthem Pathway,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Alliance,Anthem Alliance,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Anthem Medicare,Anthem Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Cigna,Cigna,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Cigna PPO,Cigna PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Cigna Medicare Advantage,Cigna Medicare Advantage,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Essence,Essence,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Healthlink HMO,Healthlink HMO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Healthlink PPO,Healthlink PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,HomeState Health Plan,HomeState Health Plan,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Humana Gold,Humana Gold,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Medicaid MO,Medicaid MO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Medica,Medica,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Tricare,Tricare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,UHC All Payer,UHC All Payer,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,UHC Exchange,UHC Exchange,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicaid,UHC Medicaid,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,UMR CPD,UMR CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicare,UHC Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38205622,CDM,306,RC,87015,CPT,,,,Inpatient,,,47.74,47.74,Wellcare,Wellcare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE AEROBIC               ,38205624,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
LEGIONELLA CULTURE            ,38205625,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
CULTURE TRANS                 ,38205626,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
BETA STREP SCREEN             ,38205627,CDM,306,RC,87081,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Meritain Health PPO CPD,Meritain Health PPO CPD,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Aetna/Commercial Product,Aetna/Commercial Product,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Meritain Health CPD,Meritain Health CPD,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Starmark CPD,Starmark CPD,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Aetna Medicare,Aetna Medicare,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Ambetter ,Ambetter ,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Blue Access,Anthem Blue Access,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Blue Access Choice,Anthem Blue Access Choice,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Blue Preferred,Anthem Blue Preferred,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Pathway,Anthem Pathway,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Alliance,Anthem Alliance,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Anthem Medicare,Anthem Medicare,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Cigna,Cigna,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Cigna PPO,Cigna PPO,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Cigna Medicare Advantage,Cigna Medicare Advantage,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Essence,Essence,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Healthlink HMO,Healthlink HMO,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Healthlink PPO,Healthlink PPO,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,HomeState Health Plan,HomeState Health Plan,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Humana Gold,Humana Gold,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Medicaid MO,Medicaid MO,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Medica,Medica,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Tricare,Tricare,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,UHC All Payer,UHC All Payer,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,UHC Exchange,UHC Exchange,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,UHC Medicaid,UHC Medicaid,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,UMR CPD,UMR CPD,135.27,,,,,,,per diem,135.27,135.27,"Per diem rate, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,UHC Medicare,UHC Medicare,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
FUNGUS CULTURE SKIN           ,38205628,CDM,306,RC,87101,CPT,,,,Inpatient,,,135.27,135.27,Wellcare,Wellcare,135.27,,,,,,,case rate,135.27,135.27,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38205629,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM                  ,38205630,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
ESBL CONFIRM 2                ,38205631,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
OXACILLIN SUSCEPT CONFIRM     ,38205632,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY KB       ,38205633,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
MOLD SUSCEPTIBILITY           ,38205634,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY          ,38205635,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
YEAST SUSCEPTIBILITY MIC      ,38205636,CDM,306,RC,87186,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
GRAM STAIN CREDIT             ,38205637,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
SPUTUM GRAM STAIN             ,38205638,CDM,306,RC,87205,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Meritain Health PPO CPD,Meritain Health PPO CPD,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Aetna/Commercial Product,Aetna/Commercial Product,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Meritain Health CPD,Meritain Health CPD,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Starmark CPD,Starmark CPD,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Aetna Medicare,Aetna Medicare,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Ambetter ,Ambetter ,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Blue Access,Anthem Blue Access,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Blue Access Choice,Anthem Blue Access Choice,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Blue Preferred,Anthem Blue Preferred,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Pathway,Anthem Pathway,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Alliance,Anthem Alliance,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Anthem Medicare,Anthem Medicare,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Cigna,Cigna,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Cigna PPO,Cigna PPO,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Cigna Medicare Advantage,Cigna Medicare Advantage,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Essence,Essence,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Healthlink HMO,Healthlink HMO,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Healthlink PPO,Healthlink PPO,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,HomeState Health Plan,HomeState Health Plan,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Humana Gold,Humana Gold,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Medicaid MO,Medicaid MO,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Medica,Medica,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Tricare,Tricare,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,UHC All Payer,UHC All Payer,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,UHC Exchange,UHC Exchange,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,UHC Medicaid,UHC Medicaid,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,UMR CPD,UMR CPD,375.22,,,,,,,per diem,375.22,375.22,"Per diem rate, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,UHC Medicare,UHC Medicare,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HERPES CULTURE                ,38205643,CDM,306,RC,87252,CPT,,,,Inpatient,,,375.22,375.22,Wellcare,Wellcare,375.22,,,,,,,case rate,375.22,375.22,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Meritain Health PPO CPD,Meritain Health PPO CPD,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Aetna/Commercial Product,Aetna/Commercial Product,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Meritain Health CPD,Meritain Health CPD,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Starmark CPD,Starmark CPD,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Aetna Medicare,Aetna Medicare,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Ambetter ,Ambetter ,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Blue Access,Anthem Blue Access,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Blue Access Choice,Anthem Blue Access Choice,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Blue Preferred,Anthem Blue Preferred,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Pathway,Anthem Pathway,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Alliance,Anthem Alliance,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Anthem Medicare,Anthem Medicare,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Cigna,Cigna,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Cigna PPO,Cigna PPO,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Cigna Medicare Advantage,Cigna Medicare Advantage,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Essence,Essence,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Healthlink HMO,Healthlink HMO,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Healthlink PPO,Healthlink PPO,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,HomeState Health Plan,HomeState Health Plan,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Humana Gold,Humana Gold,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Medicaid MO,Medicaid MO,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Medica,Medica,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Tricare,Tricare,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,UHC All Payer,UHC All Payer,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,UHC Exchange,UHC Exchange,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,UHC Medicaid,UHC Medicaid,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,UMR CPD,UMR CPD,372.86,,,,,,,per diem,372.86,372.86,"Per diem rate, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,UHC Medicare,UHC Medicare,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
HEP C PCR QUAL                ,38205650,CDM,306,RC,87521,CPT,,,,Inpatient,,,372.86,372.86,Wellcare,Wellcare,372.86,,,,,,,case rate,372.86,372.86,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Meritain Health PPO CPD,Meritain Health PPO CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Aetna/Commercial Product,Aetna/Commercial Product,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Meritain Health CPD,Meritain Health CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Starmark CPD,Starmark CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Aetna Medicare,Aetna Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Ambetter ,Ambetter ,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Access,Anthem Blue Access,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Access Choice,Anthem Blue Access Choice,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Blue Preferred,Anthem Blue Preferred,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Pathway,Anthem Pathway,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Alliance,Anthem Alliance,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Anthem Medicare,Anthem Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Cigna,Cigna,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Cigna PPO,Cigna PPO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Cigna Medicare Advantage,Cigna Medicare Advantage,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Essence,Essence,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Healthlink HMO,Healthlink HMO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Healthlink PPO,Healthlink PPO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,HomeState Health Plan,HomeState Health Plan,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Humana Gold,Humana Gold,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Medicaid MO,Medicaid MO,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Medica,Medica,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Tricare,Tricare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,UHC All Payer,UHC All Payer,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,UHC Exchange,UHC Exchange,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,UHC Medicaid,UHC Medicaid,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,UMR CPD,UMR CPD,22.06,,,,,,,per diem,22.06,22.06,"Per diem rate, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,UHC Medicare,UHC Medicare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
WRIGHT STAIN FOR EOSINOPHIL   ,38205656,CDM,300,RC,89190,CPT,,,,Inpatient,,,22.06,22.06,Wellcare,Wellcare,22.06,,,,,,,case rate,22.06,22.06,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health PPO CPD,Meritain Health PPO CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/Commercial Product,Aetna/Commercial Product,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health CPD,Meritain Health CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Starmark CPD,Starmark CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna Medicare,Aetna Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Ambetter ,Ambetter ,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access,Anthem Blue Access,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access Choice,Anthem Blue Access Choice,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Preferred,Anthem Blue Preferred,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Pathway,Anthem Pathway,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Alliance,Anthem Alliance,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Medicare,Anthem Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna,Cigna,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna PPO,Cigna PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna Medicare Advantage,Cigna Medicare Advantage,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Essence,Essence,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink HMO,Healthlink HMO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink PPO,Healthlink PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,HomeState Health Plan,HomeState Health Plan,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Humana Gold,Humana Gold,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medicaid MO,Medicaid MO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medica,Medica,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Tricare,Tricare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC All Payer,UHC All Payer,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Exchange,UHC Exchange,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicaid,UHC Medicaid,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UMR CPD,UMR CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicare,UHC Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
THYROID CASCADE               ,38205662,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Wellcare,Wellcare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health PPO CPD,Meritain Health PPO CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna/Commercial Product,Aetna/Commercial Product,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Meritain Health CPD,Meritain Health CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Starmark CPD,Starmark CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Aetna Medicare,Aetna Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Ambetter ,Ambetter ,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access,Anthem Blue Access,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Access Choice,Anthem Blue Access Choice,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Blue Preferred,Anthem Blue Preferred,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Pathway,Anthem Pathway,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Alliance,Anthem Alliance,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Anthem Medicare,Anthem Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna,Cigna,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna PPO,Cigna PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Cigna Medicare Advantage,Cigna Medicare Advantage,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Essence,Essence,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink HMO,Healthlink HMO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Healthlink PPO,Healthlink PPO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,HomeState Health Plan,HomeState Health Plan,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Humana Gold,Humana Gold,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medicaid MO,Medicaid MO,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Medica,Medica,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Tricare,Tricare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC All Payer,UHC All Payer,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Exchange,UHC Exchange,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicaid,UHC Medicaid,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UMR CPD,UMR CPD,199.45,,,,,,,per diem,199.45,199.45,"Per diem rate, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,UHC Medicare,UHC Medicare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
SOLUTION CULTURE              ,38205667,CDM,306,RC,87070,CPT,,,,Inpatient,,,199.45,199.45,Wellcare,Wellcare,199.45,,,,,,,case rate,199.45,199.45,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE PRESUMPTIVE ID CREDIT   ,38205669,CDM,306,RC,87088,CPT,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Meritain Health PPO CPD,Meritain Health PPO CPD,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Aetna/Commercial Product,Aetna/Commercial Product,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Meritain Health CPD,Meritain Health CPD,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Starmark CPD,Starmark CPD,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Aetna Medicare,Aetna Medicare,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Ambetter ,Ambetter ,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Blue Access,Anthem Blue Access,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Blue Access Choice,Anthem Blue Access Choice,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Blue Preferred,Anthem Blue Preferred,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Pathway,Anthem Pathway,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Alliance,Anthem Alliance,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Anthem Medicare,Anthem Medicare,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Cigna,Cigna,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Cigna PPO,Cigna PPO,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Cigna Medicare Advantage,Cigna Medicare Advantage,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Essence,Essence,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Healthlink HMO,Healthlink HMO,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Healthlink PPO,Healthlink PPO,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,HomeState Health Plan,HomeState Health Plan,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Humana Gold,Humana Gold,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Medicaid MO,Medicaid MO,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Medica,Medica,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Tricare,Tricare,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,UHC All Payer,UHC All Payer,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,UHC Exchange,UHC Exchange,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,UHC Medicaid,UHC Medicaid,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,UMR CPD,UMR CPD,293.12,,,,,,,per diem,293.12,293.12,"Per diem rate, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,UHC Medicare,UHC Medicare,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
MTHFR                         ,38205680,CDM,301,RC,81291,CPT,,,,Inpatient,,,293.12,293.12,Wellcare,Wellcare,293.12,,,,,,,case rate,293.12,293.12,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Meritain Health PPO CPD,Meritain Health PPO CPD,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Aetna/Commercial Product,Aetna/Commercial Product,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Meritain Health CPD,Meritain Health CPD,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Starmark CPD,Starmark CPD,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Aetna Medicare,Aetna Medicare,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Ambetter ,Ambetter ,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Blue Access,Anthem Blue Access,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Blue Access Choice,Anthem Blue Access Choice,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Blue Preferred,Anthem Blue Preferred,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Pathway,Anthem Pathway,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Alliance,Anthem Alliance,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Anthem Medicare,Anthem Medicare,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Cigna,Cigna,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Cigna PPO,Cigna PPO,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Cigna Medicare Advantage,Cigna Medicare Advantage,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Essence,Essence,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Healthlink HMO,Healthlink HMO,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Healthlink PPO,Healthlink PPO,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,HomeState Health Plan,HomeState Health Plan,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Humana Gold,Humana Gold,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Medicaid MO,Medicaid MO,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Medica,Medica,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Tricare,Tricare,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,UHC All Payer,UHC All Payer,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,UHC Exchange,UHC Exchange,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,UHC Medicaid,UHC Medicaid,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,UMR CPD,UMR CPD,104.5,,,,,,,per diem,104.5,104.5,"Per diem rate, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,UHC Medicare,UHC Medicare,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
EOS SMEAR (NASAL)             ,38206009,CDM,300,RC,89190,CPT,,,,Inpatient,,,104.5,104.5,Wellcare,Wellcare,104.5,,,,,,,case rate,104.5,104.5,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Meritain Health PPO CPD,Meritain Health PPO CPD,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Aetna/Commercial Product,Aetna/Commercial Product,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Meritain Health CPD,Meritain Health CPD,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Starmark CPD,Starmark CPD,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Aetna Medicare,Aetna Medicare,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Ambetter ,Ambetter ,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Blue Access,Anthem Blue Access,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Blue Access Choice,Anthem Blue Access Choice,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Blue Preferred,Anthem Blue Preferred,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Pathway,Anthem Pathway,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Alliance,Anthem Alliance,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Anthem Medicare,Anthem Medicare,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Cigna,Cigna,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Cigna PPO,Cigna PPO,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Cigna Medicare Advantage,Cigna Medicare Advantage,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Essence,Essence,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Healthlink HMO,Healthlink HMO,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Healthlink PPO,Healthlink PPO,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,HomeState Health Plan,HomeState Health Plan,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Humana Gold,Humana Gold,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Medicaid MO,Medicaid MO,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Medica,Medica,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Tricare,Tricare,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,UHC All Payer,UHC All Payer,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,UHC Exchange,UHC Exchange,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,UHC Medicaid,UHC Medicaid,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,UMR CPD,UMR CPD,101.65,,,,,,,per diem,101.65,101.65,"Per diem rate, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,UHC Medicare,UHC Medicare,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
STOOL CRYPTOSPORIDIU          ,38206022,CDM,300,RC,87015,CPT,,,,Inpatient,,,101.65,101.65,Wellcare,Wellcare,101.65,,,,,,,case rate,101.65,101.65,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Meritain Health PPO CPD,Meritain Health PPO CPD,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Aetna/Commercial Product,Aetna/Commercial Product,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Meritain Health CPD,Meritain Health CPD,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Starmark CPD,Starmark CPD,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Aetna Medicare,Aetna Medicare,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Ambetter ,Ambetter ,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Blue Access,Anthem Blue Access,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Blue Access Choice,Anthem Blue Access Choice,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Blue Preferred,Anthem Blue Preferred,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Pathway,Anthem Pathway,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Alliance,Anthem Alliance,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Anthem Medicare,Anthem Medicare,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Cigna,Cigna,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Cigna PPO,Cigna PPO,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Cigna Medicare Advantage,Cigna Medicare Advantage,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Essence,Essence,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Healthlink HMO,Healthlink HMO,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Healthlink PPO,Healthlink PPO,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,HomeState Health Plan,HomeState Health Plan,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Humana Gold,Humana Gold,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Medicaid MO,Medicaid MO,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Medica,Medica,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Tricare,Tricare,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,UHC All Payer,UHC All Payer,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,UHC Exchange,UHC Exchange,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,UHC Medicaid,UHC Medicaid,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,UMR CPD,UMR CPD,46.05,,,,,,,per diem,46.05,46.05,"Per diem rate, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,UHC Medicare,UHC Medicare,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
URINALYSIS NONAUTO W/MICROSCOP,38206028,CDM,307,RC,81000,CPT,,,,Inpatient,,,46.05,46.05,Wellcare,Wellcare,46.05,,,,,,,case rate,46.05,46.05,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Meritain Health PPO CPD,Meritain Health PPO CPD,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Aetna/Commercial Product,Aetna/Commercial Product,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Meritain Health CPD,Meritain Health CPD,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Starmark CPD,Starmark CPD,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Aetna Medicare,Aetna Medicare,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Ambetter ,Ambetter ,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Blue Access,Anthem Blue Access,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Blue Access Choice,Anthem Blue Access Choice,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Blue Preferred,Anthem Blue Preferred,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Pathway,Anthem Pathway,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Alliance,Anthem Alliance,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Anthem Medicare,Anthem Medicare,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Cigna,Cigna,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Cigna PPO,Cigna PPO,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Cigna Medicare Advantage,Cigna Medicare Advantage,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Essence,Essence,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Healthlink HMO,Healthlink HMO,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Healthlink PPO,Healthlink PPO,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,HomeState Health Plan,HomeState Health Plan,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Humana Gold,Humana Gold,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Medicaid MO,Medicaid MO,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Medica,Medica,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Tricare,Tricare,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,UHC All Payer,UHC All Payer,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,UHC Exchange,UHC Exchange,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,UHC Medicaid,UHC Medicaid,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,UMR CPD,UMR CPD,215.73,,,,,,,per diem,215.73,215.73,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,UHC Medicare,UHC Medicare,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR XIII          ,38206434,CDM,305,RC,85291,CPT,,,,Inpatient,,,215.73,215.73,Wellcare,Wellcare,215.73,,,,,,,case rate,215.73,215.73,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Meritain Health PPO CPD,Meritain Health PPO CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Aetna/Commercial Product,Aetna/Commercial Product,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Meritain Health CPD,Meritain Health CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Starmark CPD,Starmark CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Aetna Medicare,Aetna Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Ambetter ,Ambetter ,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Blue Access,Anthem Blue Access,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Blue Access Choice,Anthem Blue Access Choice,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Blue Preferred,Anthem Blue Preferred,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Pathway,Anthem Pathway,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Alliance,Anthem Alliance,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Anthem Medicare,Anthem Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Cigna,Cigna,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Cigna PPO,Cigna PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Cigna Medicare Advantage,Cigna Medicare Advantage,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Essence,Essence,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Healthlink HMO,Healthlink HMO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Healthlink PPO,Healthlink PPO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,HomeState Health Plan,HomeState Health Plan,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Humana Gold,Humana Gold,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Medicaid MO,Medicaid MO,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Medica,Medica,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Tricare,Tricare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,UHC All Payer,UHC All Payer,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,UHC Exchange,UHC Exchange,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,UHC Medicaid,UHC Medicaid,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,UMR CPD,UMR CPD,73.02,,,,,,,per diem,73.02,73.02,"Per diem rate, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,UHC Medicare,UHC Medicare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
MOLEC DIAG SEPARATION         ,38206520,CDM,301,RC,83894,CPT,,,,Inpatient,,,73.02,73.02,Wellcare,Wellcare,73.02,,,,,,,case rate,73.02,73.02,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Meritain Health PPO CPD,Meritain Health PPO CPD,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Aetna/Commercial Product,Aetna/Commercial Product,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Meritain Health CPD,Meritain Health CPD,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Starmark CPD,Starmark CPD,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Aetna Medicare,Aetna Medicare,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Ambetter ,Ambetter ,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Blue Access,Anthem Blue Access,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Blue Access Choice,Anthem Blue Access Choice,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Blue Preferred,Anthem Blue Preferred,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Pathway,Anthem Pathway,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Alliance,Anthem Alliance,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Anthem Medicare,Anthem Medicare,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Cigna,Cigna,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Cigna PPO,Cigna PPO,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Cigna Medicare Advantage,Cigna Medicare Advantage,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Essence,Essence,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Healthlink HMO,Healthlink HMO,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Healthlink PPO,Healthlink PPO,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,HomeState Health Plan,HomeState Health Plan,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Humana Gold,Humana Gold,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Medicaid MO,Medicaid MO,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Medica,Medica,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Tricare,Tricare,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,UHC All Payer,UHC All Payer,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,UHC Exchange,UHC Exchange,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,UHC Medicaid,UHC Medicaid,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,UMR CPD,UMR CPD,617.06,,,,,,,per diem,617.06,617.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,UHC Medicare,UHC Medicare,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR V             ,38206560,CDM,305,RC,85220,CPT,,,,Inpatient,,,617.06,617.06,Wellcare,Wellcare,617.06,,,,,,,case rate,617.06,617.06,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
PROTHROMBIN SUBSTITUTION      ,38206590,CDM,305,RC,85611,CPT,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Meritain Health PPO CPD,Meritain Health PPO CPD,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Aetna/Commercial Product,Aetna/Commercial Product,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Meritain Health CPD,Meritain Health CPD,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Starmark CPD,Starmark CPD,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Aetna Medicare,Aetna Medicare,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Ambetter ,Ambetter ,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Blue Access,Anthem Blue Access,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Blue Access Choice,Anthem Blue Access Choice,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Blue Preferred,Anthem Blue Preferred,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Pathway,Anthem Pathway,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Alliance,Anthem Alliance,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Anthem Medicare,Anthem Medicare,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Cigna,Cigna,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Cigna PPO,Cigna PPO,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Cigna Medicare Advantage,Cigna Medicare Advantage,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Essence,Essence,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Healthlink HMO,Healthlink HMO,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Healthlink PPO,Healthlink PPO,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,HomeState Health Plan,HomeState Health Plan,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Humana Gold,Humana Gold,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Medicaid MO,Medicaid MO,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Medica,Medica,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Tricare,Tricare,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,UHC All Payer,UHC All Payer,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,UHC Exchange,UHC Exchange,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,UHC Medicaid,UHC Medicaid,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,UMR CPD,UMR CPD,47.45,,,,,,,per diem,47.45,47.45,"Per diem rate, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,UHC Medicare,UHC Medicare,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
THROMBOPLASTIN SUBSTITUTION   ,38206600,CDM,305,RC,85732,CPT,,,,Inpatient,,,47.45,47.45,Wellcare,Wellcare,47.45,,,,,,,case rate,47.45,47.45,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Meritain Health PPO CPD,Meritain Health PPO CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Aetna/Commercial Product,Aetna/Commercial Product,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Meritain Health CPD,Meritain Health CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Starmark CPD,Starmark CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Aetna Medicare,Aetna Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Ambetter ,Ambetter ,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Access,Anthem Blue Access,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Access Choice,Anthem Blue Access Choice,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Preferred,Anthem Blue Preferred,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Pathway,Anthem Pathway,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Alliance,Anthem Alliance,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Anthem Medicare,Anthem Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Cigna,Cigna,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Cigna PPO,Cigna PPO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Cigna Medicare Advantage,Cigna Medicare Advantage,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Essence,Essence,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Healthlink HMO,Healthlink HMO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Healthlink PPO,Healthlink PPO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,HomeState Health Plan,HomeState Health Plan,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Humana Gold,Humana Gold,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Medicaid MO,Medicaid MO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Medica,Medica,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Tricare,Tricare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,UHC All Payer,UHC All Payer,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,UHC Exchange,UHC Exchange,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,UHC Medicaid,UHC Medicaid,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,UMR CPD,UMR CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,UHC Medicare,UHC Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38206700,CDM,302,RC,86147,CPT,,,,Inpatient,,,231.28,231.28,Wellcare,Wellcare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Meritain Health PPO CPD,Meritain Health PPO CPD,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Aetna/Commercial Product,Aetna/Commercial Product,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Meritain Health CPD,Meritain Health CPD,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Starmark CPD,Starmark CPD,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Aetna Medicare,Aetna Medicare,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Ambetter ,Ambetter ,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Blue Access,Anthem Blue Access,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Blue Access Choice,Anthem Blue Access Choice,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Blue Preferred,Anthem Blue Preferred,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Pathway,Anthem Pathway,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Alliance,Anthem Alliance,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Anthem Medicare,Anthem Medicare,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Cigna,Cigna,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Cigna PPO,Cigna PPO,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Cigna Medicare Advantage,Cigna Medicare Advantage,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Essence,Essence,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Healthlink HMO,Healthlink HMO,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Healthlink PPO,Healthlink PPO,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,HomeState Health Plan,HomeState Health Plan,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Humana Gold,Humana Gold,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Medicaid MO,Medicaid MO,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Medica,Medica,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Tricare,Tricare,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,UHC All Payer,UHC All Payer,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,UHC Exchange,UHC Exchange,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,UHC Medicaid,UHC Medicaid,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,UMR CPD,UMR CPD,128.9,,,,,,,per diem,128.9,128.9,"Per diem rate, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,UHC Medicare,UHC Medicare,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
ASPERGILLUS ANTIBODY          ,38206710,CDM,302,RC,86606,CPT,,,,Inpatient,,,128.9,128.9,Wellcare,Wellcare,128.9,,,,,,,case rate,128.9,128.9,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Meritain Health PPO CPD,Meritain Health PPO CPD,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Aetna/Commercial Product,Aetna/Commercial Product,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Meritain Health CPD,Meritain Health CPD,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Starmark CPD,Starmark CPD,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Aetna Medicare,Aetna Medicare,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Ambetter ,Ambetter ,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Blue Access,Anthem Blue Access,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Blue Access Choice,Anthem Blue Access Choice,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Blue Preferred,Anthem Blue Preferred,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Pathway,Anthem Pathway,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Alliance,Anthem Alliance,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Anthem Medicare,Anthem Medicare,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Cigna,Cigna,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Cigna PPO,Cigna PPO,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Cigna Medicare Advantage,Cigna Medicare Advantage,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Essence,Essence,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Healthlink HMO,Healthlink HMO,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Healthlink PPO,Healthlink PPO,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,HomeState Health Plan,HomeState Health Plan,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Humana Gold,Humana Gold,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Medicaid MO,Medicaid MO,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Medica,Medica,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Tricare,Tricare,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,UHC All Payer,UHC All Payer,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,UHC Exchange,UHC Exchange,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,UHC Medicaid,UHC Medicaid,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,UMR CPD,UMR CPD,257.8,,,,,,,per diem,257.8,257.8,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,UHC Medicare,UHC Medicare,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38206757,CDM,301,RC,83090,CPT,,,,Inpatient,,,257.8,257.8,Wellcare,Wellcare,257.8,,,,,,,case rate,257.8,257.8,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Meritain Health PPO CPD,Meritain Health PPO CPD,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Aetna/Commercial Product,Aetna/Commercial Product,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Meritain Health CPD,Meritain Health CPD,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Starmark CPD,Starmark CPD,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Aetna Medicare,Aetna Medicare,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Ambetter ,Ambetter ,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Blue Access,Anthem Blue Access,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Blue Access Choice,Anthem Blue Access Choice,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Blue Preferred,Anthem Blue Preferred,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Pathway,Anthem Pathway,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Alliance,Anthem Alliance,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Anthem Medicare,Anthem Medicare,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Cigna,Cigna,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Cigna PPO,Cigna PPO,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Cigna Medicare Advantage,Cigna Medicare Advantage,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Essence,Essence,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Healthlink HMO,Healthlink HMO,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Healthlink PPO,Healthlink PPO,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,HomeState Health Plan,HomeState Health Plan,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Humana Gold,Humana Gold,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Medicaid MO,Medicaid MO,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Medica,Medica,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Tricare,Tricare,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,UHC All Payer,UHC All Payer,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,UHC Exchange,UHC Exchange,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,UHC Medicaid,UHC Medicaid,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,UMR CPD,UMR CPD,402.08,,,,,,,per diem,402.08,402.08,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,UHC Medicare,UHC Medicare,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38206802,CDM,306,RC,87517,CPT,,,,Inpatient,,,402.08,402.08,Wellcare,Wellcare,402.08,,,,,,,case rate,402.08,402.08,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CARNITINE                     ,38206806,CDM,301,RC,82379,CPT,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Meritain Health PPO CPD,Meritain Health PPO CPD,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Aetna/Commercial Product,Aetna/Commercial Product,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Meritain Health CPD,Meritain Health CPD,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Starmark CPD,Starmark CPD,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Aetna Medicare,Aetna Medicare,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Ambetter ,Ambetter ,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Blue Access,Anthem Blue Access,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Blue Access Choice,Anthem Blue Access Choice,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Blue Preferred,Anthem Blue Preferred,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Pathway,Anthem Pathway,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Alliance,Anthem Alliance,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Anthem Medicare,Anthem Medicare,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Cigna,Cigna,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Cigna PPO,Cigna PPO,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Cigna Medicare Advantage,Cigna Medicare Advantage,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Essence,Essence,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Healthlink HMO,Healthlink HMO,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Healthlink PPO,Healthlink PPO,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,HomeState Health Plan,HomeState Health Plan,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Humana Gold,Humana Gold,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Medicaid MO,Medicaid MO,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Medica,Medica,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Tricare,Tricare,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,UHC All Payer,UHC All Payer,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,UHC Exchange,UHC Exchange,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,UHC Medicaid,UHC Medicaid,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,UMR CPD,UMR CPD,66.5,,,,,,,per diem,66.5,66.5,"Per diem rate, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,UHC Medicare,UHC Medicare,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
IMMUNOFLUR STDY EA AB INDIRECT,38206810,CDM,311,RC,88347,CPT,,,,Inpatient,,,66.5,66.5,Wellcare,Wellcare,66.5,,,,,,,case rate,66.5,66.5,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Meritain Health PPO CPD,Meritain Health PPO CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Aetna/Commercial Product,Aetna/Commercial Product,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Meritain Health CPD,Meritain Health CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Starmark CPD,Starmark CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Aetna Medicare,Aetna Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Ambetter ,Ambetter ,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Access,Anthem Blue Access,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Access Choice,Anthem Blue Access Choice,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Preferred,Anthem Blue Preferred,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Pathway,Anthem Pathway,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Alliance,Anthem Alliance,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Anthem Medicare,Anthem Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Cigna,Cigna,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Cigna PPO,Cigna PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Cigna Medicare Advantage,Cigna Medicare Advantage,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Essence,Essence,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Healthlink HMO,Healthlink HMO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Healthlink PPO,Healthlink PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,HomeState Health Plan,HomeState Health Plan,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Humana Gold,Humana Gold,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Medicaid MO,Medicaid MO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Medica,Medica,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Tricare,Tricare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,UHC All Payer,UHC All Payer,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,UHC Exchange,UHC Exchange,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,UHC Medicaid,UHC Medicaid,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,UMR CPD,UMR CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,UHC Medicare,UHC Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
STREP A AMP PROBE TECH        ,38206815,CDM,306,RC,87651,CPT,,,,Inpatient,,,133.9,133.9,Wellcare,Wellcare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Meritain Health PPO CPD,Meritain Health PPO CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna/Commercial Product,Aetna/Commercial Product,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Meritain Health CPD,Meritain Health CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Starmark CPD,Starmark CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna Medicare,Aetna Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Ambetter ,Ambetter ,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Access,Anthem Blue Access,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Access Choice,Anthem Blue Access Choice,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Preferred,Anthem Blue Preferred,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Pathway,Anthem Pathway,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Alliance,Anthem Alliance,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Medicare,Anthem Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna,Cigna,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna PPO,Cigna PPO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna Medicare Advantage,Cigna Medicare Advantage,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Essence,Essence,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthlink HMO,Healthlink HMO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthlink PPO,Healthlink PPO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,HomeState Health Plan,HomeState Health Plan,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Humana Gold,Humana Gold,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Medicaid MO,Medicaid MO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Medica,Medica,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Tricare,Tricare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC All Payer,UHC All Payer,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Exchange,UHC Exchange,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Medicaid,UHC Medicaid,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UMR CPD,UMR CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Medicare,UHC Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38207001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Wellcare,Wellcare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Meritain Health PPO CPD,Meritain Health PPO CPD,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Aetna/Commercial Product,Aetna/Commercial Product,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Meritain Health CPD,Meritain Health CPD,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Starmark CPD,Starmark CPD,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Aetna Medicare,Aetna Medicare,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Ambetter ,Ambetter ,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Blue Access,Anthem Blue Access,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Blue Access Choice,Anthem Blue Access Choice,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Blue Preferred,Anthem Blue Preferred,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Pathway,Anthem Pathway,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Alliance,Anthem Alliance,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Anthem Medicare,Anthem Medicare,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Cigna,Cigna,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Cigna PPO,Cigna PPO,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Cigna Medicare Advantage,Cigna Medicare Advantage,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Essence,Essence,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Healthlink HMO,Healthlink HMO,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Healthlink PPO,Healthlink PPO,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,HomeState Health Plan,HomeState Health Plan,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Humana Gold,Humana Gold,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Medicaid MO,Medicaid MO,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Medica,Medica,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Tricare,Tricare,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,UHC All Payer,UHC All Payer,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,UHC Exchange,UHC Exchange,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,UHC Medicaid,UHC Medicaid,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,UMR CPD,UMR CPD,25.46,,,,,,,per diem,25.46,25.46,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,UHC Medicare,UHC Medicare,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38207002,CDM,300,RC,36416,CPT,,,,Inpatient,,,25.46,25.46,Wellcare,Wellcare,25.46,,,,,,,case rate,25.46,25.46,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Meritain Health PPO CPD,Meritain Health PPO CPD,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Aetna/Commercial Product,Aetna/Commercial Product,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Meritain Health CPD,Meritain Health CPD,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Starmark CPD,Starmark CPD,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Aetna Medicare,Aetna Medicare,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Ambetter ,Ambetter ,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Blue Access,Anthem Blue Access,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Blue Access Choice,Anthem Blue Access Choice,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Blue Preferred,Anthem Blue Preferred,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Pathway,Anthem Pathway,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Alliance,Anthem Alliance,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Anthem Medicare,Anthem Medicare,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Cigna,Cigna,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Cigna PPO,Cigna PPO,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Cigna Medicare Advantage,Cigna Medicare Advantage,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Essence,Essence,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Healthlink HMO,Healthlink HMO,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Healthlink PPO,Healthlink PPO,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,HomeState Health Plan,HomeState Health Plan,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Humana Gold,Humana Gold,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Medicaid MO,Medicaid MO,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Medica,Medica,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Tricare,Tricare,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,UHC All Payer,UHC All Payer,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,UHC Exchange,UHC Exchange,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,UHC Medicaid,UHC Medicaid,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,UMR CPD,UMR CPD,217.48,,,,,,,per diem,217.48,217.48,"Per diem rate, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,UHC Medicare,UHC Medicare,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
"HIV1 & HIV2, SINGLE ASSSAY    ",38207004,CDM,300,RC,86703,CPT,G0432,HCPCS,,Inpatient,,,217.48,217.48,Wellcare,Wellcare,217.48,,,,,,,case rate,217.48,217.48,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Meritain Health PPO CPD,Meritain Health PPO CPD,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Aetna/Commercial Product,Aetna/Commercial Product,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Meritain Health CPD,Meritain Health CPD,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Starmark CPD,Starmark CPD,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Aetna Medicare,Aetna Medicare,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Ambetter ,Ambetter ,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Blue Access,Anthem Blue Access,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Blue Access Choice,Anthem Blue Access Choice,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Blue Preferred,Anthem Blue Preferred,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Pathway,Anthem Pathway,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Alliance,Anthem Alliance,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Anthem Medicare,Anthem Medicare,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Cigna,Cigna,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Cigna PPO,Cigna PPO,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Cigna Medicare Advantage,Cigna Medicare Advantage,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Essence,Essence,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Healthlink HMO,Healthlink HMO,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Healthlink PPO,Healthlink PPO,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,HomeState Health Plan,HomeState Health Plan,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Humana Gold,Humana Gold,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Medicaid MO,Medicaid MO,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Medica,Medica,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Tricare,Tricare,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,UHC All Payer,UHC All Payer,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,UHC Exchange,UHC Exchange,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,UHC Medicaid,UHC Medicaid,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,UMR CPD,UMR CPD,233.99,,,,,,,per diem,233.99,233.99,"Per diem rate, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,UHC Medicare,UHC Medicare,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CHROMIUM                      ,38207006,CDM,300,RC,82495,CPT,,,,Inpatient,,,233.99,233.99,Wellcare,Wellcare,233.99,,,,,,,case rate,233.99,233.99,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Meritain Health PPO CPD,Meritain Health PPO CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Aetna/Commercial Product,Aetna/Commercial Product,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Meritain Health CPD,Meritain Health CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Starmark CPD,Starmark CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Aetna Medicare,Aetna Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Ambetter ,Ambetter ,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Access,Anthem Blue Access,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Access Choice,Anthem Blue Access Choice,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Preferred,Anthem Blue Preferred,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Pathway,Anthem Pathway,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Alliance,Anthem Alliance,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Anthem Medicare,Anthem Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Cigna,Cigna,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Cigna PPO,Cigna PPO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Cigna Medicare Advantage,Cigna Medicare Advantage,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Essence,Essence,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Healthlink HMO,Healthlink HMO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Healthlink PPO,Healthlink PPO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,HomeState Health Plan,HomeState Health Plan,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Humana Gold,Humana Gold,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Medicaid MO,Medicaid MO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Medica,Medica,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Tricare,Tricare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,UHC All Payer,UHC All Payer,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,UHC Exchange,UHC Exchange,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,UHC Medicaid,UHC Medicaid,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,UMR CPD,UMR CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,UHC Medicare,UHC Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR II            ,38207007,CDM,305,RC,85210,CPT,,,,Inpatient,,,458.06,458.06,Wellcare,Wellcare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, CALIFORNIA      ",38207008,CDM,300,RC,86651,CPT,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, EASTERN EQUINE  ",38207009,CDM,300,RC,86652,CPT,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, ST. LOUIS       ",38207010,CDM,300,RC,86653,CPT,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
"ENCEPHALITIS, WESTERN EQUINE  ",38207011,CDM,300,RC,86654,CPT,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Meritain Health PPO CPD,Meritain Health PPO CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Aetna/Commercial Product,Aetna/Commercial Product,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Meritain Health CPD,Meritain Health CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Starmark CPD,Starmark CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Aetna Medicare,Aetna Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Ambetter ,Ambetter ,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Blue Access,Anthem Blue Access,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Blue Access Choice,Anthem Blue Access Choice,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Blue Preferred,Anthem Blue Preferred,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Pathway,Anthem Pathway,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Alliance,Anthem Alliance,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Anthem Medicare,Anthem Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Cigna,Cigna,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Cigna PPO,Cigna PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Cigna Medicare Advantage,Cigna Medicare Advantage,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Essence,Essence,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Healthlink HMO,Healthlink HMO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Healthlink PPO,Healthlink PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,HomeState Health Plan,HomeState Health Plan,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Humana Gold,Humana Gold,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Medicaid MO,Medicaid MO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Medica,Medica,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Tricare,Tricare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,UHC All Payer,UHC All Payer,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,UHC Exchange,UHC Exchange,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,UHC Medicaid,UHC Medicaid,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,UMR CPD,UMR CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,UHC Medicare,UHC Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
BARTONELLA/CAT SCRATCH DISEASE,38207012,CDM,300,RC,86611,CPT,,,,Inpatient,,,42.02,42.02,Wellcare,Wellcare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Meritain Health PPO CPD,Meritain Health PPO CPD,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Aetna/Commercial Product,Aetna/Commercial Product,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Meritain Health CPD,Meritain Health CPD,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Starmark CPD,Starmark CPD,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Aetna Medicare,Aetna Medicare,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Ambetter ,Ambetter ,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Blue Access,Anthem Blue Access,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Blue Access Choice,Anthem Blue Access Choice,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Blue Preferred,Anthem Blue Preferred,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Pathway,Anthem Pathway,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Alliance,Anthem Alliance,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Anthem Medicare,Anthem Medicare,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Cigna,Cigna,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Cigna PPO,Cigna PPO,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Cigna Medicare Advantage,Cigna Medicare Advantage,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Essence,Essence,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Healthlink HMO,Healthlink HMO,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Healthlink PPO,Healthlink PPO,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,HomeState Health Plan,HomeState Health Plan,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Humana Gold,Humana Gold,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Medicaid MO,Medicaid MO,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Medica,Medica,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Tricare,Tricare,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,UHC All Payer,UHC All Payer,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,UHC Exchange,UHC Exchange,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,UHC Medicaid,UHC Medicaid,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,UMR CPD,UMR CPD,161.01,,,,,,,per diem,161.01,161.01,"Per diem rate, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,UHC Medicare,UHC Medicare,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
"HELICOBACTER PYLORI, STOOL    ",38207013,CDM,300,RC,87338,CPT,,,,Inpatient,,,161.01,161.01,Wellcare,Wellcare,161.01,,,,,,,case rate,161.01,161.01,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Meritain Health PPO CPD,Meritain Health PPO CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna/Commercial Product,Aetna/Commercial Product,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Meritain Health CPD,Meritain Health CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Starmark CPD,Starmark CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna Medicare,Aetna Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Ambetter ,Ambetter ,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Access,Anthem Blue Access,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Access Choice,Anthem Blue Access Choice,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Preferred,Anthem Blue Preferred,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Pathway,Anthem Pathway,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Alliance,Anthem Alliance,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Medicare,Anthem Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna,Cigna,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna PPO,Cigna PPO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna Medicare Advantage,Cigna Medicare Advantage,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Essence,Essence,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthlink HMO,Healthlink HMO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthlink PPO,Healthlink PPO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,HomeState Health Plan,HomeState Health Plan,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Humana Gold,Humana Gold,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Medicaid MO,Medicaid MO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Medica,Medica,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Tricare,Tricare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC All Payer,UHC All Payer,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Exchange,UHC Exchange,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Medicaid,UHC Medicaid,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UMR CPD,UMR CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Medicare,UHC Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38207014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Wellcare,Wellcare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
KB SENSITIVITY                ,38207015,CDM,306,RC,87184,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Meritain Health PPO CPD,Meritain Health PPO CPD,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Aetna/Commercial Product,Aetna/Commercial Product,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Meritain Health CPD,Meritain Health CPD,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Starmark CPD,Starmark CPD,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Aetna Medicare,Aetna Medicare,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Ambetter ,Ambetter ,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Blue Access,Anthem Blue Access,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Blue Access Choice,Anthem Blue Access Choice,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Blue Preferred,Anthem Blue Preferred,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Pathway,Anthem Pathway,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Alliance,Anthem Alliance,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Anthem Medicare,Anthem Medicare,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Cigna,Cigna,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Cigna PPO,Cigna PPO,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Cigna Medicare Advantage,Cigna Medicare Advantage,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Essence,Essence,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Healthlink HMO,Healthlink HMO,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Healthlink PPO,Healthlink PPO,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,HomeState Health Plan,HomeState Health Plan,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Humana Gold,Humana Gold,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Medicaid MO,Medicaid MO,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Medica,Medica,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Tricare,Tricare,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,UHC All Payer,UHC All Payer,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,UHC Exchange,UHC Exchange,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,UHC Medicaid,UHC Medicaid,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,UMR CPD,UMR CPD,345.71,,,,,,,per diem,345.71,345.71,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,UHC Medicare,UHC Medicare,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38207016,CDM,305,RC,85306,CPT,,,,Inpatient,,,345.71,345.71,Wellcare,Wellcare,345.71,,,,,,,case rate,345.71,345.71,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Meritain Health PPO CPD,Meritain Health PPO CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Aetna/Commercial Product,Aetna/Commercial Product,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Meritain Health CPD,Meritain Health CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Starmark CPD,Starmark CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Aetna Medicare,Aetna Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Ambetter ,Ambetter ,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Blue Access,Anthem Blue Access,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Blue Access Choice,Anthem Blue Access Choice,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Blue Preferred,Anthem Blue Preferred,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Pathway,Anthem Pathway,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Alliance,Anthem Alliance,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Anthem Medicare,Anthem Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Cigna,Cigna,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Cigna PPO,Cigna PPO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Cigna Medicare Advantage,Cigna Medicare Advantage,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Essence,Essence,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Healthlink HMO,Healthlink HMO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Healthlink PPO,Healthlink PPO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,HomeState Health Plan,HomeState Health Plan,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Humana Gold,Humana Gold,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Medicaid MO,Medicaid MO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Medica,Medica,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Tricare,Tricare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,UHC All Payer,UHC All Payer,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,UHC Exchange,UHC Exchange,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,UHC Medicaid,UHC Medicaid,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,UMR CPD,UMR CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,UHC Medicare,UHC Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
PNEUMOCYSTIS CARINII          ,38207018,CDM,306,RC,87281,CPT,,,,Inpatient,,,225.88,225.88,Wellcare,Wellcare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
METHEMOGLOBIN QUANT           ,38207019,CDM,301,RC,83050,CPT,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Meritain Health PPO CPD,Meritain Health PPO CPD,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Aetna/Commercial Product,Aetna/Commercial Product,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Meritain Health CPD,Meritain Health CPD,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Starmark CPD,Starmark CPD,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Aetna Medicare,Aetna Medicare,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Ambetter ,Ambetter ,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Blue Access,Anthem Blue Access,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Blue Access Choice,Anthem Blue Access Choice,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Blue Preferred,Anthem Blue Preferred,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Pathway,Anthem Pathway,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Alliance,Anthem Alliance,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Anthem Medicare,Anthem Medicare,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Cigna,Cigna,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Cigna PPO,Cigna PPO,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Cigna Medicare Advantage,Cigna Medicare Advantage,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Essence,Essence,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Healthlink HMO,Healthlink HMO,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Healthlink PPO,Healthlink PPO,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,HomeState Health Plan,HomeState Health Plan,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Humana Gold,Humana Gold,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Medicaid MO,Medicaid MO,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Medica,Medica,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Tricare,Tricare,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,UHC All Payer,UHC All Payer,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,UHC Exchange,UHC Exchange,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,UHC Medicaid,UHC Medicaid,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,UMR CPD,UMR CPD,111.39,,,,,,,per diem,111.39,111.39,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,UHC Medicare,UHC Medicare,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38207020,CDM,306,RC,87181,CPT,,,,Inpatient,,,111.39,111.39,Wellcare,Wellcare,111.39,,,,,,,case rate,111.39,111.39,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Meritain Health PPO CPD,Meritain Health PPO CPD,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Aetna/Commercial Product,Aetna/Commercial Product,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Meritain Health CPD,Meritain Health CPD,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Starmark CPD,Starmark CPD,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Aetna Medicare,Aetna Medicare,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Ambetter ,Ambetter ,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Blue Access,Anthem Blue Access,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Blue Access Choice,Anthem Blue Access Choice,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Blue Preferred,Anthem Blue Preferred,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Pathway,Anthem Pathway,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Alliance,Anthem Alliance,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Anthem Medicare,Anthem Medicare,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Cigna,Cigna,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Cigna PPO,Cigna PPO,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Cigna Medicare Advantage,Cigna Medicare Advantage,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Essence,Essence,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Healthlink HMO,Healthlink HMO,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Healthlink PPO,Healthlink PPO,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,HomeState Health Plan,HomeState Health Plan,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Humana Gold,Humana Gold,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Medicaid MO,Medicaid MO,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Medica,Medica,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Tricare,Tricare,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,UHC All Payer,UHC All Payer,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,UHC Exchange,UHC Exchange,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,UHC Medicaid,UHC Medicaid,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,UMR CPD,UMR CPD,142.82,,,,,,,per diem,142.82,142.82,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,UHC Medicare,UHC Medicare,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUCLEIC ACID     ,38207023,CDM,306,RC,87149,CPT,,,,Inpatient,,,142.82,142.82,Wellcare,Wellcare,142.82,,,,,,,case rate,142.82,142.82,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Meritain Health PPO CPD,Meritain Health PPO CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Aetna/Commercial Product,Aetna/Commercial Product,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Meritain Health CPD,Meritain Health CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Starmark CPD,Starmark CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Aetna Medicare,Aetna Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Ambetter ,Ambetter ,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Access,Anthem Blue Access,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Access Choice,Anthem Blue Access Choice,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Blue Preferred,Anthem Blue Preferred,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Pathway,Anthem Pathway,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Alliance,Anthem Alliance,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Anthem Medicare,Anthem Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Cigna,Cigna,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Cigna PPO,Cigna PPO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Cigna Medicare Advantage,Cigna Medicare Advantage,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Essence,Essence,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Healthlink HMO,Healthlink HMO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Healthlink PPO,Healthlink PPO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,HomeState Health Plan,HomeState Health Plan,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Humana Gold,Humana Gold,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Medicaid MO,Medicaid MO,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Medica,Medica,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Tricare,Tricare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,UHC All Payer,UHC All Payer,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,UHC Exchange,UHC Exchange,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,UHC Medicaid,UHC Medicaid,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,UMR CPD,UMR CPD,374.5,,,,,,,per diem,374.5,374.5,"Per diem rate, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,UHC Medicare,UHC Medicare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
DRUG TEST PRSMV CHEM ANLYZR   ,38207024,CDM,300,RC,80307,CPT,,,,Inpatient,,,374.5,374.5,Wellcare,Wellcare,374.5,,,,,,,case rate,374.5,374.5,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Meritain Health PPO CPD,Meritain Health PPO CPD,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Aetna/Commercial Product,Aetna/Commercial Product,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Meritain Health CPD,Meritain Health CPD,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Starmark CPD,Starmark CPD,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Aetna Medicare,Aetna Medicare,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Ambetter ,Ambetter ,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Blue Access,Anthem Blue Access,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Blue Access Choice,Anthem Blue Access Choice,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Blue Preferred,Anthem Blue Preferred,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Pathway,Anthem Pathway,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Alliance,Anthem Alliance,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Anthem Medicare,Anthem Medicare,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Cigna,Cigna,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Cigna PPO,Cigna PPO,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Cigna Medicare Advantage,Cigna Medicare Advantage,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Essence,Essence,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Healthlink HMO,Healthlink HMO,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Healthlink PPO,Healthlink PPO,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,HomeState Health Plan,HomeState Health Plan,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Humana Gold,Humana Gold,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Medicaid MO,Medicaid MO,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Medica,Medica,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Tricare,Tricare,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,UHC All Payer,UHC All Payer,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,UHC Exchange,UHC Exchange,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,UHC Medicaid,UHC Medicaid,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,UMR CPD,UMR CPD,345.96,,,,,,,per diem,345.96,345.96,"Per diem rate, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,UHC Medicare,UHC Medicare,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
GI PATHOGEN 12-25 TARGETS     ,38207027,CDM,300,RC,87507,CPT,,,,Inpatient,,,345.96,345.96,Wellcare,Wellcare,345.96,,,,,,,case rate,345.96,345.96,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health PPO CPD,Meritain Health PPO CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Aetna/Commercial Product,Aetna/Commercial Product,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health CPD,Meritain Health CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Starmark CPD,Starmark CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Aetna Medicare,Aetna Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Ambetter ,Ambetter ,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access,Anthem Blue Access,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access Choice,Anthem Blue Access Choice,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Preferred,Anthem Blue Preferred,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Pathway,Anthem Pathway,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Alliance,Anthem Alliance,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Anthem Medicare,Anthem Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Cigna,Cigna,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Cigna PPO,Cigna PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Cigna Medicare Advantage,Cigna Medicare Advantage,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Essence,Essence,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Healthlink HMO,Healthlink HMO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Healthlink PPO,Healthlink PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,HomeState Health Plan,HomeState Health Plan,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Humana Gold,Humana Gold,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Medicaid MO,Medicaid MO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Medica,Medica,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Tricare,Tricare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,UHC All Payer,UHC All Payer,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,UHC Exchange,UHC Exchange,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicaid,UHC Medicaid,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,UMR CPD,UMR CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicare,UHC Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-2 ANTIBODY                ,38207034,CDM,300,RC,86702,CPT,,,,Inpatient,,,154.89,154.89,Wellcare,Wellcare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Meritain Health PPO CPD,Meritain Health PPO CPD,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Aetna/Commercial Product,Aetna/Commercial Product,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Meritain Health CPD,Meritain Health CPD,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Starmark CPD,Starmark CPD,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Aetna Medicare,Aetna Medicare,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Ambetter ,Ambetter ,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Blue Access,Anthem Blue Access,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Blue Access Choice,Anthem Blue Access Choice,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Blue Preferred,Anthem Blue Preferred,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Pathway,Anthem Pathway,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Alliance,Anthem Alliance,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Anthem Medicare,Anthem Medicare,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Cigna,Cigna,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Cigna PPO,Cigna PPO,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Cigna Medicare Advantage,Cigna Medicare Advantage,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Essence,Essence,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Healthlink HMO,Healthlink HMO,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Healthlink PPO,Healthlink PPO,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,HomeState Health Plan,HomeState Health Plan,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Humana Gold,Humana Gold,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Medicaid MO,Medicaid MO,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Medica,Medica,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Tricare,Tricare,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,UHC All Payer,UHC All Payer,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,UHC Exchange,UHC Exchange,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,UHC Medicaid,UHC Medicaid,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,UMR CPD,UMR CPD,131.55,,,,,,,per diem,131.55,131.55,"Per diem rate, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,UHC Medicare,UHC Medicare,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
HIV-1 AG W/HIV-1 & HIV-2 AB   ,38207035,CDM,300,RC,87389,CPT,,,,Inpatient,,,131.55,131.55,Wellcare,Wellcare,131.55,,,,,,,case rate,131.55,131.55,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Meritain Health PPO CPD,Meritain Health PPO CPD,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Aetna/Commercial Product,Aetna/Commercial Product,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Meritain Health CPD,Meritain Health CPD,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Starmark CPD,Starmark CPD,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Aetna Medicare,Aetna Medicare,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Ambetter ,Ambetter ,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Blue Access,Anthem Blue Access,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Blue Access Choice,Anthem Blue Access Choice,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Blue Preferred,Anthem Blue Preferred,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Pathway,Anthem Pathway,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Alliance,Anthem Alliance,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Anthem Medicare,Anthem Medicare,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Cigna,Cigna,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Cigna PPO,Cigna PPO,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Cigna Medicare Advantage,Cigna Medicare Advantage,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Essence,Essence,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Healthlink HMO,Healthlink HMO,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Healthlink PPO,Healthlink PPO,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,HomeState Health Plan,HomeState Health Plan,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Humana Gold,Humana Gold,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Medicaid MO,Medicaid MO,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Medica,Medica,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Tricare,Tricare,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,UHC All Payer,UHC All Payer,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,UHC Exchange,UHC Exchange,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,UHC Medicaid,UHC Medicaid,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,UMR CPD,UMR CPD,14.49,,,,,,,per diem,14.49,14.49,"Per diem rate, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,UHC Medicare,UHC Medicare,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
FUNGI IDENTIFICATION MOLD     ,38207037,CDM,300,RC,87107,CPT,,,,Inpatient,,,14.49,14.49,Wellcare,Wellcare,14.49,,,,,,,case rate,14.49,14.49,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS AG SERUM TITER   ,38220001,CDM,306,RC,86406,CPT,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
IMMFLUOR TYPE                 ,38220510,CDM,306,RC,87140,CPT,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Meritain Health PPO CPD,Meritain Health PPO CPD,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Aetna/Commercial Product,Aetna/Commercial Product,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Meritain Health CPD,Meritain Health CPD,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Starmark CPD,Starmark CPD,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Aetna Medicare,Aetna Medicare,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Ambetter ,Ambetter ,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Blue Access,Anthem Blue Access,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Blue Access Choice,Anthem Blue Access Choice,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Blue Preferred,Anthem Blue Preferred,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Pathway,Anthem Pathway,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Alliance,Anthem Alliance,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Anthem Medicare,Anthem Medicare,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Cigna,Cigna,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Cigna PPO,Cigna PPO,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Cigna Medicare Advantage,Cigna Medicare Advantage,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Essence,Essence,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Healthlink HMO,Healthlink HMO,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Healthlink PPO,Healthlink PPO,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,HomeState Health Plan,HomeState Health Plan,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Humana Gold,Humana Gold,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Medicaid MO,Medicaid MO,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Medica,Medica,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Tricare,Tricare,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,UHC All Payer,UHC All Payer,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,UHC Exchange,UHC Exchange,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,UHC Medicaid,UHC Medicaid,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,UMR CPD,UMR CPD,148.96,,,,,,,per diem,148.96,148.96,"Per diem rate, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,UHC Medicare,UHC Medicare,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
CREATININE RANDOM URINE       ,38243603,CDM,301,RC,82570,CPT,,,,Inpatient,,,148.96,148.96,Wellcare,Wellcare,148.96,,,,,,,case rate,148.96,148.96,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Meritain Health PPO CPD,Meritain Health PPO CPD,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Aetna/Commercial Product,Aetna/Commercial Product,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Meritain Health CPD,Meritain Health CPD,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Starmark CPD,Starmark CPD,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Aetna Medicare,Aetna Medicare,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Ambetter ,Ambetter ,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Blue Access,Anthem Blue Access,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Blue Access Choice,Anthem Blue Access Choice,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Blue Preferred,Anthem Blue Preferred,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Pathway,Anthem Pathway,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Alliance,Anthem Alliance,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Anthem Medicare,Anthem Medicare,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Cigna,Cigna,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Cigna PPO,Cigna PPO,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Cigna Medicare Advantage,Cigna Medicare Advantage,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Essence,Essence,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Healthlink HMO,Healthlink HMO,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Healthlink PPO,Healthlink PPO,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,HomeState Health Plan,HomeState Health Plan,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Humana Gold,Humana Gold,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Medicaid MO,Medicaid MO,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Medica,Medica,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Tricare,Tricare,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,UHC All Payer,UHC All Payer,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,UHC Exchange,UHC Exchange,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,UHC Medicaid,UHC Medicaid,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,UMR CPD,UMR CPD,81.17,,,,,,,per diem,81.17,81.17,"Per diem rate, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,UHC Medicare,UHC Medicare,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PHOSPHOROUS URINE             ,38243604,CDM,301,RC,84105,CPT,,,,Inpatient,,,81.17,81.17,Wellcare,Wellcare,81.17,,,,,,,case rate,81.17,81.17,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Meritain Health PPO CPD,Meritain Health PPO CPD,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Aetna/Commercial Product,Aetna/Commercial Product,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Meritain Health CPD,Meritain Health CPD,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Starmark CPD,Starmark CPD,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Aetna Medicare,Aetna Medicare,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Ambetter ,Ambetter ,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Blue Access,Anthem Blue Access,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Blue Access Choice,Anthem Blue Access Choice,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Blue Preferred,Anthem Blue Preferred,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Pathway,Anthem Pathway,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Alliance,Anthem Alliance,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Anthem Medicare,Anthem Medicare,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Cigna,Cigna,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Cigna PPO,Cigna PPO,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Cigna Medicare Advantage,Cigna Medicare Advantage,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Essence,Essence,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Healthlink HMO,Healthlink HMO,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Healthlink PPO,Healthlink PPO,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,HomeState Health Plan,HomeState Health Plan,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Humana Gold,Humana Gold,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Medicaid MO,Medicaid MO,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Medica,Medica,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Tricare,Tricare,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,UHC All Payer,UHC All Payer,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,UHC Exchange,UHC Exchange,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,UHC Medicaid,UHC Medicaid,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,UMR CPD,UMR CPD,351.23,,,,,,,per diem,351.23,351.23,"Per diem rate, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,UHC Medicare,UHC Medicare,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
PROTEIN URINE                 ,38243605,CDM,301,RC,84156,CPT,,,,Inpatient,,,351.23,351.23,Wellcare,Wellcare,351.23,,,,,,,case rate,351.23,351.23,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Meritain Health PPO CPD,Meritain Health PPO CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Aetna/Commercial Product,Aetna/Commercial Product,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Meritain Health CPD,Meritain Health CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Starmark CPD,Starmark CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Aetna Medicare,Aetna Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Ambetter ,Ambetter ,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Access,Anthem Blue Access,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Access Choice,Anthem Blue Access Choice,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Preferred,Anthem Blue Preferred,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Pathway,Anthem Pathway,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Alliance,Anthem Alliance,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Anthem Medicare,Anthem Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Cigna,Cigna,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Cigna PPO,Cigna PPO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Cigna Medicare Advantage,Cigna Medicare Advantage,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Essence,Essence,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Healthlink HMO,Healthlink HMO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Healthlink PPO,Healthlink PPO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,HomeState Health Plan,HomeState Health Plan,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Humana Gold,Humana Gold,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Medicaid MO,Medicaid MO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Medica,Medica,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Tricare,Tricare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,UHC All Payer,UHC All Payer,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,UHC Exchange,UHC Exchange,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,UHC Medicaid,UHC Medicaid,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,UMR CPD,UMR CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,UHC Medicare,UHC Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
"URIC ACID, NON-BLOOD          ",38243608,CDM,301,RC,84560,CPT,,,,Inpatient,,,128.37,128.37,Wellcare,Wellcare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38243613,CDM,301,RC,84206,CPT,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health PPO CPD,Meritain Health PPO CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Aetna/Commercial Product,Aetna/Commercial Product,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Meritain Health CPD,Meritain Health CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Starmark CPD,Starmark CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Aetna Medicare,Aetna Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Ambetter ,Ambetter ,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access,Anthem Blue Access,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Access Choice,Anthem Blue Access Choice,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Blue Preferred,Anthem Blue Preferred,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Pathway,Anthem Pathway,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Alliance,Anthem Alliance,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Anthem Medicare,Anthem Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Cigna,Cigna,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Cigna PPO,Cigna PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Cigna Medicare Advantage,Cigna Medicare Advantage,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Essence,Essence,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Healthlink HMO,Healthlink HMO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Healthlink PPO,Healthlink PPO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,HomeState Health Plan,HomeState Health Plan,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Humana Gold,Humana Gold,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Medicaid MO,Medicaid MO,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Medica,Medica,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Tricare,Tricare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,UHC All Payer,UHC All Payer,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,UHC Exchange,UHC Exchange,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicaid,UHC Medicaid,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,UMR CPD,UMR CPD,133.67,,,,,,,per diem,133.67,133.67,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,UHC Medicare,UHC Medicare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38243614,CDM,302,RC,86431,CPT,,,,Inpatient,,,133.67,133.67,Wellcare,Wellcare,133.67,,,,,,,case rate,133.67,133.67,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Meritain Health PPO CPD,Meritain Health PPO CPD,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Aetna/Commercial Product,Aetna/Commercial Product,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Meritain Health CPD,Meritain Health CPD,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Starmark CPD,Starmark CPD,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Aetna Medicare,Aetna Medicare,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Ambetter ,Ambetter ,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Blue Access,Anthem Blue Access,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Blue Access Choice,Anthem Blue Access Choice,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Blue Preferred,Anthem Blue Preferred,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Pathway,Anthem Pathway,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Alliance,Anthem Alliance,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Anthem Medicare,Anthem Medicare,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Cigna,Cigna,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Cigna PPO,Cigna PPO,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Cigna Medicare Advantage,Cigna Medicare Advantage,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Essence,Essence,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Healthlink HMO,Healthlink HMO,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Healthlink PPO,Healthlink PPO,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,HomeState Health Plan,HomeState Health Plan,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Humana Gold,Humana Gold,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Medicaid MO,Medicaid MO,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Medica,Medica,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Tricare,Tricare,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,UHC All Payer,UHC All Payer,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,UHC Exchange,UHC Exchange,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,UHC Medicaid,UHC Medicaid,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,UMR CPD,UMR CPD,305.54,,,,,,,per diem,305.54,305.54,"Per diem rate, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,UHC Medicare,UHC Medicare,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
DHEA (DEHYDROEPIANDROSTERONE) ,38243615,CDM,301,RC,82626,CPT,,,,Inpatient,,,305.54,305.54,Wellcare,Wellcare,305.54,,,,,,,case rate,305.54,305.54,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Meritain Health PPO CPD,Meritain Health PPO CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Aetna/Commercial Product,Aetna/Commercial Product,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Meritain Health CPD,Meritain Health CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Starmark CPD,Starmark CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Aetna Medicare,Aetna Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Ambetter ,Ambetter ,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Blue Access,Anthem Blue Access,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Blue Access Choice,Anthem Blue Access Choice,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Blue Preferred,Anthem Blue Preferred,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Pathway,Anthem Pathway,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Alliance,Anthem Alliance,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Anthem Medicare,Anthem Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Cigna,Cigna,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Cigna PPO,Cigna PPO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Cigna Medicare Advantage,Cigna Medicare Advantage,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Essence,Essence,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Healthlink HMO,Healthlink HMO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Healthlink PPO,Healthlink PPO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,HomeState Health Plan,HomeState Health Plan,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Humana Gold,Humana Gold,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Medicaid MO,Medicaid MO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Medica,Medica,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Tricare,Tricare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,UHC All Payer,UHC All Payer,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,UHC Exchange,UHC Exchange,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,UHC Medicaid,UHC Medicaid,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,UMR CPD,UMR CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,UHC Medicare,UHC Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
PARAINFLUENZA VIRUS (IFA)     ,38243616,CDM,306,RC,87279,CPT,,,,Inpatient,,,152.34,152.34,Wellcare,Wellcare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ALPROZOLAM (XANAX)            ,38243617,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Meritain Health PPO CPD,Meritain Health PPO CPD,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Aetna/Commercial Product,Aetna/Commercial Product,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Meritain Health CPD,Meritain Health CPD,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Starmark CPD,Starmark CPD,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Aetna Medicare,Aetna Medicare,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Ambetter ,Ambetter ,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Blue Access,Anthem Blue Access,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Blue Access Choice,Anthem Blue Access Choice,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Blue Preferred,Anthem Blue Preferred,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Pathway,Anthem Pathway,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Alliance,Anthem Alliance,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Anthem Medicare,Anthem Medicare,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Cigna,Cigna,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Cigna PPO,Cigna PPO,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Cigna Medicare Advantage,Cigna Medicare Advantage,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Essence,Essence,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Healthlink HMO,Healthlink HMO,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Healthlink PPO,Healthlink PPO,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,HomeState Health Plan,HomeState Health Plan,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Humana Gold,Humana Gold,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Medicaid MO,Medicaid MO,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Medica,Medica,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Tricare,Tricare,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,UHC All Payer,UHC All Payer,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,UHC Exchange,UHC Exchange,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,UHC Medicaid,UHC Medicaid,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,UMR CPD,UMR CPD,293.87,,,,,,,per diem,293.87,293.87,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,UHC Medicare,UHC Medicare,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38243620,CDM,305,RC,85260,CPT,,,,Inpatient,,,293.87,293.87,Wellcare,Wellcare,293.87,,,,,,,case rate,293.87,293.87,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Meritain Health PPO CPD,Meritain Health PPO CPD,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Aetna/Commercial Product,Aetna/Commercial Product,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Meritain Health CPD,Meritain Health CPD,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Starmark CPD,Starmark CPD,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Aetna Medicare,Aetna Medicare,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Ambetter ,Ambetter ,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Blue Access,Anthem Blue Access,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Blue Access Choice,Anthem Blue Access Choice,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Blue Preferred,Anthem Blue Preferred,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Pathway,Anthem Pathway,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Alliance,Anthem Alliance,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Anthem Medicare,Anthem Medicare,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Cigna,Cigna,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Cigna PPO,Cigna PPO,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Cigna Medicare Advantage,Cigna Medicare Advantage,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Essence,Essence,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Healthlink HMO,Healthlink HMO,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Healthlink PPO,Healthlink PPO,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,HomeState Health Plan,HomeState Health Plan,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Humana Gold,Humana Gold,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Medicaid MO,Medicaid MO,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Medica,Medica,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Tricare,Tricare,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,UHC All Payer,UHC All Payer,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,UHC Exchange,UHC Exchange,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,UHC Medicaid,UHC Medicaid,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,UMR CPD,UMR CPD,142.05,,,,,,,per diem,142.05,142.05,"Per diem rate, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,UHC Medicare,UHC Medicare,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
SOMATOMEDIN                   ,38243621,CDM,301,RC,84305,CPT,,,,Inpatient,,,142.05,142.05,Wellcare,Wellcare,142.05,,,,,,,case rate,142.05,142.05,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Meritain Health PPO CPD,Meritain Health PPO CPD,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Aetna/Commercial Product,Aetna/Commercial Product,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Meritain Health CPD,Meritain Health CPD,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Starmark CPD,Starmark CPD,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Aetna Medicare,Aetna Medicare,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Ambetter ,Ambetter ,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Blue Access,Anthem Blue Access,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Blue Access Choice,Anthem Blue Access Choice,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Blue Preferred,Anthem Blue Preferred,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Pathway,Anthem Pathway,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Alliance,Anthem Alliance,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Anthem Medicare,Anthem Medicare,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Cigna,Cigna,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Cigna PPO,Cigna PPO,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Cigna Medicare Advantage,Cigna Medicare Advantage,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Essence,Essence,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Healthlink HMO,Healthlink HMO,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Healthlink PPO,Healthlink PPO,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,HomeState Health Plan,HomeState Health Plan,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Humana Gold,Humana Gold,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Medicaid MO,Medicaid MO,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Medica,Medica,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Tricare,Tricare,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,UHC All Payer,UHC All Payer,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,UHC Exchange,UHC Exchange,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,UHC Medicaid,UHC Medicaid,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,UMR CPD,UMR CPD,356.72,,,,,,,per diem,356.72,356.72,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,UHC Medicare,UHC Medicare,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38243624,CDM,306,RC,87522,CPT,,,,Inpatient,,,356.72,356.72,Wellcare,Wellcare,356.72,,,,,,,case rate,356.72,356.72,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Meritain Health PPO CPD,Meritain Health PPO CPD,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Aetna/Commercial Product,Aetna/Commercial Product,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Meritain Health CPD,Meritain Health CPD,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Starmark CPD,Starmark CPD,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Aetna Medicare,Aetna Medicare,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Ambetter ,Ambetter ,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Blue Access,Anthem Blue Access,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Blue Access Choice,Anthem Blue Access Choice,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Blue Preferred,Anthem Blue Preferred,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Pathway,Anthem Pathway,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Alliance,Anthem Alliance,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Anthem Medicare,Anthem Medicare,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Cigna,Cigna,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Cigna PPO,Cigna PPO,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Cigna Medicare Advantage,Cigna Medicare Advantage,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Essence,Essence,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Healthlink HMO,Healthlink HMO,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Healthlink PPO,Healthlink PPO,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,HomeState Health Plan,HomeState Health Plan,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Humana Gold,Humana Gold,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Medicaid MO,Medicaid MO,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Medica,Medica,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Tricare,Tricare,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,UHC All Payer,UHC All Payer,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,UHC Exchange,UHC Exchange,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,UHC Medicaid,UHC Medicaid,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,UMR CPD,UMR CPD,139.51,,,,,,,per diem,139.51,139.51,"Per diem rate, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,UHC Medicare,UHC Medicare,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
GIARDIA ANTIGEN               ,38243626,CDM,306,RC,87329,CPT,,,,Inpatient,,,139.51,139.51,Wellcare,Wellcare,139.51,,,,,,,case rate,139.51,139.51,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health PPO CPD,Meritain Health PPO CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Aetna/Commercial Product,Aetna/Commercial Product,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health CPD,Meritain Health CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Starmark CPD,Starmark CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Aetna Medicare,Aetna Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Ambetter ,Ambetter ,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access,Anthem Blue Access,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access Choice,Anthem Blue Access Choice,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Preferred,Anthem Blue Preferred,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Pathway,Anthem Pathway,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Alliance,Anthem Alliance,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Anthem Medicare,Anthem Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Cigna,Cigna,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Cigna PPO,Cigna PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Cigna Medicare Advantage,Cigna Medicare Advantage,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Essence,Essence,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Healthlink HMO,Healthlink HMO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Healthlink PPO,Healthlink PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,HomeState Health Plan,HomeState Health Plan,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Humana Gold,Humana Gold,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Medicaid MO,Medicaid MO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Medica,Medica,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Tricare,Tricare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,UHC All Payer,UHC All Payer,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,UHC Exchange,UHC Exchange,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicaid,UHC Medicaid,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,UMR CPD,UMR CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicare,UHC Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ETHYLENE GLYCOL               ,38243628,CDM,301,RC,82693,CPT,,,,Inpatient,,,98.76,98.76,Wellcare,Wellcare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Meritain Health PPO CPD,Meritain Health PPO CPD,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Aetna/Commercial Product,Aetna/Commercial Product,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Meritain Health CPD,Meritain Health CPD,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Starmark CPD,Starmark CPD,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Aetna Medicare,Aetna Medicare,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Ambetter ,Ambetter ,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Blue Access,Anthem Blue Access,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Blue Access Choice,Anthem Blue Access Choice,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Blue Preferred,Anthem Blue Preferred,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Pathway,Anthem Pathway,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Alliance,Anthem Alliance,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Anthem Medicare,Anthem Medicare,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Cigna,Cigna,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Cigna PPO,Cigna PPO,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Cigna Medicare Advantage,Cigna Medicare Advantage,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Essence,Essence,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Healthlink HMO,Healthlink HMO,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Healthlink PPO,Healthlink PPO,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,HomeState Health Plan,HomeState Health Plan,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Humana Gold,Humana Gold,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Medicaid MO,Medicaid MO,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Medica,Medica,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Tricare,Tricare,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,UHC All Payer,UHC All Payer,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,UHC Exchange,UHC Exchange,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,UHC Medicaid,UHC Medicaid,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,UMR CPD,UMR CPD,154.44,,,,,,,per diem,154.44,154.44,"Per diem rate, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,UHC Medicare,UHC Medicare,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
METHYL ALCOHOL                ,38243630,CDM,301,RC,84600,CPT,,,,Inpatient,,,154.44,154.44,Wellcare,Wellcare,154.44,,,,,,,case rate,154.44,154.44,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Meritain Health PPO CPD,Meritain Health PPO CPD,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Aetna/Commercial Product,Aetna/Commercial Product,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Meritain Health CPD,Meritain Health CPD,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Starmark CPD,Starmark CPD,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Aetna Medicare,Aetna Medicare,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Ambetter ,Ambetter ,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Blue Access,Anthem Blue Access,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Blue Access Choice,Anthem Blue Access Choice,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Blue Preferred,Anthem Blue Preferred,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Pathway,Anthem Pathway,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Alliance,Anthem Alliance,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Anthem Medicare,Anthem Medicare,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Cigna,Cigna,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Cigna PPO,Cigna PPO,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Cigna Medicare Advantage,Cigna Medicare Advantage,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Essence,Essence,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Healthlink HMO,Healthlink HMO,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Healthlink PPO,Healthlink PPO,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,HomeState Health Plan,HomeState Health Plan,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Humana Gold,Humana Gold,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Medicaid MO,Medicaid MO,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Medica,Medica,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Tricare,Tricare,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,UHC All Payer,UHC All Payer,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,UHC Exchange,UHC Exchange,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,UHC Medicaid,UHC Medicaid,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,UMR CPD,UMR CPD,322.15,,,,,,,per diem,322.15,322.15,"Per diem rate, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,UHC Medicare,UHC Medicare,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
PARVOVIRUS ANTIBODY           ,38243631,CDM,302,RC,86747,CPT,,,,Inpatient,,,322.15,322.15,Wellcare,Wellcare,322.15,,,,,,,case rate,322.15,322.15,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Meritain Health PPO CPD,Meritain Health PPO CPD,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Aetna/Commercial Product,Aetna/Commercial Product,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Meritain Health CPD,Meritain Health CPD,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Starmark CPD,Starmark CPD,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Aetna Medicare,Aetna Medicare,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Ambetter ,Ambetter ,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Blue Access,Anthem Blue Access,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Blue Access Choice,Anthem Blue Access Choice,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Blue Preferred,Anthem Blue Preferred,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Pathway,Anthem Pathway,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Alliance,Anthem Alliance,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Anthem Medicare,Anthem Medicare,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Cigna,Cigna,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Cigna PPO,Cigna PPO,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Cigna Medicare Advantage,Cigna Medicare Advantage,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Essence,Essence,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Healthlink HMO,Healthlink HMO,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Healthlink PPO,Healthlink PPO,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,HomeState Health Plan,HomeState Health Plan,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Humana Gold,Humana Gold,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Medicaid MO,Medicaid MO,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Medica,Medica,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Tricare,Tricare,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,UHC All Payer,UHC All Payer,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,UHC Exchange,UHC Exchange,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,UHC Medicaid,UHC Medicaid,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,UMR CPD,UMR CPD,154.7,,,,,,,per diem,154.7,154.7,"Per diem rate, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,UHC Medicare,UHC Medicare,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
CRYPTOSPORIDIUM IMMUNOFLUOR   ,38243650,CDM,306,RC,87272,CPT,,,,Inpatient,,,154.7,154.7,Wellcare,Wellcare,154.7,,,,,,,case rate,154.7,154.7,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Meritain Health PPO CPD,Meritain Health PPO CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna/Commercial Product,Aetna/Commercial Product,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Meritain Health CPD,Meritain Health CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Starmark CPD,Starmark CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna Medicare,Aetna Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Ambetter ,Ambetter ,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Access,Anthem Blue Access,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Access Choice,Anthem Blue Access Choice,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Preferred,Anthem Blue Preferred,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Pathway,Anthem Pathway,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Alliance,Anthem Alliance,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Medicare,Anthem Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna,Cigna,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna PPO,Cigna PPO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna Medicare Advantage,Cigna Medicare Advantage,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Essence,Essence,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthlink HMO,Healthlink HMO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthlink PPO,Healthlink PPO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,HomeState Health Plan,HomeState Health Plan,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Humana Gold,Humana Gold,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Medicaid MO,Medicaid MO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Medica,Medica,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Tricare,Tricare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC All Payer,UHC All Payer,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Exchange,UHC Exchange,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Medicaid,UHC Medicaid,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UMR CPD,UMR CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Medicare,UHC Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250000,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Wellcare,Wellcare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Meritain Health PPO CPD,Meritain Health PPO CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna/Commercial Product,Aetna/Commercial Product,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Meritain Health CPD,Meritain Health CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Starmark CPD,Starmark CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna Medicare,Aetna Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Ambetter ,Ambetter ,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Access,Anthem Blue Access,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Access Choice,Anthem Blue Access Choice,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Preferred,Anthem Blue Preferred,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Pathway,Anthem Pathway,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Alliance,Anthem Alliance,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Medicare,Anthem Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna,Cigna,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna PPO,Cigna PPO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna Medicare Advantage,Cigna Medicare Advantage,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Essence,Essence,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthlink HMO,Healthlink HMO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthlink PPO,Healthlink PPO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,HomeState Health Plan,HomeState Health Plan,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Humana Gold,Humana Gold,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Medicaid MO,Medicaid MO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Medica,Medica,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Tricare,Tricare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC All Payer,UHC All Payer,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Exchange,UHC Exchange,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Medicaid,UHC Medicaid,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UMR CPD,UMR CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Medicare,UHC Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250001,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Wellcare,Wellcare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health PPO CPD,Meritain Health PPO CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/Commercial Product,Aetna/Commercial Product,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health CPD,Meritain Health CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Starmark CPD,Starmark CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna Medicare,Aetna Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Ambetter ,Ambetter ,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access,Anthem Blue Access,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access Choice,Anthem Blue Access Choice,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Preferred,Anthem Blue Preferred,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Pathway,Anthem Pathway,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Alliance,Anthem Alliance,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Medicare,Anthem Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna,Cigna,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna PPO,Cigna PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna Medicare Advantage,Cigna Medicare Advantage,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Essence,Essence,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink HMO,Healthlink HMO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink PPO,Healthlink PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,HomeState Health Plan,HomeState Health Plan,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Humana Gold,Humana Gold,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Medicaid MO,Medicaid MO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Medica,Medica,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Tricare,Tricare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC All Payer,UHC All Payer,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Exchange,UHC Exchange,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicaid,UHC Medicaid,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UMR CPD,UMR CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicare,UHC Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38250002,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Wellcare,Wellcare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health PPO CPD,Meritain Health PPO CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/Commercial Product,Aetna/Commercial Product,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health CPD,Meritain Health CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Starmark CPD,Starmark CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Aetna Medicare,Aetna Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Ambetter ,Ambetter ,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access,Anthem Blue Access,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access Choice,Anthem Blue Access Choice,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Preferred,Anthem Blue Preferred,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Pathway,Anthem Pathway,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Alliance,Anthem Alliance,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Medicare,Anthem Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Cigna,Cigna,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Cigna PPO,Cigna PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Cigna Medicare Advantage,Cigna Medicare Advantage,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Essence,Essence,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink HMO,Healthlink HMO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink PPO,Healthlink PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,HomeState Health Plan,HomeState Health Plan,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Humana Gold,Humana Gold,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Medicaid MO,Medicaid MO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Medica,Medica,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Tricare,Tricare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,UHC All Payer,UHC All Payer,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,UHC Exchange,UHC Exchange,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicaid,UHC Medicaid,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,UMR CPD,UMR CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicare,UHC Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38250003,CDM,311,RC,,,,,,Inpatient,,,150.24,150.24,Wellcare,Wellcare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250004,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250005,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250006,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250007,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38250008,CDM,311,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Meritain Health PPO CPD,Meritain Health PPO CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna/Commercial Product,Aetna/Commercial Product,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Meritain Health CPD,Meritain Health CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Starmark CPD,Starmark CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna Medicare,Aetna Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Ambetter ,Ambetter ,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Access,Anthem Blue Access,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Access Choice,Anthem Blue Access Choice,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Preferred,Anthem Blue Preferred,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Pathway,Anthem Pathway,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Alliance,Anthem Alliance,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Medicare,Anthem Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna,Cigna,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna PPO,Cigna PPO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna Medicare Advantage,Cigna Medicare Advantage,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Essence,Essence,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthlink HMO,Healthlink HMO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthlink PPO,Healthlink PPO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,HomeState Health Plan,HomeState Health Plan,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Humana Gold,Humana Gold,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Medicaid MO,Medicaid MO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Medica,Medica,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Tricare,Tricare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC All Payer,UHC All Payer,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Exchange,UHC Exchange,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Medicaid,UHC Medicaid,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UMR CPD,UMR CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Medicare,UHC Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250009,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Wellcare,Wellcare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38250010,CDM,311,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health PPO CPD,Meritain Health PPO CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/Commercial Product,Aetna/Commercial Product,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health CPD,Meritain Health CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Starmark CPD,Starmark CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna Medicare,Aetna Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Ambetter ,Ambetter ,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access,Anthem Blue Access,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access Choice,Anthem Blue Access Choice,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Preferred,Anthem Blue Preferred,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Pathway,Anthem Pathway,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Alliance,Anthem Alliance,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Medicare,Anthem Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna,Cigna,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna PPO,Cigna PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna Medicare Advantage,Cigna Medicare Advantage,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Essence,Essence,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink HMO,Healthlink HMO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink PPO,Healthlink PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,HomeState Health Plan,HomeState Health Plan,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Humana Gold,Humana Gold,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medicaid MO,Medicaid MO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medica,Medica,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Tricare,Tricare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC All Payer,UHC All Payer,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Exchange,UHC Exchange,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicaid,UHC Medicaid,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UMR CPD,UMR CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicare,UHC Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38250011,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Wellcare,Wellcare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health PPO CPD,Meritain Health PPO CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/Commercial Product,Aetna/Commercial Product,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health CPD,Meritain Health CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Starmark CPD,Starmark CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Aetna Medicare,Aetna Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Ambetter ,Ambetter ,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access,Anthem Blue Access,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access Choice,Anthem Blue Access Choice,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Preferred,Anthem Blue Preferred,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Pathway,Anthem Pathway,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Alliance,Anthem Alliance,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Medicare,Anthem Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Cigna,Cigna,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Cigna PPO,Cigna PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Cigna Medicare Advantage,Cigna Medicare Advantage,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Essence,Essence,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink HMO,Healthlink HMO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink PPO,Healthlink PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,HomeState Health Plan,HomeState Health Plan,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Humana Gold,Humana Gold,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Medicaid MO,Medicaid MO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Medica,Medica,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Tricare,Tricare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,UHC All Payer,UHC All Payer,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,UHC Exchange,UHC Exchange,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicaid,UHC Medicaid,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,UMR CPD,UMR CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicare,UHC Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ZAP-70 ANLYSIS            ,38250013,CDM,311,RC,,,,,,Inpatient,,,134.48,134.48,Wellcare,Wellcare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Meritain Health PPO CPD,Meritain Health PPO CPD,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Aetna/Commercial Product,Aetna/Commercial Product,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Meritain Health CPD,Meritain Health CPD,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Starmark CPD,Starmark CPD,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Aetna Medicare,Aetna Medicare,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Ambetter ,Ambetter ,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Blue Access,Anthem Blue Access,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Blue Access Choice,Anthem Blue Access Choice,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Blue Preferred,Anthem Blue Preferred,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Pathway,Anthem Pathway,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Alliance,Anthem Alliance,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Anthem Medicare,Anthem Medicare,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Cigna,Cigna,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Cigna PPO,Cigna PPO,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Cigna Medicare Advantage,Cigna Medicare Advantage,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Essence,Essence,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Healthlink HMO,Healthlink HMO,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Healthlink PPO,Healthlink PPO,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,HomeState Health Plan,HomeState Health Plan,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Humana Gold,Humana Gold,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Medicaid MO,Medicaid MO,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Medica,Medica,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Tricare,Tricare,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,UHC All Payer,UHC All Payer,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,UHC Exchange,UHC Exchange,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,UHC Medicaid,UHC Medicaid,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,UMR CPD,UMR CPD,961.3,,,,,,,per diem,961.3,961.3,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,UHC Medicare,UHC Medicare,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 1            ,38250014,CDM,301,RC,,,,,,Inpatient,,,961.3,961.3,Wellcare,Wellcare,961.3,,,,,,,case rate,961.3,961.3,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health PPO CPD,Meritain Health PPO CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/Commercial Product,Aetna/Commercial Product,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health CPD,Meritain Health CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Starmark CPD,Starmark CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna Medicare,Aetna Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Ambetter ,Ambetter ,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access,Anthem Blue Access,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access Choice,Anthem Blue Access Choice,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Preferred,Anthem Blue Preferred,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Pathway,Anthem Pathway,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Alliance,Anthem Alliance,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Medicare,Anthem Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna,Cigna,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna PPO,Cigna PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna Medicare Advantage,Cigna Medicare Advantage,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Essence,Essence,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink HMO,Healthlink HMO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink PPO,Healthlink PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,HomeState Health Plan,HomeState Health Plan,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Humana Gold,Humana Gold,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medicaid MO,Medicaid MO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medica,Medica,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Tricare,Tricare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC All Payer,UHC All Payer,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Exchange,UHC Exchange,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicaid,UHC Medicaid,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UMR CPD,UMR CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicare,UHC Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 3            ,38250015,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Wellcare,Wellcare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health PPO CPD,Meritain Health PPO CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/Commercial Product,Aetna/Commercial Product,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health CPD,Meritain Health CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Starmark CPD,Starmark CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna Medicare,Aetna Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Ambetter ,Ambetter ,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access,Anthem Blue Access,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access Choice,Anthem Blue Access Choice,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Preferred,Anthem Blue Preferred,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Pathway,Anthem Pathway,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Alliance,Anthem Alliance,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Medicare,Anthem Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna,Cigna,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna PPO,Cigna PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna Medicare Advantage,Cigna Medicare Advantage,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Essence,Essence,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink HMO,Healthlink HMO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink PPO,Healthlink PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,HomeState Health Plan,HomeState Health Plan,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Humana Gold,Humana Gold,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medicaid MO,Medicaid MO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medica,Medica,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Tricare,Tricare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC All Payer,UHC All Payer,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Exchange,UHC Exchange,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicaid,UHC Medicaid,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UMR CPD,UMR CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicare,UHC Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O IGG SUBCLASS 4            ,38250016,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Wellcare,Wellcare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BEEF              ,38250017,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CARROT            ,38250018,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHOCOLATE         ,38250019,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CODFISH IGE       ,38250020,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGEY CORN             ,38250021,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORANGE            ,38250022,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PORK              ,38250023,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY STRAWBERRY        ,38250024,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN           ,38250025,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BERMUDA     ,38250026,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAT DANDER        ,38250027,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCKROACH GER     ,38250028,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE COTTONWD     ,38250029,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES             ,38250030,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MESQUITE     ,38250031,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE CEDAR        ,38250032,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OLIVE        ,38250033,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS RYE         ,38250034,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED PIGWEED      ,38250035,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED THISTLE      ,38250036,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED SCALE        ,38250037,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY APPLE             ,38250038,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHITE         ,38250039,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY MILK COW          ,38250040,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY OAT               ,38250041,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOMATO            ,38250042,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEANUT            ,38250043,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY BARLEY            ,38250044,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RYE               ,38250045,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY RICE              ,38250046,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLUTEN            ,38250047,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEAT             ,38250048,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ASH          ,38250049,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SALMON            ,38250050,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY SHRIMP            ,38250051,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TROUT             ,38250052,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY TURKEY            ,38250053,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health PPO CPD,Meritain Health PPO CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/Commercial Product,Aetna/Commercial Product,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health CPD,Meritain Health CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Starmark CPD,Starmark CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna Medicare,Aetna Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Ambetter ,Ambetter ,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access,Anthem Blue Access,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access Choice,Anthem Blue Access Choice,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Preferred,Anthem Blue Preferred,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Pathway,Anthem Pathway,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Alliance,Anthem Alliance,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Medicare,Anthem Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna,Cigna,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna PPO,Cigna PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna Medicare Advantage,Cigna Medicare Advantage,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Essence,Essence,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink HMO,Healthlink HMO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink PPO,Healthlink PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,HomeState Health Plan,HomeState Health Plan,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Humana Gold,Humana Gold,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medicaid MO,Medicaid MO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medica,Medica,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Tricare,Tricare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC All Payer,UHC All Payer,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Exchange,UHC Exchange,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicaid,UHC Medicaid,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UMR CPD,UMR CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicare,UHC Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG ALTERNARIA ALT     ,38250054,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Wellcare,Wellcare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY BRAZIL NUT        ,38250055,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASHEW            ,38250056,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health PPO CPD,Meritain Health PPO CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/Commercial Product,Aetna/Commercial Product,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health CPD,Meritain Health CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Starmark CPD,Starmark CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna Medicare,Aetna Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Ambetter ,Ambetter ,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access,Anthem Blue Access,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access Choice,Anthem Blue Access Choice,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Preferred,Anthem Blue Preferred,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Pathway,Anthem Pathway,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Alliance,Anthem Alliance,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Medicare,Anthem Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna,Cigna,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna PPO,Cigna PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna Medicare Advantage,Cigna Medicare Advantage,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Essence,Essence,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink HMO,Healthlink HMO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink PPO,Healthlink PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,HomeState Health Plan,HomeState Health Plan,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Humana Gold,Humana Gold,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medicaid MO,Medicaid MO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medica,Medica,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Tricare,Tricare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC All Payer,UHC All Payer,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Exchange,UHC Exchange,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicaid,UHC Medicaid,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UMR CPD,UMR CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicare,UHC Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY MITES D PTERO     ,38250057,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Wellcare,Wellcare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health PPO CPD,Meritain Health PPO CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/Commercial Product,Aetna/Commercial Product,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health CPD,Meritain Health CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Starmark CPD,Starmark CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna Medicare,Aetna Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Ambetter ,Ambetter ,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access,Anthem Blue Access,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access Choice,Anthem Blue Access Choice,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Preferred,Anthem Blue Preferred,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Pathway,Anthem Pathway,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Alliance,Anthem Alliance,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Medicare,Anthem Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna,Cigna,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna PPO,Cigna PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna Medicare Advantage,Cigna Medicare Advantage,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Essence,Essence,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink HMO,Healthlink HMO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink PPO,Healthlink PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,HomeState Health Plan,HomeState Health Plan,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Humana Gold,Humana Gold,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medicaid MO,Medicaid MO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medica,Medica,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Tricare,Tricare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC All Payer,UHC All Payer,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Exchange,UHC Exchange,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicaid,UHC Medicaid,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UMR CPD,UMR CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicare,UHC Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG YOLK          ,38250058,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Wellcare,Wellcare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAZELNUT          ,38250059,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PECAN             ,38250060,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health PPO CPD,Meritain Health PPO CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna/Commercial Product,Aetna/Commercial Product,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Meritain Health CPD,Meritain Health CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Starmark CPD,Starmark CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Aetna Medicare,Aetna Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Ambetter ,Ambetter ,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access,Anthem Blue Access,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Access Choice,Anthem Blue Access Choice,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Blue Preferred,Anthem Blue Preferred,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Pathway,Anthem Pathway,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Alliance,Anthem Alliance,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Anthem Medicare,Anthem Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna,Cigna,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna PPO,Cigna PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Cigna Medicare Advantage,Cigna Medicare Advantage,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Essence,Essence,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink HMO,Healthlink HMO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Healthlink PPO,Healthlink PPO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,HomeState Health Plan,HomeState Health Plan,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Humana Gold,Humana Gold,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medicaid MO,Medicaid MO,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Medica,Medica,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Tricare,Tricare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC All Payer,UHC All Payer,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Exchange,UHC Exchange,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicaid,UHC Medicaid,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UMR CPD,UMR CPD,47.28,,,,,,,per diem,47.28,47.28,"Per diem rate, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,UHC Medicare,UHC Medicare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERG PENICILLM NOTA     ,38250061,CDM,302,RC,,,,,,Inpatient,,,47.28,47.28,Wellcare,Wellcare,47.28,,,,,,,case rate,47.28,47.28,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY PISTACHIO         ,38250062,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEST RAGWEED      ,38250063,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMOXICILLIN       ,38250064,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AMPICILLIN        ,38250065,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN G      ,38250066,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PENICILLIN V      ,38250067,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARAKEET DROP     ,38250068,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKEN FEATH     ,38250069,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY COW HAIR/DAND     ,38250070,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY DOG DANDER        ,38250071,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOOSE FEATHER     ,38250072,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HAMSTER EPITH     ,38250073,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG HORSE HAIR/DND     ,38250074,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE EPITHEL     ,38250075,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARAKEET FEATH     ,38250076,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RABBIT EPITH      ,38250077,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG SHEEP EPITH/WL     ,38250078,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALMOND            ,38250079,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY APRICOT           ,38250080,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY AVOCADO           ,38250081,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BANANA            ,38250082,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER BELL       ,38250083,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK PEPPER      ,38250084,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUEBERRY         ,38250085,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BROCCOLI          ,38250086,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CABBAGE           ,38250087,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CASEIN            ,38250088,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CELERY            ,38250089,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE CHEDDR     ,38250090,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEESE MOLD       ,38250091,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHESTNUT          ,38250092,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHICKPEA          ,38250093,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEPPER CHILI      ,38250094,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLAM              ,38250095,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COCONUT           ,38250096,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY COFFEE            ,38250097,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRAB              ,38250098,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGGPLANT          ,38250099,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY EGG WHOLE         ,38250100,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLOUNDER GULF     ,38250101,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GARLIC            ,38250102,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPE             ,38250103,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRAPEFRUIT        ,38250104,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GREEN BEAN        ,38250105,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HALIBUT           ,38250106,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HOPS              ,38250107,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIDNEY BEAN       ,38250108,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY KIWI              ,38250109,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LAMB              ,38250110,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEMON             ,38250111,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LENTIL            ,38250112,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY LETTUCE           ,38250113,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG LIMA/WHIT BEAN     ,38250114,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LIME IGE          ,38250115,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LOBSTER           ,38250116,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACKEREL          ,38250117,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MALT              ,38250118,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MANGO             ,38250119,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYDEW/CANTA     ,38250120,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA LACTALB     ,38250121,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BETA LACTOGLO     ,38250122,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSHROOM          ,38250123,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLUE MUSSEL       ,38250124,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MUSTARD           ,38250125,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY NAVY BEAN         ,38250126,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ONION             ,38250127,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY OYSTER            ,38250128,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Meritain Health PPO CPD,Meritain Health PPO CPD,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Aetna/Commercial Product,Aetna/Commercial Product,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Meritain Health CPD,Meritain Health CPD,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Starmark CPD,Starmark CPD,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Aetna Medicare,Aetna Medicare,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Ambetter ,Ambetter ,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Blue Access,Anthem Blue Access,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Blue Access Choice,Anthem Blue Access Choice,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Blue Preferred,Anthem Blue Preferred,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Pathway,Anthem Pathway,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Alliance,Anthem Alliance,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Anthem Medicare,Anthem Medicare,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Cigna,Cigna,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Cigna PPO,Cigna PPO,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Cigna Medicare Advantage,Cigna Medicare Advantage,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Essence,Essence,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Healthlink HMO,Healthlink HMO,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Healthlink PPO,Healthlink PPO,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,HomeState Health Plan,HomeState Health Plan,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Humana Gold,Humana Gold,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Medicaid MO,Medicaid MO,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Medica,Medica,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Tricare,Tricare,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,UHC All Payer,UHC All Payer,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,UHC Exchange,UHC Exchange,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,UHC Medicaid,UHC Medicaid,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,UMR CPD,UMR CPD,247.57,,,,,,,per diem,247.57,247.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,UHC Medicare,UHC Medicare,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPAYA            ,38250129,CDM,302,RC,,,,,,Inpatient,,,247.57,247.57,Wellcare,Wellcare,247.57,,,,,,,case rate,247.57,247.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEA               ,38250130,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEACH             ,38250131,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PEAR              ,38250132,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINE NUT          ,38250133,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PINEAPPLE         ,38250134,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PLUM              ,38250135,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY POTATO            ,38250136,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SCALLOP           ,38250137,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SESAME SEED       ,38250138,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOYBEAN           ,38250139,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SPINACH           ,38250140,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TEA               ,38250141,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TUNA              ,38250142,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY VANILLA           ,38250143,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALNUT IGE        ,38250144,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WATERMELON IGE     ,38250145,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHEY IGE          ,38250146,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BAHIA       ,38250147,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS BENT/RED     ,38250148,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BROME       ,38250149,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS CANARY      ,38250150,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULTCORN     ,38250151,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULT OAT     ,38250152,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS CULWHEAT     ,38250153,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS JOHNSON     ,38250154,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS JUN/KENT     ,38250155,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS MEADOW      ,38250156,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS ORCHARD     ,38250157,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG GRASS SWEETVER     ,38250158,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS TIMOTHY     ,38250159,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY FIRE ANT          ,38250160,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG HONEYBEE VENOM     ,38250161,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LEPIDOGLYPHUS     ,38250162,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TRICHOPHYTON      ,38250163,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY PAPER WASP        ,38250164,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET WHITE      ,38250165,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY HORNET YELLOW     ,38250166,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY YELLOW JACKET     ,38250167,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD ASPERGIL     ,38250168,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD AUREOBAS     ,38250169,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CANDIDA      ,38250170,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CEPHALOS     ,38250171,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD CURVULAR     ,38250172,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD EPICOCCUM     ,38250173,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD FUSARIUM     ,38250174,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD HELMINTHO     ,38250175,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD HORMODEN     ,38250176,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD MUCOR RAC     ,38250177,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD PHOMA BET     ,38250178,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD RHIZOPUS      ,38250179,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG MOLD STEMPHYL      ,38250180,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE HDI     ,38250181,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE MDI     ,38250182,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ISOCYANATE TDI     ,38250183,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUNFLOWER IGE     ,38250184,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TOBACCO           ,38250185,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG PARASITE ASCAR     ,38250186,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ACACIA       ,38250187,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ALDER        ,38250188,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE/BOX     ,38250189,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE ELM          ,38250190,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MOUN CEDR     ,38250191,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE OAK          ,38250192,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PECAN        ,38250193,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE WHIT PINE     ,38250194,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE PRIVET       ,38250195,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE SWEET GUM     ,38250196,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health PPO CPD,Meritain Health PPO CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/Commercial Product,Aetna/Commercial Product,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health CPD,Meritain Health CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Starmark CPD,Starmark CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna Medicare,Aetna Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Ambetter ,Ambetter ,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access,Anthem Blue Access,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access Choice,Anthem Blue Access Choice,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Preferred,Anthem Blue Preferred,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Pathway,Anthem Pathway,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Alliance,Anthem Alliance,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Medicare,Anthem Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna,Cigna,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna PPO,Cigna PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna Medicare Advantage,Cigna Medicare Advantage,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Essence,Essence,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink HMO,Healthlink HMO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink PPO,Healthlink PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,HomeState Health Plan,HomeState Health Plan,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Humana Gold,Humana Gold,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medicaid MO,Medicaid MO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medica,Medica,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Tricare,Tricare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC All Payer,UHC All Payer,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Exchange,UHC Exchange,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicaid,UHC Medicaid,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UMR CPD,UMR CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicare,UHC Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE SYCAMORE     ,38250197,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Wellcare,Wellcare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE VIRG OAK      ,38250198,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WALNUT       ,38250199,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE MULBERRY     ,38250200,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY TREE WILLOW       ,38250201,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED COCKLEBUR     ,38250202,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEEG C/S       ,38250203,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED FALSE     ,38250204,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAGWEED GIANT     ,38250205,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED DANDELION     ,38250206,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED ENGL PLAN     ,38250207,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED GOLDENROD     ,38250208,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED KOCH/FIRE     ,38250209,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED LAMB QRT     ,38250210,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED MARSH ELD     ,38250211,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED MUGWORT      ,38250212,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED NETTLE       ,38250213,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SAGE/WOOD     ,38250214,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SHEEP SOR     ,38250215,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ACARUS SIRO       ,38250216,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALFALFA IGE       ,38250217,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ARIZ      ,38250218,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CYPRESS ITAL      ,38250219,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ASPARAGUS IGE     ,38250220,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PARROT DROP       ,38250221,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE GROUNDSEL     ,38250222,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS BARLEY      ,38250223,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BASS BLACK        ,38250224,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY BAYBERRY IGE      ,38250225,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHERRY IGE        ,38250226,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CLOVE IGE         ,38250227,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CINNAMON          ,38250228,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CRANBERRY IGE     ,38250229,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY CUCUMBER IGE      ,38250230,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG D MICROCER IGE     ,38250231,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG ETHYLENE OXIDE     ,38250232,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY EUROGLYPHUS       ,38250233,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY FORMALDEHYDE      ,38250234,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GINGER IGE        ,38250235,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GLYCOPHAGUS       ,38250236,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT EPITHEL      ,38250237,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GUINEA PIG EP     ,38250238,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY HADDOCK IGE       ,38250239,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MELALEUCA     ,38250240,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOSQUITO IGE      ,38250241,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOUSE URINE       ,38250242,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ORRIS ROOT        ,38250243,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE PALM/QUEN     ,38250244,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIG EPITH IGE     ,38250245,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY PIGEON STOOL      ,38250246,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE POPLAR WH     ,38250247,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY POPPY SEED        ,38250248,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG PTHALIC ANHYDR     ,38250249,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RASPBERRY IGE     ,38250250,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT EPITHIL       ,38250251,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY RAT URINE IGE     ,38250252,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY REED POLLEN       ,38250253,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY GRASS SALT        ,38250254,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY MOLD STEMPHYL     ,38250255,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARBEET IGE     ,38250256,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SUGARCANE IGE     ,38250257,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SQUASH SUMMER     ,38250258,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWEET POTATO      ,38250259,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY TYROPHAGUS        ,38250260,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY YAM IGE           ,38250261,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY WEED YEL DOCK     ,38250262,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERGY ZUCCHINI IGE      ,38250263,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKOLIVE IGG     ,38250264,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY MACADAMIA NUT     ,38250265,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERGY LATEX IGE         ,38250266,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERG ASPERGIL NIGER     ,38250267,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ARTICHOKE IGE     ,38250268,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY ANCHOVY IGE       ,38250269,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CAROB GUM IGE     ,38250270,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY NUTMEG IGE        ,38250271,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PUMPK SEED IGE     ,38250272,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED DYE 4 IgE     ,38250273,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY RED SNAPP IGE     ,38250274,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SAGE IGE          ,38250275,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SOLE IGE          ,38250276,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY SWORDFISH IGE     ,38250277,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY THYME IGE         ,38250278,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY TILAPIA IGE       ,38250279,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY FLAXSEED IGE      ,38250280,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHITEFISH IGE     ,38250281,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLRG DOUGLAS FIR IGE     ,38250282,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED SUNFLOWER     ,38250283,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BLACKBERRY IGE     ,38250284,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY CILANTRO IGE      ,38250285,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY GOAT MILK IGE     ,38250286,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HONEY IGE         ,38250287,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY MINT IGE          ,38250288,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY WALLEYE PIKE      ,38250289,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CHAETOMIUM IGE     ,38250290,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BUMBLE BEE IGE     ,38250291,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG BALD CYPRESS       ,38250292,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERGY HACKBERRY IGE     ,38250293,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG WEED CARELESS      ,38250294,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG CUMIN SEED IGE     ,38250295,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE ASPEN IGE     ,38250296,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY BLACK WILLOW      ,38250297,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERG TREE MAPLE SUG     ,38250298,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health PPO CPD,Meritain Health PPO CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/Commercial Product,Aetna/Commercial Product,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health CPD,Meritain Health CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Starmark CPD,Starmark CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna Medicare,Aetna Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Ambetter ,Ambetter ,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access,Anthem Blue Access,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access Choice,Anthem Blue Access Choice,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Preferred,Anthem Blue Preferred,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Pathway,Anthem Pathway,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Alliance,Anthem Alliance,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Medicare,Anthem Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna,Cigna,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna PPO,Cigna PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna Medicare Advantage,Cigna Medicare Advantage,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Essence,Essence,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink HMO,Healthlink HMO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink PPO,Healthlink PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,HomeState Health Plan,HomeState Health Plan,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Humana Gold,Humana Gold,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medicaid MO,Medicaid MO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medica,Medica,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Tricare,Tricare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC All Payer,UHC All Payer,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Exchange,UHC Exchange,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicaid,UHC Medicaid,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UMR CPD,UMR CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicare,UHC Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O ALLERGY ALPHA GAL IGE     ,38250299,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Wellcare,Wellcare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250300,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250301,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST GREER     ,38250302,CDM,302,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG HOUS DUST STIER     ,38250303,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Meritain Health PPO CPD,Meritain Health PPO CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna/Commercial Product,Aetna/Commercial Product,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Meritain Health CPD,Meritain Health CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Starmark CPD,Starmark CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna Medicare,Aetna Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Ambetter ,Ambetter ,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Access,Anthem Blue Access,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Access Choice,Anthem Blue Access Choice,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Preferred,Anthem Blue Preferred,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Pathway,Anthem Pathway,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Alliance,Anthem Alliance,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Medicare,Anthem Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna,Cigna,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna PPO,Cigna PPO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna Medicare Advantage,Cigna Medicare Advantage,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Essence,Essence,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthlink HMO,Healthlink HMO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthlink PPO,Healthlink PPO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,HomeState Health Plan,HomeState Health Plan,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Humana Gold,Humana Gold,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Medicaid MO,Medicaid MO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Medica,Medica,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Tricare,Tricare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC All Payer,UHC All Payer,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Exchange,UHC Exchange,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Medicaid,UHC Medicaid,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UMR CPD,UMR CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Medicare,UHC Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250304,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Wellcare,Wellcare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Meritain Health PPO CPD,Meritain Health PPO CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna/Commercial Product,Aetna/Commercial Product,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Meritain Health CPD,Meritain Health CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Starmark CPD,Starmark CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Aetna Medicare,Aetna Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Ambetter ,Ambetter ,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Access,Anthem Blue Access,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Access Choice,Anthem Blue Access Choice,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Blue Preferred,Anthem Blue Preferred,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Pathway,Anthem Pathway,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Alliance,Anthem Alliance,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Anthem Medicare,Anthem Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna,Cigna,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna PPO,Cigna PPO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Cigna Medicare Advantage,Cigna Medicare Advantage,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Essence,Essence,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthlink HMO,Healthlink HMO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Healthlink PPO,Healthlink PPO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,HomeState Health Plan,HomeState Health Plan,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Humana Gold,Humana Gold,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Medicaid MO,Medicaid MO,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Medica,Medica,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Tricare,Tricare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC All Payer,UHC All Payer,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Exchange,UHC Exchange,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Medicaid,UHC Medicaid,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UMR CPD,UMR CPD,323.58,,,,,,,per diem,323.58,323.58,"Per diem rate, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,UHC Medicare,UHC Medicare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O VARICELLA ZOST AB IGG     ,38250305,CDM,302,RC,,,,,,Inpatient,,,323.58,323.58,Wellcare,Wellcare,323.58,,,,,,,case rate,323.58,323.58,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health PPO CPD,Meritain Health PPO CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/Commercial Product,Aetna/Commercial Product,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health CPD,Meritain Health CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Starmark CPD,Starmark CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna Medicare,Aetna Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Ambetter ,Ambetter ,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access,Anthem Blue Access,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access Choice,Anthem Blue Access Choice,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Preferred,Anthem Blue Preferred,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Pathway,Anthem Pathway,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Alliance,Anthem Alliance,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Medicare,Anthem Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna,Cigna,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna PPO,Cigna PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna Medicare Advantage,Cigna Medicare Advantage,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Essence,Essence,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink HMO,Healthlink HMO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink PPO,Healthlink PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,HomeState Health Plan,HomeState Health Plan,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Humana Gold,Humana Gold,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medicaid MO,Medicaid MO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medica,Medica,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Tricare,Tricare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC All Payer,UHC All Payer,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Exchange,UHC Exchange,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicaid,UHC Medicaid,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UMR CPD,UMR CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicare,UHC Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL G IGG        ,38250306,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Wellcare,Wellcare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health PPO CPD,Meritain Health PPO CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/Commercial Product,Aetna/Commercial Product,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health CPD,Meritain Health CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Starmark CPD,Starmark CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna Medicare,Aetna Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Ambetter ,Ambetter ,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access,Anthem Blue Access,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access Choice,Anthem Blue Access Choice,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Preferred,Anthem Blue Preferred,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Pathway,Anthem Pathway,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Alliance,Anthem Alliance,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Medicare,Anthem Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna,Cigna,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna PPO,Cigna PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna Medicare Advantage,Cigna Medicare Advantage,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Essence,Essence,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink HMO,Healthlink HMO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink PPO,Healthlink PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,HomeState Health Plan,HomeState Health Plan,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Humana Gold,Humana Gold,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medicaid MO,Medicaid MO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medica,Medica,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Tricare,Tricare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC All Payer,UHC All Payer,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Exchange,UHC Exchange,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicaid,UHC Medicaid,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UMR CPD,UMR CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicare,UHC Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBUL M IGM        ,38250307,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Wellcare,Wellcare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health PPO CPD,Meritain Health PPO CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/Commercial Product,Aetna/Commercial Product,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health CPD,Meritain Health CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Starmark CPD,Starmark CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna Medicare,Aetna Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Ambetter ,Ambetter ,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access,Anthem Blue Access,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access Choice,Anthem Blue Access Choice,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Preferred,Anthem Blue Preferred,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Pathway,Anthem Pathway,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Alliance,Anthem Alliance,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Medicare,Anthem Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna,Cigna,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna PPO,Cigna PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna Medicare Advantage,Cigna Medicare Advantage,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Essence,Essence,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink HMO,Healthlink HMO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink PPO,Healthlink PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,HomeState Health Plan,HomeState Health Plan,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Humana Gold,Humana Gold,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medicaid MO,Medicaid MO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medica,Medica,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Tricare,Tricare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC All Payer,UHC All Payer,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Exchange,UHC Exchange,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicaid,UHC Medicaid,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UMR CPD,UMR CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicare,UHC Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250308,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Wellcare,Wellcare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health PPO CPD,Meritain Health PPO CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna/Commercial Product,Aetna/Commercial Product,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Meritain Health CPD,Meritain Health CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Starmark CPD,Starmark CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Aetna Medicare,Aetna Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Ambetter ,Ambetter ,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access,Anthem Blue Access,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Access Choice,Anthem Blue Access Choice,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Blue Preferred,Anthem Blue Preferred,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Pathway,Anthem Pathway,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Alliance,Anthem Alliance,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Anthem Medicare,Anthem Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna,Cigna,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna PPO,Cigna PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Cigna Medicare Advantage,Cigna Medicare Advantage,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Essence,Essence,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink HMO,Healthlink HMO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Healthlink PPO,Healthlink PPO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,HomeState Health Plan,HomeState Health Plan,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Humana Gold,Humana Gold,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medicaid MO,Medicaid MO,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Medica,Medica,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Tricare,Tricare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC All Payer,UHC All Payer,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Exchange,UHC Exchange,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicaid,UHC Medicaid,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UMR CPD,UMR CPD,202.77,,,,,,,per diem,202.77,202.77,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,UHC Medicare,UHC Medicare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250309,CDM,301,RC,,,,,,Inpatient,,,202.77,202.77,Wellcare,Wellcare,202.77,,,,,,,case rate,202.77,202.77,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health PPO CPD,Meritain Health PPO CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/Commercial Product,Aetna/Commercial Product,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health CPD,Meritain Health CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Starmark CPD,Starmark CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna Medicare,Aetna Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Ambetter ,Ambetter ,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access,Anthem Blue Access,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access Choice,Anthem Blue Access Choice,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Preferred,Anthem Blue Preferred,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Pathway,Anthem Pathway,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Alliance,Anthem Alliance,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Medicare,Anthem Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna,Cigna,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna PPO,Cigna PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna Medicare Advantage,Cigna Medicare Advantage,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Essence,Essence,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink HMO,Healthlink HMO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink PPO,Healthlink PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,HomeState Health Plan,HomeState Health Plan,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Humana Gold,Humana Gold,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medicaid MO,Medicaid MO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medica,Medica,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Tricare,Tricare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC All Payer,UHC All Payer,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Exchange,UHC Exchange,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicaid,UHC Medicaid,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UMR CPD,UMR CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicare,UHC Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250310,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Wellcare,Wellcare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN D SERM     ,38250311,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health PPO CPD,Meritain Health PPO CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/Commercial Product,Aetna/Commercial Product,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health CPD,Meritain Health CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Starmark CPD,Starmark CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna Medicare,Aetna Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Ambetter ,Ambetter ,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access,Anthem Blue Access,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access Choice,Anthem Blue Access Choice,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Preferred,Anthem Blue Preferred,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Pathway,Anthem Pathway,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Alliance,Anthem Alliance,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Medicare,Anthem Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna,Cigna,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna PPO,Cigna PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna Medicare Advantage,Cigna Medicare Advantage,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Essence,Essence,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink HMO,Healthlink HMO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink PPO,Healthlink PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,HomeState Health Plan,HomeState Health Plan,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Humana Gold,Humana Gold,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medicaid MO,Medicaid MO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medica,Medica,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Tricare,Tricare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC All Payer,UHC All Payer,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Exchange,UHC Exchange,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicaid,UHC Medicaid,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UMR CPD,UMR CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicare,UHC Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250312,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Wellcare,Wellcare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250313,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health PPO CPD,Meritain Health PPO CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/Commercial Product,Aetna/Commercial Product,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health CPD,Meritain Health CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Starmark CPD,Starmark CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna Medicare,Aetna Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Ambetter ,Ambetter ,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access,Anthem Blue Access,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access Choice,Anthem Blue Access Choice,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Preferred,Anthem Blue Preferred,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Pathway,Anthem Pathway,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Alliance,Anthem Alliance,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Medicare,Anthem Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna,Cigna,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna PPO,Cigna PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna Medicare Advantage,Cigna Medicare Advantage,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Essence,Essence,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink HMO,Healthlink HMO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink PPO,Healthlink PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,HomeState Health Plan,HomeState Health Plan,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Humana Gold,Humana Gold,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medicaid MO,Medicaid MO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medica,Medica,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Tricare,Tricare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC All Payer,UHC All Payer,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Exchange,UHC Exchange,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicaid,UHC Medicaid,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UMR CPD,UMR CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicare,UHC Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250314,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Wellcare,Wellcare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250315,CDM,301,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250316,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health PPO CPD,Meritain Health PPO CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/Commercial Product,Aetna/Commercial Product,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health CPD,Meritain Health CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Starmark CPD,Starmark CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Aetna Medicare,Aetna Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Ambetter ,Ambetter ,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access,Anthem Blue Access,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access Choice,Anthem Blue Access Choice,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Preferred,Anthem Blue Preferred,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Pathway,Anthem Pathway,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Alliance,Anthem Alliance,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Medicare,Anthem Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Cigna,Cigna,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Cigna PPO,Cigna PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Cigna Medicare Advantage,Cigna Medicare Advantage,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Essence,Essence,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink HMO,Healthlink HMO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink PPO,Healthlink PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,HomeState Health Plan,HomeState Health Plan,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Humana Gold,Humana Gold,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Medicaid MO,Medicaid MO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Medica,Medica,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Tricare,Tricare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,UHC All Payer,UHC All Payer,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,UHC Exchange,UHC Exchange,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicaid,UHC Medicaid,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,UMR CPD,UMR CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicare,UHC Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O ABO DISCREPANCY UBS       ,38250317,CDM,309,RC,,,,,,Inpatient,,,153.39,153.39,Wellcare,Wellcare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health PPO CPD,Meritain Health PPO CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/Commercial Product,Aetna/Commercial Product,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health CPD,Meritain Health CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Starmark CPD,Starmark CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Aetna Medicare,Aetna Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Ambetter ,Ambetter ,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access,Anthem Blue Access,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access Choice,Anthem Blue Access Choice,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Preferred,Anthem Blue Preferred,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Pathway,Anthem Pathway,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Alliance,Anthem Alliance,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Medicare,Anthem Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Cigna,Cigna,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Cigna PPO,Cigna PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Cigna Medicare Advantage,Cigna Medicare Advantage,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Essence,Essence,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink HMO,Healthlink HMO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink PPO,Healthlink PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,HomeState Health Plan,HomeState Health Plan,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Humana Gold,Humana Gold,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Medicaid MO,Medicaid MO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Medica,Medica,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Tricare,Tricare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,UHC All Payer,UHC All Payer,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,UHC Exchange,UHC Exchange,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicaid,UHC Medicaid,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,UMR CPD,UMR CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicare,UHC Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH DISCREPANCY UBS        ,38250318,CDM,309,RC,,,,,,Inpatient,,,305.72,305.72,Wellcare,Wellcare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O RH TYPE                   ,38250319,CDM,309,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Meritain Health PPO CPD,Meritain Health PPO CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Aetna/Commercial Product,Aetna/Commercial Product,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Meritain Health CPD,Meritain Health CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Starmark CPD,Starmark CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Aetna Medicare,Aetna Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Ambetter ,Ambetter ,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Access,Anthem Blue Access,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Access Choice,Anthem Blue Access Choice,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Preferred,Anthem Blue Preferred,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Pathway,Anthem Pathway,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Alliance,Anthem Alliance,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Medicare,Anthem Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Cigna,Cigna,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Cigna PPO,Cigna PPO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Cigna Medicare Advantage,Cigna Medicare Advantage,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Essence,Essence,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Healthlink HMO,Healthlink HMO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Healthlink PPO,Healthlink PPO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,HomeState Health Plan,HomeState Health Plan,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Humana Gold,Humana Gold,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Medicaid MO,Medicaid MO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Medica,Medica,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Tricare,Tricare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,UHC All Payer,UHC All Payer,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,UHC Exchange,UHC Exchange,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,UHC Medicaid,UHC Medicaid,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,UMR CPD,UMR CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,UHC Medicare,UHC Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O PCCA/ANNA IFA W/RFLX      ,38250320,CDM,302,RC,,,,,,Inpatient,,,161.79,161.79,Wellcare,Wellcare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Meritain Health PPO CPD,Meritain Health PPO CPD,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Aetna/Commercial Product,Aetna/Commercial Product,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Meritain Health CPD,Meritain Health CPD,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Starmark CPD,Starmark CPD,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Aetna Medicare,Aetna Medicare,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Ambetter ,Ambetter ,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Blue Access,Anthem Blue Access,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Blue Access Choice,Anthem Blue Access Choice,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Blue Preferred,Anthem Blue Preferred,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Pathway,Anthem Pathway,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Alliance,Anthem Alliance,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Anthem Medicare,Anthem Medicare,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Cigna,Cigna,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Cigna PPO,Cigna PPO,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Cigna Medicare Advantage,Cigna Medicare Advantage,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Essence,Essence,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Healthlink HMO,Healthlink HMO,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Healthlink PPO,Healthlink PPO,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,HomeState Health Plan,HomeState Health Plan,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Humana Gold,Humana Gold,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Medicaid MO,Medicaid MO,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Medica,Medica,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Tricare,Tricare,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,UHC All Payer,UHC All Payer,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,UHC Exchange,UHC Exchange,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,UHC Medicaid,UHC Medicaid,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,UMR CPD,UMR CPD,592.54,,,,,,,per diem,592.54,592.54,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,UHC Medicare,UHC Medicare,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA W RFLX      ,38250321,CDM,302,RC,,,,,,Inpatient,,,592.54,592.54,Wellcare,Wellcare,592.54,,,,,,,case rate,592.54,592.54,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health PPO CPD,Meritain Health PPO CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/Commercial Product,Aetna/Commercial Product,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health CPD,Meritain Health CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Starmark CPD,Starmark CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Aetna Medicare,Aetna Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Ambetter ,Ambetter ,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access,Anthem Blue Access,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access Choice,Anthem Blue Access Choice,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Preferred,Anthem Blue Preferred,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Pathway,Anthem Pathway,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Alliance,Anthem Alliance,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Medicare,Anthem Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Cigna,Cigna,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Cigna PPO,Cigna PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Cigna Medicare Advantage,Cigna Medicare Advantage,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Essence,Essence,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink HMO,Healthlink HMO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink PPO,Healthlink PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,HomeState Health Plan,HomeState Health Plan,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Humana Gold,Humana Gold,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Medicaid MO,Medicaid MO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Medica,Medica,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Tricare,Tricare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,UHC All Payer,UHC All Payer,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,UHC Exchange,UHC Exchange,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicaid,UHC Medicaid,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,UMR CPD,UMR CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicare,UHC Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O STRIATED MUSCLE IGG       ,38250322,CDM,302,RC,,,,,,Inpatient,,,79.85,79.85,Wellcare,Wellcare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL AB IGG         ,38250323,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Meritain Health PPO CPD,Meritain Health PPO CPD,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Aetna/Commercial Product,Aetna/Commercial Product,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Meritain Health CPD,Meritain Health CPD,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Starmark CPD,Starmark CPD,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Aetna Medicare,Aetna Medicare,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Ambetter ,Ambetter ,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Blue Access,Anthem Blue Access,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Blue Access Choice,Anthem Blue Access Choice,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Blue Preferred,Anthem Blue Preferred,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Pathway,Anthem Pathway,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Alliance,Anthem Alliance,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Anthem Medicare,Anthem Medicare,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Cigna,Cigna,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Cigna PPO,Cigna PPO,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Cigna Medicare Advantage,Cigna Medicare Advantage,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Essence,Essence,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Healthlink HMO,Healthlink HMO,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Healthlink PPO,Healthlink PPO,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,HomeState Health Plan,HomeState Health Plan,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Humana Gold,Humana Gold,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Medicaid MO,Medicaid MO,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Medica,Medica,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Tricare,Tricare,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,UHC All Payer,UHC All Payer,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,UHC Exchange,UHC Exchange,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,UHC Medicaid,UHC Medicaid,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,UMR CPD,UMR CPD,797.41,,,,,,,per diem,797.41,797.41,"Per diem rate, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,UHC Medicare,UHC Medicare,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O YO AB CSF W/RFLX          ,38250324,CDM,302,RC,,,,,,Inpatient,,,797.41,797.41,Wellcare,Wellcare,797.41,,,,,,,case rate,797.41,797.41,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health PPO CPD,Meritain Health PPO CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/Commercial Product,Aetna/Commercial Product,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health CPD,Meritain Health CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Starmark CPD,Starmark CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna Medicare,Aetna Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Ambetter ,Ambetter ,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access,Anthem Blue Access,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access Choice,Anthem Blue Access Choice,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Preferred,Anthem Blue Preferred,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Pathway,Anthem Pathway,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Alliance,Anthem Alliance,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Medicare,Anthem Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna,Cigna,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna PPO,Cigna PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna Medicare Advantage,Cigna Medicare Advantage,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Essence,Essence,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink HMO,Healthlink HMO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink PPO,Healthlink PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,HomeState Health Plan,HomeState Health Plan,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Humana Gold,Humana Gold,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Medicaid MO,Medicaid MO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Medica,Medica,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Tricare,Tricare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC All Payer,UHC All Payer,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Exchange,UHC Exchange,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicaid,UHC Medicaid,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UMR CPD,UMR CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicare,UHC Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O ANCA W REFLEX             ,38250325,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Wellcare,Wellcare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health PPO CPD,Meritain Health PPO CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/Commercial Product,Aetna/Commercial Product,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health CPD,Meritain Health CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Starmark CPD,Starmark CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Aetna Medicare,Aetna Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Ambetter ,Ambetter ,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access,Anthem Blue Access,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access Choice,Anthem Blue Access Choice,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Preferred,Anthem Blue Preferred,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Pathway,Anthem Pathway,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Alliance,Anthem Alliance,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Medicare,Anthem Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna,Cigna,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna PPO,Cigna PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Cigna Medicare Advantage,Cigna Medicare Advantage,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Essence,Essence,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink HMO,Healthlink HMO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink PPO,Healthlink PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,HomeState Health Plan,HomeState Health Plan,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Humana Gold,Humana Gold,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Medicaid MO,Medicaid MO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Medica,Medica,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Tricare,Tricare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC All Payer,UHC All Payer,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Exchange,UHC Exchange,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicaid,UHC Medicaid,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UMR CPD,UMR CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicare,UHC Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250326,CDM,302,RC,,,,,,Inpatient,,,85.1,85.1,Wellcare,Wellcare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health PPO CPD,Meritain Health PPO CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/Commercial Product,Aetna/Commercial Product,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health CPD,Meritain Health CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Starmark CPD,Starmark CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Aetna Medicare,Aetna Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Ambetter ,Ambetter ,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access,Anthem Blue Access,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access Choice,Anthem Blue Access Choice,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Preferred,Anthem Blue Preferred,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Pathway,Anthem Pathway,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Alliance,Anthem Alliance,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Medicare,Anthem Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Cigna,Cigna,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Cigna PPO,Cigna PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Cigna Medicare Advantage,Cigna Medicare Advantage,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Essence,Essence,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink HMO,Healthlink HMO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink PPO,Healthlink PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,HomeState Health Plan,HomeState Health Plan,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Humana Gold,Humana Gold,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Medicaid MO,Medicaid MO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Medica,Medica,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Tricare,Tricare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,UHC All Payer,UHC All Payer,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,UHC Exchange,UHC Exchange,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicaid,UHC Medicaid,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,UMR CPD,UMR CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicare,UHC Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O HU IFA W/RFLX             ,38250327,CDM,302,RC,,,,,,Inpatient,,,906.67,906.67,Wellcare,Wellcare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250328,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG WRFLX         ,38250329,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Meritain Health PPO CPD,Meritain Health PPO CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna/Commercial Product,Aetna/Commercial Product,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Meritain Health CPD,Meritain Health CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Starmark CPD,Starmark CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Aetna Medicare,Aetna Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Ambetter ,Ambetter ,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Access,Anthem Blue Access,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Access Choice,Anthem Blue Access Choice,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Blue Preferred,Anthem Blue Preferred,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Pathway,Anthem Pathway,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Alliance,Anthem Alliance,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Anthem Medicare,Anthem Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna,Cigna,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna PPO,Cigna PPO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Cigna Medicare Advantage,Cigna Medicare Advantage,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Essence,Essence,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthlink HMO,Healthlink HMO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Healthlink PPO,Healthlink PPO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,HomeState Health Plan,HomeState Health Plan,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Humana Gold,Humana Gold,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Medicaid MO,Medicaid MO,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Medica,Medica,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Tricare,Tricare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC All Payer,UHC All Payer,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Exchange,UHC Exchange,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Medicaid,UHC Medicaid,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,UMR CPD,UMR CPD,1286.99,,,,,,,per diem,1286.99,1286.99,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,UHC Medicare,UHC Medicare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 RCPT AB CSF     ,38250330,CDM,302,RC,,,,,,Inpatient,,,1286.99,1286.99,Wellcare,Wellcare,1286.99,,,,,,,case rate,1286.99,1286.99,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O BETA HCG QN TUMR MARK     ,38250331,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250332,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LIPOPROFILE NMR           ,38250333,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PLEURAL      ,38250334,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ADENO DEAMIN PERITON      ,38250335,CDM,301,RC,,,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Meritain Health PPO CPD,Meritain Health PPO CPD,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Aetna/Commercial Product,Aetna/Commercial Product,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Meritain Health CPD,Meritain Health CPD,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Starmark CPD,Starmark CPD,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Aetna Medicare,Aetna Medicare,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Ambetter ,Ambetter ,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Blue Access,Anthem Blue Access,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Blue Access Choice,Anthem Blue Access Choice,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Blue Preferred,Anthem Blue Preferred,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Pathway,Anthem Pathway,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Alliance,Anthem Alliance,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Anthem Medicare,Anthem Medicare,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Cigna,Cigna,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Cigna PPO,Cigna PPO,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Cigna Medicare Advantage,Cigna Medicare Advantage,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Essence,Essence,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Healthlink HMO,Healthlink HMO,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Healthlink PPO,Healthlink PPO,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,HomeState Health Plan,HomeState Health Plan,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Humana Gold,Humana Gold,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Medicaid MO,Medicaid MO,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Medica,Medica,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Tricare,Tricare,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,UHC All Payer,UHC All Payer,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,UHC Exchange,UHC Exchange,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,UHC Medicaid,UHC Medicaid,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,UMR CPD,UMR CPD,31.52,,,,,,,per diem,31.52,31.52,"Per diem rate, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,UHC Medicare,UHC Medicare,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PORPHYRIN TTL PLM/SRM     ,38250336,CDM,301,RC,,,,,,Inpatient,,,31.52,31.52,Wellcare,Wellcare,31.52,,,,,,,case rate,31.52,31.52,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250337,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250338,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Meritain Health PPO CPD,Meritain Health PPO CPD,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Aetna/Commercial Product,Aetna/Commercial Product,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Meritain Health CPD,Meritain Health CPD,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Starmark CPD,Starmark CPD,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Aetna Medicare,Aetna Medicare,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Ambetter ,Ambetter ,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Blue Access,Anthem Blue Access,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Blue Access Choice,Anthem Blue Access Choice,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Blue Preferred,Anthem Blue Preferred,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Pathway,Anthem Pathway,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Alliance,Anthem Alliance,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Anthem Medicare,Anthem Medicare,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Cigna,Cigna,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Cigna PPO,Cigna PPO,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Cigna Medicare Advantage,Cigna Medicare Advantage,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Essence,Essence,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Healthlink HMO,Healthlink HMO,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Healthlink PPO,Healthlink PPO,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,HomeState Health Plan,HomeState Health Plan,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Humana Gold,Humana Gold,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Medicaid MO,Medicaid MO,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Medica,Medica,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Tricare,Tricare,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,UHC All Payer,UHC All Payer,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,UHC Exchange,UHC Exchange,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,UHC Medicaid,UHC Medicaid,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,UMR CPD,UMR CPD,219.58,,,,,,,per diem,219.58,219.58,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,UHC Medicare,UHC Medicare,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250339,CDM,305,RC,,,,,,Inpatient,,,219.58,219.58,Wellcare,Wellcare,219.58,,,,,,,case rate,219.58,219.58,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health PPO CPD,Meritain Health PPO CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/Commercial Product,Aetna/Commercial Product,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health CPD,Meritain Health CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Starmark CPD,Starmark CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Aetna Medicare,Aetna Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Ambetter ,Ambetter ,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access,Anthem Blue Access,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access Choice,Anthem Blue Access Choice,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Preferred,Anthem Blue Preferred,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Pathway,Anthem Pathway,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Alliance,Anthem Alliance,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Medicare,Anthem Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Cigna,Cigna,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Cigna PPO,Cigna PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Cigna Medicare Advantage,Cigna Medicare Advantage,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Essence,Essence,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink HMO,Healthlink HMO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink PPO,Healthlink PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,HomeState Health Plan,HomeState Health Plan,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Humana Gold,Humana Gold,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Medicaid MO,Medicaid MO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Medica,Medica,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Tricare,Tricare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,UHC All Payer,UHC All Payer,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,UHC Exchange,UHC Exchange,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicaid,UHC Medicaid,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,UMR CPD,UMR CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicare,UHC Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O FREE KAPPA/LAMBDA         ,38250340,CDM,301,RC,,,,,,Inpatient,,,277.36,277.36,Wellcare,Wellcare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Meritain Health PPO CPD,Meritain Health PPO CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna/Commercial Product,Aetna/Commercial Product,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Meritain Health CPD,Meritain Health CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Starmark CPD,Starmark CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna Medicare,Aetna Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Ambetter ,Ambetter ,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Access,Anthem Blue Access,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Access Choice,Anthem Blue Access Choice,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Preferred,Anthem Blue Preferred,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Pathway,Anthem Pathway,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Alliance,Anthem Alliance,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Medicare,Anthem Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna,Cigna,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna PPO,Cigna PPO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna Medicare Advantage,Cigna Medicare Advantage,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Essence,Essence,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthlink HMO,Healthlink HMO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthlink PPO,Healthlink PPO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,HomeState Health Plan,HomeState Health Plan,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Humana Gold,Humana Gold,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Medicaid MO,Medicaid MO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Medica,Medica,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Tricare,Tricare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC All Payer,UHC All Payer,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Exchange,UHC Exchange,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Medicaid,UHC Medicaid,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UMR CPD,UMR CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Medicare,UHC Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O TRYPTASE                  ,38250341,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Wellcare,Wellcare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG SUGARCANE IGG4     ,38250342,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Meritain Health PPO CPD,Meritain Health PPO CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna/Commercial Product,Aetna/Commercial Product,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Meritain Health CPD,Meritain Health CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Starmark CPD,Starmark CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna Medicare,Aetna Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Ambetter ,Ambetter ,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Access,Anthem Blue Access,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Access Choice,Anthem Blue Access Choice,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Preferred,Anthem Blue Preferred,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Pathway,Anthem Pathway,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Alliance,Anthem Alliance,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Medicare,Anthem Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna,Cigna,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna PPO,Cigna PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna Medicare Advantage,Cigna Medicare Advantage,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Essence,Essence,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthlink HMO,Healthlink HMO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthlink PPO,Healthlink PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,HomeState Health Plan,HomeState Health Plan,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Humana Gold,Humana Gold,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Medicaid MO,Medicaid MO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Medica,Medica,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Tricare,Tricare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC All Payer,UHC All Payer,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Exchange,UHC Exchange,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Medicaid,UHC Medicaid,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UMR CPD,UMR CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Medicare,UHC Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 6             ,38250343,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Wellcare,Wellcare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O TSH RECEPTOR AB           ,38250344,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health PPO CPD,Meritain Health PPO CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/Commercial Product,Aetna/Commercial Product,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health CPD,Meritain Health CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Starmark CPD,Starmark CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna Medicare,Aetna Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Ambetter ,Ambetter ,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access,Anthem Blue Access,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access Choice,Anthem Blue Access Choice,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Preferred,Anthem Blue Preferred,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Pathway,Anthem Pathway,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Alliance,Anthem Alliance,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Medicare,Anthem Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna,Cigna,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna PPO,Cigna PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna Medicare Advantage,Cigna Medicare Advantage,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Essence,Essence,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink HMO,Healthlink HMO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink PPO,Healthlink PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,HomeState Health Plan,HomeState Health Plan,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Humana Gold,Humana Gold,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Medicaid MO,Medicaid MO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Medica,Medica,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Tricare,Tricare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC All Payer,UHC All Payer,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Exchange,UHC Exchange,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicaid,UHC Medicaid,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UMR CPD,UMR CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicare,UHC Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INHIBIN B                 ,38250345,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Wellcare,Wellcare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O INTERLEUKIN 1 BETA        ,38250346,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TUMOR NECROSIS FACTOR     ,38250347,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O ANTI MULLERIAN HORMON     ,38250348,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Meritain Health PPO CPD,Meritain Health PPO CPD,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Aetna/Commercial Product,Aetna/Commercial Product,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Meritain Health CPD,Meritain Health CPD,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Starmark CPD,Starmark CPD,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Aetna Medicare,Aetna Medicare,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Ambetter ,Ambetter ,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Blue Access,Anthem Blue Access,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Blue Access Choice,Anthem Blue Access Choice,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Blue Preferred,Anthem Blue Preferred,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Pathway,Anthem Pathway,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Alliance,Anthem Alliance,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Anthem Medicare,Anthem Medicare,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Cigna,Cigna,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Cigna PPO,Cigna PPO,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Cigna Medicare Advantage,Cigna Medicare Advantage,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Essence,Essence,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Healthlink HMO,Healthlink HMO,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Healthlink PPO,Healthlink PPO,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,HomeState Health Plan,HomeState Health Plan,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Humana Gold,Humana Gold,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Medicaid MO,Medicaid MO,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Medica,Medica,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Tricare,Tricare,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,UHC All Payer,UHC All Payer,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,UHC Exchange,UHC Exchange,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,UHC Medicaid,UHC Medicaid,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,UMR CPD,UMR CPD,727.02,,,,,,,per diem,727.02,727.02,"Per diem rate, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,UHC Medicare,UHC Medicare,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O TOTAL INHIBIN             ,38250349,CDM,301,RC,,,,,,Inpatient,,,727.02,727.02,Wellcare,Wellcare,727.02,,,,,,,case rate,727.02,727.02,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PANCREATC ELAST FECAL     ,38250350,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Meritain Health PPO CPD,Meritain Health PPO CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna/Commercial Product,Aetna/Commercial Product,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Meritain Health CPD,Meritain Health CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Starmark CPD,Starmark CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna Medicare,Aetna Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Ambetter ,Ambetter ,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Access,Anthem Blue Access,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Access Choice,Anthem Blue Access Choice,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Preferred,Anthem Blue Preferred,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Pathway,Anthem Pathway,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Alliance,Anthem Alliance,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Medicare,Anthem Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna,Cigna,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna PPO,Cigna PPO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna Medicare Advantage,Cigna Medicare Advantage,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Essence,Essence,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthlink HMO,Healthlink HMO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthlink PPO,Healthlink PPO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,HomeState Health Plan,HomeState Health Plan,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Humana Gold,Humana Gold,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Medicaid MO,Medicaid MO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Medica,Medica,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Tricare,Tricare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC All Payer,UHC All Payer,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Exchange,UHC Exchange,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Medicaid,UHC Medicaid,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UMR CPD,UMR CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Medicare,UHC Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O ALPHA SUBUNIT PGH         ,38250351,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Wellcare,Wellcare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O INTERLEUK 2 RCPT CD25     ,38250352,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Meritain Health PPO CPD,Meritain Health PPO CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna/Commercial Product,Aetna/Commercial Product,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Meritain Health CPD,Meritain Health CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Starmark CPD,Starmark CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna Medicare,Aetna Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Ambetter ,Ambetter ,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Access,Anthem Blue Access,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Access Choice,Anthem Blue Access Choice,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Preferred,Anthem Blue Preferred,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Pathway,Anthem Pathway,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Alliance,Anthem Alliance,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Medicare,Anthem Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna,Cigna,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna PPO,Cigna PPO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna Medicare Advantage,Cigna Medicare Advantage,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Essence,Essence,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthlink HMO,Healthlink HMO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthlink PPO,Healthlink PPO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,HomeState Health Plan,HomeState Health Plan,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Humana Gold,Humana Gold,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Medicaid MO,Medicaid MO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Medica,Medica,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Tricare,Tricare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC All Payer,UHC All Payer,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Exchange,UHC Exchange,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Medicaid,UHC Medicaid,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UMR CPD,UMR CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Medicare,UHC Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250353,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Wellcare,Wellcare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Meritain Health PPO CPD,Meritain Health PPO CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna/Commercial Product,Aetna/Commercial Product,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Meritain Health CPD,Meritain Health CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Starmark CPD,Starmark CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Aetna Medicare,Aetna Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Ambetter ,Ambetter ,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Access,Anthem Blue Access,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Access Choice,Anthem Blue Access Choice,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Blue Preferred,Anthem Blue Preferred,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Pathway,Anthem Pathway,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Alliance,Anthem Alliance,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Anthem Medicare,Anthem Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna,Cigna,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna PPO,Cigna PPO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Cigna Medicare Advantage,Cigna Medicare Advantage,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Essence,Essence,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthlink HMO,Healthlink HMO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Healthlink PPO,Healthlink PPO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,HomeState Health Plan,HomeState Health Plan,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Humana Gold,Humana Gold,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Medicaid MO,Medicaid MO,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Medica,Medica,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Tricare,Tricare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC All Payer,UHC All Payer,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Exchange,UHC Exchange,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Medicaid,UHC Medicaid,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UMR CPD,UMR CPD,1649.44,,,,,,,per diem,1649.44,1649.44,"Per diem rate, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,UHC Medicare,UHC Medicare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O ADMARK CSF ANALYS         ,38250354,CDM,301,RC,,,,,,Inpatient,,,1649.44,1649.44,Wellcare,Wellcare,1649.44,,,,,,,case rate,1649.44,1649.44,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Meritain Health PPO CPD,Meritain Health PPO CPD,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Aetna/Commercial Product,Aetna/Commercial Product,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Meritain Health CPD,Meritain Health CPD,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Starmark CPD,Starmark CPD,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Aetna Medicare,Aetna Medicare,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Ambetter ,Ambetter ,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Blue Access,Anthem Blue Access,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Blue Access Choice,Anthem Blue Access Choice,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Blue Preferred,Anthem Blue Preferred,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Pathway,Anthem Pathway,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Alliance,Anthem Alliance,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Anthem Medicare,Anthem Medicare,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Cigna,Cigna,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Cigna PPO,Cigna PPO,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Cigna Medicare Advantage,Cigna Medicare Advantage,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Essence,Essence,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Healthlink HMO,Healthlink HMO,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Healthlink PPO,Healthlink PPO,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,HomeState Health Plan,HomeState Health Plan,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Humana Gold,Humana Gold,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Medicaid MO,Medicaid MO,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Medica,Medica,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Tricare,Tricare,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,UHC All Payer,UHC All Payer,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,UHC Exchange,UHC Exchange,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,UHC Medicaid,UHC Medicaid,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,UMR CPD,UMR CPD,377.17,,,,,,,per diem,377.17,377.17,"Per diem rate, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,UHC Medicare,UHC Medicare,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O VITAMIN B7                ,38250356,CDM,301,RC,,,,,,Inpatient,,,377.17,377.17,Wellcare,Wellcare,377.17,,,,,,,case rate,377.17,377.17,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health PPO CPD,Meritain Health PPO CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/Commercial Product,Aetna/Commercial Product,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health CPD,Meritain Health CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Starmark CPD,Starmark CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna Medicare,Aetna Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Ambetter ,Ambetter ,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access,Anthem Blue Access,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access Choice,Anthem Blue Access Choice,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Preferred,Anthem Blue Preferred,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Pathway,Anthem Pathway,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Alliance,Anthem Alliance,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Medicare,Anthem Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna,Cigna,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna PPO,Cigna PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna Medicare Advantage,Cigna Medicare Advantage,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Essence,Essence,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink HMO,Healthlink HMO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink PPO,Healthlink PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,HomeState Health Plan,HomeState Health Plan,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Humana Gold,Humana Gold,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medicaid MO,Medicaid MO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medica,Medica,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Tricare,Tricare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC All Payer,UHC All Payer,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Exchange,UHC Exchange,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicaid,UHC Medicaid,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UMR CPD,UMR CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicare,UHC Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250357,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Wellcare,Wellcare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health PPO CPD,Meritain Health PPO CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/Commercial Product,Aetna/Commercial Product,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health CPD,Meritain Health CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Starmark CPD,Starmark CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna Medicare,Aetna Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Ambetter ,Ambetter ,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access,Anthem Blue Access,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access Choice,Anthem Blue Access Choice,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Preferred,Anthem Blue Preferred,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Pathway,Anthem Pathway,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Alliance,Anthem Alliance,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Medicare,Anthem Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna,Cigna,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna PPO,Cigna PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna Medicare Advantage,Cigna Medicare Advantage,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Essence,Essence,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink HMO,Healthlink HMO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink PPO,Healthlink PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,HomeState Health Plan,HomeState Health Plan,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Humana Gold,Humana Gold,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medicaid MO,Medicaid MO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medica,Medica,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Tricare,Tricare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC All Payer,UHC All Payer,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Exchange,UHC Exchange,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicaid,UHC Medicaid,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UMR CPD,UMR CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicare,UHC Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250358,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Wellcare,Wellcare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Meritain Health PPO CPD,Meritain Health PPO CPD,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Aetna/Commercial Product,Aetna/Commercial Product,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Meritain Health CPD,Meritain Health CPD,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Starmark CPD,Starmark CPD,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Aetna Medicare,Aetna Medicare,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Ambetter ,Ambetter ,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Blue Access,Anthem Blue Access,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Blue Access Choice,Anthem Blue Access Choice,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Blue Preferred,Anthem Blue Preferred,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Pathway,Anthem Pathway,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Alliance,Anthem Alliance,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Anthem Medicare,Anthem Medicare,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Cigna,Cigna,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Cigna PPO,Cigna PPO,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Cigna Medicare Advantage,Cigna Medicare Advantage,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Essence,Essence,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Healthlink HMO,Healthlink HMO,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Healthlink PPO,Healthlink PPO,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,HomeState Health Plan,HomeState Health Plan,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Humana Gold,Humana Gold,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Medicaid MO,Medicaid MO,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Medica,Medica,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Tricare,Tricare,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,UHC All Payer,UHC All Payer,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,UHC Exchange,UHC Exchange,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,UHC Medicaid,UHC Medicaid,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,UMR CPD,UMR CPD,546.31,,,,,,,per diem,546.31,546.31,"Per diem rate, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,UHC Medicare,UHC Medicare,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALPHA FETOPROTEIN         ,38250359,CDM,301,RC,,,,,,Inpatient,,,546.31,546.31,Wellcare,Wellcare,546.31,,,,,,,case rate,546.31,546.31,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Meritain Health PPO CPD,Meritain Health PPO CPD,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Aetna/Commercial Product,Aetna/Commercial Product,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Meritain Health CPD,Meritain Health CPD,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Starmark CPD,Starmark CPD,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Aetna Medicare,Aetna Medicare,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Ambetter ,Ambetter ,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Blue Access,Anthem Blue Access,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Blue Access Choice,Anthem Blue Access Choice,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Blue Preferred,Anthem Blue Preferred,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Pathway,Anthem Pathway,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Alliance,Anthem Alliance,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Anthem Medicare,Anthem Medicare,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Cigna,Cigna,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Cigna PPO,Cigna PPO,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Cigna Medicare Advantage,Cigna Medicare Advantage,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Essence,Essence,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Healthlink HMO,Healthlink HMO,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Healthlink PPO,Healthlink PPO,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,HomeState Health Plan,HomeState Health Plan,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Humana Gold,Humana Gold,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Medicaid MO,Medicaid MO,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Medica,Medica,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Tricare,Tricare,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,UHC All Payer,UHC All Payer,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,UHC Exchange,UHC Exchange,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,UHC Medicaid,UHC Medicaid,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,UMR CPD,UMR CPD,557.87,,,,,,,per diem,557.87,557.87,"Per diem rate, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,UHC Medicare,UHC Medicare,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALDOSTERONE SERUM         ,38250360,CDM,301,RC,,,,,,Inpatient,,,557.87,557.87,Wellcare,Wellcare,557.87,,,,,,,case rate,557.87,557.87,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250361,CDM,301,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health PPO CPD,Meritain Health PPO CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/Commercial Product,Aetna/Commercial Product,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health CPD,Meritain Health CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Starmark CPD,Starmark CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna Medicare,Aetna Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Ambetter ,Ambetter ,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access,Anthem Blue Access,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access Choice,Anthem Blue Access Choice,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Preferred,Anthem Blue Preferred,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Pathway,Anthem Pathway,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Alliance,Anthem Alliance,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Medicare,Anthem Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna,Cigna,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna PPO,Cigna PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna Medicare Advantage,Cigna Medicare Advantage,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Essence,Essence,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink HMO,Healthlink HMO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink PPO,Healthlink PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,HomeState Health Plan,HomeState Health Plan,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Humana Gold,Humana Gold,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Medicaid MO,Medicaid MO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Medica,Medica,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Tricare,Tricare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC All Payer,UHC All Payer,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Exchange,UHC Exchange,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicaid,UHC Medicaid,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UMR CPD,UMR CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicare,UHC Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN TROUGH LEVEL     ,38250362,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Wellcare,Wellcare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health PPO CPD,Meritain Health PPO CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/Commercial Product,Aetna/Commercial Product,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health CPD,Meritain Health CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Starmark CPD,Starmark CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Aetna Medicare,Aetna Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Ambetter ,Ambetter ,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access,Anthem Blue Access,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access Choice,Anthem Blue Access Choice,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Preferred,Anthem Blue Preferred,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Pathway,Anthem Pathway,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Alliance,Anthem Alliance,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Medicare,Anthem Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna,Cigna,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna PPO,Cigna PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Cigna Medicare Advantage,Cigna Medicare Advantage,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Essence,Essence,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink HMO,Healthlink HMO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink PPO,Healthlink PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,HomeState Health Plan,HomeState Health Plan,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Humana Gold,Humana Gold,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Medicaid MO,Medicaid MO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Medica,Medica,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Tricare,Tricare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC All Payer,UHC All Payer,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Exchange,UHC Exchange,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicaid,UHC Medicaid,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UMR CPD,UMR CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicare,UHC Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O AMIKACIN RANDOM LEVEL     ,38250363,CDM,301,RC,,,,,,Inpatient,,,349.85,349.85,Wellcare,Wellcare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O SULFONAMIDES              ,38250364,CDM,301,RC,,,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health PPO CPD,Meritain Health PPO CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/Commercial Product,Aetna/Commercial Product,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health CPD,Meritain Health CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Starmark CPD,Starmark CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna Medicare,Aetna Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Ambetter ,Ambetter ,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access,Anthem Blue Access,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access Choice,Anthem Blue Access Choice,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Preferred,Anthem Blue Preferred,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Pathway,Anthem Pathway,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Alliance,Anthem Alliance,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Medicare,Anthem Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna,Cigna,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna PPO,Cigna PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna Medicare Advantage,Cigna Medicare Advantage,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Essence,Essence,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink HMO,Healthlink HMO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink PPO,Healthlink PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,HomeState Health Plan,HomeState Health Plan,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Humana Gold,Humana Gold,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medicaid MO,Medicaid MO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medica,Medica,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Tricare,Tricare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC All Payer,UHC All Payer,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Exchange,UHC Exchange,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicaid,UHC Medicaid,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UMR CPD,UMR CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicare,UHC Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O STREPTOMYCIN HPLC S/P     ,38250365,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Wellcare,Wellcare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health PPO CPD,Meritain Health PPO CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/Commercial Product,Aetna/Commercial Product,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health CPD,Meritain Health CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Starmark CPD,Starmark CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Aetna Medicare,Aetna Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Ambetter ,Ambetter ,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access,Anthem Blue Access,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access Choice,Anthem Blue Access Choice,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Preferred,Anthem Blue Preferred,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Pathway,Anthem Pathway,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Alliance,Anthem Alliance,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Medicare,Anthem Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Cigna,Cigna,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Cigna PPO,Cigna PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Cigna Medicare Advantage,Cigna Medicare Advantage,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Essence,Essence,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink HMO,Healthlink HMO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink PPO,Healthlink PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,HomeState Health Plan,HomeState Health Plan,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Humana Gold,Humana Gold,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Medicaid MO,Medicaid MO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Medica,Medica,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Tricare,Tricare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,UHC All Payer,UHC All Payer,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,UHC Exchange,UHC Exchange,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicaid,UHC Medicaid,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,UMR CPD,UMR CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicare,UHC Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O AMIODARONE METABOLITE     ,38250366,CDM,301,RC,,,,,,Inpatient,,,158.64,158.64,Wellcare,Wellcare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O 5 FLUOROCYTOSINE          ,38250367,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O FLECAINIDE                ,38250368,CDM,301,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O METHOTREXATE              ,38250369,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health PPO CPD,Meritain Health PPO CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/Commercial Product,Aetna/Commercial Product,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health CPD,Meritain Health CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Starmark CPD,Starmark CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Aetna Medicare,Aetna Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Ambetter ,Ambetter ,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access,Anthem Blue Access,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access Choice,Anthem Blue Access Choice,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Preferred,Anthem Blue Preferred,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Pathway,Anthem Pathway,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Alliance,Anthem Alliance,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Medicare,Anthem Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna,Cigna,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna PPO,Cigna PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Cigna Medicare Advantage,Cigna Medicare Advantage,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Essence,Essence,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink HMO,Healthlink HMO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink PPO,Healthlink PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,HomeState Health Plan,HomeState Health Plan,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Humana Gold,Humana Gold,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medicaid MO,Medicaid MO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Medica,Medica,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Tricare,Tricare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC All Payer,UHC All Payer,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Exchange,UHC Exchange,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicaid,UHC Medicaid,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UMR CPD,UMR CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicare,UHC Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CLOZAPINE QNT SRM/PLS     ,38250370,CDM,301,RC,,,,,,Inpatient,,,430.75,430.75,Wellcare,Wellcare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
ACETONE/KETONES QN            ,38250371,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health PPO CPD,Meritain Health PPO CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Aetna/Commercial Product,Aetna/Commercial Product,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Meritain Health CPD,Meritain Health CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Starmark CPD,Starmark CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Aetna Medicare,Aetna Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Ambetter ,Ambetter ,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access,Anthem Blue Access,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Access Choice,Anthem Blue Access Choice,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Blue Preferred,Anthem Blue Preferred,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Pathway,Anthem Pathway,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Alliance,Anthem Alliance,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Anthem Medicare,Anthem Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Cigna,Cigna,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Cigna PPO,Cigna PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Cigna Medicare Advantage,Cigna Medicare Advantage,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Essence,Essence,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink HMO,Healthlink HMO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Healthlink PPO,Healthlink PPO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,HomeState Health Plan,HomeState Health Plan,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Humana Gold,Humana Gold,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Medicaid MO,Medicaid MO,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Medica,Medica,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Tricare,Tricare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,UHC All Payer,UHC All Payer,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,UHC Exchange,UHC Exchange,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicaid,UHC Medicaid,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,UMR CPD,UMR CPD,430.75,,,,,,,per diem,430.75,430.75,"Per diem rate, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,UHC Medicare,UHC Medicare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O CA 15-3                   ,38250372,CDM,302,RC,,,,,,Inpatient,,,430.75,430.75,Wellcare,Wellcare,430.75,,,,,,,case rate,430.75,430.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Meritain Health PPO CPD,Meritain Health PPO CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Aetna/Commercial Product,Aetna/Commercial Product,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Meritain Health CPD,Meritain Health CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Starmark CPD,Starmark CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Aetna Medicare,Aetna Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Ambetter ,Ambetter ,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Access,Anthem Blue Access,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Access Choice,Anthem Blue Access Choice,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Preferred,Anthem Blue Preferred,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Pathway,Anthem Pathway,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Alliance,Anthem Alliance,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Medicare,Anthem Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Cigna,Cigna,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Cigna PPO,Cigna PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Cigna Medicare Advantage,Cigna Medicare Advantage,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Essence,Essence,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Healthlink HMO,Healthlink HMO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Healthlink PPO,Healthlink PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,HomeState Health Plan,HomeState Health Plan,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Humana Gold,Humana Gold,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Medicaid MO,Medicaid MO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Medica,Medica,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Tricare,Tricare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,UHC All Payer,UHC All Payer,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,UHC Exchange,UHC Exchange,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,UHC Medicaid,UHC Medicaid,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,UMR CPD,UMR CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,UHC Medicare,UHC Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250373,CDM,305,RC,,,,,,Inpatient,,,264.75,264.75,Wellcare,Wellcare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250374,CDM,305,RC,,,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
AMYLASE                       ,38250375,CDM,301,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O AMYLASE ISOENZYME         ,38250376,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250377,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250378,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health PPO CPD,Meritain Health PPO CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/Commercial Product,Aetna/Commercial Product,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health CPD,Meritain Health CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Starmark CPD,Starmark CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna Medicare,Aetna Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Ambetter ,Ambetter ,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access,Anthem Blue Access,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access Choice,Anthem Blue Access Choice,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Preferred,Anthem Blue Preferred,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Pathway,Anthem Pathway,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Alliance,Anthem Alliance,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Medicare,Anthem Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna,Cigna,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna PPO,Cigna PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna Medicare Advantage,Cigna Medicare Advantage,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Essence,Essence,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink HMO,Healthlink HMO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink PPO,Healthlink PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,HomeState Health Plan,HomeState Health Plan,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Humana Gold,Humana Gold,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medicaid MO,Medicaid MO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medica,Medica,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Tricare,Tricare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC All Payer,UHC All Payer,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Exchange,UHC Exchange,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicaid,UHC Medicaid,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UMR CPD,UMR CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicare,UHC Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA ANTINUCLEAR BLD       ,38250379,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Wellcare,Wellcare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250380,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SCLER ANA IGG IFA         ,38250381,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Meritain Health PPO CPD,Meritain Health PPO CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Aetna/Commercial Product,Aetna/Commercial Product,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Meritain Health CPD,Meritain Health CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Starmark CPD,Starmark CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Aetna Medicare,Aetna Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Ambetter ,Ambetter ,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Access,Anthem Blue Access,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Access Choice,Anthem Blue Access Choice,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Preferred,Anthem Blue Preferred,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Pathway,Anthem Pathway,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Alliance,Anthem Alliance,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Medicare,Anthem Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Cigna,Cigna,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Cigna PPO,Cigna PPO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Cigna Medicare Advantage,Cigna Medicare Advantage,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Essence,Essence,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Healthlink HMO,Healthlink HMO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Healthlink PPO,Healthlink PPO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,HomeState Health Plan,HomeState Health Plan,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Humana Gold,Humana Gold,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Medicaid MO,Medicaid MO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Medica,Medica,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Tricare,Tricare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,UHC All Payer,UHC All Payer,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,UHC Exchange,UHC Exchange,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,UHC Medicaid,UHC Medicaid,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,UMR CPD,UMR CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,UHC Medicare,UHC Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O ANGIOTEN CONVERT CSF      ,38250382,CDM,301,RC,,,,,,Inpatient,,,222.73,222.73,Wellcare,Wellcare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O CYSTICERCO AB IGG CSF     ,38250383,CDM,302,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O STRONGYLOD AB IGG SRM     ,38250384,CDM,302,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TOXOCARA AB IGG ELISA     ,38250385,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health PPO CPD,Meritain Health PPO CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/Commercial Product,Aetna/Commercial Product,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health CPD,Meritain Health CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Starmark CPD,Starmark CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Aetna Medicare,Aetna Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Ambetter ,Ambetter ,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access,Anthem Blue Access,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access Choice,Anthem Blue Access Choice,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Preferred,Anthem Blue Preferred,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Pathway,Anthem Pathway,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Alliance,Anthem Alliance,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Medicare,Anthem Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Cigna,Cigna,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Cigna PPO,Cigna PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Cigna Medicare Advantage,Cigna Medicare Advantage,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Essence,Essence,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink HMO,Healthlink HMO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink PPO,Healthlink PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,HomeState Health Plan,HomeState Health Plan,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Humana Gold,Humana Gold,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Medicaid MO,Medicaid MO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Medica,Medica,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Tricare,Tricare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,UHC All Payer,UHC All Payer,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,UHC Exchange,UHC Exchange,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicaid,UHC Medicaid,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,UMR CPD,UMR CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicare,UHC Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O SCHISTOSOMA AB IGG        ,38250386,CDM,302,RC,,,,,,Inpatient,,,133.43,133.43,Wellcare,Wellcare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Meritain Health PPO CPD,Meritain Health PPO CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Aetna/Commercial Product,Aetna/Commercial Product,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Meritain Health CPD,Meritain Health CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Starmark CPD,Starmark CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Aetna Medicare,Aetna Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Ambetter ,Ambetter ,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Access,Anthem Blue Access,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Access Choice,Anthem Blue Access Choice,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Blue Preferred,Anthem Blue Preferred,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Pathway,Anthem Pathway,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Alliance,Anthem Alliance,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Anthem Medicare,Anthem Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Cigna,Cigna,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Cigna PPO,Cigna PPO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Cigna Medicare Advantage,Cigna Medicare Advantage,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Essence,Essence,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Healthlink HMO,Healthlink HMO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Healthlink PPO,Healthlink PPO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,HomeState Health Plan,HomeState Health Plan,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Humana Gold,Humana Gold,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Medicaid MO,Medicaid MO,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Medica,Medica,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Tricare,Tricare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,UHC All Payer,UHC All Payer,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,UHC Exchange,UHC Exchange,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,UHC Medicaid,UHC Medicaid,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,UMR CPD,UMR CPD,529.5,,,,,,,per diem,529.5,529.5,"Per diem rate, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,UHC Medicare,UHC Medicare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
S/O ECHINOCOCCUS AB IGG       ,38250387,CDM,302,RC,,,,,,Inpatient,,,529.5,529.5,Wellcare,Wellcare,529.5,,,,,,,case rate,529.5,529.5,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health PPO CPD,Meritain Health PPO CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/Commercial Product,Aetna/Commercial Product,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health CPD,Meritain Health CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Starmark CPD,Starmark CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Aetna Medicare,Aetna Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Ambetter ,Ambetter ,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access,Anthem Blue Access,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access Choice,Anthem Blue Access Choice,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Preferred,Anthem Blue Preferred,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Pathway,Anthem Pathway,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Alliance,Anthem Alliance,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Medicare,Anthem Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Cigna,Cigna,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Cigna PPO,Cigna PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Cigna Medicare Advantage,Cigna Medicare Advantage,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Essence,Essence,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink HMO,Healthlink HMO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink PPO,Healthlink PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,HomeState Health Plan,HomeState Health Plan,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Humana Gold,Humana Gold,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Medicaid MO,Medicaid MO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Medica,Medica,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Tricare,Tricare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,UHC All Payer,UHC All Payer,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,UHC Exchange,UHC Exchange,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicaid,UHC Medicaid,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,UMR CPD,UMR CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicare,UHC Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
AB ID RBC EACH PANEL          ,38250388,CDM,309,RC,,,,,,Inpatient,,,439.15,439.15,Wellcare,Wellcare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Meritain Health PPO CPD,Meritain Health PPO CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Aetna/Commercial Product,Aetna/Commercial Product,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Meritain Health CPD,Meritain Health CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Starmark CPD,Starmark CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Aetna Medicare,Aetna Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Ambetter ,Ambetter ,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Access,Anthem Blue Access,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Access Choice,Anthem Blue Access Choice,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Blue Preferred,Anthem Blue Preferred,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Pathway,Anthem Pathway,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Alliance,Anthem Alliance,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Anthem Medicare,Anthem Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Cigna,Cigna,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Cigna PPO,Cigna PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Cigna Medicare Advantage,Cigna Medicare Advantage,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Essence,Essence,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Healthlink HMO,Healthlink HMO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Healthlink PPO,Healthlink PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,HomeState Health Plan,HomeState Health Plan,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Humana Gold,Humana Gold,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Medicaid MO,Medicaid MO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Medica,Medica,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Tricare,Tricare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,UHC All Payer,UHC All Payer,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,UHC Exchange,UHC Exchange,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,UHC Medicaid,UHC Medicaid,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,UMR CPD,UMR CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,UHC Medicare,UHC Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O ANTIBODY ID UBS           ,38250389,CDM,309,RC,,,,,,Inpatient,,,194.36,194.36,Wellcare,Wellcare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Meritain Health PPO CPD,Meritain Health PPO CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna/Commercial Product,Aetna/Commercial Product,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Meritain Health CPD,Meritain Health CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Starmark CPD,Starmark CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna Medicare,Aetna Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Ambetter ,Ambetter ,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Access,Anthem Blue Access,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Access Choice,Anthem Blue Access Choice,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Preferred,Anthem Blue Preferred,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Pathway,Anthem Pathway,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Alliance,Anthem Alliance,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Medicare,Anthem Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna,Cigna,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna PPO,Cigna PPO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna Medicare Advantage,Cigna Medicare Advantage,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Essence,Essence,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthlink HMO,Healthlink HMO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthlink PPO,Healthlink PPO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,HomeState Health Plan,HomeState Health Plan,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Humana Gold,Humana Gold,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Medicaid MO,Medicaid MO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Medica,Medica,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Tricare,Tricare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC All Payer,UHC All Payer,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Exchange,UHC Exchange,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Medicaid,UHC Medicaid,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UMR CPD,UMR CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Medicare,UHC Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O FICIN AB ID UBS           ,38250390,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Wellcare,Wellcare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Meritain Health PPO CPD,Meritain Health PPO CPD,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Aetna/Commercial Product,Aetna/Commercial Product,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Meritain Health CPD,Meritain Health CPD,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Starmark CPD,Starmark CPD,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Aetna Medicare,Aetna Medicare,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Ambetter ,Ambetter ,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Blue Access,Anthem Blue Access,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Blue Access Choice,Anthem Blue Access Choice,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Blue Preferred,Anthem Blue Preferred,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Pathway,Anthem Pathway,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Alliance,Anthem Alliance,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Anthem Medicare,Anthem Medicare,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Cigna,Cigna,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Cigna PPO,Cigna PPO,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Cigna Medicare Advantage,Cigna Medicare Advantage,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Essence,Essence,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Healthlink HMO,Healthlink HMO,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Healthlink PPO,Healthlink PPO,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,HomeState Health Plan,HomeState Health Plan,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Humana Gold,Humana Gold,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Medicaid MO,Medicaid MO,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Medica,Medica,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Tricare,Tricare,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,UHC All Payer,UHC All Payer,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,UHC Exchange,UHC Exchange,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,UHC Medicaid,UHC Medicaid,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,UMR CPD,UMR CPD,212.22,,,,,,,per diem,212.22,212.22,"Per diem rate, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,UHC Medicare,UHC Medicare,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O AB ID RBC EACH PANEL      ,38250391,CDM,309,RC,,,,,,Inpatient,,,212.22,212.22,Wellcare,Wellcare,212.22,,,,,,,case rate,212.22,212.22,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Meritain Health PPO CPD,Meritain Health PPO CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna/Commercial Product,Aetna/Commercial Product,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Meritain Health CPD,Meritain Health CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Starmark CPD,Starmark CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Aetna Medicare,Aetna Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Ambetter ,Ambetter ,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Access,Anthem Blue Access,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Access Choice,Anthem Blue Access Choice,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Blue Preferred,Anthem Blue Preferred,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Pathway,Anthem Pathway,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Alliance,Anthem Alliance,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Anthem Medicare,Anthem Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna,Cigna,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna PPO,Cigna PPO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Cigna Medicare Advantage,Cigna Medicare Advantage,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Essence,Essence,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthlink HMO,Healthlink HMO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Healthlink PPO,Healthlink PPO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,HomeState Health Plan,HomeState Health Plan,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Humana Gold,Humana Gold,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Medicaid MO,Medicaid MO,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Medica,Medica,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Tricare,Tricare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC All Payer,UHC All Payer,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Exchange,UHC Exchange,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Medicaid,UHC Medicaid,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UMR CPD,UMR CPD,102.96,,,,,,,per diem,102.96,102.96,"Per diem rate, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,UHC Medicare,UHC Medicare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O ANTIBODY DETECT UBS       ,38250392,CDM,309,RC,,,,,,Inpatient,,,102.96,102.96,Wellcare,Wellcare,102.96,,,,,,,case rate,102.96,102.96,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250393,CDM,309,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Meritain Health PPO CPD,Meritain Health PPO CPD,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Aetna/Commercial Product,Aetna/Commercial Product,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Meritain Health CPD,Meritain Health CPD,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Starmark CPD,Starmark CPD,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Aetna Medicare,Aetna Medicare,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Ambetter ,Ambetter ,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Blue Access,Anthem Blue Access,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Blue Access Choice,Anthem Blue Access Choice,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Blue Preferred,Anthem Blue Preferred,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Pathway,Anthem Pathway,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Alliance,Anthem Alliance,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Anthem Medicare,Anthem Medicare,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Cigna,Cigna,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Cigna PPO,Cigna PPO,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Cigna Medicare Advantage,Cigna Medicare Advantage,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Essence,Essence,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Healthlink HMO,Healthlink HMO,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Healthlink PPO,Healthlink PPO,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,HomeState Health Plan,HomeState Health Plan,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Humana Gold,Humana Gold,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Medicaid MO,Medicaid MO,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Medica,Medica,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Tricare,Tricare,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,UHC All Payer,UHC All Payer,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,UHC Exchange,UHC Exchange,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,UHC Medicaid,UHC Medicaid,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,UMR CPD,UMR CPD,371.91,,,,,,,per diem,371.91,371.91,"Per diem rate, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,UHC Medicare,UHC Medicare,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O ANTI-DSDNA                ,38250394,CDM,302,RC,,,,,,Inpatient,,,371.91,371.91,Wellcare,Wellcare,371.91,,,,,,,case rate,371.91,371.91,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG ELISA           ,38250395,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Meritain Health PPO CPD,Meritain Health PPO CPD,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Aetna/Commercial Product,Aetna/Commercial Product,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Meritain Health CPD,Meritain Health CPD,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Starmark CPD,Starmark CPD,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Aetna Medicare,Aetna Medicare,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Ambetter ,Ambetter ,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Blue Access,Anthem Blue Access,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Blue Access Choice,Anthem Blue Access Choice,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Blue Preferred,Anthem Blue Preferred,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Pathway,Anthem Pathway,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Alliance,Anthem Alliance,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Anthem Medicare,Anthem Medicare,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Cigna,Cigna,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Cigna PPO,Cigna PPO,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Cigna Medicare Advantage,Cigna Medicare Advantage,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Essence,Essence,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Healthlink HMO,Healthlink HMO,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Healthlink PPO,Healthlink PPO,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,HomeState Health Plan,HomeState Health Plan,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Humana Gold,Humana Gold,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Medicaid MO,Medicaid MO,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Medica,Medica,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Tricare,Tricare,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,UHC All Payer,UHC All Payer,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,UHC Exchange,UHC Exchange,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,UHC Medicaid,UHC Medicaid,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,UMR CPD,UMR CPD,1461.38,,,,,,,per diem,1461.38,1461.38,"Per diem rate, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,UHC Medicare,UHC Medicare,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O SRA UNFRAC HEPARIN        ,38250396,CDM,302,RC,,,,,,Inpatient,,,1461.38,1461.38,Wellcare,Wellcare,1461.38,,,,,,,case rate,1461.38,1461.38,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Meritain Health PPO CPD,Meritain Health PPO CPD,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Aetna/Commercial Product,Aetna/Commercial Product,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Meritain Health CPD,Meritain Health CPD,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Starmark CPD,Starmark CPD,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Aetna Medicare,Aetna Medicare,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Ambetter ,Ambetter ,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Blue Access,Anthem Blue Access,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Blue Access Choice,Anthem Blue Access Choice,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Blue Preferred,Anthem Blue Preferred,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Pathway,Anthem Pathway,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Alliance,Anthem Alliance,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Anthem Medicare,Anthem Medicare,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Cigna,Cigna,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Cigna PPO,Cigna PPO,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Cigna Medicare Advantage,Cigna Medicare Advantage,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Essence,Essence,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Healthlink HMO,Healthlink HMO,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Healthlink PPO,Healthlink PPO,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,HomeState Health Plan,HomeState Health Plan,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Humana Gold,Humana Gold,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Medicaid MO,Medicaid MO,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Medica,Medica,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Tricare,Tricare,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,UHC All Payer,UHC All Payer,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,UHC Exchange,UHC Exchange,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,UHC Medicaid,UHC Medicaid,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,UMR CPD,UMR CPD,577.83,,,,,,,per diem,577.83,577.83,"Per diem rate, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,UHC Medicare,UHC Medicare,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET AB INDIRECT      ,38250397,CDM,302,RC,,,,,,Inpatient,,,577.83,577.83,Wellcare,Wellcare,577.83,,,,,,,case rate,577.83,577.83,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Meritain Health PPO CPD,Meritain Health PPO CPD,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Aetna/Commercial Product,Aetna/Commercial Product,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Meritain Health CPD,Meritain Health CPD,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Starmark CPD,Starmark CPD,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Aetna Medicare,Aetna Medicare,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Ambetter ,Ambetter ,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Blue Access,Anthem Blue Access,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Blue Access Choice,Anthem Blue Access Choice,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Blue Preferred,Anthem Blue Preferred,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Pathway,Anthem Pathway,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Alliance,Anthem Alliance,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Anthem Medicare,Anthem Medicare,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Cigna,Cigna,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Cigna PPO,Cigna PPO,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Cigna Medicare Advantage,Cigna Medicare Advantage,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Essence,Essence,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Healthlink HMO,Healthlink HMO,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Healthlink PPO,Healthlink PPO,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,HomeState Health Plan,HomeState Health Plan,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Humana Gold,Humana Gold,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Medicaid MO,Medicaid MO,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Medica,Medica,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Tricare,Tricare,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,UHC All Payer,UHC All Payer,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,UHC Exchange,UHC Exchange,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,UHC Medicaid,UHC Medicaid,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,UMR CPD,UMR CPD,528.12,,,,,,,per diem,528.12,528.12,"Per diem rate, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,UHC Medicare,UHC Medicare,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET ANTIBODY ID      ,38250398,CDM,302,RC,,,,,,Inpatient,,,528.12,528.12,Wellcare,Wellcare,528.12,,,,,,,case rate,528.12,528.12,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health PPO CPD,Meritain Health PPO CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/Commercial Product,Aetna/Commercial Product,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health CPD,Meritain Health CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Starmark CPD,Starmark CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Aetna Medicare,Aetna Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Ambetter ,Ambetter ,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access,Anthem Blue Access,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access Choice,Anthem Blue Access Choice,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Preferred,Anthem Blue Preferred,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Pathway,Anthem Pathway,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Alliance,Anthem Alliance,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Medicare,Anthem Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Cigna,Cigna,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Cigna PPO,Cigna PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Cigna Medicare Advantage,Cigna Medicare Advantage,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Essence,Essence,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink HMO,Healthlink HMO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink PPO,Healthlink PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,HomeState Health Plan,HomeState Health Plan,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Humana Gold,Humana Gold,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Medicaid MO,Medicaid MO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Medica,Medica,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Tricare,Tricare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,UHC All Payer,UHC All Payer,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,UHC Exchange,UHC Exchange,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicaid,UHC Medicaid,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,UMR CPD,UMR CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicare,UHC Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET AB HIT ASSAY     ,38250399,CDM,302,RC,,,,,,Inpatient,,,72.49,72.49,Wellcare,Wellcare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Meritain Health PPO CPD,Meritain Health PPO CPD,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Aetna/Commercial Product,Aetna/Commercial Product,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Meritain Health CPD,Meritain Health CPD,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Starmark CPD,Starmark CPD,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Aetna Medicare,Aetna Medicare,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Ambetter ,Ambetter ,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Blue Access,Anthem Blue Access,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Blue Access Choice,Anthem Blue Access Choice,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Blue Preferred,Anthem Blue Preferred,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Pathway,Anthem Pathway,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Alliance,Anthem Alliance,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Anthem Medicare,Anthem Medicare,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Cigna,Cigna,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Cigna PPO,Cigna PPO,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Cigna Medicare Advantage,Cigna Medicare Advantage,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Essence,Essence,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Healthlink HMO,Healthlink HMO,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Healthlink PPO,Healthlink PPO,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,HomeState Health Plan,HomeState Health Plan,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Humana Gold,Humana Gold,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Medicaid MO,Medicaid MO,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Medica,Medica,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Tricare,Tricare,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,UHC All Payer,UHC All Payer,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,UHC Exchange,UHC Exchange,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,UHC Medicaid,UHC Medicaid,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,UMR CPD,UMR CPD,174.4,,,,,,,per diem,174.4,174.4,"Per diem rate, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,UHC Medicare,UHC Medicare,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET CROSSM ELISA     ,38250400,CDM,302,RC,,,,,,Inpatient,,,174.4,174.4,Wellcare,Wellcare,174.4,,,,,,,case rate,174.4,174.4,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Meritain Health PPO CPD,Meritain Health PPO CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna/Commercial Product,Aetna/Commercial Product,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Meritain Health CPD,Meritain Health CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Starmark CPD,Starmark CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna Medicare,Aetna Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Ambetter ,Ambetter ,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Access,Anthem Blue Access,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Access Choice,Anthem Blue Access Choice,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Preferred,Anthem Blue Preferred,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Pathway,Anthem Pathway,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Alliance,Anthem Alliance,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Medicare,Anthem Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna,Cigna,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna PPO,Cigna PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna Medicare Advantage,Cigna Medicare Advantage,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Essence,Essence,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthlink HMO,Healthlink HMO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthlink PPO,Healthlink PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,HomeState Health Plan,HomeState Health Plan,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Humana Gold,Humana Gold,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Medicaid MO,Medicaid MO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Medica,Medica,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Tricare,Tricare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC All Payer,UHC All Payer,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Exchange,UHC Exchange,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Medicaid,UHC Medicaid,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UMR CPD,UMR CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Medicare,UHC Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O PLATELET AB SCR ELISA     ,38250401,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Wellcare,Wellcare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Meritain Health PPO CPD,Meritain Health PPO CPD,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Aetna/Commercial Product,Aetna/Commercial Product,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Meritain Health CPD,Meritain Health CPD,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Starmark CPD,Starmark CPD,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Aetna Medicare,Aetna Medicare,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Ambetter ,Ambetter ,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Blue Access,Anthem Blue Access,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Blue Access Choice,Anthem Blue Access Choice,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Blue Preferred,Anthem Blue Preferred,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Pathway,Anthem Pathway,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Alliance,Anthem Alliance,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Anthem Medicare,Anthem Medicare,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Cigna,Cigna,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Cigna PPO,Cigna PPO,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Cigna Medicare Advantage,Cigna Medicare Advantage,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Essence,Essence,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Healthlink HMO,Healthlink HMO,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Healthlink PPO,Healthlink PPO,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,HomeState Health Plan,HomeState Health Plan,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Humana Gold,Humana Gold,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Medicaid MO,Medicaid MO,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Medica,Medica,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Tricare,Tricare,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,UHC All Payer,UHC All Payer,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,UHC Exchange,UHC Exchange,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,UHC Medicaid,UHC Medicaid,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,UMR CPD,UMR CPD,514.79,,,,,,,per diem,514.79,514.79,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,UHC Medicare,UHC Medicare,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250402,CDM,305,RC,,,,,,Inpatient,,,514.79,514.79,Wellcare,Wellcare,514.79,,,,,,,case rate,514.79,514.79,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Meritain Health PPO CPD,Meritain Health PPO CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Aetna/Commercial Product,Aetna/Commercial Product,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Meritain Health CPD,Meritain Health CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Starmark CPD,Starmark CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Aetna Medicare,Aetna Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Ambetter ,Ambetter ,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Access,Anthem Blue Access,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Access Choice,Anthem Blue Access Choice,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Preferred,Anthem Blue Preferred,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Pathway,Anthem Pathway,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Alliance,Anthem Alliance,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Medicare,Anthem Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Cigna,Cigna,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Cigna PPO,Cigna PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Cigna Medicare Advantage,Cigna Medicare Advantage,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Essence,Essence,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Healthlink HMO,Healthlink HMO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Healthlink PPO,Healthlink PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,HomeState Health Plan,HomeState Health Plan,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Humana Gold,Humana Gold,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Medicaid MO,Medicaid MO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Medica,Medica,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Tricare,Tricare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,UHC All Payer,UHC All Payer,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,UHC Exchange,UHC Exchange,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,UHC Medicaid,UHC Medicaid,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,UMR CPD,UMR CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,UHC Medicare,UHC Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O TISSUE PLASM ACTIV AG     ,38250403,CDM,305,RC,,,,,,Inpatient,,,77.74,77.74,Wellcare,Wellcare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Meritain Health PPO CPD,Meritain Health PPO CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Aetna/Commercial Product,Aetna/Commercial Product,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Meritain Health CPD,Meritain Health CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Starmark CPD,Starmark CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Aetna Medicare,Aetna Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Ambetter ,Ambetter ,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Access,Anthem Blue Access,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Access Choice,Anthem Blue Access Choice,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Preferred,Anthem Blue Preferred,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Pathway,Anthem Pathway,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Alliance,Anthem Alliance,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Medicare,Anthem Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Cigna,Cigna,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Cigna PPO,Cigna PPO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Cigna Medicare Advantage,Cigna Medicare Advantage,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Essence,Essence,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Healthlink HMO,Healthlink HMO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Healthlink PPO,Healthlink PPO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,HomeState Health Plan,HomeState Health Plan,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Humana Gold,Humana Gold,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Medicaid MO,Medicaid MO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Medica,Medica,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Tricare,Tricare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,UHC All Payer,UHC All Payer,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,UHC Exchange,UHC Exchange,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,UHC Medicaid,UHC Medicaid,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,UMR CPD,UMR CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,UHC Medicare,UHC Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250404,CDM,305,RC,,,,,,Inpatient,,,214.32,214.32,Wellcare,Wellcare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health PPO CPD,Meritain Health PPO CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/Commercial Product,Aetna/Commercial Product,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health CPD,Meritain Health CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Starmark CPD,Starmark CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna Medicare,Aetna Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Ambetter ,Ambetter ,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access,Anthem Blue Access,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access Choice,Anthem Blue Access Choice,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Preferred,Anthem Blue Preferred,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Pathway,Anthem Pathway,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Alliance,Anthem Alliance,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Medicare,Anthem Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna,Cigna,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna PPO,Cigna PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna Medicare Advantage,Cigna Medicare Advantage,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Essence,Essence,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink HMO,Healthlink HMO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink PPO,Healthlink PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,HomeState Health Plan,HomeState Health Plan,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Humana Gold,Humana Gold,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Medicaid MO,Medicaid MO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Medica,Medica,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Tricare,Tricare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC All Payer,UHC All Payer,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Exchange,UHC Exchange,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicaid,UHC Medicaid,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UMR CPD,UMR CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicare,UHC Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
"S/O 1,3 BETA D GLUCAN         ",38250405,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Wellcare,Wellcare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health PPO CPD,Meritain Health PPO CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna/Commercial Product,Aetna/Commercial Product,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Meritain Health CPD,Meritain Health CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Starmark CPD,Starmark CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Aetna Medicare,Aetna Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Ambetter ,Ambetter ,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access,Anthem Blue Access,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Access Choice,Anthem Blue Access Choice,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Blue Preferred,Anthem Blue Preferred,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Pathway,Anthem Pathway,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Alliance,Anthem Alliance,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Anthem Medicare,Anthem Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna,Cigna,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna PPO,Cigna PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Cigna Medicare Advantage,Cigna Medicare Advantage,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Essence,Essence,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink HMO,Healthlink HMO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Healthlink PPO,Healthlink PPO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,HomeState Health Plan,HomeState Health Plan,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Humana Gold,Humana Gold,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Medicaid MO,Medicaid MO,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Medica,Medica,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Tricare,Tricare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC All Payer,UHC All Payer,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Exchange,UHC Exchange,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicaid,UHC Medicaid,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UMR CPD,UMR CPD,491.68,,,,,,,per diem,491.68,491.68,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,UHC Medicare,UHC Medicare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES DERM EIA      ,38250406,CDM,306,RC,,,,,,Inpatient,,,491.68,491.68,Wellcare,Wellcare,491.68,,,,,,,case rate,491.68,491.68,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA A AB IGM        ,38250407,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGG        ,38250408,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O INFLUENZA B AB IGM        ,38250409,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health PPO CPD,Meritain Health PPO CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/Commercial Product,Aetna/Commercial Product,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health CPD,Meritain Health CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Starmark CPD,Starmark CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna Medicare,Aetna Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Ambetter ,Ambetter ,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access,Anthem Blue Access,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access Choice,Anthem Blue Access Choice,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Preferred,Anthem Blue Preferred,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Pathway,Anthem Pathway,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Alliance,Anthem Alliance,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Medicare,Anthem Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna,Cigna,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna PPO,Cigna PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna Medicare Advantage,Cigna Medicare Advantage,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Essence,Essence,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink HMO,Healthlink HMO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink PPO,Healthlink PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,HomeState Health Plan,HomeState Health Plan,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Humana Gold,Humana Gold,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medicaid MO,Medicaid MO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medica,Medica,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Tricare,Tricare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC All Payer,UHC All Payer,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Exchange,UHC Exchange,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicaid,UHC Medicaid,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UMR CPD,UMR CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicare,UHC Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROBNP NT                 ,38250410,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Wellcare,Wellcare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250411,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250412,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250413,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250414,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250415,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250416,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250417,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250418,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250419,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health PPO CPD,Meritain Health PPO CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna/Commercial Product,Aetna/Commercial Product,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Meritain Health CPD,Meritain Health CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Starmark CPD,Starmark CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Aetna Medicare,Aetna Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Ambetter ,Ambetter ,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access,Anthem Blue Access,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Access Choice,Anthem Blue Access Choice,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Blue Preferred,Anthem Blue Preferred,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Pathway,Anthem Pathway,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Alliance,Anthem Alliance,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Anthem Medicare,Anthem Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna,Cigna,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna PPO,Cigna PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Cigna Medicare Advantage,Cigna Medicare Advantage,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Essence,Essence,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink HMO,Healthlink HMO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Healthlink PPO,Healthlink PPO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,HomeState Health Plan,HomeState Health Plan,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Humana Gold,Humana Gold,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medicaid MO,Medicaid MO,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Medica,Medica,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Tricare,Tricare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC All Payer,UHC All Payer,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Exchange,UHC Exchange,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicaid,UHC Medicaid,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UMR CPD,UMR CPD,345.65,,,,,,,per diem,345.65,345.65,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,UHC Medicare,UHC Medicare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38250420,CDM,306,RC,,,,,,Inpatient,,,345.65,345.65,Wellcare,Wellcare,345.65,,,,,,,case rate,345.65,345.65,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O UREA NITROGEN FLUID       ,38250421,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Meritain Health PPO CPD,Meritain Health PPO CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Aetna/Commercial Product,Aetna/Commercial Product,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Meritain Health CPD,Meritain Health CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Starmark CPD,Starmark CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Aetna Medicare,Aetna Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Ambetter ,Ambetter ,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Access,Anthem Blue Access,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Access Choice,Anthem Blue Access Choice,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Preferred,Anthem Blue Preferred,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Pathway,Anthem Pathway,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Alliance,Anthem Alliance,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Medicare,Anthem Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Cigna,Cigna,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Cigna PPO,Cigna PPO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Cigna Medicare Advantage,Cigna Medicare Advantage,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Essence,Essence,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Healthlink HMO,Healthlink HMO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Healthlink PPO,Healthlink PPO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,HomeState Health Plan,HomeState Health Plan,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Humana Gold,Humana Gold,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Medicaid MO,Medicaid MO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Medica,Medica,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Tricare,Tricare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,UHC All Payer,UHC All Payer,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,UHC Exchange,UHC Exchange,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,UHC Medicaid,UHC Medicaid,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,UMR CPD,UMR CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,UHC Medicare,UHC Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250422,CDM,301,RC,,,,,,Inpatient,,,227.98,227.98,Wellcare,Wellcare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health PPO CPD,Meritain Health PPO CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/Commercial Product,Aetna/Commercial Product,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health CPD,Meritain Health CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Starmark CPD,Starmark CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Aetna Medicare,Aetna Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Ambetter ,Ambetter ,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access,Anthem Blue Access,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access Choice,Anthem Blue Access Choice,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Preferred,Anthem Blue Preferred,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Pathway,Anthem Pathway,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Alliance,Anthem Alliance,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Medicare,Anthem Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Cigna,Cigna,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Cigna PPO,Cigna PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Cigna Medicare Advantage,Cigna Medicare Advantage,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Essence,Essence,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink HMO,Healthlink HMO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink PPO,Healthlink PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,HomeState Health Plan,HomeState Health Plan,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Humana Gold,Humana Gold,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Medicaid MO,Medicaid MO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Medica,Medica,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Tricare,Tricare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,UHC All Payer,UHC All Payer,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,UHC Exchange,UHC Exchange,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicaid,UHC Medicaid,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,UMR CPD,UMR CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicare,UHC Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY          ,38250423,CDM,302,RC,,,,,,Inpatient,,,265.8,265.8,Wellcare,Wellcare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CALCIUM IONIZED SERUM     ,38250424,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYON AG FLD     ,38250425,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONIC AG       ,38250426,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health PPO CPD,Meritain Health PPO CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/Commercial Product,Aetna/Commercial Product,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health CPD,Meritain Health CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Starmark CPD,Starmark CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Aetna Medicare,Aetna Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Ambetter ,Ambetter ,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access,Anthem Blue Access,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access Choice,Anthem Blue Access Choice,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Preferred,Anthem Blue Preferred,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Pathway,Anthem Pathway,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Alliance,Anthem Alliance,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Medicare,Anthem Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Cigna,Cigna,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Cigna PPO,Cigna PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Cigna Medicare Advantage,Cigna Medicare Advantage,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Essence,Essence,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink HMO,Healthlink HMO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink PPO,Healthlink PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,HomeState Health Plan,HomeState Health Plan,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Humana Gold,Humana Gold,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Medicaid MO,Medicaid MO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Medica,Medica,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Tricare,Tricare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,UHC All Payer,UHC All Payer,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,UHC Exchange,UHC Exchange,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicaid,UHC Medicaid,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,UMR CPD,UMR CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicare,UHC Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CARCINOEMBRYONC AG BF     ,38250427,CDM,301,RC,,,,,,Inpatient,,,74.59,74.59,Wellcare,Wellcare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Meritain Health PPO CPD,Meritain Health PPO CPD,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Aetna/Commercial Product,Aetna/Commercial Product,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Meritain Health CPD,Meritain Health CPD,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Starmark CPD,Starmark CPD,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Aetna Medicare,Aetna Medicare,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Ambetter ,Ambetter ,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Blue Access,Anthem Blue Access,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Blue Access Choice,Anthem Blue Access Choice,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Blue Preferred,Anthem Blue Preferred,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Pathway,Anthem Pathway,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Alliance,Anthem Alliance,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Anthem Medicare,Anthem Medicare,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Cigna,Cigna,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Cigna PPO,Cigna PPO,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Cigna Medicare Advantage,Cigna Medicare Advantage,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Essence,Essence,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Healthlink HMO,Healthlink HMO,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Healthlink PPO,Healthlink PPO,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,HomeState Health Plan,HomeState Health Plan,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Humana Gold,Humana Gold,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Medicaid MO,Medicaid MO,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Medica,Medica,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Tricare,Tricare,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,UHC All Payer,UHC All Payer,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,UHC Exchange,UHC Exchange,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,UHC Medicaid,UHC Medicaid,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,UMR CPD,UMR CPD,534.76,,,,,,,per diem,534.76,534.76,"Per diem rate, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,UHC Medicare,UHC Medicare,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O CATECHOLAMIN FRAC UR      ,38250428,CDM,301,RC,,,,,,Inpatient,,,534.76,534.76,Wellcare,Wellcare,534.76,,,,,,,case rate,534.76,534.76,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MTB SUSCEPT/BROTH DIL     ,38250429,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NOCARD     ,38250430,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O BETA2 GLYCOPR1 AB         ,38250431,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250432,CDM,302,RC,,,,,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250433,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGCC AB                   ,38250434,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O VGKC AB                   ,38250435,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PANCREATIC POLYPEPTID     ,38250436,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O 21 HYDROXYLASE AB         ,38250437,CDM,301,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health PPO CPD,Meritain Health PPO CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/Commercial Product,Aetna/Commercial Product,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health CPD,Meritain Health CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Starmark CPD,Starmark CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna Medicare,Aetna Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Ambetter ,Ambetter ,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access,Anthem Blue Access,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access Choice,Anthem Blue Access Choice,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Preferred,Anthem Blue Preferred,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Pathway,Anthem Pathway,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Alliance,Anthem Alliance,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Medicare,Anthem Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna,Cigna,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna PPO,Cigna PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna Medicare Advantage,Cigna Medicare Advantage,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Essence,Essence,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink HMO,Healthlink HMO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink PPO,Healthlink PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,HomeState Health Plan,HomeState Health Plan,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Humana Gold,Humana Gold,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medicaid MO,Medicaid MO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medica,Medica,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Tricare,Tricare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC All Payer,UHC All Payer,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Exchange,UHC Exchange,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicaid,UHC Medicaid,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UMR CPD,UMR CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicare,UHC Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM ALPHA     ,38250438,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Wellcare,Wellcare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health PPO CPD,Meritain Health PPO CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/Commercial Product,Aetna/Commercial Product,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health CPD,Meritain Health CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Starmark CPD,Starmark CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna Medicare,Aetna Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Ambetter ,Ambetter ,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access,Anthem Blue Access,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access Choice,Anthem Blue Access Choice,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Preferred,Anthem Blue Preferred,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Pathway,Anthem Pathway,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Alliance,Anthem Alliance,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Medicare,Anthem Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna,Cigna,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna PPO,Cigna PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna Medicare Advantage,Cigna Medicare Advantage,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Essence,Essence,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink HMO,Healthlink HMO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink PPO,Healthlink PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,HomeState Health Plan,HomeState Health Plan,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Humana Gold,Humana Gold,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medicaid MO,Medicaid MO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medica,Medica,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Tricare,Tricare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC All Payer,UHC All Payer,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Exchange,UHC Exchange,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicaid,UHC Medicaid,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UMR CPD,UMR CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicare,UHC Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM GAMMA     ,38250439,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Wellcare,Wellcare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health PPO CPD,Meritain Health PPO CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna/Commercial Product,Aetna/Commercial Product,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Meritain Health CPD,Meritain Health CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Starmark CPD,Starmark CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Aetna Medicare,Aetna Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Ambetter ,Ambetter ,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access,Anthem Blue Access,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Access Choice,Anthem Blue Access Choice,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Blue Preferred,Anthem Blue Preferred,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Pathway,Anthem Pathway,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Alliance,Anthem Alliance,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Anthem Medicare,Anthem Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna,Cigna,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna PPO,Cigna PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Cigna Medicare Advantage,Cigna Medicare Advantage,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Essence,Essence,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink HMO,Healthlink HMO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Healthlink PPO,Healthlink PPO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,HomeState Health Plan,HomeState Health Plan,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Humana Gold,Humana Gold,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medicaid MO,Medicaid MO,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Medica,Medica,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Tricare,Tricare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC All Payer,UHC All Payer,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Exchange,UHC Exchange,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicaid,UHC Medicaid,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UMR CPD,UMR CPD,906.67,,,,,,,per diem,906.67,906.67,"Per diem rate, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,UHC Medicare,UHC Medicare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
S/O MELANOCYTE STIM BETA      ,38250440,CDM,301,RC,,,,,,Inpatient,,,906.67,906.67,Wellcare,Wellcare,906.67,,,,,,,case rate,906.67,906.67,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health PPO CPD,Meritain Health PPO CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/Commercial Product,Aetna/Commercial Product,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health CPD,Meritain Health CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Starmark CPD,Starmark CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna Medicare,Aetna Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Ambetter ,Ambetter ,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access,Anthem Blue Access,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access Choice,Anthem Blue Access Choice,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Preferred,Anthem Blue Preferred,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Pathway,Anthem Pathway,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Alliance,Anthem Alliance,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Medicare,Anthem Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna,Cigna,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna PPO,Cigna PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna Medicare Advantage,Cigna Medicare Advantage,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Essence,Essence,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink HMO,Healthlink HMO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink PPO,Healthlink PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,HomeState Health Plan,HomeState Health Plan,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Humana Gold,Humana Gold,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Medicaid MO,Medicaid MO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Medica,Medica,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Tricare,Tricare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC All Payer,UHC All Payer,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Exchange,UHC Exchange,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicaid,UHC Medicaid,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UMR CPD,UMR CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicare,UHC Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
RL-A-IGF 2 2007565            ,38250441,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Wellcare,Wellcare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Meritain Health PPO CPD,Meritain Health PPO CPD,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Aetna/Commercial Product,Aetna/Commercial Product,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Meritain Health CPD,Meritain Health CPD,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Starmark CPD,Starmark CPD,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Aetna Medicare,Aetna Medicare,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Ambetter ,Ambetter ,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Blue Access,Anthem Blue Access,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Blue Access Choice,Anthem Blue Access Choice,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Blue Preferred,Anthem Blue Preferred,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Pathway,Anthem Pathway,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Alliance,Anthem Alliance,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Anthem Medicare,Anthem Medicare,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Cigna,Cigna,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Cigna PPO,Cigna PPO,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Cigna Medicare Advantage,Cigna Medicare Advantage,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Essence,Essence,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Healthlink HMO,Healthlink HMO,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Healthlink PPO,Healthlink PPO,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,HomeState Health Plan,HomeState Health Plan,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Humana Gold,Humana Gold,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Medicaid MO,Medicaid MO,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Medica,Medica,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Tricare,Tricare,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,UHC All Payer,UHC All Payer,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,UHC Exchange,UHC Exchange,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,UHC Medicaid,UHC Medicaid,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,UMR CPD,UMR CPD,192.61,,,,,,,per diem,192.61,192.61,"Per diem rate, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,UHC Medicare,UHC Medicare,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
CELL CT FLUID W/DIFF          ,38250442,CDM,309,RC,,,,,,Inpatient,,,192.61,192.61,Wellcare,Wellcare,192.61,,,,,,,case rate,192.61,192.61,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TUBERCULOSIS AMP DD     ,38250443,CDM,306,RC,,,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health PPO CPD,Meritain Health PPO CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/Commercial Product,Aetna/Commercial Product,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health CPD,Meritain Health CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Starmark CPD,Starmark CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna Medicare,Aetna Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Ambetter ,Ambetter ,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access,Anthem Blue Access,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access Choice,Anthem Blue Access Choice,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Preferred,Anthem Blue Preferred,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Pathway,Anthem Pathway,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Alliance,Anthem Alliance,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Medicare,Anthem Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna,Cigna,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna PPO,Cigna PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna Medicare Advantage,Cigna Medicare Advantage,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Essence,Essence,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink HMO,Healthlink HMO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink PPO,Healthlink PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,HomeState Health Plan,HomeState Health Plan,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Humana Gold,Humana Gold,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medicaid MO,Medicaid MO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medica,Medica,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Tricare,Tricare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC All Payer,UHC All Payer,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Exchange,UHC Exchange,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicaid,UHC Medicaid,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UMR CPD,UMR CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicare,UHC Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250444,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Wellcare,Wellcare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250445,CDM,302,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Meritain Health PPO CPD,Meritain Health PPO CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna/Commercial Product,Aetna/Commercial Product,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Meritain Health CPD,Meritain Health CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Starmark CPD,Starmark CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna Medicare,Aetna Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Ambetter ,Ambetter ,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Access,Anthem Blue Access,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Access Choice,Anthem Blue Access Choice,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Preferred,Anthem Blue Preferred,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Pathway,Anthem Pathway,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Alliance,Anthem Alliance,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Medicare,Anthem Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna,Cigna,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna PPO,Cigna PPO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna Medicare Advantage,Cigna Medicare Advantage,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Essence,Essence,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthlink HMO,Healthlink HMO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthlink PPO,Healthlink PPO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,HomeState Health Plan,HomeState Health Plan,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Humana Gold,Humana Gold,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Medicaid MO,Medicaid MO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Medica,Medica,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Tricare,Tricare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC All Payer,UHC All Payer,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Exchange,UHC Exchange,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Medicaid,UHC Medicaid,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UMR CPD,UMR CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Medicare,UHC Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250446,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Wellcare,Wellcare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Meritain Health PPO CPD,Meritain Health PPO CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna/Commercial Product,Aetna/Commercial Product,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Meritain Health CPD,Meritain Health CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Starmark CPD,Starmark CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Aetna Medicare,Aetna Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Ambetter ,Ambetter ,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Access,Anthem Blue Access,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Access Choice,Anthem Blue Access Choice,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Blue Preferred,Anthem Blue Preferred,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Pathway,Anthem Pathway,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Alliance,Anthem Alliance,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Anthem Medicare,Anthem Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna,Cigna,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna PPO,Cigna PPO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Cigna Medicare Advantage,Cigna Medicare Advantage,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Essence,Essence,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthlink HMO,Healthlink HMO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Healthlink PPO,Healthlink PPO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,HomeState Health Plan,HomeState Health Plan,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Humana Gold,Humana Gold,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Medicaid MO,Medicaid MO,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Medica,Medica,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Tricare,Tricare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC All Payer,UHC All Payer,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Exchange,UHC Exchange,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Medicaid,UHC Medicaid,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UMR CPD,UMR CPD,538.96,,,,,,,per diem,538.96,538.96,"Per diem rate, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,UHC Medicare,UHC Medicare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O VONWILLE MULT PNL         ,38250447,CDM,305,RC,,,,,,Inpatient,,,538.96,538.96,Wellcare,Wellcare,538.96,,,,,,,case rate,538.96,538.96,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health PPO CPD,Meritain Health PPO CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/Commercial Product,Aetna/Commercial Product,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health CPD,Meritain Health CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Starmark CPD,Starmark CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Aetna Medicare,Aetna Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Ambetter ,Ambetter ,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access,Anthem Blue Access,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access Choice,Anthem Blue Access Choice,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Preferred,Anthem Blue Preferred,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Pathway,Anthem Pathway,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Alliance,Anthem Alliance,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Medicare,Anthem Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Cigna,Cigna,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Cigna PPO,Cigna PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Cigna Medicare Advantage,Cigna Medicare Advantage,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Essence,Essence,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink HMO,Healthlink HMO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink PPO,Healthlink PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,HomeState Health Plan,HomeState Health Plan,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Humana Gold,Humana Gold,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Medicaid MO,Medicaid MO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Medica,Medica,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Tricare,Tricare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,UHC All Payer,UHC All Payer,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,UHC Exchange,UHC Exchange,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicaid,UHC Medicaid,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,UMR CPD,UMR CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicare,UHC Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O FACTOR VIII ACTIVITY      ,38250448,CDM,305,RC,,,,,,Inpatient,,,74.59,74.59,Wellcare,Wellcare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Meritain Health PPO CPD,Meritain Health PPO CPD,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Aetna/Commercial Product,Aetna/Commercial Product,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Meritain Health CPD,Meritain Health CPD,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Starmark CPD,Starmark CPD,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Aetna Medicare,Aetna Medicare,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Ambetter ,Ambetter ,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Blue Access,Anthem Blue Access,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Blue Access Choice,Anthem Blue Access Choice,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Blue Preferred,Anthem Blue Preferred,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Pathway,Anthem Pathway,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Alliance,Anthem Alliance,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Anthem Medicare,Anthem Medicare,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Cigna,Cigna,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Cigna PPO,Cigna PPO,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Cigna Medicare Advantage,Cigna Medicare Advantage,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Essence,Essence,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Healthlink HMO,Healthlink HMO,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Healthlink PPO,Healthlink PPO,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,HomeState Health Plan,HomeState Health Plan,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Humana Gold,Humana Gold,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Medicaid MO,Medicaid MO,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Medica,Medica,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Tricare,Tricare,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,UHC All Payer,UHC All Payer,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,UHC Exchange,UHC Exchange,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,UHC Medicaid,UHC Medicaid,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,UMR CPD,UMR CPD,420.24,,,,,,,per diem,420.24,420.24,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,UHC Medicare,UHC Medicare,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 2         ,38250449,CDM,302,RC,,,,,,Inpatient,,,420.24,420.24,Wellcare,Wellcare,420.24,,,,,,,case rate,420.24,420.24,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT COMP 1Q        ,38250450,CDM,302,RC,,,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Meritain Health PPO CPD,Meritain Health PPO CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Aetna/Commercial Product,Aetna/Commercial Product,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Meritain Health CPD,Meritain Health CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Starmark CPD,Starmark CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Aetna Medicare,Aetna Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Ambetter ,Ambetter ,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Access,Anthem Blue Access,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Access Choice,Anthem Blue Access Choice,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Preferred,Anthem Blue Preferred,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Pathway,Anthem Pathway,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Alliance,Anthem Alliance,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Medicare,Anthem Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Cigna,Cigna,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Cigna PPO,Cigna PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Cigna Medicare Advantage,Cigna Medicare Advantage,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Essence,Essence,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Healthlink HMO,Healthlink HMO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Healthlink PPO,Healthlink PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,HomeState Health Plan,HomeState Health Plan,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Humana Gold,Humana Gold,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Medicaid MO,Medicaid MO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Medica,Medica,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Tricare,Tricare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,UHC All Payer,UHC All Payer,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,UHC Exchange,UHC Exchange,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,UHC Medicaid,UHC Medicaid,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,UMR CPD,UMR CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,UHC Medicare,UHC Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C3             ,38250451,CDM,302,RC,,,,,,Inpatient,,,489.58,489.58,Wellcare,Wellcare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Meritain Health PPO CPD,Meritain Health PPO CPD,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Aetna/Commercial Product,Aetna/Commercial Product,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Meritain Health CPD,Meritain Health CPD,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Starmark CPD,Starmark CPD,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Aetna Medicare,Aetna Medicare,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Ambetter ,Ambetter ,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Blue Access,Anthem Blue Access,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Blue Access Choice,Anthem Blue Access Choice,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Blue Preferred,Anthem Blue Preferred,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Pathway,Anthem Pathway,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Alliance,Anthem Alliance,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Anthem Medicare,Anthem Medicare,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Cigna,Cigna,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Cigna PPO,Cigna PPO,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Cigna Medicare Advantage,Cigna Medicare Advantage,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Essence,Essence,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Healthlink HMO,Healthlink HMO,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Healthlink PPO,Healthlink PPO,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,HomeState Health Plan,HomeState Health Plan,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Humana Gold,Humana Gold,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Medicaid MO,Medicaid MO,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Medica,Medica,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Tricare,Tricare,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,UHC All Payer,UHC All Payer,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,UHC Exchange,UHC Exchange,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,UHC Medicaid,UHC Medicaid,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,UMR CPD,UMR CPD,545.26,,,,,,,per diem,545.26,545.26,"Per diem rate, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,UHC Medicare,UHC Medicare,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COMPLEMENT C4             ,38250452,CDM,302,RC,,,,,,Inpatient,,,545.26,545.26,Wellcare,Wellcare,545.26,,,,,,,case rate,545.26,545.26,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Meritain Health PPO CPD,Meritain Health PPO CPD,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Aetna/Commercial Product,Aetna/Commercial Product,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Meritain Health CPD,Meritain Health CPD,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Starmark CPD,Starmark CPD,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Aetna Medicare,Aetna Medicare,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Ambetter ,Ambetter ,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Blue Access,Anthem Blue Access,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Blue Access Choice,Anthem Blue Access Choice,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Blue Preferred,Anthem Blue Preferred,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Pathway,Anthem Pathway,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Alliance,Anthem Alliance,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Anthem Medicare,Anthem Medicare,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Cigna,Cigna,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Cigna PPO,Cigna PPO,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Cigna Medicare Advantage,Cigna Medicare Advantage,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Essence,Essence,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Healthlink HMO,Healthlink HMO,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Healthlink PPO,Healthlink PPO,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,HomeState Health Plan,HomeState Health Plan,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Humana Gold,Humana Gold,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Medicaid MO,Medicaid MO,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Medica,Medica,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Tricare,Tricare,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,UHC All Payer,UHC All Payer,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,UHC Exchange,UHC Exchange,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,UHC Medicaid,UHC Medicaid,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,UMR CPD,UMR CPD,205.92,,,,,,,per diem,205.92,205.92,"Per diem rate, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,UHC Medicare,UHC Medicare,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER SERUM/PLASMA       ,38250453,CDM,301,RC,,,,,,Inpatient,,,205.92,205.92,Wellcare,Wellcare,205.92,,,,,,,case rate,205.92,205.92,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Meritain Health PPO CPD,Meritain Health PPO CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Aetna/Commercial Product,Aetna/Commercial Product,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Meritain Health CPD,Meritain Health CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Starmark CPD,Starmark CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Aetna Medicare,Aetna Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Ambetter ,Ambetter ,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Access,Anthem Blue Access,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Access Choice,Anthem Blue Access Choice,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Preferred,Anthem Blue Preferred,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Pathway,Anthem Pathway,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Alliance,Anthem Alliance,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Medicare,Anthem Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Cigna,Cigna,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Cigna PPO,Cigna PPO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Cigna Medicare Advantage,Cigna Medicare Advantage,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Essence,Essence,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Healthlink HMO,Healthlink HMO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Healthlink PPO,Healthlink PPO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,HomeState Health Plan,HomeState Health Plan,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Humana Gold,Humana Gold,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Medicaid MO,Medicaid MO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Medica,Medica,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Tricare,Tricare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,UHC All Payer,UHC All Payer,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,UHC Exchange,UHC Exchange,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,UHC Medicaid,UHC Medicaid,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,UMR CPD,UMR CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,UHC Medicare,UHC Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
S/O COPPER URINE              ,38250454,CDM,301,RC,,,,,,Inpatient,,,389.77,389.77,Wellcare,Wellcare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health PPO CPD,Meritain Health PPO CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/Commercial Product,Aetna/Commercial Product,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health CPD,Meritain Health CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Starmark CPD,Starmark CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Aetna Medicare,Aetna Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Ambetter ,Ambetter ,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access,Anthem Blue Access,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access Choice,Anthem Blue Access Choice,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Preferred,Anthem Blue Preferred,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Pathway,Anthem Pathway,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Alliance,Anthem Alliance,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Medicare,Anthem Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Cigna,Cigna,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Cigna PPO,Cigna PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Cigna Medicare Advantage,Cigna Medicare Advantage,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Essence,Essence,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink HMO,Healthlink HMO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink PPO,Healthlink PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,HomeState Health Plan,HomeState Health Plan,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Humana Gold,Humana Gold,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Medicaid MO,Medicaid MO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Medica,Medica,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Tricare,Tricare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,UHC All Payer,UHC All Payer,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,UHC Exchange,UHC Exchange,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicaid,UHC Medicaid,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,UMR CPD,UMR CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicare,UHC Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38250455,CDM,301,RC,,,,,,Inpatient,,,265.8,265.8,Wellcare,Wellcare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Meritain Health PPO CPD,Meritain Health PPO CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna/Commercial Product,Aetna/Commercial Product,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Meritain Health CPD,Meritain Health CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Starmark CPD,Starmark CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna Medicare,Aetna Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Ambetter ,Ambetter ,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Access,Anthem Blue Access,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Access Choice,Anthem Blue Access Choice,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Preferred,Anthem Blue Preferred,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Pathway,Anthem Pathway,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Alliance,Anthem Alliance,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Medicare,Anthem Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna,Cigna,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna PPO,Cigna PPO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna Medicare Advantage,Cigna Medicare Advantage,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Essence,Essence,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthlink HMO,Healthlink HMO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthlink PPO,Healthlink PPO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,HomeState Health Plan,HomeState Health Plan,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Humana Gold,Humana Gold,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Medicaid MO,Medicaid MO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Medica,Medica,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Tricare,Tricare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC All Payer,UHC All Payer,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Exchange,UHC Exchange,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Medicaid,UHC Medicaid,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UMR CPD,UMR CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Medicare,UHC Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O CORTISOL SALIVA           ,38250456,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Wellcare,Wellcare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Meritain Health PPO CPD,Meritain Health PPO CPD,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Aetna/Commercial Product,Aetna/Commercial Product,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Meritain Health CPD,Meritain Health CPD,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Starmark CPD,Starmark CPD,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Aetna Medicare,Aetna Medicare,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Ambetter ,Ambetter ,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Blue Access,Anthem Blue Access,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Blue Access Choice,Anthem Blue Access Choice,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Blue Preferred,Anthem Blue Preferred,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Pathway,Anthem Pathway,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Alliance,Anthem Alliance,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Anthem Medicare,Anthem Medicare,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Cigna,Cigna,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Cigna PPO,Cigna PPO,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Cigna Medicare Advantage,Cigna Medicare Advantage,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Essence,Essence,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Healthlink HMO,Healthlink HMO,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Healthlink PPO,Healthlink PPO,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,HomeState Health Plan,HomeState Health Plan,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Humana Gold,Humana Gold,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Medicaid MO,Medicaid MO,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Medica,Medica,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Tricare,Tricare,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,UHC All Payer,UHC All Payer,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,UHC Exchange,UHC Exchange,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,UHC Medicaid,UHC Medicaid,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,UMR CPD,UMR CPD,278.41,,,,,,,per diem,278.41,278.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,UHC Medicare,UHC Medicare,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250457,CDM,302,RC,,,,,,Inpatient,,,278.41,278.41,Wellcare,Wellcare,278.41,,,,,,,case rate,278.41,278.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250458,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O SACCHAR CEREVIS AB        ,38250459,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250460,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O INFLAMM BOWEL PROFILE     ,38250461,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGA WRFLX     ,38250462,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IGM WRFLX     ,38250463,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250464,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250465,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O B PERTUSSIS IMMUN         ,38250466,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O CELIAC PANEL              ,38250467,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGA      ,38250468,CDM,301,RC,,,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health PPO CPD,Meritain Health PPO CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/Commercial Product,Aetna/Commercial Product,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health CPD,Meritain Health CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Starmark CPD,Starmark CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna Medicare,Aetna Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Ambetter ,Ambetter ,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access,Anthem Blue Access,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access Choice,Anthem Blue Access Choice,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Preferred,Anthem Blue Preferred,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Pathway,Anthem Pathway,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Alliance,Anthem Alliance,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Medicare,Anthem Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna,Cigna,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna PPO,Cigna PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna Medicare Advantage,Cigna Medicare Advantage,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Essence,Essence,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink HMO,Healthlink HMO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink PPO,Healthlink PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,HomeState Health Plan,HomeState Health Plan,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Humana Gold,Humana Gold,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Medicaid MO,Medicaid MO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Medica,Medica,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Tricare,Tricare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC All Payer,UHC All Payer,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Exchange,UHC Exchange,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicaid,UHC Medicaid,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UMR CPD,UMR CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicare,UHC Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGA            ,38250469,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Wellcare,Wellcare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health PPO CPD,Meritain Health PPO CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/Commercial Product,Aetna/Commercial Product,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health CPD,Meritain Health CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Starmark CPD,Starmark CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna Medicare,Aetna Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Ambetter ,Ambetter ,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access,Anthem Blue Access,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access Choice,Anthem Blue Access Choice,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Preferred,Anthem Blue Preferred,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Pathway,Anthem Pathway,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Alliance,Anthem Alliance,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Medicare,Anthem Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna,Cigna,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna PPO,Cigna PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna Medicare Advantage,Cigna Medicare Advantage,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Essence,Essence,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink HMO,Healthlink HMO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink PPO,Healthlink PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,HomeState Health Plan,HomeState Health Plan,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Humana Gold,Humana Gold,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Medicaid MO,Medicaid MO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Medica,Medica,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Tricare,Tricare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC All Payer,UHC All Payer,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Exchange,UHC Exchange,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicaid,UHC Medicaid,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UMR CPD,UMR CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicare,UHC Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O GLIADIN DP IGG            ,38250470,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Wellcare,Wellcare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O TISSUE TRANSGLUT IGG      ,38250471,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Meritain Health PPO CPD,Meritain Health PPO CPD,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Aetna/Commercial Product,Aetna/Commercial Product,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Meritain Health CPD,Meritain Health CPD,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Starmark CPD,Starmark CPD,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Aetna Medicare,Aetna Medicare,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Ambetter ,Ambetter ,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Blue Access,Anthem Blue Access,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Blue Access Choice,Anthem Blue Access Choice,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Blue Preferred,Anthem Blue Preferred,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Pathway,Anthem Pathway,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Alliance,Anthem Alliance,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Anthem Medicare,Anthem Medicare,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Cigna,Cigna,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Cigna PPO,Cigna PPO,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Cigna Medicare Advantage,Cigna Medicare Advantage,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Essence,Essence,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Healthlink HMO,Healthlink HMO,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Healthlink PPO,Healthlink PPO,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,HomeState Health Plan,HomeState Health Plan,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Humana Gold,Humana Gold,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Medicaid MO,Medicaid MO,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Medica,Medica,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Tricare,Tricare,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,UHC All Payer,UHC All Payer,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,UHC Exchange,UHC Exchange,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,UHC Medicaid,UHC Medicaid,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,UMR CPD,UMR CPD,144.86,,,,,,,per diem,144.86,144.86,"Per diem rate, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,UHC Medicare,UHC Medicare,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O SOLUBLE LIVER AG IGG      ,38250472,CDM,301,RC,,,,,,Inpatient,,,144.86,144.86,Wellcare,Wellcare,144.86,,,,,,,case rate,144.86,144.86,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health PPO CPD,Meritain Health PPO CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/Commercial Product,Aetna/Commercial Product,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health CPD,Meritain Health CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Starmark CPD,Starmark CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna Medicare,Aetna Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Ambetter ,Ambetter ,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access,Anthem Blue Access,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access Choice,Anthem Blue Access Choice,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Preferred,Anthem Blue Preferred,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Pathway,Anthem Pathway,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Alliance,Anthem Alliance,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Medicare,Anthem Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna,Cigna,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna PPO,Cigna PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna Medicare Advantage,Cigna Medicare Advantage,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Essence,Essence,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink HMO,Healthlink HMO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink PPO,Healthlink PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,HomeState Health Plan,HomeState Health Plan,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Humana Gold,Humana Gold,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Medicaid MO,Medicaid MO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Medica,Medica,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Tricare,Tricare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC All Payer,UHC All Payer,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Exchange,UHC Exchange,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicaid,UHC Medicaid,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UMR CPD,UMR CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicare,UHC Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O MAG AB IGM                ,38250473,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Wellcare,Wellcare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Meritain Health PPO CPD,Meritain Health PPO CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna/Commercial Product,Aetna/Commercial Product,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Meritain Health CPD,Meritain Health CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Starmark CPD,Starmark CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna Medicare,Aetna Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Ambetter ,Ambetter ,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Access,Anthem Blue Access,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Access Choice,Anthem Blue Access Choice,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Preferred,Anthem Blue Preferred,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Pathway,Anthem Pathway,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Alliance,Anthem Alliance,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Medicare,Anthem Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna,Cigna,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna PPO,Cigna PPO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna Medicare Advantage,Cigna Medicare Advantage,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Essence,Essence,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthlink HMO,Healthlink HMO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthlink PPO,Healthlink PPO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,HomeState Health Plan,HomeState Health Plan,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Humana Gold,Humana Gold,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Medicaid MO,Medicaid MO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Medica,Medica,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Tricare,Tricare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC All Payer,UHC All Payer,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Exchange,UHC Exchange,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Medicaid,UHC Medicaid,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UMR CPD,UMR CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Medicare,UHC Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O GLUTAMIC ACID DECARB      ,38250474,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Wellcare,Wellcare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Meritain Health PPO CPD,Meritain Health PPO CPD,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Aetna/Commercial Product,Aetna/Commercial Product,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Meritain Health CPD,Meritain Health CPD,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Starmark CPD,Starmark CPD,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Aetna Medicare,Aetna Medicare,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Ambetter ,Ambetter ,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Blue Access,Anthem Blue Access,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Blue Access Choice,Anthem Blue Access Choice,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Blue Preferred,Anthem Blue Preferred,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Pathway,Anthem Pathway,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Alliance,Anthem Alliance,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Anthem Medicare,Anthem Medicare,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Cigna,Cigna,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Cigna PPO,Cigna PPO,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Cigna Medicare Advantage,Cigna Medicare Advantage,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Essence,Essence,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Healthlink HMO,Healthlink HMO,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Healthlink PPO,Healthlink PPO,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,HomeState Health Plan,HomeState Health Plan,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Humana Gold,Humana Gold,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Medicaid MO,Medicaid MO,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Medica,Medica,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Tricare,Tricare,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,UHC All Payer,UHC All Payer,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,UHC Exchange,UHC Exchange,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,UHC Medicaid,UHC Medicaid,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,UMR CPD,UMR CPD,178.6,,,,,,,per diem,178.6,178.6,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,UHC Medicare,UHC Medicare,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC BLOCK AB     ,38250475,CDM,301,RC,,,,,,Inpatient,,,178.6,178.6,Wellcare,Wellcare,178.6,,,,,,,case rate,178.6,178.6,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Meritain Health PPO CPD,Meritain Health PPO CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Aetna/Commercial Product,Aetna/Commercial Product,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Meritain Health CPD,Meritain Health CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Starmark CPD,Starmark CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Aetna Medicare,Aetna Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Ambetter ,Ambetter ,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Access,Anthem Blue Access,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Access Choice,Anthem Blue Access Choice,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Preferred,Anthem Blue Preferred,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Pathway,Anthem Pathway,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Alliance,Anthem Alliance,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Medicare,Anthem Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Cigna,Cigna,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Cigna PPO,Cigna PPO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Cigna Medicare Advantage,Cigna Medicare Advantage,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Essence,Essence,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Healthlink HMO,Healthlink HMO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Healthlink PPO,Healthlink PPO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,HomeState Health Plan,HomeState Health Plan,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Humana Gold,Humana Gold,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Medicaid MO,Medicaid MO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Medica,Medica,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Tricare,Tricare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,UHC All Payer,UHC All Payer,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,UHC Exchange,UHC Exchange,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,UHC Medicaid,UHC Medicaid,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,UMR CPD,UMR CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,UHC Medicare,UHC Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ACETYLCH REC MODUL AB     ,38250476,CDM,301,RC,,,,,,Inpatient,,,184.91,184.91,Wellcare,Wellcare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O SIGNAL RECOG PARTICLE     ,38250477,CDM,301,RC,,,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Meritain Health PPO CPD,Meritain Health PPO CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Aetna/Commercial Product,Aetna/Commercial Product,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Meritain Health CPD,Meritain Health CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Starmark CPD,Starmark CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Aetna Medicare,Aetna Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Ambetter ,Ambetter ,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Access,Anthem Blue Access,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Access Choice,Anthem Blue Access Choice,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Preferred,Anthem Blue Preferred,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Pathway,Anthem Pathway,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Alliance,Anthem Alliance,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Medicare,Anthem Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Cigna,Cigna,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Cigna PPO,Cigna PPO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Cigna Medicare Advantage,Cigna Medicare Advantage,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Essence,Essence,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Healthlink HMO,Healthlink HMO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Healthlink PPO,Healthlink PPO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,HomeState Health Plan,HomeState Health Plan,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Humana Gold,Humana Gold,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Medicaid MO,Medicaid MO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Medica,Medica,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Tricare,Tricare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,UHC All Payer,UHC All Payer,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,UHC Exchange,UHC Exchange,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,UHC Medicaid,UHC Medicaid,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,UMR CPD,UMR CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,UHC Medicare,UHC Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O GASTRIC PARIETAL IGG      ,38250478,CDM,301,RC,,,,,,Inpatient,,,280.51,280.51,Wellcare,Wellcare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Meritain Health PPO CPD,Meritain Health PPO CPD,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Aetna/Commercial Product,Aetna/Commercial Product,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Meritain Health CPD,Meritain Health CPD,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Starmark CPD,Starmark CPD,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Aetna Medicare,Aetna Medicare,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Ambetter ,Ambetter ,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Blue Access,Anthem Blue Access,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Blue Access Choice,Anthem Blue Access Choice,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Blue Preferred,Anthem Blue Preferred,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Pathway,Anthem Pathway,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Alliance,Anthem Alliance,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Anthem Medicare,Anthem Medicare,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Cigna,Cigna,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Cigna PPO,Cigna PPO,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Cigna Medicare Advantage,Cigna Medicare Advantage,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Essence,Essence,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Healthlink HMO,Healthlink HMO,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Healthlink PPO,Healthlink PPO,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,HomeState Health Plan,HomeState Health Plan,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Humana Gold,Humana Gold,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Medicaid MO,Medicaid MO,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Medica,Medica,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Tricare,Tricare,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,UHC All Payer,UHC All Payer,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,UHC Exchange,UHC Exchange,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,UHC Medicaid,UHC Medicaid,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,UMR CPD,UMR CPD,396.08,,,,,,,per diem,396.08,396.08,"Per diem rate, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,UHC Medicare,UHC Medicare,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O HISTONE ANTIBODY IGG      ,38250479,CDM,301,RC,,,,,,Inpatient,,,396.08,396.08,Wellcare,Wellcare,396.08,,,,,,,case rate,396.08,396.08,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O AQUAPORIN 4 RECEPT AB     ,38250480,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O TITAN ANTIBODY            ,38250481,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Meritain Health PPO CPD,Meritain Health PPO CPD,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Aetna/Commercial Product,Aetna/Commercial Product,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Meritain Health CPD,Meritain Health CPD,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Starmark CPD,Starmark CPD,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Aetna Medicare,Aetna Medicare,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Ambetter ,Ambetter ,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Blue Access,Anthem Blue Access,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Blue Access Choice,Anthem Blue Access Choice,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Blue Preferred,Anthem Blue Preferred,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Pathway,Anthem Pathway,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Alliance,Anthem Alliance,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Anthem Medicare,Anthem Medicare,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Cigna,Cigna,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Cigna PPO,Cigna PPO,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Cigna Medicare Advantage,Cigna Medicare Advantage,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Essence,Essence,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Healthlink HMO,Healthlink HMO,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Healthlink PPO,Healthlink PPO,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,HomeState Health Plan,HomeState Health Plan,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Humana Gold,Humana Gold,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Medicaid MO,Medicaid MO,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Medica,Medica,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Tricare,Tricare,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,UHC All Payer,UHC All Payer,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,UHC Exchange,UHC Exchange,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,UHC Medicaid,UHC Medicaid,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,UMR CPD,UMR CPD,156.51,,,,,,,per diem,156.51,156.51,"Per diem rate, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,UHC Medicare,UHC Medicare,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O RNA POLYMERAS III IGG     ,38250482,CDM,301,RC,,,,,,Inpatient,,,156.51,156.51,Wellcare,Wellcare,156.51,,,,,,,case rate,156.51,156.51,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN ANTIBODY IGA      ,38250483,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O F-ACTIN AB IGG ELISA      ,38250484,CDM,301,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O MYELOPEROXIDASE AB        ,38250485,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O SERINE PROTEASE 3 AB      ,38250486,CDM,301,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250487,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250488,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250489,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250490,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250491,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250492,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250493,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250494,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250495,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Meritain Health PPO CPD,Meritain Health PPO CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna/Commercial Product,Aetna/Commercial Product,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Meritain Health CPD,Meritain Health CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Starmark CPD,Starmark CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna Medicare,Aetna Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Ambetter ,Ambetter ,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Access,Anthem Blue Access,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Access Choice,Anthem Blue Access Choice,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Preferred,Anthem Blue Preferred,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Pathway,Anthem Pathway,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Alliance,Anthem Alliance,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Medicare,Anthem Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna,Cigna,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna PPO,Cigna PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna Medicare Advantage,Cigna Medicare Advantage,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Essence,Essence,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthlink HMO,Healthlink HMO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthlink PPO,Healthlink PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,HomeState Health Plan,HomeState Health Plan,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Humana Gold,Humana Gold,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Medicaid MO,Medicaid MO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Medica,Medica,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Tricare,Tricare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC All Payer,UHC All Payer,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Exchange,UHC Exchange,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Medicaid,UHC Medicaid,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UMR CPD,UMR CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Medicare,UHC Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250496,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Wellcare,Wellcare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Meritain Health PPO CPD,Meritain Health PPO CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna/Commercial Product,Aetna/Commercial Product,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Meritain Health CPD,Meritain Health CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Starmark CPD,Starmark CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Aetna Medicare,Aetna Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Ambetter ,Ambetter ,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Access,Anthem Blue Access,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Access Choice,Anthem Blue Access Choice,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Blue Preferred,Anthem Blue Preferred,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Pathway,Anthem Pathway,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Alliance,Anthem Alliance,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Anthem Medicare,Anthem Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna,Cigna,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna PPO,Cigna PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Cigna Medicare Advantage,Cigna Medicare Advantage,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Essence,Essence,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthlink HMO,Healthlink HMO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Healthlink PPO,Healthlink PPO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,HomeState Health Plan,HomeState Health Plan,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Humana Gold,Humana Gold,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Medicaid MO,Medicaid MO,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Medica,Medica,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Tricare,Tricare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC All Payer,UHC All Payer,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Exchange,UHC Exchange,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Medicaid,UHC Medicaid,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UMR CPD,UMR CPD,433.9,,,,,,,per diem,433.9,433.9,"Per diem rate, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,UHC Medicare,UHC Medicare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
"S/O IGG DESMOGLEN 1,3         ",38250497,CDM,301,RC,,,,,,Inpatient,,,433.9,433.9,Wellcare,Wellcare,433.9,,,,,,,case rate,433.9,433.9,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250498,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250499,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250500,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250501,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250502,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O GANGLIOSID IGG/IGM        ,38250503,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Meritain Health PPO CPD,Meritain Health PPO CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna/Commercial Product,Aetna/Commercial Product,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Meritain Health CPD,Meritain Health CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Starmark CPD,Starmark CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna Medicare,Aetna Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Ambetter ,Ambetter ,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Access,Anthem Blue Access,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Access Choice,Anthem Blue Access Choice,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Preferred,Anthem Blue Preferred,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Pathway,Anthem Pathway,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Alliance,Anthem Alliance,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Medicare,Anthem Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna,Cigna,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna PPO,Cigna PPO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna Medicare Advantage,Cigna Medicare Advantage,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Essence,Essence,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthlink HMO,Healthlink HMO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthlink PPO,Healthlink PPO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,HomeState Health Plan,HomeState Health Plan,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Humana Gold,Humana Gold,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Medicaid MO,Medicaid MO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Medica,Medica,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Tricare,Tricare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC All Payer,UHC All Payer,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Exchange,UHC Exchange,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Medicaid,UHC Medicaid,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UMR CPD,UMR CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Medicare,UHC Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250504,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Wellcare,Wellcare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Meritain Health PPO CPD,Meritain Health PPO CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna/Commercial Product,Aetna/Commercial Product,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Meritain Health CPD,Meritain Health CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Starmark CPD,Starmark CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Aetna Medicare,Aetna Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Ambetter ,Ambetter ,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Access,Anthem Blue Access,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Access Choice,Anthem Blue Access Choice,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Blue Preferred,Anthem Blue Preferred,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Pathway,Anthem Pathway,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Alliance,Anthem Alliance,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Anthem Medicare,Anthem Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna,Cigna,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna PPO,Cigna PPO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Cigna Medicare Advantage,Cigna Medicare Advantage,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Essence,Essence,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthlink HMO,Healthlink HMO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Healthlink PPO,Healthlink PPO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,HomeState Health Plan,HomeState Health Plan,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Humana Gold,Humana Gold,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Medicaid MO,Medicaid MO,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Medica,Medica,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Tricare,Tricare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC All Payer,UHC All Payer,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Exchange,UHC Exchange,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Medicaid,UHC Medicaid,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UMR CPD,UMR CPD,432.85,,,,,,,per diem,432.85,432.85,"Per diem rate, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,UHC Medicare,UHC Medicare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O BP 180 230 AG IGG         ,38250505,CDM,301,RC,,,,,,Inpatient,,,432.85,432.85,Wellcare,Wellcare,432.85,,,,,,,case rate,432.85,432.85,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O GBM IGG MBA IFA           ,38250506,CDM,301,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O CHROMATIN AB IGG          ,38250507,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health PPO CPD,Meritain Health PPO CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/Commercial Product,Aetna/Commercial Product,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health CPD,Meritain Health CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Starmark CPD,Starmark CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna Medicare,Aetna Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Ambetter ,Ambetter ,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access,Anthem Blue Access,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access Choice,Anthem Blue Access Choice,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Preferred,Anthem Blue Preferred,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Pathway,Anthem Pathway,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Alliance,Anthem Alliance,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Medicare,Anthem Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna,Cigna,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna PPO,Cigna PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna Medicare Advantage,Cigna Medicare Advantage,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Essence,Essence,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink HMO,Healthlink HMO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink PPO,Healthlink PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,HomeState Health Plan,HomeState Health Plan,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Humana Gold,Humana Gold,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Medicaid MO,Medicaid MO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Medica,Medica,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Tricare,Tricare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC All Payer,UHC All Payer,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Exchange,UHC Exchange,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicaid,UHC Medicaid,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UMR CPD,UMR CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicare,UHC Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER TH/TO BY IPP        ,38250508,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Wellcare,Wellcare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health PPO CPD,Meritain Health PPO CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/Commercial Product,Aetna/Commercial Product,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health CPD,Meritain Health CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Starmark CPD,Starmark CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Aetna Medicare,Aetna Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Ambetter ,Ambetter ,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access,Anthem Blue Access,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access Choice,Anthem Blue Access Choice,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Preferred,Anthem Blue Preferred,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Pathway,Anthem Pathway,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Alliance,Anthem Alliance,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Medicare,Anthem Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna,Cigna,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna PPO,Cigna PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Cigna Medicare Advantage,Cigna Medicare Advantage,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Essence,Essence,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink HMO,Healthlink HMO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink PPO,Healthlink PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,HomeState Health Plan,HomeState Health Plan,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Humana Gold,Humana Gold,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Medicaid MO,Medicaid MO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Medica,Medica,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Tricare,Tricare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC All Payer,UHC All Payer,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Exchange,UHC Exchange,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicaid,UHC Medicaid,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UMR CPD,UMR CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicare,UHC Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNA POL III IGG     ,38250509,CDM,301,RC,,,,,,Inpatient,,,422.34,422.34,Wellcare,Wellcare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP JO-1 IGG     ,38250510,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP MI-2         ,38250511,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-7         ,38250512,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PL-12        ,38250513,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP P155/140     ,38250514,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP EJ           ,38250515,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP KU           ,38250516,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SRP          ,38250517,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP OJ           ,38250518,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP PM/SCL       ,38250519,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250520,CDM,301,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HISTAMINE URINE           ,38250521,CDM,301,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE FLD                ,38250522,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
CREATININE OTHER              ,38250523,CDM,301,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250524,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health PPO CPD,Meritain Health PPO CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/Commercial Product,Aetna/Commercial Product,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health CPD,Meritain Health CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Starmark CPD,Starmark CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Aetna Medicare,Aetna Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Ambetter ,Ambetter ,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access,Anthem Blue Access,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access Choice,Anthem Blue Access Choice,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Preferred,Anthem Blue Preferred,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Pathway,Anthem Pathway,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Alliance,Anthem Alliance,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Medicare,Anthem Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Cigna,Cigna,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Cigna PPO,Cigna PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Cigna Medicare Advantage,Cigna Medicare Advantage,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Essence,Essence,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink HMO,Healthlink HMO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink PPO,Healthlink PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,HomeState Health Plan,HomeState Health Plan,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Humana Gold,Humana Gold,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Medicaid MO,Medicaid MO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Medica,Medica,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Tricare,Tricare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,UHC All Payer,UHC All Payer,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,UHC Exchange,UHC Exchange,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicaid,UHC Medicaid,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,UMR CPD,UMR CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicare,UHC Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O CK ISOENZYMES             ,38250525,CDM,301,RC,,,,,,Inpatient,,,85.1,85.1,Wellcare,Wellcare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O C-REACTIVE PROTEIN        ,38250526,CDM,302,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health PPO CPD,Meritain Health PPO CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/Commercial Product,Aetna/Commercial Product,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health CPD,Meritain Health CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Starmark CPD,Starmark CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Aetna Medicare,Aetna Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Ambetter ,Ambetter ,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access,Anthem Blue Access,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access Choice,Anthem Blue Access Choice,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Preferred,Anthem Blue Preferred,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Pathway,Anthem Pathway,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Alliance,Anthem Alliance,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Medicare,Anthem Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Cigna,Cigna,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Cigna PPO,Cigna PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Cigna Medicare Advantage,Cigna Medicare Advantage,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Essence,Essence,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink HMO,Healthlink HMO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink PPO,Healthlink PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,HomeState Health Plan,HomeState Health Plan,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Humana Gold,Humana Gold,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Medicaid MO,Medicaid MO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Medica,Medica,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Tricare,Tricare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,UHC All Payer,UHC All Payer,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,UHC Exchange,UHC Exchange,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicaid,UHC Medicaid,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,UMR CPD,UMR CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicare,UHC Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O THROM RISK REPTL TIME     ,38250527,CDM,305,RC,,,,,,Inpatient,,,69.34,69.34,Wellcare,Wellcare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PLATELET ASSOC AB         ,38250528,CDM,302,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health PPO CPD,Meritain Health PPO CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/Commercial Product,Aetna/Commercial Product,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health CPD,Meritain Health CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Starmark CPD,Starmark CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna Medicare,Aetna Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Ambetter ,Ambetter ,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access,Anthem Blue Access,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access Choice,Anthem Blue Access Choice,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Preferred,Anthem Blue Preferred,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Pathway,Anthem Pathway,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Alliance,Anthem Alliance,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Medicare,Anthem Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna,Cigna,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna PPO,Cigna PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna Medicare Advantage,Cigna Medicare Advantage,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Essence,Essence,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink HMO,Healthlink HMO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink PPO,Healthlink PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,HomeState Health Plan,HomeState Health Plan,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Humana Gold,Humana Gold,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medicaid MO,Medicaid MO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medica,Medica,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Tricare,Tricare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC All Payer,UHC All Payer,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Exchange,UHC Exchange,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicaid,UHC Medicaid,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UMR CPD,UMR CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicare,UHC Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250529,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Wellcare,Wellcare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250530,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250531,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250532,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250533,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250534,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250535,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250536,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250537,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health PPO CPD,Meritain Health PPO CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna/Commercial Product,Aetna/Commercial Product,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Meritain Health CPD,Meritain Health CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Starmark CPD,Starmark CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Aetna Medicare,Aetna Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Ambetter ,Ambetter ,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access,Anthem Blue Access,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Access Choice,Anthem Blue Access Choice,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Blue Preferred,Anthem Blue Preferred,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Pathway,Anthem Pathway,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Alliance,Anthem Alliance,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Anthem Medicare,Anthem Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna,Cigna,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna PPO,Cigna PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Cigna Medicare Advantage,Cigna Medicare Advantage,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Essence,Essence,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink HMO,Healthlink HMO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Healthlink PPO,Healthlink PPO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,HomeState Health Plan,HomeState Health Plan,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Humana Gold,Humana Gold,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medicaid MO,Medicaid MO,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Medica,Medica,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Tricare,Tricare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC All Payer,UHC All Payer,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Exchange,UHC Exchange,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicaid,UHC Medicaid,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UMR CPD,UMR CPD,111.36,,,,,,,per diem,111.36,111.36,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,UHC Medicare,UHC Medicare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250538,CDM,302,RC,,,,,,Inpatient,,,111.36,111.36,Wellcare,Wellcare,111.36,,,,,,,case rate,111.36,111.36,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health PPO CPD,Meritain Health PPO CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/Commercial Product,Aetna/Commercial Product,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health CPD,Meritain Health CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Starmark CPD,Starmark CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna Medicare,Aetna Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Ambetter ,Ambetter ,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access,Anthem Blue Access,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access Choice,Anthem Blue Access Choice,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Preferred,Anthem Blue Preferred,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Pathway,Anthem Pathway,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Alliance,Anthem Alliance,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Medicare,Anthem Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna,Cigna,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna PPO,Cigna PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna Medicare Advantage,Cigna Medicare Advantage,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Essence,Essence,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink HMO,Healthlink HMO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink PPO,Healthlink PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,HomeState Health Plan,HomeState Health Plan,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Humana Gold,Humana Gold,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medicaid MO,Medicaid MO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medica,Medica,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Tricare,Tricare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC All Payer,UHC All Payer,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Exchange,UHC Exchange,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicaid,UHC Medicaid,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UMR CPD,UMR CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicare,UHC Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250539,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Wellcare,Wellcare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB PANEL        ,38250540,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250541,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250542,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250543,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AB DIFF         ,38250544,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Meritain Health PPO CPD,Meritain Health PPO CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna/Commercial Product,Aetna/Commercial Product,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Meritain Health CPD,Meritain Health CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Starmark CPD,Starmark CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna Medicare,Aetna Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Ambetter ,Ambetter ,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Access,Anthem Blue Access,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Access Choice,Anthem Blue Access Choice,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Preferred,Anthem Blue Preferred,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Pathway,Anthem Pathway,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Alliance,Anthem Alliance,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Medicare,Anthem Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna,Cigna,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna PPO,Cigna PPO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna Medicare Advantage,Cigna Medicare Advantage,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Essence,Essence,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthlink HMO,Healthlink HMO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthlink PPO,Healthlink PPO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,HomeState Health Plan,HomeState Health Plan,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Humana Gold,Humana Gold,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Medicaid MO,Medicaid MO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Medica,Medica,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Tricare,Tricare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC All Payer,UHC All Payer,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Exchange,UHC Exchange,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Medicaid,UHC Medicaid,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UMR CPD,UMR CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Medicare,UHC Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O PHENYTOIN FREE/TOTAL      ,38250545,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Wellcare,Wellcare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
AMPHETAMINE PRESUM NO OPT     ,38250546,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BARBITURATE PRESUM NO OPT     ,38250547,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
BENZODIAZEP PRESUM NO OPT     ,38250548,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CANNABINOID PRESUM NO OPT     ,38250549,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
COCAINE PRESUMP NOT OPT       ,38250550,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
CHAIN OF CUSTODY CHG          ,38250551,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
OPIATES PRESUMP NOT OPT       ,38250552,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
PCP SCRN PRESUMP NOT OPT      ,38250553,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TRICYCLIC ANTIDEPRESS     ,38250554,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O ETHANOL URINE QUAL        ,38250555,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Meritain Health PPO CPD,Meritain Health PPO CPD,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Aetna/Commercial Product,Aetna/Commercial Product,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Meritain Health CPD,Meritain Health CPD,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Starmark CPD,Starmark CPD,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Aetna Medicare,Aetna Medicare,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Ambetter ,Ambetter ,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Blue Access,Anthem Blue Access,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Blue Access Choice,Anthem Blue Access Choice,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Blue Preferred,Anthem Blue Preferred,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Pathway,Anthem Pathway,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Alliance,Anthem Alliance,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Anthem Medicare,Anthem Medicare,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Cigna,Cigna,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Cigna PPO,Cigna PPO,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Cigna Medicare Advantage,Cigna Medicare Advantage,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Essence,Essence,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Healthlink HMO,Healthlink HMO,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Healthlink PPO,Healthlink PPO,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,HomeState Health Plan,HomeState Health Plan,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Humana Gold,Humana Gold,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Medicaid MO,Medicaid MO,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Medica,Medica,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Tricare,Tricare,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,UHC All Payer,UHC All Payer,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,UHC Exchange,UHC Exchange,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,UHC Medicaid,UHC Medicaid,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,UMR CPD,UMR CPD,391.87,,,,,,,per diem,391.87,391.87,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,UHC Medicare,UHC Medicare,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM          ,38250556,CDM,301,RC,,,,,,Inpatient,,,391.87,391.87,Wellcare,Wellcare,391.87,,,,,,,case rate,391.87,391.87,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Meritain Health PPO CPD,Meritain Health PPO CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Aetna/Commercial Product,Aetna/Commercial Product,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Meritain Health CPD,Meritain Health CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Starmark CPD,Starmark CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Aetna Medicare,Aetna Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Ambetter ,Ambetter ,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Access,Anthem Blue Access,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Access Choice,Anthem Blue Access Choice,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Blue Preferred,Anthem Blue Preferred,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Pathway,Anthem Pathway,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Alliance,Anthem Alliance,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Anthem Medicare,Anthem Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Cigna,Cigna,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Cigna PPO,Cigna PPO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Cigna Medicare Advantage,Cigna Medicare Advantage,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Essence,Essence,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Healthlink HMO,Healthlink HMO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Healthlink PPO,Healthlink PPO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,HomeState Health Plan,HomeState Health Plan,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Humana Gold,Humana Gold,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Medicaid MO,Medicaid MO,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Medica,Medica,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Tricare,Tricare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,UHC All Payer,UHC All Payer,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,UHC Exchange,UHC Exchange,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,UHC Medicaid,UHC Medicaid,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,UMR CPD,UMR CPD,110.31,,,,,,,per diem,110.31,110.31,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,UHC Medicare,UHC Medicare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250557,CDM,301,RC,,,,,,Inpatient,,,110.31,110.31,Wellcare,Wellcare,110.31,,,,,,,case rate,110.31,110.31,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Meritain Health PPO CPD,Meritain Health PPO CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna/Commercial Product,Aetna/Commercial Product,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Meritain Health CPD,Meritain Health CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Starmark CPD,Starmark CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Aetna Medicare,Aetna Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Ambetter ,Ambetter ,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Access,Anthem Blue Access,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Access Choice,Anthem Blue Access Choice,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Blue Preferred,Anthem Blue Preferred,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Pathway,Anthem Pathway,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Alliance,Anthem Alliance,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Anthem Medicare,Anthem Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna,Cigna,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna PPO,Cigna PPO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Cigna Medicare Advantage,Cigna Medicare Advantage,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Essence,Essence,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthlink HMO,Healthlink HMO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Healthlink PPO,Healthlink PPO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,HomeState Health Plan,HomeState Health Plan,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Humana Gold,Humana Gold,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Medicaid MO,Medicaid MO,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Medica,Medica,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Tricare,Tricare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC All Payer,UHC All Payer,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Exchange,UHC Exchange,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Medicaid,UHC Medicaid,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UMR CPD,UMR CPD,147.08,,,,,,,per diem,147.08,147.08,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,UHC Medicare,UHC Medicare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250558,CDM,301,RC,,,,,,Inpatient,,,147.08,147.08,Wellcare,Wellcare,147.08,,,,,,,case rate,147.08,147.08,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Meritain Health PPO CPD,Meritain Health PPO CPD,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Aetna/Commercial Product,Aetna/Commercial Product,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Meritain Health CPD,Meritain Health CPD,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Starmark CPD,Starmark CPD,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Aetna Medicare,Aetna Medicare,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Ambetter ,Ambetter ,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Blue Access,Anthem Blue Access,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Blue Access Choice,Anthem Blue Access Choice,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Blue Preferred,Anthem Blue Preferred,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Pathway,Anthem Pathway,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Alliance,Anthem Alliance,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Anthem Medicare,Anthem Medicare,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Cigna,Cigna,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Cigna PPO,Cigna PPO,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Cigna Medicare Advantage,Cigna Medicare Advantage,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Essence,Essence,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Healthlink HMO,Healthlink HMO,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Healthlink PPO,Healthlink PPO,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,HomeState Health Plan,HomeState Health Plan,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Humana Gold,Humana Gold,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Medicaid MO,Medicaid MO,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Medica,Medica,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Tricare,Tricare,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,UHC All Payer,UHC All Payer,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,UHC Exchange,UHC Exchange,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,UHC Medicaid,UHC Medicaid,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,UMR CPD,UMR CPD,793.2,,,,,,,per diem,793.2,793.2,"Per diem rate, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,UHC Medicare,UHC Medicare,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
SALICYLATE                    ,38250560,CDM,301,RC,,,,,,Inpatient,,,793.2,793.2,Wellcare,Wellcare,793.2,,,,,,,case rate,793.2,793.2,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Meritain Health PPO CPD,Meritain Health PPO CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Aetna/Commercial Product,Aetna/Commercial Product,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Meritain Health CPD,Meritain Health CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Starmark CPD,Starmark CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Aetna Medicare,Aetna Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Ambetter ,Ambetter ,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Access,Anthem Blue Access,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Access Choice,Anthem Blue Access Choice,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Preferred,Anthem Blue Preferred,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Pathway,Anthem Pathway,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Alliance,Anthem Alliance,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Medicare,Anthem Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Cigna,Cigna,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Cigna PPO,Cigna PPO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Cigna Medicare Advantage,Cigna Medicare Advantage,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Essence,Essence,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Healthlink HMO,Healthlink HMO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Healthlink PPO,Healthlink PPO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,HomeState Health Plan,HomeState Health Plan,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Humana Gold,Humana Gold,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Medicaid MO,Medicaid MO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Medica,Medica,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Tricare,Tricare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,UHC All Payer,UHC All Payer,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,UHC Exchange,UHC Exchange,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,UHC Medicaid,UHC Medicaid,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,UMR CPD,UMR CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,UHC Medicare,UHC Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O ETHYL GLUC UR W/RFLX      ,38250561,CDM,301,RC,,,,,,Inpatient,,,425.49,425.49,Wellcare,Wellcare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Meritain Health PPO CPD,Meritain Health PPO CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna/Commercial Product,Aetna/Commercial Product,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Meritain Health CPD,Meritain Health CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Starmark CPD,Starmark CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Aetna Medicare,Aetna Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Ambetter ,Ambetter ,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Access,Anthem Blue Access,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Access Choice,Anthem Blue Access Choice,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Blue Preferred,Anthem Blue Preferred,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Pathway,Anthem Pathway,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Alliance,Anthem Alliance,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Anthem Medicare,Anthem Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna,Cigna,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna PPO,Cigna PPO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Cigna Medicare Advantage,Cigna Medicare Advantage,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Essence,Essence,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthlink HMO,Healthlink HMO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Healthlink PPO,Healthlink PPO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,HomeState Health Plan,HomeState Health Plan,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Humana Gold,Humana Gold,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Medicaid MO,Medicaid MO,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Medica,Medica,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Tricare,Tricare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC All Payer,UHC All Payer,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Exchange,UHC Exchange,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Medicaid,UHC Medicaid,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UMR CPD,UMR CPD,761.69,,,,,,,per diem,761.69,761.69,"Per diem rate, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,UHC Medicare,UHC Medicare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O GHB URINE W/RFLX          ,38250562,CDM,301,RC,,,,,,Inpatient,,,761.69,761.69,Wellcare,Wellcare,761.69,,,,,,,case rate,761.69,761.69,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health PPO CPD,Meritain Health PPO CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/Commercial Product,Aetna/Commercial Product,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health CPD,Meritain Health CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Starmark CPD,Starmark CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Aetna Medicare,Aetna Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Ambetter ,Ambetter ,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access,Anthem Blue Access,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access Choice,Anthem Blue Access Choice,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Preferred,Anthem Blue Preferred,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Pathway,Anthem Pathway,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Alliance,Anthem Alliance,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Medicare,Anthem Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Cigna,Cigna,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Cigna PPO,Cigna PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Cigna Medicare Advantage,Cigna Medicare Advantage,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Essence,Essence,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink HMO,Healthlink HMO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink PPO,Healthlink PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,HomeState Health Plan,HomeState Health Plan,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Humana Gold,Humana Gold,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Medicaid MO,Medicaid MO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Medica,Medica,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Tricare,Tricare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,UHC All Payer,UHC All Payer,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,UHC Exchange,UHC Exchange,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicaid,UHC Medicaid,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,UMR CPD,UMR CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicare,UHC Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O ISOPROPANOL               ,38250563,CDM,301,RC,,,,,,Inpatient,,,141.83,141.83,Wellcare,Wellcare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN UR QUAL         ,38250564,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O DRUG SCRN SERUM           ,38250565,CDM,301,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Meritain Health PPO CPD,Meritain Health PPO CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna/Commercial Product,Aetna/Commercial Product,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Meritain Health CPD,Meritain Health CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Starmark CPD,Starmark CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna Medicare,Aetna Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Ambetter ,Ambetter ,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Access,Anthem Blue Access,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Access Choice,Anthem Blue Access Choice,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Preferred,Anthem Blue Preferred,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Pathway,Anthem Pathway,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Alliance,Anthem Alliance,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Medicare,Anthem Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna,Cigna,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna PPO,Cigna PPO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna Medicare Advantage,Cigna Medicare Advantage,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Essence,Essence,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthlink HMO,Healthlink HMO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthlink PPO,Healthlink PPO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,HomeState Health Plan,HomeState Health Plan,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Humana Gold,Humana Gold,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Medicaid MO,Medicaid MO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Medica,Medica,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Tricare,Tricare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC All Payer,UHC All Payer,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Exchange,UHC Exchange,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Medicaid,UHC Medicaid,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,UMR CPD,UMR CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Medicare,UHC Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O ESTRADIOL                 ,38250566,CDM,301,RC,,,,,,Inpatient,,,1135.7,1135.7,Wellcare,Wellcare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Meritain Health PPO CPD,Meritain Health PPO CPD,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Aetna/Commercial Product,Aetna/Commercial Product,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Meritain Health CPD,Meritain Health CPD,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Starmark CPD,Starmark CPD,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Aetna Medicare,Aetna Medicare,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Ambetter ,Ambetter ,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Blue Access,Anthem Blue Access,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Blue Access Choice,Anthem Blue Access Choice,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Blue Preferred,Anthem Blue Preferred,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Pathway,Anthem Pathway,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Alliance,Anthem Alliance,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Anthem Medicare,Anthem Medicare,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Cigna,Cigna,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Cigna PPO,Cigna PPO,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Cigna Medicare Advantage,Cigna Medicare Advantage,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Essence,Essence,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Healthlink HMO,Healthlink HMO,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Healthlink PPO,Healthlink PPO,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,HomeState Health Plan,HomeState Health Plan,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Humana Gold,Humana Gold,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Medicaid MO,Medicaid MO,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Medica,Medica,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Tricare,Tricare,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,UHC All Payer,UHC All Payer,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,UHC Exchange,UHC Exchange,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,UHC Medicaid,UHC Medicaid,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,UMR CPD,UMR CPD,507.44,,,,,,,per diem,507.44,507.44,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,UHC Medicare,UHC Medicare,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38250567,CDM,301,RC,,,,,,Inpatient,,,507.44,507.44,Wellcare,Wellcare,507.44,,,,,,,case rate,507.44,507.44,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Meritain Health PPO CPD,Meritain Health PPO CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna/Commercial Product,Aetna/Commercial Product,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Meritain Health CPD,Meritain Health CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Starmark CPD,Starmark CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna Medicare,Aetna Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Ambetter ,Ambetter ,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Access,Anthem Blue Access,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Access Choice,Anthem Blue Access Choice,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Preferred,Anthem Blue Preferred,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Pathway,Anthem Pathway,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Alliance,Anthem Alliance,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Medicare,Anthem Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna,Cigna,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna PPO,Cigna PPO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna Medicare Advantage,Cigna Medicare Advantage,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Essence,Essence,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthlink HMO,Healthlink HMO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthlink PPO,Healthlink PPO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,HomeState Health Plan,HomeState Health Plan,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Humana Gold,Humana Gold,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Medicaid MO,Medicaid MO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Medica,Medica,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Tricare,Tricare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC All Payer,UHC All Payer,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Exchange,UHC Exchange,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Medicaid,UHC Medicaid,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UMR CPD,UMR CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Medicare,UHC Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250568,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Wellcare,Wellcare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Meritain Health PPO CPD,Meritain Health PPO CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna/Commercial Product,Aetna/Commercial Product,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Meritain Health CPD,Meritain Health CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Starmark CPD,Starmark CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Aetna Medicare,Aetna Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Ambetter ,Ambetter ,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Access,Anthem Blue Access,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Access Choice,Anthem Blue Access Choice,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Blue Preferred,Anthem Blue Preferred,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Pathway,Anthem Pathway,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Alliance,Anthem Alliance,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Anthem Medicare,Anthem Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna,Cigna,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna PPO,Cigna PPO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Cigna Medicare Advantage,Cigna Medicare Advantage,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Essence,Essence,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthlink HMO,Healthlink HMO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Healthlink PPO,Healthlink PPO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,HomeState Health Plan,HomeState Health Plan,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Humana Gold,Humana Gold,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Medicaid MO,Medicaid MO,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Medica,Medica,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Tricare,Tricare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC All Payer,UHC All Payer,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Exchange,UHC Exchange,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Medicaid,UHC Medicaid,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UMR CPD,UMR CPD,282.61,,,,,,,per diem,282.61,282.61,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,UHC Medicare,UHC Medicare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250569,CDM,305,RC,,,,,,Inpatient,,,282.61,282.61,Wellcare,Wellcare,282.61,,,,,,,case rate,282.61,282.61,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O T PALLIDUM IGG TP-PA      ,38250570,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TEPONEMA PALL IGG CSF     ,38250571,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGM           ,38250572,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Meritain Health PPO CPD,Meritain Health PPO CPD,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Aetna/Commercial Product,Aetna/Commercial Product,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Meritain Health CPD,Meritain Health CPD,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Starmark CPD,Starmark CPD,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Aetna Medicare,Aetna Medicare,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Ambetter ,Ambetter ,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Blue Access,Anthem Blue Access,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Blue Access Choice,Anthem Blue Access Choice,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Blue Preferred,Anthem Blue Preferred,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Pathway,Anthem Pathway,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Alliance,Anthem Alliance,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Anthem Medicare,Anthem Medicare,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Cigna,Cigna,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Cigna PPO,Cigna PPO,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Cigna Medicare Advantage,Cigna Medicare Advantage,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Essence,Essence,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Healthlink HMO,Healthlink HMO,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Healthlink PPO,Healthlink PPO,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,HomeState Health Plan,HomeState Health Plan,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Humana Gold,Humana Gold,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Medicaid MO,Medicaid MO,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Medica,Medica,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Tricare,Tricare,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,UHC All Payer,UHC All Payer,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,UHC Exchange,UHC Exchange,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,UHC Medicaid,UHC Medicaid,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,UMR CPD,UMR CPD,437.05,,,,,,,per diem,437.05,437.05,"Per diem rate, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,UHC Medicare,UHC Medicare,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O H PYLORI AB IGG           ,38250573,CDM,302,RC,,,,,,Inpatient,,,437.05,437.05,Wellcare,Wellcare,437.05,,,,,,,case rate,437.05,437.05,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS A AB TOTAL      ,38250574,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O HEPATITIS C AB CIA        ,38250575,CDM,302,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT 1:1 MIX RFLX        ,38250576,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O DRVVT CONFIRM RFLX        ,38250577,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250578,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O THROM RISK DRVVT CONF     ,38250579,CDM,305,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST CLT         ,38250580,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HIV-1 AB DIFFERENTIAT     ,38250581,CDM,302,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 2 GLYCO IGG      ,38250582,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O TRYPANOSOMA CRUZI IGM     ,38250583,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Meritain Health PPO CPD,Meritain Health PPO CPD,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Aetna/Commercial Product,Aetna/Commercial Product,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Meritain Health CPD,Meritain Health CPD,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Starmark CPD,Starmark CPD,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Aetna Medicare,Aetna Medicare,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Ambetter ,Ambetter ,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Blue Access,Anthem Blue Access,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Blue Access Choice,Anthem Blue Access Choice,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Blue Preferred,Anthem Blue Preferred,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Pathway,Anthem Pathway,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Alliance,Anthem Alliance,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Anthem Medicare,Anthem Medicare,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Cigna,Cigna,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Cigna PPO,Cigna PPO,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Cigna Medicare Advantage,Cigna Medicare Advantage,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Essence,Essence,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Healthlink HMO,Healthlink HMO,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Healthlink PPO,Healthlink PPO,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,HomeState Health Plan,HomeState Health Plan,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Humana Gold,Humana Gold,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Medicaid MO,Medicaid MO,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Medica,Medica,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Tricare,Tricare,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,UHC All Payer,UHC All Payer,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,UHC Exchange,UHC Exchange,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,UHC Medicaid,UHC Medicaid,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,UMR CPD,UMR CPD,366.66,,,,,,,per diem,366.66,366.66,"Per diem rate, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,UHC Medicare,UHC Medicare,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O ENTAMOEBA HIST AB IGG     ,38250584,CDM,302,RC,,,,,,Inpatient,,,366.66,366.66,Wellcare,Wellcare,366.66,,,,,,,case rate,366.66,366.66,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGG       ,38250585,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O BABESIA MICROTI IGM       ,38250586,CDM,302,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Meritain Health PPO CPD,Meritain Health PPO CPD,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Aetna/Commercial Product,Aetna/Commercial Product,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Meritain Health CPD,Meritain Health CPD,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Starmark CPD,Starmark CPD,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Aetna Medicare,Aetna Medicare,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Ambetter ,Ambetter ,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Blue Access,Anthem Blue Access,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Blue Access Choice,Anthem Blue Access Choice,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Blue Preferred,Anthem Blue Preferred,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Pathway,Anthem Pathway,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Alliance,Anthem Alliance,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Anthem Medicare,Anthem Medicare,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Cigna,Cigna,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Cigna PPO,Cigna PPO,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Cigna Medicare Advantage,Cigna Medicare Advantage,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Essence,Essence,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Healthlink HMO,Healthlink HMO,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Healthlink PPO,Healthlink PPO,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,HomeState Health Plan,HomeState Health Plan,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Humana Gold,Humana Gold,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Medicaid MO,Medicaid MO,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Medica,Medica,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Tricare,Tricare,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,UHC All Payer,UHC All Payer,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,UHC Exchange,UHC Exchange,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,UHC Medicaid,UHC Medicaid,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,UMR CPD,UMR CPD,561.02,,,,,,,per diem,561.02,561.02,"Per diem rate, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,UHC Medicare,UHC Medicare,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O INSULIN TOTAL             ,38250587,CDM,301,RC,,,,,,Inpatient,,,561.02,561.02,Wellcare,Wellcare,561.02,,,,,,,case rate,561.02,561.02,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LACTIC ACID BODY FLUD     ,38250588,CDM,301,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Meritain Health PPO CPD,Meritain Health PPO CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna/Commercial Product,Aetna/Commercial Product,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Meritain Health CPD,Meritain Health CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Starmark CPD,Starmark CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna Medicare,Aetna Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Ambetter ,Ambetter ,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Access,Anthem Blue Access,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Access Choice,Anthem Blue Access Choice,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Preferred,Anthem Blue Preferred,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Pathway,Anthem Pathway,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Alliance,Anthem Alliance,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Medicare,Anthem Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna,Cigna,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna PPO,Cigna PPO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna Medicare Advantage,Cigna Medicare Advantage,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Essence,Essence,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthlink HMO,Healthlink HMO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthlink PPO,Healthlink PPO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,HomeState Health Plan,HomeState Health Plan,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Humana Gold,Humana Gold,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Medicaid MO,Medicaid MO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Medica,Medica,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Tricare,Tricare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC All Payer,UHC All Payer,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Exchange,UHC Exchange,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Medicaid,UHC Medicaid,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UMR CPD,UMR CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Medicare,UHC Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LDH TOTAL BODY FLUID      ,38250589,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Wellcare,Wellcare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Meritain Health PPO CPD,Meritain Health PPO CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna/Commercial Product,Aetna/Commercial Product,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Meritain Health CPD,Meritain Health CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Starmark CPD,Starmark CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Aetna Medicare,Aetna Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Ambetter ,Ambetter ,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Access,Anthem Blue Access,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Access Choice,Anthem Blue Access Choice,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Blue Preferred,Anthem Blue Preferred,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Pathway,Anthem Pathway,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Alliance,Anthem Alliance,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Anthem Medicare,Anthem Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna,Cigna,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna PPO,Cigna PPO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Cigna Medicare Advantage,Cigna Medicare Advantage,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Essence,Essence,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthlink HMO,Healthlink HMO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Healthlink PPO,Healthlink PPO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,HomeState Health Plan,HomeState Health Plan,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Humana Gold,Humana Gold,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Medicaid MO,Medicaid MO,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Medica,Medica,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Tricare,Tricare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC All Payer,UHC All Payer,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Exchange,UHC Exchange,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Medicaid,UHC Medicaid,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UMR CPD,UMR CPD,17.86,,,,,,,per diem,17.86,17.86,"Per diem rate, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,UHC Medicare,UHC Medicare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LD ISOENZYMES             ,38250590,CDM,301,RC,,,,,,Inpatient,,,17.86,17.86,Wellcare,Wellcare,17.86,,,,,,,case rate,17.86,17.86,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Meritain Health PPO CPD,Meritain Health PPO CPD,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Aetna/Commercial Product,Aetna/Commercial Product,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Meritain Health CPD,Meritain Health CPD,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Starmark CPD,Starmark CPD,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Aetna Medicare,Aetna Medicare,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Ambetter ,Ambetter ,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Blue Access,Anthem Blue Access,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Blue Access Choice,Anthem Blue Access Choice,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Blue Preferred,Anthem Blue Preferred,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Pathway,Anthem Pathway,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Alliance,Anthem Alliance,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Anthem Medicare,Anthem Medicare,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Cigna,Cigna,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Cigna PPO,Cigna PPO,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Cigna Medicare Advantage,Cigna Medicare Advantage,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Essence,Essence,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Healthlink HMO,Healthlink HMO,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Healthlink PPO,Healthlink PPO,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,HomeState Health Plan,HomeState Health Plan,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Humana Gold,Humana Gold,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Medicaid MO,Medicaid MO,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Medica,Medica,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Tricare,Tricare,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,UHC All Payer,UHC All Payer,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,UHC Exchange,UHC Exchange,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,UHC Medicaid,UHC Medicaid,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,UMR CPD,UMR CPD,482.23,,,,,,,per diem,482.23,482.23,"Per diem rate, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,UHC Medicare,UHC Medicare,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LEGIONEL TYP1 IGM IFA     ,38250591,CDM,302,RC,,,,,,Inpatient,,,482.23,482.23,Wellcare,Wellcare,482.23,,,,,,,case rate,482.23,482.23,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LAP STAIN                 ,38250592,CDM,305,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250593,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38250594,CDM,301,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Meritain Health PPO CPD,Meritain Health PPO CPD,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Aetna/Commercial Product,Aetna/Commercial Product,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Meritain Health CPD,Meritain Health CPD,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Starmark CPD,Starmark CPD,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Aetna Medicare,Aetna Medicare,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Ambetter ,Ambetter ,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Blue Access,Anthem Blue Access,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Blue Access Choice,Anthem Blue Access Choice,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Blue Preferred,Anthem Blue Preferred,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Pathway,Anthem Pathway,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Alliance,Anthem Alliance,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Anthem Medicare,Anthem Medicare,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Cigna,Cigna,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Cigna PPO,Cigna PPO,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Cigna Medicare Advantage,Cigna Medicare Advantage,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Essence,Essence,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Healthlink HMO,Healthlink HMO,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Healthlink PPO,Healthlink PPO,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,HomeState Health Plan,HomeState Health Plan,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Humana Gold,Humana Gold,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Medicaid MO,Medicaid MO,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Medica,Medica,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Tricare,Tricare,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,UHC All Payer,UHC All Payer,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,UHC Exchange,UHC Exchange,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,UHC Medicaid,UHC Medicaid,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,UMR CPD,UMR CPD,637.71,,,,,,,per diem,637.71,637.71,"Per diem rate, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,UHC Medicare,UHC Medicare,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O BORRELIA BURG TTL CSF     ,38250595,CDM,302,RC,,,,,,Inpatient,,,637.71,637.71,Wellcare,Wellcare,637.71,,,,,,,case rate,637.71,637.71,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM URINE           ,38250596,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MAGNESIUM RBC             ,38250597,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250598,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB W/RFLX     ,38250599,CDM,302,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250600,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250601,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250602,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250603,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PRIMIDONE METABOL         ,38250604,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PHENOBARBITAL             ,38250605,CDM,301,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250606,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Meritain Health PPO CPD,Meritain Health PPO CPD,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Aetna/Commercial Product,Aetna/Commercial Product,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Meritain Health CPD,Meritain Health CPD,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Starmark CPD,Starmark CPD,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Aetna Medicare,Aetna Medicare,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Ambetter ,Ambetter ,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Blue Access,Anthem Blue Access,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Blue Access Choice,Anthem Blue Access Choice,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Blue Preferred,Anthem Blue Preferred,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Pathway,Anthem Pathway,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Alliance,Anthem Alliance,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Anthem Medicare,Anthem Medicare,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Cigna,Cigna,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Cigna PPO,Cigna PPO,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Cigna Medicare Advantage,Cigna Medicare Advantage,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Essence,Essence,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Healthlink HMO,Healthlink HMO,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Healthlink PPO,Healthlink PPO,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,HomeState Health Plan,HomeState Health Plan,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Humana Gold,Humana Gold,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Medicaid MO,Medicaid MO,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Medica,Medica,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Tricare,Tricare,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,UHC All Payer,UHC All Payer,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,UHC Exchange,UHC Exchange,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,UHC Medicaid,UHC Medicaid,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,UMR CPD,UMR CPD,26.98,,,,,,,per diem,26.98,26.98,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,UHC Medicare,UHC Medicare,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250607,CDM,301,RC,,,,,,Inpatient,,,26.98,26.98,Wellcare,Wellcare,26.98,,,,,,,case rate,26.98,26.98,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250608,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250609,CDM,301,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O MACROPROLACTIN            ,38250610,CDM,301,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Meritain Health PPO CPD,Meritain Health PPO CPD,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Aetna/Commercial Product,Aetna/Commercial Product,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Meritain Health CPD,Meritain Health CPD,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Starmark CPD,Starmark CPD,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Aetna Medicare,Aetna Medicare,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Ambetter ,Ambetter ,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Blue Access,Anthem Blue Access,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Blue Access Choice,Anthem Blue Access Choice,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Blue Preferred,Anthem Blue Preferred,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Pathway,Anthem Pathway,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Alliance,Anthem Alliance,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Anthem Medicare,Anthem Medicare,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Cigna,Cigna,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Cigna PPO,Cigna PPO,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Cigna Medicare Advantage,Cigna Medicare Advantage,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Essence,Essence,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Healthlink HMO,Healthlink HMO,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Healthlink PPO,Healthlink PPO,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,HomeState Health Plan,HomeState Health Plan,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Humana Gold,Humana Gold,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Medicaid MO,Medicaid MO,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Medica,Medica,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Tricare,Tricare,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,UHC All Payer,UHC All Payer,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,UHC Exchange,UHC Exchange,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,UHC Medicaid,UHC Medicaid,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,UMR CPD,UMR CPD,819.47,,,,,,,per diem,819.47,819.47,"Per diem rate, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,UHC Medicare,UHC Medicare,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PROLACTIN ASSAY           ,38250611,CDM,301,RC,,,,,,Inpatient,,,819.47,819.47,Wellcare,Wellcare,819.47,,,,,,,case rate,819.47,819.47,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O PSA FREE/TOTAL            ,38250612,CDM,301,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Meritain Health PPO CPD,Meritain Health PPO CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Aetna/Commercial Product,Aetna/Commercial Product,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Meritain Health CPD,Meritain Health CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Starmark CPD,Starmark CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Aetna Medicare,Aetna Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Ambetter ,Ambetter ,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Blue Access,Anthem Blue Access,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Blue Access Choice,Anthem Blue Access Choice,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Blue Preferred,Anthem Blue Preferred,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Pathway,Anthem Pathway,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Alliance,Anthem Alliance,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Anthem Medicare,Anthem Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Cigna,Cigna,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Cigna PPO,Cigna PPO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Cigna Medicare Advantage,Cigna Medicare Advantage,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Essence,Essence,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Healthlink HMO,Healthlink HMO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Healthlink PPO,Healthlink PPO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,HomeState Health Plan,HomeState Health Plan,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Humana Gold,Humana Gold,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Medicaid MO,Medicaid MO,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Medica,Medica,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Tricare,Tricare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,UHC All Payer,UHC All Payer,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,UHC Exchange,UHC Exchange,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,UHC Medicaid,UHC Medicaid,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,UMR CPD,UMR CPD,135.53,,,,,,,per diem,135.53,135.53,"Per diem rate, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,UHC Medicare,UHC Medicare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
PSA SCRN                      ,38250613,CDM,301,RC,,,,,,Inpatient,,,135.53,135.53,Wellcare,Wellcare,135.53,,,,,,,case rate,135.53,135.53,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTRO SRM       ,38250614,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECT CSF         ,38250615,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Meritain Health PPO CPD,Meritain Health PPO CPD,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Aetna/Commercial Product,Aetna/Commercial Product,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Meritain Health CPD,Meritain Health CPD,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Starmark CPD,Starmark CPD,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Aetna Medicare,Aetna Medicare,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Ambetter ,Ambetter ,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Blue Access,Anthem Blue Access,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Blue Access Choice,Anthem Blue Access Choice,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Blue Preferred,Anthem Blue Preferred,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Pathway,Anthem Pathway,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Alliance,Anthem Alliance,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Anthem Medicare,Anthem Medicare,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Cigna,Cigna,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Cigna PPO,Cigna PPO,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Cigna Medicare Advantage,Cigna Medicare Advantage,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Essence,Essence,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Healthlink HMO,Healthlink HMO,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Healthlink PPO,Healthlink PPO,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,HomeState Health Plan,HomeState Health Plan,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Humana Gold,Humana Gold,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Medicaid MO,Medicaid MO,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Medica,Medica,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Tricare,Tricare,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,UHC All Payer,UHC All Payer,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,UHC Exchange,UHC Exchange,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,UHC Medicaid,UHC Medicaid,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,UMR CPD,UMR CPD,192.26,,,,,,,per diem,192.26,192.26,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,UHC Medicare,UHC Medicare,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250616,CDM,301,RC,,,,,,Inpatient,,,192.26,192.26,Wellcare,Wellcare,192.26,,,,,,,case rate,192.26,192.26,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT W/RFLX     ,38250617,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250618,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250619,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Meritain Health PPO CPD,Meritain Health PPO CPD,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Aetna/Commercial Product,Aetna/Commercial Product,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Meritain Health CPD,Meritain Health CPD,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Starmark CPD,Starmark CPD,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Aetna Medicare,Aetna Medicare,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Ambetter ,Ambetter ,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Blue Access,Anthem Blue Access,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Blue Access Choice,Anthem Blue Access Choice,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Blue Preferred,Anthem Blue Preferred,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Pathway,Anthem Pathway,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Alliance,Anthem Alliance,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Anthem Medicare,Anthem Medicare,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Cigna,Cigna,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Cigna PPO,Cigna PPO,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Cigna Medicare Advantage,Cigna Medicare Advantage,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Essence,Essence,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Healthlink HMO,Healthlink HMO,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Healthlink PPO,Healthlink PPO,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,HomeState Health Plan,HomeState Health Plan,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Humana Gold,Humana Gold,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Medicaid MO,Medicaid MO,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Medica,Medica,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Tricare,Tricare,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,UHC All Payer,UHC All Payer,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,UHC Exchange,UHC Exchange,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,UHC Medicaid,UHC Medicaid,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,UMR CPD,UMR CPD,413.94,,,,,,,per diem,413.94,413.94,"Per diem rate, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,UHC Medicare,UHC Medicare,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
S/O PTH INTACT W/CA GRAPH     ,38250620,CDM,301,RC,,,,,,Inpatient,,,413.94,413.94,Wellcare,Wellcare,413.94,,,,,,,case rate,413.94,413.94,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Meritain Health PPO CPD,Meritain Health PPO CPD,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Aetna/Commercial Product,Aetna/Commercial Product,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Meritain Health CPD,Meritain Health CPD,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Starmark CPD,Starmark CPD,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Aetna Medicare,Aetna Medicare,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Ambetter ,Ambetter ,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Blue Access,Anthem Blue Access,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Blue Access Choice,Anthem Blue Access Choice,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Blue Preferred,Anthem Blue Preferred,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Pathway,Anthem Pathway,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Alliance,Anthem Alliance,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Anthem Medicare,Anthem Medicare,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Cigna,Cigna,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Cigna PPO,Cigna PPO,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Cigna Medicare Advantage,Cigna Medicare Advantage,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Essence,Essence,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Healthlink HMO,Healthlink HMO,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Healthlink PPO,Healthlink PPO,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,HomeState Health Plan,HomeState Health Plan,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Humana Gold,Humana Gold,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Medicaid MO,Medicaid MO,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Medica,Medica,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Tricare,Tricare,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,UHC All Payer,UHC All Payer,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,UHC Exchange,UHC Exchange,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,UHC Medicaid,UHC Medicaid,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,UMR CPD,UMR CPD,296.27,,,,,,,per diem,296.27,296.27,"Per diem rate, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,UHC Medicare,UHC Medicare,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
PTH INTRAOPERATIVE            ,38250621,CDM,301,RC,,,,,,Inpatient,,,296.27,296.27,Wellcare,Wellcare,296.27,,,,,,,case rate,296.27,296.27,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O LUPUS ANTICOAGULANT       ,38250622,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38250623,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PTT WRFLX     ,38250624,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250625,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250626,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health PPO CPD,Meritain Health PPO CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna/Commercial Product,Aetna/Commercial Product,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Meritain Health CPD,Meritain Health CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Starmark CPD,Starmark CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Aetna Medicare,Aetna Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Ambetter ,Ambetter ,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access,Anthem Blue Access,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Access Choice,Anthem Blue Access Choice,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Blue Preferred,Anthem Blue Preferred,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Pathway,Anthem Pathway,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Alliance,Anthem Alliance,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Anthem Medicare,Anthem Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna,Cigna,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna PPO,Cigna PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Cigna Medicare Advantage,Cigna Medicare Advantage,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Essence,Essence,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink HMO,Healthlink HMO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Healthlink PPO,Healthlink PPO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,HomeState Health Plan,HomeState Health Plan,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Humana Gold,Humana Gold,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medicaid MO,Medicaid MO,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Medica,Medica,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Tricare,Tricare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC All Payer,UHC All Payer,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Exchange,UHC Exchange,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicaid,UHC Medicaid,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UMR CPD,UMR CPD,21.01,,,,,,,per diem,21.01,21.01,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,UHC Medicare,UHC Medicare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT            ,38250627,CDM,305,RC,,,,,,Inpatient,,,21.01,21.01,Wellcare,Wellcare,21.01,,,,,,,case rate,21.01,21.01,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O HAEMOPH INFL B AB IGG     ,38250628,CDM,302,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O DIPTHERIA AB IGG          ,38250629,CDM,302,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health PPO CPD,Meritain Health PPO CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/Commercial Product,Aetna/Commercial Product,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health CPD,Meritain Health CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Starmark CPD,Starmark CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Aetna Medicare,Aetna Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Ambetter ,Ambetter ,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access,Anthem Blue Access,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access Choice,Anthem Blue Access Choice,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Preferred,Anthem Blue Preferred,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Pathway,Anthem Pathway,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Alliance,Anthem Alliance,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Medicare,Anthem Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Cigna,Cigna,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Cigna PPO,Cigna PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Cigna Medicare Advantage,Cigna Medicare Advantage,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Essence,Essence,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink HMO,Healthlink HMO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink PPO,Healthlink PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,HomeState Health Plan,HomeState Health Plan,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Humana Gold,Humana Gold,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Medicaid MO,Medicaid MO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Medica,Medica,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Tricare,Tricare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,UHC All Payer,UHC All Payer,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,UHC Exchange,UHC Exchange,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicaid,UHC Medicaid,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,UMR CPD,UMR CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicare,UHC Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O TETANUS AB IGG            ,38250630,CDM,302,RC,,,,,,Inpatient,,,64.09,64.09,Wellcare,Wellcare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250631,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250632,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250633,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250634,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250635,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250636,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250637,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250638,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250639,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250640,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250641,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250642,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O STREP PNEUM IGG14         ,38250643,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250644,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250645,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250646,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250647,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250648,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250649,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250650,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250651,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250652,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250653,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250654,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250655,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250656,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250657,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250658,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250659,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250660,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250661,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250662,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250663,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250664,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250665,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O PNEUMO AB IGG 23          ,38250666,CDM,302,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGM            ,38250667,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Meritain Health PPO CPD,Meritain Health PPO CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna/Commercial Product,Aetna/Commercial Product,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Meritain Health CPD,Meritain Health CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Starmark CPD,Starmark CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna Medicare,Aetna Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Ambetter ,Ambetter ,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Access,Anthem Blue Access,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Access Choice,Anthem Blue Access Choice,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Preferred,Anthem Blue Preferred,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Pathway,Anthem Pathway,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Alliance,Anthem Alliance,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Medicare,Anthem Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna,Cigna,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna PPO,Cigna PPO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna Medicare Advantage,Cigna Medicare Advantage,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Essence,Essence,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthlink HMO,Healthlink HMO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthlink PPO,Healthlink PPO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,HomeState Health Plan,HomeState Health Plan,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Humana Gold,Humana Gold,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Medicaid MO,Medicaid MO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Medica,Medica,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Tricare,Tricare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC All Payer,UHC All Payer,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Exchange,UHC Exchange,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Medicaid,UHC Medicaid,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UMR CPD,UMR CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Medicare,UHC Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O RUBELLA AB IGG            ,38250668,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Wellcare,Wellcare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250669,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health PPO CPD,Meritain Health PPO CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/Commercial Product,Aetna/Commercial Product,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health CPD,Meritain Health CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Starmark CPD,Starmark CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna Medicare,Aetna Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Ambetter ,Ambetter ,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access,Anthem Blue Access,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access Choice,Anthem Blue Access Choice,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Preferred,Anthem Blue Preferred,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Pathway,Anthem Pathway,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Alliance,Anthem Alliance,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Medicare,Anthem Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna,Cigna,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna PPO,Cigna PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna Medicare Advantage,Cigna Medicare Advantage,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Essence,Essence,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink HMO,Healthlink HMO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink PPO,Healthlink PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,HomeState Health Plan,HomeState Health Plan,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Humana Gold,Humana Gold,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medicaid MO,Medicaid MO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medica,Medica,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Tricare,Tricare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC All Payer,UHC All Payer,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Exchange,UHC Exchange,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicaid,UHC Medicaid,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UMR CPD,UMR CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicare,UHC Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250670,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Wellcare,Wellcare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health PPO CPD,Meritain Health PPO CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/Commercial Product,Aetna/Commercial Product,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health CPD,Meritain Health CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Starmark CPD,Starmark CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Aetna Medicare,Aetna Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Ambetter ,Ambetter ,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access,Anthem Blue Access,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access Choice,Anthem Blue Access Choice,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Preferred,Anthem Blue Preferred,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Pathway,Anthem Pathway,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Alliance,Anthem Alliance,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Medicare,Anthem Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna,Cigna,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna PPO,Cigna PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Cigna Medicare Advantage,Cigna Medicare Advantage,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Essence,Essence,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink HMO,Healthlink HMO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink PPO,Healthlink PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,HomeState Health Plan,HomeState Health Plan,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Humana Gold,Humana Gold,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medicaid MO,Medicaid MO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Medica,Medica,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Tricare,Tricare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC All Payer,UHC All Payer,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Exchange,UHC Exchange,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicaid,UHC Medicaid,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UMR CPD,UMR CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicare,UHC Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O RUBEOLLA AB IGG           ,38250671,CDM,302,RC,,,,,,Inpatient,,,320.43,320.43,Wellcare,Wellcare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O SODIUM FLUID              ,38250672,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Meritain Health PPO CPD,Meritain Health PPO CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Aetna/Commercial Product,Aetna/Commercial Product,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Meritain Health CPD,Meritain Health CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Starmark CPD,Starmark CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Aetna Medicare,Aetna Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Ambetter ,Ambetter ,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Blue Access,Anthem Blue Access,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Blue Access Choice,Anthem Blue Access Choice,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Blue Preferred,Anthem Blue Preferred,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Pathway,Anthem Pathway,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Alliance,Anthem Alliance,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Anthem Medicare,Anthem Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Cigna,Cigna,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Cigna PPO,Cigna PPO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Cigna Medicare Advantage,Cigna Medicare Advantage,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Essence,Essence,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Healthlink HMO,Healthlink HMO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Healthlink PPO,Healthlink PPO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,HomeState Health Plan,HomeState Health Plan,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Humana Gold,Humana Gold,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Medicaid MO,Medicaid MO,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Medica,Medica,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Tricare,Tricare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,UHC All Payer,UHC All Payer,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,UHC Exchange,UHC Exchange,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,UHC Medicaid,UHC Medicaid,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,UMR CPD,UMR CPD,128.17,,,,,,,per diem,128.17,128.17,"Per diem rate, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,UHC Medicare,UHC Medicare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTER FEMALE/CHLD     ,38250673,CDM,301,RC,,,,,,Inpatient,,,128.17,128.17,Wellcare,Wellcare,128.17,,,,,,,case rate,128.17,128.17,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE TOTAL        ,38250674,CDM,301,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THEOPHYLLINE HCCL         ,38250675,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health PPO CPD,Meritain Health PPO CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/Commercial Product,Aetna/Commercial Product,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health CPD,Meritain Health CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Starmark CPD,Starmark CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Aetna Medicare,Aetna Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Ambetter ,Ambetter ,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access,Anthem Blue Access,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access Choice,Anthem Blue Access Choice,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Preferred,Anthem Blue Preferred,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Pathway,Anthem Pathway,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Alliance,Anthem Alliance,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Medicare,Anthem Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Cigna,Cigna,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Cigna PPO,Cigna PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Cigna Medicare Advantage,Cigna Medicare Advantage,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Essence,Essence,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink HMO,Healthlink HMO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink PPO,Healthlink PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,HomeState Health Plan,HomeState Health Plan,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Humana Gold,Humana Gold,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Medicaid MO,Medicaid MO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Medica,Medica,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Tricare,Tricare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,UHC All Payer,UHC All Payer,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,UHC Exchange,UHC Exchange,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicaid,UHC Medicaid,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,UMR CPD,UMR CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicare,UHC Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME 1:1 MIX     ,38250676,CDM,305,RC,,,,,,Inpatient,,,71.44,71.44,Wellcare,Wellcare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Meritain Health PPO CPD,Meritain Health PPO CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna/Commercial Product,Aetna/Commercial Product,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Meritain Health CPD,Meritain Health CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Starmark CPD,Starmark CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna Medicare,Aetna Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Ambetter ,Ambetter ,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Access,Anthem Blue Access,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Access Choice,Anthem Blue Access Choice,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Preferred,Anthem Blue Preferred,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Pathway,Anthem Pathway,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Alliance,Anthem Alliance,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Medicare,Anthem Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna,Cigna,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna PPO,Cigna PPO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna Medicare Advantage,Cigna Medicare Advantage,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Essence,Essence,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthlink HMO,Healthlink HMO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthlink PPO,Healthlink PPO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,HomeState Health Plan,HomeState Health Plan,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Humana Gold,Humana Gold,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Medicaid MO,Medicaid MO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Medica,Medica,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Tricare,Tricare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC All Payer,UHC All Payer,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Exchange,UHC Exchange,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Medicaid,UHC Medicaid,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UMR CPD,UMR CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Medicare,UHC Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROMBIN TIME RLFX        ,38250677,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Wellcare,Wellcare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Meritain Health PPO CPD,Meritain Health PPO CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna/Commercial Product,Aetna/Commercial Product,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Meritain Health CPD,Meritain Health CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Starmark CPD,Starmark CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Aetna Medicare,Aetna Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Ambetter ,Ambetter ,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Access,Anthem Blue Access,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Access Choice,Anthem Blue Access Choice,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Blue Preferred,Anthem Blue Preferred,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Pathway,Anthem Pathway,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Alliance,Anthem Alliance,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Anthem Medicare,Anthem Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna,Cigna,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna PPO,Cigna PPO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Cigna Medicare Advantage,Cigna Medicare Advantage,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Essence,Essence,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthlink HMO,Healthlink HMO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Healthlink PPO,Healthlink PPO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,HomeState Health Plan,HomeState Health Plan,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Humana Gold,Humana Gold,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Medicaid MO,Medicaid MO,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Medica,Medica,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Tricare,Tricare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC All Payer,UHC All Payer,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Exchange,UHC Exchange,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Medicaid,UHC Medicaid,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UMR CPD,UMR CPD,382.42,,,,,,,per diem,382.42,382.42,"Per diem rate, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,UHC Medicare,UHC Medicare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O THROM RISK THROM TIME     ,38250678,CDM,305,RC,,,,,,Inpatient,,,382.42,382.42,Wellcare,Wellcare,382.42,,,,,,,case rate,382.42,382.42,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O VAP CHOLESTEROL           ,38250679,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
UA AUTO W/O MICRO             ,38250680,CDM,307,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Meritain Health PPO CPD,Meritain Health PPO CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Aetna/Commercial Product,Aetna/Commercial Product,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Meritain Health CPD,Meritain Health CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Starmark CPD,Starmark CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Aetna Medicare,Aetna Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Ambetter ,Ambetter ,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Access,Anthem Blue Access,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Access Choice,Anthem Blue Access Choice,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Blue Preferred,Anthem Blue Preferred,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Pathway,Anthem Pathway,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Alliance,Anthem Alliance,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Anthem Medicare,Anthem Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Cigna,Cigna,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Cigna PPO,Cigna PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Cigna Medicare Advantage,Cigna Medicare Advantage,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Essence,Essence,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Healthlink HMO,Healthlink HMO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Healthlink PPO,Healthlink PPO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,HomeState Health Plan,HomeState Health Plan,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Humana Gold,Humana Gold,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Medicaid MO,Medicaid MO,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Medica,Medica,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Tricare,Tricare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,UHC All Payer,UHC All Payer,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,UHC Exchange,UHC Exchange,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,UHC Medicaid,UHC Medicaid,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,UMR CPD,UMR CPD,264.75,,,,,,,per diem,264.75,264.75,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,UHC Medicare,UHC Medicare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AG EIA UR     ,38250681,CDM,306,RC,,,,,,Inpatient,,,264.75,264.75,Wellcare,Wellcare,264.75,,,,,,,case rate,264.75,264.75,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HTLV I/II AB ELISA        ,38250682,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGG        ,38250683,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O HEPATITIS E AB IGM        ,38250684,CDM,302,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health PPO CPD,Meritain Health PPO CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/Commercial Product,Aetna/Commercial Product,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health CPD,Meritain Health CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Starmark CPD,Starmark CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Aetna Medicare,Aetna Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Ambetter ,Ambetter ,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access,Anthem Blue Access,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access Choice,Anthem Blue Access Choice,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Preferred,Anthem Blue Preferred,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Pathway,Anthem Pathway,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Alliance,Anthem Alliance,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Medicare,Anthem Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Cigna,Cigna,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Cigna PPO,Cigna PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Cigna Medicare Advantage,Cigna Medicare Advantage,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Essence,Essence,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink HMO,Healthlink HMO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink PPO,Healthlink PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,HomeState Health Plan,HomeState Health Plan,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Humana Gold,Humana Gold,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Medicaid MO,Medicaid MO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Medica,Medica,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Tricare,Tricare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,UHC All Payer,UHC All Payer,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,UHC Exchange,UHC Exchange,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicaid,UHC Medicaid,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,UMR CPD,UMR CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicare,UHC Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O DENGUE FEVER IGG          ,38250685,CDM,302,RC,,,,,,Inpatient,,,134.48,134.48,Wellcare,Wellcare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250686,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS W RFLX         ,38250687,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGG CONF       ,38250688,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O HANTAVIRUS IGM CONF       ,38250689,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGG           ,38250690,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health PPO CPD,Meritain Health PPO CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna/Commercial Product,Aetna/Commercial Product,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Meritain Health CPD,Meritain Health CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Starmark CPD,Starmark CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Aetna Medicare,Aetna Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Ambetter ,Ambetter ,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access,Anthem Blue Access,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Access Choice,Anthem Blue Access Choice,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Blue Preferred,Anthem Blue Preferred,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Pathway,Anthem Pathway,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Alliance,Anthem Alliance,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Anthem Medicare,Anthem Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna,Cigna,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna PPO,Cigna PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Cigna Medicare Advantage,Cigna Medicare Advantage,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Essence,Essence,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink HMO,Healthlink HMO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Healthlink PPO,Healthlink PPO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,HomeState Health Plan,HomeState Health Plan,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Humana Gold,Humana Gold,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Medicaid MO,Medicaid MO,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Medica,Medica,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Tricare,Tricare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC All Payer,UHC All Payer,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Exchange,UHC Exchange,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicaid,UHC Medicaid,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UMR CPD,UMR CPD,52.53,,,,,,,per diem,52.53,52.53,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,UHC Medicare,UHC Medicare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA IGM           ,38250691,CDM,302,RC,,,,,,Inpatient,,,52.53,52.53,Wellcare,Wellcare,52.53,,,,,,,case rate,52.53,52.53,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS AB IGG         ,38250692,CDM,302,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Meritain Health PPO CPD,Meritain Health PPO CPD,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Aetna/Commercial Product,Aetna/Commercial Product,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Meritain Health CPD,Meritain Health CPD,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Starmark CPD,Starmark CPD,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Aetna Medicare,Aetna Medicare,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Ambetter ,Ambetter ,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Blue Access,Anthem Blue Access,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Blue Access Choice,Anthem Blue Access Choice,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Blue Preferred,Anthem Blue Preferred,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Pathway,Anthem Pathway,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Alliance,Anthem Alliance,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Anthem Medicare,Anthem Medicare,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Cigna,Cigna,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Cigna PPO,Cigna PPO,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Cigna Medicare Advantage,Cigna Medicare Advantage,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Essence,Essence,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Healthlink HMO,Healthlink HMO,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Healthlink PPO,Healthlink PPO,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,HomeState Health Plan,HomeState Health Plan,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Humana Gold,Humana Gold,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Medicaid MO,Medicaid MO,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Medica,Medica,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Tricare,Tricare,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,UHC All Payer,UHC All Payer,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,UHC Exchange,UHC Exchange,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,UHC Medicaid,UHC Medicaid,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,UMR CPD,UMR CPD,443.35,,,,,,,per diem,443.35,443.35,"Per diem rate, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,UHC Medicare,UHC Medicare,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ALK PHOS SRM/PLSM         ,38250693,CDM,301,RC,,,,,,Inpatient,,,443.35,443.35,Wellcare,Wellcare,443.35,,,,,,,case rate,443.35,443.35,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Meritain Health PPO CPD,Meritain Health PPO CPD,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Aetna/Commercial Product,Aetna/Commercial Product,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Meritain Health CPD,Meritain Health CPD,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Starmark CPD,Starmark CPD,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Aetna Medicare,Aetna Medicare,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Ambetter ,Ambetter ,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Blue Access,Anthem Blue Access,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Blue Access Choice,Anthem Blue Access Choice,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Blue Preferred,Anthem Blue Preferred,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Pathway,Anthem Pathway,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Alliance,Anthem Alliance,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Anthem Medicare,Anthem Medicare,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Cigna,Cigna,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Cigna PPO,Cigna PPO,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Cigna Medicare Advantage,Cigna Medicare Advantage,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Essence,Essence,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Healthlink HMO,Healthlink HMO,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Healthlink PPO,Healthlink PPO,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,HomeState Health Plan,HomeState Health Plan,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Humana Gold,Humana Gold,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Medicaid MO,Medicaid MO,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Medica,Medica,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Tricare,Tricare,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,UHC All Payer,UHC All Payer,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,UHC Exchange,UHC Exchange,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,UHC Medicaid,UHC Medicaid,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,UMR CPD,UMR CPD,410.78,,,,,,,per diem,410.78,410.78,"Per diem rate, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,UHC Medicare,UHC Medicare,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC URINE W/RFLX      ,38250694,CDM,301,RC,,,,,,Inpatient,,,410.78,410.78,Wellcare,Wellcare,410.78,,,,,,,case rate,410.78,410.78,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health PPO CPD,Meritain Health PPO CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/Commercial Product,Aetna/Commercial Product,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health CPD,Meritain Health CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Starmark CPD,Starmark CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna Medicare,Aetna Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Ambetter ,Ambetter ,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access,Anthem Blue Access,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access Choice,Anthem Blue Access Choice,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Preferred,Anthem Blue Preferred,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Pathway,Anthem Pathway,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Alliance,Anthem Alliance,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Medicare,Anthem Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna,Cigna,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna PPO,Cigna PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna Medicare Advantage,Cigna Medicare Advantage,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Essence,Essence,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink HMO,Healthlink HMO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink PPO,Healthlink PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,HomeState Health Plan,HomeState Health Plan,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Humana Gold,Humana Gold,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Medicaid MO,Medicaid MO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Medica,Medica,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Tricare,Tricare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC All Payer,UHC All Payer,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Exchange,UHC Exchange,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicaid,UHC Medicaid,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UMR CPD,UMR CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicare,UHC Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O ARSENIC FRAC URINE        ,38250695,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Wellcare,Wellcare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health PPO CPD,Meritain Health PPO CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/Commercial Product,Aetna/Commercial Product,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health CPD,Meritain Health CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Starmark CPD,Starmark CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Aetna Medicare,Aetna Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Ambetter ,Ambetter ,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access,Anthem Blue Access,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access Choice,Anthem Blue Access Choice,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Preferred,Anthem Blue Preferred,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Pathway,Anthem Pathway,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Alliance,Anthem Alliance,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Medicare,Anthem Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna,Cigna,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna PPO,Cigna PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Cigna Medicare Advantage,Cigna Medicare Advantage,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Essence,Essence,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink HMO,Healthlink HMO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink PPO,Healthlink PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,HomeState Health Plan,HomeState Health Plan,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Humana Gold,Humana Gold,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Medicaid MO,Medicaid MO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Medica,Medica,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Tricare,Tricare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC All Payer,UHC All Payer,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Exchange,UHC Exchange,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicaid,UHC Medicaid,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UMR CPD,UMR CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicare,UHC Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250696,CDM,301,RC,,,,,,Inpatient,,,423.39,423.39,Wellcare,Wellcare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Meritain Health PPO CPD,Meritain Health PPO CPD,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Aetna/Commercial Product,Aetna/Commercial Product,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Meritain Health CPD,Meritain Health CPD,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Starmark CPD,Starmark CPD,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Aetna Medicare,Aetna Medicare,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Ambetter ,Ambetter ,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Blue Access,Anthem Blue Access,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Blue Access Choice,Anthem Blue Access Choice,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Blue Preferred,Anthem Blue Preferred,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Pathway,Anthem Pathway,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Alliance,Anthem Alliance,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Anthem Medicare,Anthem Medicare,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Cigna,Cigna,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Cigna PPO,Cigna PPO,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Cigna Medicare Advantage,Cigna Medicare Advantage,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Essence,Essence,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Healthlink HMO,Healthlink HMO,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Healthlink PPO,Healthlink PPO,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,HomeState Health Plan,HomeState Health Plan,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Humana Gold,Humana Gold,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Medicaid MO,Medicaid MO,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Medica,Medica,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Tricare,Tricare,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,UHC All Payer,UHC All Payer,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,UHC Exchange,UHC Exchange,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,UHC Medicaid,UHC Medicaid,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,UMR CPD,UMR CPD,300.47,,,,,,,per diem,300.47,300.47,"Per diem rate, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,UHC Medicare,UHC Medicare,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O MERCURY WHOLE BLOOD       ,38250697,CDM,301,RC,,,,,,Inpatient,,,300.47,300.47,Wellcare,Wellcare,300.47,,,,,,,case rate,300.47,300.47,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Meritain Health PPO CPD,Meritain Health PPO CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna/Commercial Product,Aetna/Commercial Product,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Meritain Health CPD,Meritain Health CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Starmark CPD,Starmark CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Aetna Medicare,Aetna Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Ambetter ,Ambetter ,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Access,Anthem Blue Access,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Access Choice,Anthem Blue Access Choice,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Blue Preferred,Anthem Blue Preferred,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Pathway,Anthem Pathway,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Alliance,Anthem Alliance,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Anthem Medicare,Anthem Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna,Cigna,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna PPO,Cigna PPO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Cigna Medicare Advantage,Cigna Medicare Advantage,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Essence,Essence,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthlink HMO,Healthlink HMO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Healthlink PPO,Healthlink PPO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,HomeState Health Plan,HomeState Health Plan,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Humana Gold,Humana Gold,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Medicaid MO,Medicaid MO,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Medica,Medica,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Tricare,Tricare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC All Payer,UHC All Payer,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Exchange,UHC Exchange,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Medicaid,UHC Medicaid,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UMR CPD,UMR CPD,302.57,,,,,,,per diem,302.57,302.57,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,UHC Medicare,UHC Medicare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250698,CDM,301,RC,,,,,,Inpatient,,,302.57,302.57,Wellcare,Wellcare,302.57,,,,,,,case rate,302.57,302.57,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health PPO CPD,Meritain Health PPO CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/Commercial Product,Aetna/Commercial Product,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health CPD,Meritain Health CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Starmark CPD,Starmark CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Aetna Medicare,Aetna Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Ambetter ,Ambetter ,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access,Anthem Blue Access,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access Choice,Anthem Blue Access Choice,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Preferred,Anthem Blue Preferred,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Pathway,Anthem Pathway,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Alliance,Anthem Alliance,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Medicare,Anthem Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna,Cigna,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna PPO,Cigna PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Cigna Medicare Advantage,Cigna Medicare Advantage,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Essence,Essence,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink HMO,Healthlink HMO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink PPO,Healthlink PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,HomeState Health Plan,HomeState Health Plan,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Humana Gold,Humana Gold,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Medicaid MO,Medicaid MO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Medica,Medica,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Tricare,Tricare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC All Payer,UHC All Payer,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Exchange,UHC Exchange,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicaid,UHC Medicaid,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UMR CPD,UMR CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicare,UHC Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O PENTOBARBITAL             ,38250699,CDM,301,RC,,,,,,Inpatient,,,198.56,198.56,Wellcare,Wellcare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250700,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health PPO CPD,Meritain Health PPO CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/Commercial Product,Aetna/Commercial Product,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health CPD,Meritain Health CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Starmark CPD,Starmark CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna Medicare,Aetna Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Ambetter ,Ambetter ,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access,Anthem Blue Access,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access Choice,Anthem Blue Access Choice,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Preferred,Anthem Blue Preferred,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Pathway,Anthem Pathway,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Alliance,Anthem Alliance,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Medicare,Anthem Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna,Cigna,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna PPO,Cigna PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna Medicare Advantage,Cigna Medicare Advantage,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Essence,Essence,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink HMO,Healthlink HMO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink PPO,Healthlink PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,HomeState Health Plan,HomeState Health Plan,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Humana Gold,Humana Gold,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Medicaid MO,Medicaid MO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Medica,Medica,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Tricare,Tricare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC All Payer,UHC All Payer,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Exchange,UHC Exchange,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicaid,UHC Medicaid,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UMR CPD,UMR CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicare,UHC Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O THC METAB URINE QUANT     ,38250701,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Wellcare,Wellcare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Meritain Health PPO CPD,Meritain Health PPO CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Aetna/Commercial Product,Aetna/Commercial Product,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Meritain Health CPD,Meritain Health CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Starmark CPD,Starmark CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Aetna Medicare,Aetna Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Ambetter ,Ambetter ,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Access,Anthem Blue Access,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Access Choice,Anthem Blue Access Choice,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Blue Preferred,Anthem Blue Preferred,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Pathway,Anthem Pathway,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Alliance,Anthem Alliance,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Anthem Medicare,Anthem Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Cigna,Cigna,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Cigna PPO,Cigna PPO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Cigna Medicare Advantage,Cigna Medicare Advantage,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Essence,Essence,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Healthlink HMO,Healthlink HMO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Healthlink PPO,Healthlink PPO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,HomeState Health Plan,HomeState Health Plan,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Humana Gold,Humana Gold,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Medicaid MO,Medicaid MO,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Medica,Medica,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Tricare,Tricare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,UHC All Payer,UHC All Payer,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,UHC Exchange,UHC Exchange,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,UHC Medicaid,UHC Medicaid,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,UMR CPD,UMR CPD,1096.83,,,,,,,per diem,1096.83,1096.83,"Per diem rate, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,UHC Medicare,UHC Medicare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BONE MARR         ,38250702,CDM,311,RC,,,,,,Inpatient,,,1096.83,1096.83,Wellcare,Wellcare,1096.83,,,,,,,case rate,1096.83,1096.83,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Meritain Health PPO CPD,Meritain Health PPO CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna/Commercial Product,Aetna/Commercial Product,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Meritain Health CPD,Meritain Health CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Starmark CPD,Starmark CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna Medicare,Aetna Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Ambetter ,Ambetter ,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Access,Anthem Blue Access,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Access Choice,Anthem Blue Access Choice,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Preferred,Anthem Blue Preferred,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Pathway,Anthem Pathway,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Alliance,Anthem Alliance,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Medicare,Anthem Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna,Cigna,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna PPO,Cigna PPO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna Medicare Advantage,Cigna Medicare Advantage,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Essence,Essence,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthlink HMO,Healthlink HMO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthlink PPO,Healthlink PPO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,HomeState Health Plan,HomeState Health Plan,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Humana Gold,Humana Gold,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Medicaid MO,Medicaid MO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Medica,Medica,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Tricare,Tricare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC All Payer,UHC All Payer,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Exchange,UHC Exchange,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Medicaid,UHC Medicaid,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UMR CPD,UMR CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Medicare,UHC Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38250703,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Wellcare,Wellcare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Meritain Health PPO CPD,Meritain Health PPO CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna/Commercial Product,Aetna/Commercial Product,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Meritain Health CPD,Meritain Health CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Starmark CPD,Starmark CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Aetna Medicare,Aetna Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Ambetter ,Ambetter ,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Access,Anthem Blue Access,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Access Choice,Anthem Blue Access Choice,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Blue Preferred,Anthem Blue Preferred,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Pathway,Anthem Pathway,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Alliance,Anthem Alliance,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Anthem Medicare,Anthem Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna,Cigna,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna PPO,Cigna PPO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Cigna Medicare Advantage,Cigna Medicare Advantage,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Essence,Essence,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthlink HMO,Healthlink HMO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Healthlink PPO,Healthlink PPO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,HomeState Health Plan,HomeState Health Plan,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Humana Gold,Humana Gold,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Medicaid MO,Medicaid MO,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Medica,Medica,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Tricare,Tricare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC All Payer,UHC All Payer,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Exchange,UHC Exchange,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Medicaid,UHC Medicaid,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UMR CPD,UMR CPD,1890.03,,,,,,,per diem,1890.03,1890.03,"Per diem rate, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,UHC Medicare,UHC Medicare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL LYMPH NOD         ,38250704,CDM,311,RC,,,,,,Inpatient,,,1890.03,1890.03,Wellcare,Wellcare,1890.03,,,,,,,case rate,1890.03,1890.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Meritain Health PPO CPD,Meritain Health PPO CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna/Commercial Product,Aetna/Commercial Product,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Meritain Health CPD,Meritain Health CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Starmark CPD,Starmark CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna Medicare,Aetna Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Ambetter ,Ambetter ,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Access,Anthem Blue Access,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Access Choice,Anthem Blue Access Choice,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Preferred,Anthem Blue Preferred,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Pathway,Anthem Pathway,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Alliance,Anthem Alliance,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Medicare,Anthem Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna,Cigna,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna PPO,Cigna PPO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna Medicare Advantage,Cigna Medicare Advantage,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Essence,Essence,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthlink HMO,Healthlink HMO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthlink PPO,Healthlink PPO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,HomeState Health Plan,HomeState Health Plan,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Humana Gold,Humana Gold,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Medicaid MO,Medicaid MO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Medica,Medica,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Tricare,Tricare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC All Payer,UHC All Payer,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Exchange,UHC Exchange,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Medicaid,UHC Medicaid,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UMR CPD,UMR CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Medicare,UHC Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38250705,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Wellcare,Wellcare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Meritain Health PPO CPD,Meritain Health PPO CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna/Commercial Product,Aetna/Commercial Product,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Meritain Health CPD,Meritain Health CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Starmark CPD,Starmark CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Aetna Medicare,Aetna Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Ambetter ,Ambetter ,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Access,Anthem Blue Access,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Access Choice,Anthem Blue Access Choice,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Blue Preferred,Anthem Blue Preferred,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Pathway,Anthem Pathway,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Alliance,Anthem Alliance,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Anthem Medicare,Anthem Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna,Cigna,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna PPO,Cigna PPO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Cigna Medicare Advantage,Cigna Medicare Advantage,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Essence,Essence,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthlink HMO,Healthlink HMO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Healthlink PPO,Healthlink PPO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,HomeState Health Plan,HomeState Health Plan,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Humana Gold,Humana Gold,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Medicaid MO,Medicaid MO,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Medica,Medica,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Tricare,Tricare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC All Payer,UHC All Payer,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Exchange,UHC Exchange,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Medicaid,UHC Medicaid,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UMR CPD,UMR CPD,1077.92,,,,,,,per diem,1077.92,1077.92,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,UHC Medicare,UHC Medicare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38250706,CDM,311,RC,,,,,,Inpatient,,,1077.92,1077.92,Wellcare,Wellcare,1077.92,,,,,,,case rate,1077.92,1077.92,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Meritain Health PPO CPD,Meritain Health PPO CPD,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Aetna/Commercial Product,Aetna/Commercial Product,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Meritain Health CPD,Meritain Health CPD,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Starmark CPD,Starmark CPD,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Aetna Medicare,Aetna Medicare,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Ambetter ,Ambetter ,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Blue Access,Anthem Blue Access,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Blue Access Choice,Anthem Blue Access Choice,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Blue Preferred,Anthem Blue Preferred,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Pathway,Anthem Pathway,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Alliance,Anthem Alliance,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Anthem Medicare,Anthem Medicare,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Cigna,Cigna,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Cigna PPO,Cigna PPO,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Cigna Medicare Advantage,Cigna Medicare Advantage,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Essence,Essence,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Healthlink HMO,Healthlink HMO,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Healthlink PPO,Healthlink PPO,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,HomeState Health Plan,HomeState Health Plan,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Humana Gold,Humana Gold,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Medicaid MO,Medicaid MO,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Medica,Medica,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Tricare,Tricare,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,UHC All Payer,UHC All Payer,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,UHC Exchange,UHC Exchange,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,UHC Medicaid,UHC Medicaid,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,UMR CPD,UMR CPD,179.65,,,,,,,per diem,179.65,179.65,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,UHC Medicare,UHC Medicare,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38250707,CDM,311,RC,,,,,,Inpatient,,,179.65,179.65,Wellcare,Wellcare,179.65,,,,,,,case rate,179.65,179.65,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Meritain Health PPO CPD,Meritain Health PPO CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna/Commercial Product,Aetna/Commercial Product,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Meritain Health CPD,Meritain Health CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Starmark CPD,Starmark CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Aetna Medicare,Aetna Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Ambetter ,Ambetter ,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Access,Anthem Blue Access,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Access Choice,Anthem Blue Access Choice,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Blue Preferred,Anthem Blue Preferred,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Pathway,Anthem Pathway,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Alliance,Anthem Alliance,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Anthem Medicare,Anthem Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna,Cigna,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna PPO,Cigna PPO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Cigna Medicare Advantage,Cigna Medicare Advantage,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Essence,Essence,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthlink HMO,Healthlink HMO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Healthlink PPO,Healthlink PPO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,HomeState Health Plan,HomeState Health Plan,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Humana Gold,Humana Gold,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Medicaid MO,Medicaid MO,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Medica,Medica,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Tricare,Tricare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC All Payer,UHC All Payer,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Exchange,UHC Exchange,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Medicaid,UHC Medicaid,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UMR CPD,UMR CPD,897.21,,,,,,,per diem,897.21,897.21,"Per diem rate, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,UHC Medicare,UHC Medicare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL LEUK BLD          ,38250708,CDM,311,RC,,,,,,Inpatient,,,897.21,897.21,Wellcare,Wellcare,897.21,,,,,,,case rate,897.21,897.21,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Meritain Health PPO CPD,Meritain Health PPO CPD,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Aetna/Commercial Product,Aetna/Commercial Product,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Meritain Health CPD,Meritain Health CPD,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Starmark CPD,Starmark CPD,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Aetna Medicare,Aetna Medicare,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Ambetter ,Ambetter ,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Blue Access,Anthem Blue Access,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Blue Access Choice,Anthem Blue Access Choice,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Blue Preferred,Anthem Blue Preferred,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Pathway,Anthem Pathway,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Alliance,Anthem Alliance,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Anthem Medicare,Anthem Medicare,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Cigna,Cigna,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Cigna PPO,Cigna PPO,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Cigna Medicare Advantage,Cigna Medicare Advantage,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Essence,Essence,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Healthlink HMO,Healthlink HMO,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Healthlink PPO,Healthlink PPO,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,HomeState Health Plan,HomeState Health Plan,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Humana Gold,Humana Gold,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Medicaid MO,Medicaid MO,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Medica,Medica,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Tricare,Tricare,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,UHC All Payer,UHC All Payer,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,UHC Exchange,UHC Exchange,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,UHC Medicaid,UHC Medicaid,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,UMR CPD,UMR CPD,712.31,,,,,,,per diem,712.31,712.31,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,UHC Medicare,UHC Medicare,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38250709,CDM,311,RC,,,,,,Inpatient,,,712.31,712.31,Wellcare,Wellcare,712.31,,,,,,,case rate,712.31,712.31,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O IGF BINDING PROTEIN 3     ,38250710,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O CHLORIDE FLUID            ,38250711,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Meritain Health PPO CPD,Meritain Health PPO CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna/Commercial Product,Aetna/Commercial Product,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Meritain Health CPD,Meritain Health CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Starmark CPD,Starmark CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna Medicare,Aetna Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Ambetter ,Ambetter ,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Access,Anthem Blue Access,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Access Choice,Anthem Blue Access Choice,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Preferred,Anthem Blue Preferred,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Pathway,Anthem Pathway,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Alliance,Anthem Alliance,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Medicare,Anthem Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna,Cigna,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna PPO,Cigna PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna Medicare Advantage,Cigna Medicare Advantage,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Essence,Essence,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthlink HMO,Healthlink HMO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthlink PPO,Healthlink PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,HomeState Health Plan,HomeState Health Plan,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Humana Gold,Humana Gold,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Medicaid MO,Medicaid MO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Medica,Medica,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Tricare,Tricare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC All Payer,UHC All Payer,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Exchange,UHC Exchange,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Medicaid,UHC Medicaid,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UMR CPD,UMR CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Medicare,UHC Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O COCAINE URINE QUANT       ,38250712,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Wellcare,Wellcare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health PPO CPD,Meritain Health PPO CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/Commercial Product,Aetna/Commercial Product,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health CPD,Meritain Health CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Starmark CPD,Starmark CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna Medicare,Aetna Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Ambetter ,Ambetter ,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access,Anthem Blue Access,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access Choice,Anthem Blue Access Choice,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Preferred,Anthem Blue Preferred,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Pathway,Anthem Pathway,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Alliance,Anthem Alliance,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Medicare,Anthem Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna,Cigna,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna PPO,Cigna PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna Medicare Advantage,Cigna Medicare Advantage,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Essence,Essence,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink HMO,Healthlink HMO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink PPO,Healthlink PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,HomeState Health Plan,HomeState Health Plan,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Humana Gold,Humana Gold,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Medicaid MO,Medicaid MO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Medica,Medica,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Tricare,Tricare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC All Payer,UHC All Payer,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Exchange,UHC Exchange,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicaid,UHC Medicaid,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UMR CPD,UMR CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicare,UHC Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CORTISOL SERUM FREE       ,38250713,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Wellcare,Wellcare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health PPO CPD,Meritain Health PPO CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/Commercial Product,Aetna/Commercial Product,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health CPD,Meritain Health CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Starmark CPD,Starmark CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Aetna Medicare,Aetna Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Ambetter ,Ambetter ,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access,Anthem Blue Access,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access Choice,Anthem Blue Access Choice,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Preferred,Anthem Blue Preferred,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Pathway,Anthem Pathway,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Alliance,Anthem Alliance,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Medicare,Anthem Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Cigna,Cigna,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Cigna PPO,Cigna PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Cigna Medicare Advantage,Cigna Medicare Advantage,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Essence,Essence,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink HMO,Healthlink HMO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink PPO,Healthlink PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,HomeState Health Plan,HomeState Health Plan,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Humana Gold,Humana Gold,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Medicaid MO,Medicaid MO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Medica,Medica,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Tricare,Tricare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,UHC All Payer,UHC All Payer,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,UHC Exchange,UHC Exchange,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicaid,UHC Medicaid,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,UMR CPD,UMR CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicare,UHC Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O COXSACKIE A9 AB CF        ,38250714,CDM,302,RC,,,,,,Inpatient,,,349.85,349.85,Wellcare,Wellcare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250715,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250716,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250717,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O ECHOVIRUS AB              ,38250718,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250719,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250720,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250721,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250722,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250723,CDM,302,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Meritain Health PPO CPD,Meritain Health PPO CPD,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Aetna/Commercial Product,Aetna/Commercial Product,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Meritain Health CPD,Meritain Health CPD,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Starmark CPD,Starmark CPD,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Aetna Medicare,Aetna Medicare,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Ambetter ,Ambetter ,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Blue Access,Anthem Blue Access,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Blue Access Choice,Anthem Blue Access Choice,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Blue Preferred,Anthem Blue Preferred,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Pathway,Anthem Pathway,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Alliance,Anthem Alliance,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Anthem Medicare,Anthem Medicare,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Cigna,Cigna,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Cigna PPO,Cigna PPO,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Cigna Medicare Advantage,Cigna Medicare Advantage,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Essence,Essence,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Healthlink HMO,Healthlink HMO,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Healthlink PPO,Healthlink PPO,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,HomeState Health Plan,HomeState Health Plan,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Humana Gold,Humana Gold,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Medicaid MO,Medicaid MO,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Medica,Medica,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Tricare,Tricare,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,UHC All Payer,UHC All Payer,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,UHC Exchange,UHC Exchange,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,UHC Medicaid,UHC Medicaid,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,UMR CPD,UMR CPD,427.59,,,,,,,per diem,427.59,427.59,"Per diem rate, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,UHC Medicare,UHC Medicare,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O COXSACKIE B AB            ,38250724,CDM,302,RC,,,,,,Inpatient,,,427.59,427.59,Wellcare,Wellcare,427.59,,,,,,,case rate,427.59,427.59,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Meritain Health PPO CPD,Meritain Health PPO CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna/Commercial Product,Aetna/Commercial Product,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Meritain Health CPD,Meritain Health CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Starmark CPD,Starmark CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna Medicare,Aetna Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Ambetter ,Ambetter ,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Access,Anthem Blue Access,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Access Choice,Anthem Blue Access Choice,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Preferred,Anthem Blue Preferred,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Pathway,Anthem Pathway,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Alliance,Anthem Alliance,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Medicare,Anthem Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna,Cigna,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna PPO,Cigna PPO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna Medicare Advantage,Cigna Medicare Advantage,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Essence,Essence,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthlink HMO,Healthlink HMO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthlink PPO,Healthlink PPO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,HomeState Health Plan,HomeState Health Plan,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Humana Gold,Humana Gold,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Medicaid MO,Medicaid MO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Medica,Medica,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Tricare,Tricare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC All Payer,UHC All Payer,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Exchange,UHC Exchange,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Medicaid,UHC Medicaid,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UMR CPD,UMR CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Medicare,UHC Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 48H       ,38250725,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Wellcare,Wellcare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Meritain Health PPO CPD,Meritain Health PPO CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna/Commercial Product,Aetna/Commercial Product,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Meritain Health CPD,Meritain Health CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Starmark CPD,Starmark CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Aetna Medicare,Aetna Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Ambetter ,Ambetter ,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Access,Anthem Blue Access,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Access Choice,Anthem Blue Access Choice,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Blue Preferred,Anthem Blue Preferred,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Pathway,Anthem Pathway,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Alliance,Anthem Alliance,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Anthem Medicare,Anthem Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna,Cigna,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna PPO,Cigna PPO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Cigna Medicare Advantage,Cigna Medicare Advantage,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Essence,Essence,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthlink HMO,Healthlink HMO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Healthlink PPO,Healthlink PPO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,HomeState Health Plan,HomeState Health Plan,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Humana Gold,Humana Gold,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Medicaid MO,Medicaid MO,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Medica,Medica,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Tricare,Tricare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC All Payer,UHC All Payer,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Exchange,UHC Exchange,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Medicaid,UHC Medicaid,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UMR CPD,UMR CPD,595.69,,,,,,,per diem,595.69,595.69,"Per diem rate, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,UHC Medicare,UHC Medicare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O FAT FECAL QUANT 72H       ,38250726,CDM,301,RC,,,,,,Inpatient,,,595.69,595.69,Wellcare,Wellcare,595.69,,,,,,,case rate,595.69,595.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O HSV TYPE 1 GLYCO IGG      ,38250727,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYELOMA I                 ,38250728,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Meritain Health PPO CPD,Meritain Health PPO CPD,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Aetna/Commercial Product,Aetna/Commercial Product,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Meritain Health CPD,Meritain Health CPD,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Starmark CPD,Starmark CPD,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Aetna Medicare,Aetna Medicare,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Ambetter ,Ambetter ,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Blue Access,Anthem Blue Access,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Blue Access Choice,Anthem Blue Access Choice,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Blue Preferred,Anthem Blue Preferred,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Pathway,Anthem Pathway,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Alliance,Anthem Alliance,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Anthem Medicare,Anthem Medicare,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Cigna,Cigna,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Cigna PPO,Cigna PPO,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Cigna Medicare Advantage,Cigna Medicare Advantage,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Essence,Essence,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Healthlink HMO,Healthlink HMO,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Healthlink PPO,Healthlink PPO,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,HomeState Health Plan,HomeState Health Plan,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Humana Gold,Humana Gold,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Medicaid MO,Medicaid MO,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Medica,Medica,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Tricare,Tricare,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,UHC All Payer,UHC All Payer,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,UHC Exchange,UHC Exchange,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,UHC Medicaid,UHC Medicaid,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,UMR CPD,UMR CPD,44.13,,,,,,,per diem,44.13,44.13,"Per diem rate, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,UHC Medicare,UHC Medicare,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O BETA2 TRANSFERRIN         ,38250729,CDM,302,RC,,,,,,Inpatient,,,44.13,44.13,Wellcare,Wellcare,44.13,,,,,,,case rate,44.13,44.13,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health PPO CPD,Meritain Health PPO CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/Commercial Product,Aetna/Commercial Product,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health CPD,Meritain Health CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Starmark CPD,Starmark CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna Medicare,Aetna Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Ambetter ,Ambetter ,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access,Anthem Blue Access,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access Choice,Anthem Blue Access Choice,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Preferred,Anthem Blue Preferred,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Pathway,Anthem Pathway,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Alliance,Anthem Alliance,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Medicare,Anthem Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna,Cigna,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna PPO,Cigna PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna Medicare Advantage,Cigna Medicare Advantage,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Essence,Essence,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink HMO,Healthlink HMO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink PPO,Healthlink PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,HomeState Health Plan,HomeState Health Plan,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Humana Gold,Humana Gold,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medicaid MO,Medicaid MO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medica,Medica,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Tricare,Tricare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC All Payer,UHC All Payer,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Exchange,UHC Exchange,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicaid,UHC Medicaid,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UMR CPD,UMR CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicare,UHC Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD URINE                ,38250730,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Wellcare,Wellcare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health PPO CPD,Meritain Health PPO CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/Commercial Product,Aetna/Commercial Product,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health CPD,Meritain Health CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Starmark CPD,Starmark CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna Medicare,Aetna Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Ambetter ,Ambetter ,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access,Anthem Blue Access,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access Choice,Anthem Blue Access Choice,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Preferred,Anthem Blue Preferred,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Pathway,Anthem Pathway,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Alliance,Anthem Alliance,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Medicare,Anthem Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna,Cigna,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna PPO,Cigna PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna Medicare Advantage,Cigna Medicare Advantage,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Essence,Essence,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink HMO,Healthlink HMO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink PPO,Healthlink PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,HomeState Health Plan,HomeState Health Plan,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Humana Gold,Humana Gold,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medicaid MO,Medicaid MO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medica,Medica,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Tricare,Tricare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC All Payer,UHC All Payer,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Exchange,UHC Exchange,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicaid,UHC Medicaid,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UMR CPD,UMR CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicare,UHC Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD VENOUS         ,38250731,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Wellcare,Wellcare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health PPO CPD,Meritain Health PPO CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/Commercial Product,Aetna/Commercial Product,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health CPD,Meritain Health CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Starmark CPD,Starmark CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna Medicare,Aetna Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Ambetter ,Ambetter ,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access,Anthem Blue Access,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access Choice,Anthem Blue Access Choice,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Preferred,Anthem Blue Preferred,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Pathway,Anthem Pathway,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Alliance,Anthem Alliance,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Medicare,Anthem Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna,Cigna,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna PPO,Cigna PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna Medicare Advantage,Cigna Medicare Advantage,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Essence,Essence,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink HMO,Healthlink HMO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink PPO,Healthlink PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,HomeState Health Plan,HomeState Health Plan,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Humana Gold,Humana Gold,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medicaid MO,Medicaid MO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medica,Medica,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Tricare,Tricare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC All Payer,UHC All Payer,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Exchange,UHC Exchange,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicaid,UHC Medicaid,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UMR CPD,UMR CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicare,UHC Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEAD BLOOD CAPILLARY      ,38250732,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Wellcare,Wellcare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health PPO CPD,Meritain Health PPO CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna/Commercial Product,Aetna/Commercial Product,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Meritain Health CPD,Meritain Health CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Starmark CPD,Starmark CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Aetna Medicare,Aetna Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Ambetter ,Ambetter ,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access,Anthem Blue Access,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Access Choice,Anthem Blue Access Choice,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Blue Preferred,Anthem Blue Preferred,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Pathway,Anthem Pathway,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Alliance,Anthem Alliance,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Anthem Medicare,Anthem Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna,Cigna,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna PPO,Cigna PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Cigna Medicare Advantage,Cigna Medicare Advantage,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Essence,Essence,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink HMO,Healthlink HMO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Healthlink PPO,Healthlink PPO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,HomeState Health Plan,HomeState Health Plan,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Humana Gold,Humana Gold,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medicaid MO,Medicaid MO,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Medica,Medica,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Tricare,Tricare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC All Payer,UHC All Payer,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Exchange,UHC Exchange,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicaid,UHC Medicaid,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UMR CPD,UMR CPD,623.01,,,,,,,per diem,623.01,623.01,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,UHC Medicare,UHC Medicare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38250733,CDM,301,RC,,,,,,Inpatient,,,623.01,623.01,Wellcare,Wellcare,623.01,,,,,,,case rate,623.01,623.01,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health PPO CPD,Meritain Health PPO CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/Commercial Product,Aetna/Commercial Product,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health CPD,Meritain Health CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Starmark CPD,Starmark CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna Medicare,Aetna Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Ambetter ,Ambetter ,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access,Anthem Blue Access,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access Choice,Anthem Blue Access Choice,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Preferred,Anthem Blue Preferred,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Pathway,Anthem Pathway,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Alliance,Anthem Alliance,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Medicare,Anthem Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna,Cigna,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna PPO,Cigna PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna Medicare Advantage,Cigna Medicare Advantage,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Essence,Essence,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink HMO,Healthlink HMO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink PPO,Healthlink PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,HomeState Health Plan,HomeState Health Plan,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Humana Gold,Humana Gold,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Medicaid MO,Medicaid MO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Medica,Medica,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Tricare,Tricare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC All Payer,UHC All Payer,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Exchange,UHC Exchange,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicaid,UHC Medicaid,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UMR CPD,UMR CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicare,UHC Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LEPTOSPIRA AB IGM DOT     ,38250734,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Wellcare,Wellcare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Meritain Health PPO CPD,Meritain Health PPO CPD,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Aetna/Commercial Product,Aetna/Commercial Product,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Meritain Health CPD,Meritain Health CPD,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Starmark CPD,Starmark CPD,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Aetna Medicare,Aetna Medicare,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Ambetter ,Ambetter ,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Blue Access,Anthem Blue Access,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Blue Access Choice,Anthem Blue Access Choice,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Blue Preferred,Anthem Blue Preferred,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Pathway,Anthem Pathway,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Alliance,Anthem Alliance,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Anthem Medicare,Anthem Medicare,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Cigna,Cigna,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Cigna PPO,Cigna PPO,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Cigna Medicare Advantage,Cigna Medicare Advantage,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Essence,Essence,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Healthlink HMO,Healthlink HMO,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Healthlink PPO,Healthlink PPO,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,HomeState Health Plan,HomeState Health Plan,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Humana Gold,Humana Gold,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Medicaid MO,Medicaid MO,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Medica,Medica,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Tricare,Tricare,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,UHC All Payer,UHC All Payer,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,UHC Exchange,UHC Exchange,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,UHC Medicaid,UHC Medicaid,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,UMR CPD,UMR CPD,782.7,,,,,,,per diem,782.7,782.7,"Per diem rate, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,UHC Medicare,UHC Medicare,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O METANEPHRINE FRAC UR      ,38250735,CDM,301,RC,,,,,,Inpatient,,,782.7,782.7,Wellcare,Wellcare,782.7,,,,,,,case rate,782.7,782.7,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health PPO CPD,Meritain Health PPO CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/Commercial Product,Aetna/Commercial Product,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health CPD,Meritain Health CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Starmark CPD,Starmark CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna Medicare,Aetna Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Ambetter ,Ambetter ,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access,Anthem Blue Access,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access Choice,Anthem Blue Access Choice,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Preferred,Anthem Blue Preferred,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Pathway,Anthem Pathway,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Alliance,Anthem Alliance,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Medicare,Anthem Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna,Cigna,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna PPO,Cigna PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna Medicare Advantage,Cigna Medicare Advantage,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Essence,Essence,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink HMO,Healthlink HMO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink PPO,Healthlink PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,HomeState Health Plan,HomeState Health Plan,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Humana Gold,Humana Gold,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medicaid MO,Medicaid MO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medica,Medica,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Tricare,Tricare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC All Payer,UHC All Payer,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Exchange,UHC Exchange,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicaid,UHC Medicaid,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UMR CPD,UMR CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicare,UHC Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250736,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Wellcare,Wellcare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health PPO CPD,Meritain Health PPO CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna/Commercial Product,Aetna/Commercial Product,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Meritain Health CPD,Meritain Health CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Starmark CPD,Starmark CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Aetna Medicare,Aetna Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Ambetter ,Ambetter ,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access,Anthem Blue Access,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Access Choice,Anthem Blue Access Choice,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Blue Preferred,Anthem Blue Preferred,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Pathway,Anthem Pathway,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Alliance,Anthem Alliance,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Anthem Medicare,Anthem Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna,Cigna,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna PPO,Cigna PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Cigna Medicare Advantage,Cigna Medicare Advantage,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Essence,Essence,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink HMO,Healthlink HMO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Healthlink PPO,Healthlink PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,HomeState Health Plan,HomeState Health Plan,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Humana Gold,Humana Gold,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medicaid MO,Medicaid MO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Medica,Medica,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Tricare,Tricare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC All Payer,UHC All Payer,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Exchange,UHC Exchange,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicaid,UHC Medicaid,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UMR CPD,UMR CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,UHC Medicare,UHC Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MUMPS AB IGG              ,38250737,CDM,302,RC,,,,,,Inpatient,,,187.01,187.01,Wellcare,Wellcare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUMO IGM     ,38250738,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Meritain Health PPO CPD,Meritain Health PPO CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Aetna/Commercial Product,Aetna/Commercial Product,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Meritain Health CPD,Meritain Health CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Starmark CPD,Starmark CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Aetna Medicare,Aetna Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Ambetter ,Ambetter ,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Access,Anthem Blue Access,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Access Choice,Anthem Blue Access Choice,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Preferred,Anthem Blue Preferred,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Pathway,Anthem Pathway,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Alliance,Anthem Alliance,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Medicare,Anthem Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Cigna,Cigna,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Cigna PPO,Cigna PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Cigna Medicare Advantage,Cigna Medicare Advantage,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Essence,Essence,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Healthlink HMO,Healthlink HMO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Healthlink PPO,Healthlink PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,HomeState Health Plan,HomeState Health Plan,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Humana Gold,Humana Gold,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Medicaid MO,Medicaid MO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Medica,Medica,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Tricare,Tricare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,UHC All Payer,UHC All Payer,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,UHC Exchange,UHC Exchange,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,UHC Medicaid,UHC Medicaid,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,UMR CPD,UMR CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,UHC Medicare,UHC Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA AB IGG         ,38250739,CDM,302,RC,,,,,,Inpatient,,,243.74,243.74,Wellcare,Wellcare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O VARIC ZOST/VZV RT PCR     ,38250740,CDM,306,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Meritain Health PPO CPD,Meritain Health PPO CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna/Commercial Product,Aetna/Commercial Product,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Meritain Health CPD,Meritain Health CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Starmark CPD,Starmark CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna Medicare,Aetna Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Ambetter ,Ambetter ,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Access,Anthem Blue Access,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Access Choice,Anthem Blue Access Choice,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Preferred,Anthem Blue Preferred,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Pathway,Anthem Pathway,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Alliance,Anthem Alliance,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Medicare,Anthem Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna,Cigna,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna PPO,Cigna PPO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna Medicare Advantage,Cigna Medicare Advantage,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Essence,Essence,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthlink HMO,Healthlink HMO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthlink PPO,Healthlink PPO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,HomeState Health Plan,HomeState Health Plan,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Humana Gold,Humana Gold,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Medicaid MO,Medicaid MO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Medica,Medica,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Tricare,Tricare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC All Payer,UHC All Payer,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Exchange,UHC Exchange,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Medicaid,UHC Medicaid,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UMR CPD,UMR CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Medicare,UHC Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O TOXOPLASMA GONDII PCR     ,38250741,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Wellcare,Wellcare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health PPO CPD,Meritain Health PPO CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/Commercial Product,Aetna/Commercial Product,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health CPD,Meritain Health CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Starmark CPD,Starmark CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna Medicare,Aetna Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Ambetter ,Ambetter ,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access,Anthem Blue Access,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access Choice,Anthem Blue Access Choice,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Preferred,Anthem Blue Preferred,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Pathway,Anthem Pathway,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Alliance,Anthem Alliance,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Medicare,Anthem Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna,Cigna,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna PPO,Cigna PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna Medicare Advantage,Cigna Medicare Advantage,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Essence,Essence,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink HMO,Healthlink HMO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink PPO,Healthlink PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,HomeState Health Plan,HomeState Health Plan,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Humana Gold,Humana Gold,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Medicaid MO,Medicaid MO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Medica,Medica,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Tricare,Tricare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC All Payer,UHC All Payer,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Exchange,UHC Exchange,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicaid,UHC Medicaid,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UMR CPD,UMR CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicare,UHC Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR        ,38250742,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Wellcare,Wellcare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health PPO CPD,Meritain Health PPO CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/Commercial Product,Aetna/Commercial Product,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health CPD,Meritain Health CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Starmark CPD,Starmark CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Aetna Medicare,Aetna Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Ambetter ,Ambetter ,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access,Anthem Blue Access,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access Choice,Anthem Blue Access Choice,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Preferred,Anthem Blue Preferred,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Pathway,Anthem Pathway,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Alliance,Anthem Alliance,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Medicare,Anthem Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna,Cigna,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna PPO,Cigna PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Cigna Medicare Advantage,Cigna Medicare Advantage,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Essence,Essence,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink HMO,Healthlink HMO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink PPO,Healthlink PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,HomeState Health Plan,HomeState Health Plan,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Humana Gold,Humana Gold,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Medicaid MO,Medicaid MO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Medica,Medica,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Tricare,Tricare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC All Payer,UHC All Payer,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Exchange,UHC Exchange,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicaid,UHC Medicaid,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UMR CPD,UMR CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicare,UHC Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 PCR BM     ,38250743,CDM,306,RC,,,,,,Inpatient,,,208.02,208.02,Wellcare,Wellcare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR VIRU PCR     ,38250744,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Meritain Health PPO CPD,Meritain Health PPO CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Aetna/Commercial Product,Aetna/Commercial Product,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Meritain Health CPD,Meritain Health CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Starmark CPD,Starmark CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Aetna Medicare,Aetna Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Ambetter ,Ambetter ,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Access,Anthem Blue Access,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Access Choice,Anthem Blue Access Choice,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Blue Preferred,Anthem Blue Preferred,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Pathway,Anthem Pathway,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Alliance,Anthem Alliance,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Anthem Medicare,Anthem Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Cigna,Cigna,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Cigna PPO,Cigna PPO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Cigna Medicare Advantage,Cigna Medicare Advantage,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Essence,Essence,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Healthlink HMO,Healthlink HMO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Healthlink PPO,Healthlink PPO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,HomeState Health Plan,HomeState Health Plan,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Humana Gold,Humana Gold,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Medicaid MO,Medicaid MO,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Medica,Medica,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Tricare,Tricare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,UHC All Payer,UHC All Payer,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,UHC Exchange,UHC Exchange,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,UHC Medicaid,UHC Medicaid,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,UMR CPD,UMR CPD,499.04,,,,,,,per diem,499.04,499.04,"Per diem rate, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,UHC Medicare,UHC Medicare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O WEST NILE RNA RT PCR      ,38250745,CDM,306,RC,,,,,,Inpatient,,,499.04,499.04,Wellcare,Wellcare,499.04,,,,,,,case rate,499.04,499.04,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Meritain Health PPO CPD,Meritain Health PPO CPD,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Aetna/Commercial Product,Aetna/Commercial Product,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Meritain Health CPD,Meritain Health CPD,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Starmark CPD,Starmark CPD,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Aetna Medicare,Aetna Medicare,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Ambetter ,Ambetter ,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Blue Access,Anthem Blue Access,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Blue Access Choice,Anthem Blue Access Choice,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Blue Preferred,Anthem Blue Preferred,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Pathway,Anthem Pathway,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Alliance,Anthem Alliance,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Anthem Medicare,Anthem Medicare,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Cigna,Cigna,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Cigna PPO,Cigna PPO,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Cigna Medicare Advantage,Cigna Medicare Advantage,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Essence,Essence,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Healthlink HMO,Healthlink HMO,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Healthlink PPO,Healthlink PPO,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,HomeState Health Plan,HomeState Health Plan,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Humana Gold,Humana Gold,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Medicaid MO,Medicaid MO,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Medica,Medica,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Tricare,Tricare,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,UHC All Payer,UHC All Payer,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,UHC Exchange,UHC Exchange,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,UHC Medicaid,UHC Medicaid,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,UMR CPD,UMR CPD,923.48,,,,,,,per diem,923.48,923.48,"Per diem rate, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,UHC Medicare,UHC Medicare,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O TROPHERY WHIPPLEI PCR     ,38250746,CDM,306,RC,,,,,,Inpatient,,,923.48,923.48,Wellcare,Wellcare,923.48,,,,,,,case rate,923.48,923.48,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Meritain Health PPO CPD,Meritain Health PPO CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna/Commercial Product,Aetna/Commercial Product,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Meritain Health CPD,Meritain Health CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Starmark CPD,Starmark CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Aetna Medicare,Aetna Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Ambetter ,Ambetter ,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Access,Anthem Blue Access,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Access Choice,Anthem Blue Access Choice,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Blue Preferred,Anthem Blue Preferred,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Pathway,Anthem Pathway,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Alliance,Anthem Alliance,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Anthem Medicare,Anthem Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna,Cigna,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna PPO,Cigna PPO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Cigna Medicare Advantage,Cigna Medicare Advantage,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Essence,Essence,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthlink HMO,Healthlink HMO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Healthlink PPO,Healthlink PPO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,HomeState Health Plan,HomeState Health Plan,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Humana Gold,Humana Gold,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Medicaid MO,Medicaid MO,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Medica,Medica,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Tricare,Tricare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC All Payer,UHC All Payer,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Exchange,UHC Exchange,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Medicaid,UHC Medicaid,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UMR CPD,UMR CPD,254.25,,,,,,,per diem,254.25,254.25,"Per diem rate, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,UHC Medicare,UHC Medicare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O JC VIRUS BY PCR           ,38250747,CDM,306,RC,,,,,,Inpatient,,,254.25,254.25,Wellcare,Wellcare,254.25,,,,,,,case rate,254.25,254.25,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health PPO CPD,Meritain Health PPO CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/Commercial Product,Aetna/Commercial Product,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health CPD,Meritain Health CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Starmark CPD,Starmark CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna Medicare,Aetna Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Ambetter ,Ambetter ,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access,Anthem Blue Access,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access Choice,Anthem Blue Access Choice,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Preferred,Anthem Blue Preferred,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Pathway,Anthem Pathway,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Alliance,Anthem Alliance,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Medicare,Anthem Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna,Cigna,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna PPO,Cigna PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna Medicare Advantage,Cigna Medicare Advantage,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Essence,Essence,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink HMO,Healthlink HMO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink PPO,Healthlink PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,HomeState Health Plan,HomeState Health Plan,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Humana Gold,Humana Gold,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medicaid MO,Medicaid MO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medica,Medica,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Tricare,Tricare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC All Payer,UHC All Payer,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Exchange,UHC Exchange,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicaid,UHC Medicaid,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UMR CPD,UMR CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicare,UHC Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250748,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Wellcare,Wellcare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health PPO CPD,Meritain Health PPO CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/Commercial Product,Aetna/Commercial Product,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health CPD,Meritain Health CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Starmark CPD,Starmark CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna Medicare,Aetna Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Ambetter ,Ambetter ,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access,Anthem Blue Access,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access Choice,Anthem Blue Access Choice,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Preferred,Anthem Blue Preferred,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Pathway,Anthem Pathway,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Alliance,Anthem Alliance,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Medicare,Anthem Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna,Cigna,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna PPO,Cigna PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna Medicare Advantage,Cigna Medicare Advantage,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Essence,Essence,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink HMO,Healthlink HMO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink PPO,Healthlink PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,HomeState Health Plan,HomeState Health Plan,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Humana Gold,Humana Gold,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medicaid MO,Medicaid MO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medica,Medica,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Tricare,Tricare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC All Payer,UHC All Payer,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Exchange,UHC Exchange,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicaid,UHC Medicaid,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UMR CPD,UMR CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicare,UHC Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250749,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Wellcare,Wellcare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health PPO CPD,Meritain Health PPO CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna/Commercial Product,Aetna/Commercial Product,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Meritain Health CPD,Meritain Health CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Starmark CPD,Starmark CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Aetna Medicare,Aetna Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Ambetter ,Ambetter ,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access,Anthem Blue Access,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Access Choice,Anthem Blue Access Choice,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Blue Preferred,Anthem Blue Preferred,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Pathway,Anthem Pathway,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Alliance,Anthem Alliance,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Anthem Medicare,Anthem Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna,Cigna,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna PPO,Cigna PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Cigna Medicare Advantage,Cigna Medicare Advantage,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Essence,Essence,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink HMO,Healthlink HMO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Healthlink PPO,Healthlink PPO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,HomeState Health Plan,HomeState Health Plan,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Humana Gold,Humana Gold,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medicaid MO,Medicaid MO,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Medica,Medica,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Tricare,Tricare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC All Payer,UHC All Payer,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Exchange,UHC Exchange,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicaid,UHC Medicaid,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UMR CPD,UMR CPD,235.33,,,,,,,per diem,235.33,235.33,"Per diem rate, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,UHC Medicare,UHC Medicare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O EHRLIC/ANAPLAS PCR        ,38250750,CDM,306,RC,,,,,,Inpatient,,,235.33,235.33,Wellcare,Wellcare,235.33,,,,,,,case rate,235.33,235.33,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health PPO CPD,Meritain Health PPO CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/Commercial Product,Aetna/Commercial Product,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health CPD,Meritain Health CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Starmark CPD,Starmark CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Aetna Medicare,Aetna Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Ambetter ,Ambetter ,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access,Anthem Blue Access,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access Choice,Anthem Blue Access Choice,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Preferred,Anthem Blue Preferred,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Pathway,Anthem Pathway,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Alliance,Anthem Alliance,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Medicare,Anthem Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Cigna,Cigna,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Cigna PPO,Cigna PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Cigna Medicare Advantage,Cigna Medicare Advantage,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Essence,Essence,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink HMO,Healthlink HMO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink PPO,Healthlink PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,HomeState Health Plan,HomeState Health Plan,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Humana Gold,Humana Gold,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Medicaid MO,Medicaid MO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Medica,Medica,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Tricare,Tricare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,UHC All Payer,UHC All Payer,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,UHC Exchange,UHC Exchange,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicaid,UHC Medicaid,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,UMR CPD,UMR CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicare,UHC Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O M TB RIF RES PCR          ,38250751,CDM,306,RC,,,,,,Inpatient,,,175.45,175.45,Wellcare,Wellcare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health PPO CPD,Meritain Health PPO CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/Commercial Product,Aetna/Commercial Product,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health CPD,Meritain Health CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Starmark CPD,Starmark CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Aetna Medicare,Aetna Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Ambetter ,Ambetter ,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access,Anthem Blue Access,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access Choice,Anthem Blue Access Choice,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Preferred,Anthem Blue Preferred,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Pathway,Anthem Pathway,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Alliance,Anthem Alliance,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Medicare,Anthem Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Cigna,Cigna,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Cigna PPO,Cigna PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Cigna Medicare Advantage,Cigna Medicare Advantage,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Essence,Essence,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink HMO,Healthlink HMO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink PPO,Healthlink PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,HomeState Health Plan,HomeState Health Plan,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Humana Gold,Humana Gold,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Medicaid MO,Medicaid MO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Medica,Medica,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Tricare,Tricare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,UHC All Payer,UHC All Payer,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,UHC Exchange,UHC Exchange,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicaid,UHC Medicaid,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,UMR CPD,UMR CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicare,UHC Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O NOROVIRUS 1&2 PCR         ,38250752,CDM,360,RC,,,,,,Inpatient,,,153.39,153.39,Wellcare,Wellcare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health PPO CPD,Meritain Health PPO CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/Commercial Product,Aetna/Commercial Product,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health CPD,Meritain Health CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Starmark CPD,Starmark CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna Medicare,Aetna Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Ambetter ,Ambetter ,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access,Anthem Blue Access,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access Choice,Anthem Blue Access Choice,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Preferred,Anthem Blue Preferred,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Pathway,Anthem Pathway,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Alliance,Anthem Alliance,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Medicare,Anthem Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna,Cigna,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna PPO,Cigna PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna Medicare Advantage,Cigna Medicare Advantage,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Essence,Essence,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink HMO,Healthlink HMO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink PPO,Healthlink PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,HomeState Health Plan,HomeState Health Plan,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Humana Gold,Humana Gold,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medicaid MO,Medicaid MO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medica,Medica,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Tricare,Tricare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC All Payer,UHC All Payer,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Exchange,UHC Exchange,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicaid,UHC Medicaid,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UMR CPD,UMR CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicare,UHC Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O CHIKUNGUNYA BY PCR        ,38250753,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Wellcare,Wellcare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health PPO CPD,Meritain Health PPO CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Aetna/Commercial Product,Aetna/Commercial Product,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Meritain Health CPD,Meritain Health CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Starmark CPD,Starmark CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Aetna Medicare,Aetna Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Ambetter ,Ambetter ,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access,Anthem Blue Access,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Access Choice,Anthem Blue Access Choice,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Blue Preferred,Anthem Blue Preferred,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Pathway,Anthem Pathway,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Alliance,Anthem Alliance,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Anthem Medicare,Anthem Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Cigna,Cigna,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Cigna PPO,Cigna PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Cigna Medicare Advantage,Cigna Medicare Advantage,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Essence,Essence,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink HMO,Healthlink HMO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Healthlink PPO,Healthlink PPO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,HomeState Health Plan,HomeState Health Plan,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Humana Gold,Humana Gold,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Medicaid MO,Medicaid MO,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Medica,Medica,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Tricare,Tricare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,UHC All Payer,UHC All Payer,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,UHC Exchange,UHC Exchange,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicaid,UHC Medicaid,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,UMR CPD,UMR CPD,320.43,,,,,,,per diem,320.43,320.43,"Per diem rate, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,UHC Medicare,UHC Medicare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O MYOGLOBIN URINE           ,38250754,CDM,301,RC,,,,,,Inpatient,,,320.43,320.43,Wellcare,Wellcare,320.43,,,,,,,case rate,320.43,320.43,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health PPO CPD,Meritain Health PPO CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/Commercial Product,Aetna/Commercial Product,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health CPD,Meritain Health CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Starmark CPD,Starmark CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Aetna Medicare,Aetna Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Ambetter ,Ambetter ,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access,Anthem Blue Access,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access Choice,Anthem Blue Access Choice,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Preferred,Anthem Blue Preferred,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Pathway,Anthem Pathway,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Alliance,Anthem Alliance,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Medicare,Anthem Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Cigna,Cigna,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Cigna PPO,Cigna PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Cigna Medicare Advantage,Cigna Medicare Advantage,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Essence,Essence,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink HMO,Healthlink HMO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink PPO,Healthlink PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,HomeState Health Plan,HomeState Health Plan,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Humana Gold,Humana Gold,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Medicaid MO,Medicaid MO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Medica,Medica,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Tricare,Tricare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,UHC All Payer,UHC All Payer,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,UHC Exchange,UHC Exchange,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicaid,UHC Medicaid,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,UMR CPD,UMR CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicare,UHC Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O OLIGO BAND PROF           ,38250755,CDM,301,RC,,,,,,Inpatient,,,97.71,97.71,Wellcare,Wellcare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250756,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RMSF AB IFA IGG           ,38250757,CDM,302,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250758,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RICKETTSIA IGG/IGM        ,38250759,CDM,302,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOST FREE FEML/CHD     ,38250760,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O TESTOSTERONE FREE         ,38250761,CDM,301,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health PPO CPD,Meritain Health PPO CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Aetna/Commercial Product,Aetna/Commercial Product,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Meritain Health CPD,Meritain Health CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Starmark CPD,Starmark CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Aetna Medicare,Aetna Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Ambetter ,Ambetter ,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access,Anthem Blue Access,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Access Choice,Anthem Blue Access Choice,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Blue Preferred,Anthem Blue Preferred,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Pathway,Anthem Pathway,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Alliance,Anthem Alliance,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Anthem Medicare,Anthem Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Cigna,Cigna,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Cigna PPO,Cigna PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Cigna Medicare Advantage,Cigna Medicare Advantage,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Essence,Essence,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink HMO,Healthlink HMO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Healthlink PPO,Healthlink PPO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,HomeState Health Plan,HomeState Health Plan,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Humana Gold,Humana Gold,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Medicaid MO,Medicaid MO,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Medica,Medica,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Tricare,Tricare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,UHC All Payer,UHC All Payer,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,UHC Exchange,UHC Exchange,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicaid,UHC Medicaid,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,UMR CPD,UMR CPD,198.56,,,,,,,per diem,198.56,198.56,"Per diem rate, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,UHC Medicare,UHC Medicare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LIVER/KIDNY MICROSOME     ,38250762,CDM,302,RC,,,,,,Inpatient,,,198.56,198.56,Wellcare,Wellcare,198.56,,,,,,,case rate,198.56,198.56,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Meritain Health PPO CPD,Meritain Health PPO CPD,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Aetna/Commercial Product,Aetna/Commercial Product,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Meritain Health CPD,Meritain Health CPD,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Starmark CPD,Starmark CPD,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Aetna Medicare,Aetna Medicare,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Ambetter ,Ambetter ,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Blue Access,Anthem Blue Access,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Blue Access Choice,Anthem Blue Access Choice,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Blue Preferred,Anthem Blue Preferred,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Pathway,Anthem Pathway,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Alliance,Anthem Alliance,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Anthem Medicare,Anthem Medicare,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Cigna,Cigna,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Cigna PPO,Cigna PPO,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Cigna Medicare Advantage,Cigna Medicare Advantage,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Essence,Essence,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Healthlink HMO,Healthlink HMO,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Healthlink PPO,Healthlink PPO,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,HomeState Health Plan,HomeState Health Plan,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Humana Gold,Humana Gold,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Medicaid MO,Medicaid MO,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Medica,Medica,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Tricare,Tricare,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,UHC All Payer,UHC All Payer,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,UHC Exchange,UHC Exchange,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,UHC Medicaid,UHC Medicaid,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,UMR CPD,UMR CPD,39.92,,,,,,,per diem,39.92,39.92,"Per diem rate, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,UHC Medicare,UHC Medicare,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O LKM1 AB IGG               ,38250763,CDM,302,RC,,,,,,Inpatient,,,39.92,39.92,Wellcare,Wellcare,39.92,,,,,,,case rate,39.92,39.92,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TOXOPLSM GONDI AB IGG     ,38250764,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Meritain Health PPO CPD,Meritain Health PPO CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna/Commercial Product,Aetna/Commercial Product,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Meritain Health CPD,Meritain Health CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Starmark CPD,Starmark CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Aetna Medicare,Aetna Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Ambetter ,Ambetter ,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Access,Anthem Blue Access,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Access Choice,Anthem Blue Access Choice,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Blue Preferred,Anthem Blue Preferred,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Pathway,Anthem Pathway,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Alliance,Anthem Alliance,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Anthem Medicare,Anthem Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna,Cigna,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna PPO,Cigna PPO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Cigna Medicare Advantage,Cigna Medicare Advantage,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Essence,Essence,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthlink HMO,Healthlink HMO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Healthlink PPO,Healthlink PPO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,HomeState Health Plan,HomeState Health Plan,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Humana Gold,Humana Gold,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Medicaid MO,Medicaid MO,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Medica,Medica,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Tricare,Tricare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC All Payer,UHC All Payer,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Exchange,UHC Exchange,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Medicaid,UHC Medicaid,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UMR CPD,UMR CPD,247.94,,,,,,,per diem,247.94,247.94,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,UHC Medicare,UHC Medicare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250765,CDM,302,RC,,,,,,Inpatient,,,247.94,247.94,Wellcare,Wellcare,247.94,,,,,,,case rate,247.94,247.94,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD POC             ,38250766,CDM,301,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O STAPH AUREUS PANL         ,38250767,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O IMMUNOGLOBULIN E          ,38250768,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health PPO CPD,Meritain Health PPO CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna/Commercial Product,Aetna/Commercial Product,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Meritain Health CPD,Meritain Health CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Starmark CPD,Starmark CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Aetna Medicare,Aetna Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Ambetter ,Ambetter ,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access,Anthem Blue Access,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Access Choice,Anthem Blue Access Choice,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Blue Preferred,Anthem Blue Preferred,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Pathway,Anthem Pathway,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Alliance,Anthem Alliance,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Anthem Medicare,Anthem Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna,Cigna,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna PPO,Cigna PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Cigna Medicare Advantage,Cigna Medicare Advantage,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Essence,Essence,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink HMO,Healthlink HMO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Healthlink PPO,Healthlink PPO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,HomeState Health Plan,HomeState Health Plan,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Humana Gold,Humana Gold,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Medicaid MO,Medicaid MO,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Medica,Medica,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Tricare,Tricare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC All Payer,UHC All Payer,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Exchange,UHC Exchange,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicaid,UHC Medicaid,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UMR CPD,UMR CPD,63.04,,,,,,,per diem,63.04,63.04,"Per diem rate, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,UHC Medicare,UHC Medicare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OVA & PARASIT FECL        ,38250769,CDM,306,RC,,,,,,Inpatient,,,63.04,63.04,Wellcare,Wellcare,63.04,,,,,,,case rate,63.04,63.04,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OSMOLALITY FECAL          ,38250770,CDM,301,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Meritain Health PPO CPD,Meritain Health PPO CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna/Commercial Product,Aetna/Commercial Product,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Meritain Health CPD,Meritain Health CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Starmark CPD,Starmark CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Aetna Medicare,Aetna Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Ambetter ,Ambetter ,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Access,Anthem Blue Access,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Access Choice,Anthem Blue Access Choice,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Blue Preferred,Anthem Blue Preferred,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Pathway,Anthem Pathway,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Alliance,Anthem Alliance,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Anthem Medicare,Anthem Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna,Cigna,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna PPO,Cigna PPO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Cigna Medicare Advantage,Cigna Medicare Advantage,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Essence,Essence,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthlink HMO,Healthlink HMO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Healthlink PPO,Healthlink PPO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,HomeState Health Plan,HomeState Health Plan,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Humana Gold,Humana Gold,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Medicaid MO,Medicaid MO,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Medica,Medica,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Tricare,Tricare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC All Payer,UHC All Payer,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Exchange,UHC Exchange,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Medicaid,UHC Medicaid,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UMR CPD,UMR CPD,232.18,,,,,,,per diem,232.18,232.18,"Per diem rate, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,UHC Medicare,UHC Medicare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM BODY FLUID      ,38250771,CDM,301,RC,,,,,,Inpatient,,,232.18,232.18,Wellcare,Wellcare,232.18,,,,,,,case rate,232.18,232.18,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O POTASSIUM FLUID           ,38250772,CDM,301,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR IX ACTIVITY        ,38250773,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health PPO CPD,Meritain Health PPO CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna/Commercial Product,Aetna/Commercial Product,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Meritain Health CPD,Meritain Health CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Starmark CPD,Starmark CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Aetna Medicare,Aetna Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Ambetter ,Ambetter ,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access,Anthem Blue Access,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Access Choice,Anthem Blue Access Choice,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Blue Preferred,Anthem Blue Preferred,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Pathway,Anthem Pathway,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Alliance,Anthem Alliance,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Anthem Medicare,Anthem Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna,Cigna,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna PPO,Cigna PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Cigna Medicare Advantage,Cigna Medicare Advantage,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Essence,Essence,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink HMO,Healthlink HMO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Healthlink PPO,Healthlink PPO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,HomeState Health Plan,HomeState Health Plan,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Humana Gold,Humana Gold,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medicaid MO,Medicaid MO,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Medica,Medica,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Tricare,Tricare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC All Payer,UHC All Payer,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Exchange,UHC Exchange,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicaid,UHC Medicaid,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UMR CPD,UMR CPD,220.63,,,,,,,per diem,220.63,220.63,"Per diem rate, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,UHC Medicare,UHC Medicare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O IGG CSF INDEX             ,38250774,CDM,301,RC,,,,,,Inpatient,,,220.63,220.63,Wellcare,Wellcare,220.63,,,,,,,case rate,220.63,220.63,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Meritain Health PPO CPD,Meritain Health PPO CPD,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Aetna/Commercial Product,Aetna/Commercial Product,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Meritain Health CPD,Meritain Health CPD,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Starmark CPD,Starmark CPD,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Aetna Medicare,Aetna Medicare,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Ambetter ,Ambetter ,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Blue Access,Anthem Blue Access,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Blue Access Choice,Anthem Blue Access Choice,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Blue Preferred,Anthem Blue Preferred,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Pathway,Anthem Pathway,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Alliance,Anthem Alliance,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Anthem Medicare,Anthem Medicare,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Cigna,Cigna,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Cigna PPO,Cigna PPO,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Cigna Medicare Advantage,Cigna Medicare Advantage,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Essence,Essence,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Healthlink HMO,Healthlink HMO,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Healthlink PPO,Healthlink PPO,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,HomeState Health Plan,HomeState Health Plan,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Humana Gold,Humana Gold,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Medicaid MO,Medicaid MO,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Medica,Medica,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Tricare,Tricare,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,UHC All Payer,UHC All Payer,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,UHC Exchange,UHC Exchange,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,UHC Medicaid,UHC Medicaid,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,UMR CPD,UMR CPD,10.51,,,,,,,per diem,10.51,10.51,"Per diem rate, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,UHC Medicare,UHC Medicare,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O ALBUMIN CSF               ,38250775,CDM,301,RC,,,,,,Inpatient,,,10.51,10.51,Wellcare,Wellcare,10.51,,,,,,,case rate,10.51,10.51,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Meritain Health PPO CPD,Meritain Health PPO CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Aetna/Commercial Product,Aetna/Commercial Product,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Meritain Health CPD,Meritain Health CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Starmark CPD,Starmark CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Aetna Medicare,Aetna Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Ambetter ,Ambetter ,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Blue Access,Anthem Blue Access,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Blue Access Choice,Anthem Blue Access Choice,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Blue Preferred,Anthem Blue Preferred,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Pathway,Anthem Pathway,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Alliance,Anthem Alliance,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Anthem Medicare,Anthem Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Cigna,Cigna,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Cigna PPO,Cigna PPO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Cigna Medicare Advantage,Cigna Medicare Advantage,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Essence,Essence,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Healthlink HMO,Healthlink HMO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Healthlink PPO,Healthlink PPO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,HomeState Health Plan,HomeState Health Plan,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Humana Gold,Humana Gold,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Medicaid MO,Medicaid MO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Medica,Medica,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Tricare,Tricare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,UHC All Payer,UHC All Payer,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,UHC Exchange,UHC Exchange,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,UHC Medicaid,UHC Medicaid,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,UMR CPD,UMR CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,UHC Medicare,UHC Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV2 AB CONF IMMBLOT      ,38250776,CDM,302,RC,,,,,,Inpatient,,,451.76,451.76,Wellcare,Wellcare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health PPO CPD,Meritain Health PPO CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/Commercial Product,Aetna/Commercial Product,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health CPD,Meritain Health CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Starmark CPD,Starmark CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna Medicare,Aetna Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Ambetter ,Ambetter ,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access,Anthem Blue Access,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access Choice,Anthem Blue Access Choice,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Preferred,Anthem Blue Preferred,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Pathway,Anthem Pathway,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Alliance,Anthem Alliance,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Medicare,Anthem Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna,Cigna,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna PPO,Cigna PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna Medicare Advantage,Cigna Medicare Advantage,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Essence,Essence,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink HMO,Healthlink HMO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink PPO,Healthlink PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,HomeState Health Plan,HomeState Health Plan,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Humana Gold,Humana Gold,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Medicaid MO,Medicaid MO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Medica,Medica,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Tricare,Tricare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC All Payer,UHC All Payer,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Exchange,UHC Exchange,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicaid,UHC Medicaid,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UMR CPD,UMR CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicare,UHC Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O HIV1 CONF WESTRN BLOT     ,38250777,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Wellcare,Wellcare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SSA                  ,38250778,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI RNP                  ,38250779,CDM,302,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI JO 1                 ,38250780,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI SMITH                ,38250781,CDM,302,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI CHROMATIN AB         ,38250782,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health PPO CPD,Meritain Health PPO CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/Commercial Product,Aetna/Commercial Product,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health CPD,Meritain Health CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Starmark CPD,Starmark CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Aetna Medicare,Aetna Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Ambetter ,Ambetter ,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access,Anthem Blue Access,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access Choice,Anthem Blue Access Choice,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Preferred,Anthem Blue Preferred,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Pathway,Anthem Pathway,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Alliance,Anthem Alliance,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Medicare,Anthem Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Cigna,Cigna,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Cigna PPO,Cigna PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Cigna Medicare Advantage,Cigna Medicare Advantage,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Essence,Essence,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink HMO,Healthlink HMO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink PPO,Healthlink PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,HomeState Health Plan,HomeState Health Plan,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Humana Gold,Humana Gold,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Medicaid MO,Medicaid MO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Medica,Medica,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Tricare,Tricare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,UHC All Payer,UHC All Payer,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,UHC Exchange,UHC Exchange,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicaid,UHC Medicaid,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,UMR CPD,UMR CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicare,UHC Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANTI SCL 70               ,38250783,CDM,302,RC,,,,,,Inpatient,,,301.52,301.52,Wellcare,Wellcare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250784,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250785,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250786,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250787,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250788,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250789,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250790,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250791,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ANA REFLEX T              ,38250792,CDM,302,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA RNP-U1 AB IGG         ,38250793,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SMITH AB IGG          ,38250794,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SCL-70 AB IGG         ,38250795,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSA AB IGG            ,38250796,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O ENA SSB AB IGG            ,38250797,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PM/SCL-100 AB IGG         ,38250798,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health PPO CPD,Meritain Health PPO CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Aetna/Commercial Product,Aetna/Commercial Product,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Meritain Health CPD,Meritain Health CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Starmark CPD,Starmark CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Aetna Medicare,Aetna Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Ambetter ,Ambetter ,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access,Anthem Blue Access,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Access Choice,Anthem Blue Access Choice,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Blue Preferred,Anthem Blue Preferred,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Pathway,Anthem Pathway,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Alliance,Anthem Alliance,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Anthem Medicare,Anthem Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Cigna,Cigna,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Cigna PPO,Cigna PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Cigna Medicare Advantage,Cigna Medicare Advantage,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Essence,Essence,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink HMO,Healthlink HMO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Healthlink PPO,Healthlink PPO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,HomeState Health Plan,HomeState Health Plan,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Humana Gold,Humana Gold,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Medicaid MO,Medicaid MO,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Medica,Medica,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Tricare,Tricare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,UHC All Payer,UHC All Payer,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,UHC Exchange,UHC Exchange,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicaid,UHC Medicaid,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,UMR CPD,UMR CPD,422.34,,,,,,,per diem,422.34,422.34,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,UHC Medicare,UHC Medicare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U3 AB IGG       ,38250799,CDM,302,RC,,,,,,Inpatient,,,422.34,422.34,Wellcare,Wellcare,422.34,,,,,,,case rate,422.34,422.34,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER RNP-U1 AB IGG       ,38250800,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER SCL-70 AB IGG       ,38250801,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SCLER PM/SCL-100 IGG      ,38250802,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU2IGG     ,38250803,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP RNPU1IGG     ,38250804,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O MYOS AB COMP SSA IGG      ,38250805,CDM,302,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health PPO CPD,Meritain Health PPO CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/Commercial Product,Aetna/Commercial Product,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health CPD,Meritain Health CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Starmark CPD,Starmark CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna Medicare,Aetna Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Ambetter ,Ambetter ,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access,Anthem Blue Access,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access Choice,Anthem Blue Access Choice,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Preferred,Anthem Blue Preferred,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Pathway,Anthem Pathway,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Alliance,Anthem Alliance,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Medicare,Anthem Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna,Cigna,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna PPO,Cigna PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna Medicare Advantage,Cigna Medicare Advantage,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Essence,Essence,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink HMO,Healthlink HMO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink PPO,Healthlink PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,HomeState Health Plan,HomeState Health Plan,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Humana Gold,Humana Gold,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Medicaid MO,Medicaid MO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Medica,Medica,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Tricare,Tricare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC All Payer,UHC All Payer,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Exchange,UHC Exchange,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicaid,UHC Medicaid,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UMR CPD,UMR CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicare,UHC Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR RAN     ,38250806,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Wellcare,Wellcare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health PPO CPD,Meritain Health PPO CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/Commercial Product,Aetna/Commercial Product,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health CPD,Meritain Health CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Starmark CPD,Starmark CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Aetna Medicare,Aetna Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Ambetter ,Ambetter ,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access,Anthem Blue Access,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access Choice,Anthem Blue Access Choice,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Preferred,Anthem Blue Preferred,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Pathway,Anthem Pathway,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Alliance,Anthem Alliance,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Medicare,Anthem Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna,Cigna,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna PPO,Cigna PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Cigna Medicare Advantage,Cigna Medicare Advantage,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Essence,Essence,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink HMO,Healthlink HMO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink PPO,Healthlink PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,HomeState Health Plan,HomeState Health Plan,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Humana Gold,Humana Gold,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Medicaid MO,Medicaid MO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Medica,Medica,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Tricare,Tricare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC All Payer,UHC All Payer,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Exchange,UHC Exchange,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicaid,UHC Medicaid,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UMR CPD,UMR CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicare,UHC Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN ELECTR UR 24H     ,38250807,CDM,301,RC,,,,,,Inpatient,,,64.09,64.09,Wellcare,Wellcare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Meritain Health PPO CPD,Meritain Health PPO CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Aetna/Commercial Product,Aetna/Commercial Product,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Meritain Health CPD,Meritain Health CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Starmark CPD,Starmark CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Aetna Medicare,Aetna Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Ambetter ,Ambetter ,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Blue Access,Anthem Blue Access,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Blue Access Choice,Anthem Blue Access Choice,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Blue Preferred,Anthem Blue Preferred,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Pathway,Anthem Pathway,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Alliance,Anthem Alliance,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Anthem Medicare,Anthem Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Cigna,Cigna,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Cigna PPO,Cigna PPO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Cigna Medicare Advantage,Cigna Medicare Advantage,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Essence,Essence,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Healthlink HMO,Healthlink HMO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Healthlink PPO,Healthlink PPO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,HomeState Health Plan,HomeState Health Plan,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Humana Gold,Humana Gold,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Medicaid MO,Medicaid MO,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Medica,Medica,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Tricare,Tricare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,UHC All Payer,UHC All Payer,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,UHC Exchange,UHC Exchange,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,UHC Medicaid,UHC Medicaid,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,UMR CPD,UMR CPD,287.86,,,,,,,per diem,287.86,287.86,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,UHC Medicare,UHC Medicare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250808,CDM,302,RC,,,,,,Inpatient,,,287.86,287.86,Wellcare,Wellcare,287.86,,,,,,,case rate,287.86,287.86,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health PPO CPD,Meritain Health PPO CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/Commercial Product,Aetna/Commercial Product,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health CPD,Meritain Health CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Starmark CPD,Starmark CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Aetna Medicare,Aetna Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Ambetter ,Ambetter ,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access,Anthem Blue Access,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access Choice,Anthem Blue Access Choice,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Preferred,Anthem Blue Preferred,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Pathway,Anthem Pathway,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Alliance,Anthem Alliance,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Medicare,Anthem Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Cigna,Cigna,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Cigna PPO,Cigna PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Cigna Medicare Advantage,Cigna Medicare Advantage,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Essence,Essence,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink HMO,Healthlink HMO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink PPO,Healthlink PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,HomeState Health Plan,HomeState Health Plan,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Humana Gold,Humana Gold,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Medicaid MO,Medicaid MO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Medica,Medica,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Tricare,Tricare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,UHC All Payer,UHC All Payer,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,UHC Exchange,UHC Exchange,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicaid,UHC Medicaid,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,UMR CPD,UMR CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicare,UHC Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O BENCE JONES PROTN IFE     ,38250809,CDM,302,RC,,,,,,Inpatient,,,138.68,138.68,Wellcare,Wellcare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Meritain Health PPO CPD,Meritain Health PPO CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Aetna/Commercial Product,Aetna/Commercial Product,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Meritain Health CPD,Meritain Health CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Starmark CPD,Starmark CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Aetna Medicare,Aetna Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Ambetter ,Ambetter ,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Access,Anthem Blue Access,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Access Choice,Anthem Blue Access Choice,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Preferred,Anthem Blue Preferred,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Pathway,Anthem Pathway,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Alliance,Anthem Alliance,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Medicare,Anthem Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Cigna,Cigna,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Cigna PPO,Cigna PPO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Cigna Medicare Advantage,Cigna Medicare Advantage,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Essence,Essence,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Healthlink HMO,Healthlink HMO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Healthlink PPO,Healthlink PPO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,HomeState Health Plan,HomeState Health Plan,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Humana Gold,Humana Gold,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Medicaid MO,Medicaid MO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Medica,Medica,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Tricare,Tricare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,UHC All Payer,UHC All Payer,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,UHC Exchange,UHC Exchange,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,UHC Medicaid,UHC Medicaid,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,UMR CPD,UMR CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,UHC Medicare,UHC Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O IMMUNOFIX ELECTRO-URN     ,38250810,CDM,302,RC,,,,,,Inpatient,,,129.22,129.22,Wellcare,Wellcare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Meritain Health PPO CPD,Meritain Health PPO CPD,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Aetna/Commercial Product,Aetna/Commercial Product,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Meritain Health CPD,Meritain Health CPD,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Starmark CPD,Starmark CPD,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Aetna Medicare,Aetna Medicare,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Ambetter ,Ambetter ,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Blue Access,Anthem Blue Access,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Blue Access Choice,Anthem Blue Access Choice,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Blue Preferred,Anthem Blue Preferred,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Pathway,Anthem Pathway,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Alliance,Anthem Alliance,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Anthem Medicare,Anthem Medicare,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Cigna,Cigna,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Cigna PPO,Cigna PPO,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Cigna Medicare Advantage,Cigna Medicare Advantage,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Essence,Essence,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Healthlink HMO,Healthlink HMO,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Healthlink PPO,Healthlink PPO,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,HomeState Health Plan,HomeState Health Plan,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Humana Gold,Humana Gold,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Medicaid MO,Medicaid MO,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Medica,Medica,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Tricare,Tricare,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,UHC All Payer,UHC All Payer,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,UHC Exchange,UHC Exchange,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,UHC Medicaid,UHC Medicaid,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,UMR CPD,UMR CPD,372.96,,,,,,,per diem,372.96,372.96,"Per diem rate, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,UHC Medicare,UHC Medicare,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O COENZYME Q10 TOTAL        ,38250811,CDM,301,RC,,,,,,Inpatient,,,372.96,372.96,Wellcare,Wellcare,372.96,,,,,,,case rate,372.96,372.96,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O PTH RELATED PEPTIDE       ,38250812,CDM,301,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV VCA IGM               ,38250813,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Meritain Health PPO CPD,Meritain Health PPO CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Aetna/Commercial Product,Aetna/Commercial Product,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Meritain Health CPD,Meritain Health CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Starmark CPD,Starmark CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Aetna Medicare,Aetna Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Ambetter ,Ambetter ,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Blue Access,Anthem Blue Access,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Blue Access Choice,Anthem Blue Access Choice,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Blue Preferred,Anthem Blue Preferred,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Pathway,Anthem Pathway,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Alliance,Anthem Alliance,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Anthem Medicare,Anthem Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Cigna,Cigna,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Cigna PPO,Cigna PPO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Cigna Medicare Advantage,Cigna Medicare Advantage,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Essence,Essence,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Healthlink HMO,Healthlink HMO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Healthlink PPO,Healthlink PPO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,HomeState Health Plan,HomeState Health Plan,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Humana Gold,Humana Gold,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Medicaid MO,Medicaid MO,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Medica,Medica,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Tricare,Tricare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,UHC All Payer,UHC All Payer,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,UHC Exchange,UHC Exchange,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,UHC Medicaid,UHC Medicaid,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,UMR CPD,UMR CPD,347.75,,,,,,,per diem,347.75,347.75,"Per diem rate, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,UHC Medicare,UHC Medicare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LIBRIUM/NORDIAZEPAM       ,38250814,CDM,301,RC,,,,,,Inpatient,,,347.75,347.75,Wellcare,Wellcare,347.75,,,,,,,case rate,347.75,347.75,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health PPO CPD,Meritain Health PPO CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/Commercial Product,Aetna/Commercial Product,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health CPD,Meritain Health CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Starmark CPD,Starmark CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Aetna Medicare,Aetna Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Ambetter ,Ambetter ,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access,Anthem Blue Access,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access Choice,Anthem Blue Access Choice,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Preferred,Anthem Blue Preferred,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Pathway,Anthem Pathway,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Alliance,Anthem Alliance,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Medicare,Anthem Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Cigna,Cigna,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Cigna PPO,Cigna PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Cigna Medicare Advantage,Cigna Medicare Advantage,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Essence,Essence,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink HMO,Healthlink HMO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink PPO,Healthlink PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,HomeState Health Plan,HomeState Health Plan,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Humana Gold,Humana Gold,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Medicaid MO,Medicaid MO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Medica,Medica,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Tricare,Tricare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,UHC All Payer,UHC All Payer,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,UHC Exchange,UHC Exchange,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicaid,UHC Medicaid,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,UMR CPD,UMR CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicare,UHC Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O LORAZEPAM                 ,38250815,CDM,301,RC,,,,,,Inpatient,,,89.3,89.3,Wellcare,Wellcare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BENZODIAZ CONF/QNT SP     ,38250816,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health PPO CPD,Meritain Health PPO CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/Commercial Product,Aetna/Commercial Product,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health CPD,Meritain Health CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Starmark CPD,Starmark CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna Medicare,Aetna Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Ambetter ,Ambetter ,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access,Anthem Blue Access,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access Choice,Anthem Blue Access Choice,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Preferred,Anthem Blue Preferred,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Pathway,Anthem Pathway,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Alliance,Anthem Alliance,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Medicare,Anthem Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna,Cigna,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna PPO,Cigna PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna Medicare Advantage,Cigna Medicare Advantage,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Essence,Essence,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink HMO,Healthlink HMO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink PPO,Healthlink PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,HomeState Health Plan,HomeState Health Plan,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Humana Gold,Humana Gold,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medicaid MO,Medicaid MO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medica,Medica,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Tricare,Tricare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC All Payer,UHC All Payer,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Exchange,UHC Exchange,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicaid,UHC Medicaid,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UMR CPD,UMR CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicare,UHC Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O BJ PROTEIN QUAL UR        ,38250817,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Wellcare,Wellcare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health PPO CPD,Meritain Health PPO CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/Commercial Product,Aetna/Commercial Product,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health CPD,Meritain Health CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Starmark CPD,Starmark CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna Medicare,Aetna Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Ambetter ,Ambetter ,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access,Anthem Blue Access,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access Choice,Anthem Blue Access Choice,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Preferred,Anthem Blue Preferred,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Pathway,Anthem Pathway,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Alliance,Anthem Alliance,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Medicare,Anthem Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna,Cigna,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna PPO,Cigna PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna Medicare Advantage,Cigna Medicare Advantage,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Essence,Essence,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink HMO,Healthlink HMO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink PPO,Healthlink PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,HomeState Health Plan,HomeState Health Plan,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Humana Gold,Humana Gold,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medicaid MO,Medicaid MO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medica,Medica,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Tricare,Tricare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC All Payer,UHC All Payer,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Exchange,UHC Exchange,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicaid,UHC Medicaid,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UMR CPD,UMR CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicare,UHC Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250818,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Wellcare,Wellcare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Meritain Health PPO CPD,Meritain Health PPO CPD,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Aetna/Commercial Product,Aetna/Commercial Product,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Meritain Health CPD,Meritain Health CPD,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Starmark CPD,Starmark CPD,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Aetna Medicare,Aetna Medicare,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Ambetter ,Ambetter ,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Blue Access,Anthem Blue Access,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Blue Access Choice,Anthem Blue Access Choice,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Blue Preferred,Anthem Blue Preferred,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Pathway,Anthem Pathway,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Alliance,Anthem Alliance,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Anthem Medicare,Anthem Medicare,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Cigna,Cigna,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Cigna PPO,Cigna PPO,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Cigna Medicare Advantage,Cigna Medicare Advantage,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Essence,Essence,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Healthlink HMO,Healthlink HMO,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Healthlink PPO,Healthlink PPO,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,HomeState Health Plan,HomeState Health Plan,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Humana Gold,Humana Gold,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Medicaid MO,Medicaid MO,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Medica,Medica,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Tricare,Tricare,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,UHC All Payer,UHC All Payer,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,UHC Exchange,UHC Exchange,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,UHC Medicaid,UHC Medicaid,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,UMR CPD,UMR CPD,702.85,,,,,,,per diem,702.85,702.85,"Per diem rate, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,UHC Medicare,UHC Medicare,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
S/O HEPARIN ANTI XA LMWH      ,38250819,CDM,305,RC,,,,,,Inpatient,,,702.85,702.85,Wellcare,Wellcare,702.85,,,,,,,case rate,702.85,702.85,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
HEPARIN ANTI-XA UNFRC         ,38250820,CDM,305,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Meritain Health PPO CPD,Meritain Health PPO CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Aetna/Commercial Product,Aetna/Commercial Product,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Meritain Health CPD,Meritain Health CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Starmark CPD,Starmark CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Aetna Medicare,Aetna Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Ambetter ,Ambetter ,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Access,Anthem Blue Access,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Access Choice,Anthem Blue Access Choice,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Blue Preferred,Anthem Blue Preferred,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Pathway,Anthem Pathway,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Alliance,Anthem Alliance,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Anthem Medicare,Anthem Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Cigna,Cigna,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Cigna PPO,Cigna PPO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Cigna Medicare Advantage,Cigna Medicare Advantage,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Essence,Essence,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Healthlink HMO,Healthlink HMO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Healthlink PPO,Healthlink PPO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,HomeState Health Plan,HomeState Health Plan,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Humana Gold,Humana Gold,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Medicaid MO,Medicaid MO,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Medica,Medica,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Tricare,Tricare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,UHC All Payer,UHC All Payer,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,UHC Exchange,UHC Exchange,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,UHC Medicaid,UHC Medicaid,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,UMR CPD,UMR CPD,184.91,,,,,,,per diem,184.91,184.91,"Per diem rate, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,UHC Medicare,UHC Medicare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O RETICULIN IGA TITER       ,38250821,CDM,302,RC,,,,,,Inpatient,,,184.91,184.91,Wellcare,Wellcare,184.91,,,,,,,case rate,184.91,184.91,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Meritain Health PPO CPD,Meritain Health PPO CPD,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Aetna/Commercial Product,Aetna/Commercial Product,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Meritain Health CPD,Meritain Health CPD,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Starmark CPD,Starmark CPD,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Aetna Medicare,Aetna Medicare,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Ambetter ,Ambetter ,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Blue Access,Anthem Blue Access,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Blue Access Choice,Anthem Blue Access Choice,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Blue Preferred,Anthem Blue Preferred,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Pathway,Anthem Pathway,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Alliance,Anthem Alliance,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Anthem Medicare,Anthem Medicare,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Cigna,Cigna,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Cigna PPO,Cigna PPO,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Cigna Medicare Advantage,Cigna Medicare Advantage,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Essence,Essence,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Healthlink HMO,Healthlink HMO,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Healthlink PPO,Healthlink PPO,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,HomeState Health Plan,HomeState Health Plan,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Humana Gold,Humana Gold,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Medicaid MO,Medicaid MO,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Medica,Medica,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Tricare,Tricare,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,UHC All Payer,UHC All Payer,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,UHC Exchange,UHC Exchange,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,UHC Medicaid,UHC Medicaid,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,UMR CPD,UMR CPD,191.21,,,,,,,per diem,191.21,191.21,"Per diem rate, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,UHC Medicare,UHC Medicare,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O ENDOMYSIAL AB IGA IFA     ,38250822,CDM,302,RC,,,,,,Inpatient,,,191.21,191.21,Wellcare,Wellcare,191.21,,,,,,,case rate,191.21,191.21,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O STRIAT MUSC IGG TITER     ,38250823,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Meritain Health PPO CPD,Meritain Health PPO CPD,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Aetna/Commercial Product,Aetna/Commercial Product,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Meritain Health CPD,Meritain Health CPD,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Starmark CPD,Starmark CPD,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Aetna Medicare,Aetna Medicare,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Ambetter ,Ambetter ,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Blue Access,Anthem Blue Access,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Blue Access Choice,Anthem Blue Access Choice,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Blue Preferred,Anthem Blue Preferred,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Pathway,Anthem Pathway,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Alliance,Anthem Alliance,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Anthem Medicare,Anthem Medicare,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Cigna,Cigna,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Cigna PPO,Cigna PPO,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Cigna Medicare Advantage,Cigna Medicare Advantage,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Essence,Essence,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Healthlink HMO,Healthlink HMO,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Healthlink PPO,Healthlink PPO,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,HomeState Health Plan,HomeState Health Plan,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Humana Gold,Humana Gold,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Medicaid MO,Medicaid MO,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Medica,Medica,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Tricare,Tricare,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,UHC All Payer,UHC All Payer,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,UHC Exchange,UHC Exchange,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,UHC Medicaid,UHC Medicaid,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,UMR CPD,UMR CPD,114.52,,,,,,,per diem,114.52,114.52,"Per diem rate, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,UHC Medicare,UHC Medicare,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O MYOCARDIAL IGG TITER      ,38250824,CDM,302,RC,,,,,,Inpatient,,,114.52,114.52,Wellcare,Wellcare,114.52,,,,,,,case rate,114.52,114.52,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Meritain Health PPO CPD,Meritain Health PPO CPD,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Aetna/Commercial Product,Aetna/Commercial Product,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Meritain Health CPD,Meritain Health CPD,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Starmark CPD,Starmark CPD,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Aetna Medicare,Aetna Medicare,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Ambetter ,Ambetter ,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Blue Access,Anthem Blue Access,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Blue Access Choice,Anthem Blue Access Choice,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Blue Preferred,Anthem Blue Preferred,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Pathway,Anthem Pathway,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Alliance,Anthem Alliance,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Anthem Medicare,Anthem Medicare,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Cigna,Cigna,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Cigna PPO,Cigna PPO,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Cigna Medicare Advantage,Cigna Medicare Advantage,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Essence,Essence,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Healthlink HMO,Healthlink HMO,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Healthlink PPO,Healthlink PPO,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,HomeState Health Plan,HomeState Health Plan,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Humana Gold,Humana Gold,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Medicaid MO,Medicaid MO,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Medica,Medica,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Tricare,Tricare,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,UHC All Payer,UHC All Payer,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,UHC Exchange,UHC Exchange,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,UHC Medicaid,UHC Medicaid,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,UMR CPD,UMR CPD,510.59,,,,,,,per diem,510.59,510.59,"Per diem rate, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,UHC Medicare,UHC Medicare,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O YO AB TITER               ,38250825,CDM,302,RC,,,,,,Inpatient,,,510.59,510.59,Wellcare,Wellcare,510.59,,,,,,,case rate,510.59,510.59,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health PPO CPD,Meritain Health PPO CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna/Commercial Product,Aetna/Commercial Product,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Meritain Health CPD,Meritain Health CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Starmark CPD,Starmark CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Aetna Medicare,Aetna Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Ambetter ,Ambetter ,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access,Anthem Blue Access,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Access Choice,Anthem Blue Access Choice,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Blue Preferred,Anthem Blue Preferred,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Pathway,Anthem Pathway,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Alliance,Anthem Alliance,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Anthem Medicare,Anthem Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna,Cigna,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna PPO,Cigna PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Cigna Medicare Advantage,Cigna Medicare Advantage,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Essence,Essence,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink HMO,Healthlink HMO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Healthlink PPO,Healthlink PPO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,HomeState Health Plan,HomeState Health Plan,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Humana Gold,Humana Gold,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medicaid MO,Medicaid MO,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Medica,Medica,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Tricare,Tricare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC All Payer,UHC All Payer,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Exchange,UHC Exchange,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicaid,UHC Medicaid,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UMR CPD,UMR CPD,115.57,,,,,,,per diem,115.57,115.57,"Per diem rate, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,UHC Medicare,UHC Medicare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O SMOOTH MUSC IGG TITER     ,38250826,CDM,302,RC,,,,,,Inpatient,,,115.57,115.57,Wellcare,Wellcare,115.57,,,,,,,case rate,115.57,115.57,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health PPO CPD,Meritain Health PPO CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Aetna/Commercial Product,Aetna/Commercial Product,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Meritain Health CPD,Meritain Health CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Starmark CPD,Starmark CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Aetna Medicare,Aetna Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Ambetter ,Ambetter ,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access,Anthem Blue Access,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Access Choice,Anthem Blue Access Choice,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Blue Preferred,Anthem Blue Preferred,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Pathway,Anthem Pathway,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Alliance,Anthem Alliance,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Anthem Medicare,Anthem Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Cigna,Cigna,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Cigna PPO,Cigna PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Cigna Medicare Advantage,Cigna Medicare Advantage,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Essence,Essence,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink HMO,Healthlink HMO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Healthlink PPO,Healthlink PPO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,HomeState Health Plan,HomeState Health Plan,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Humana Gold,Humana Gold,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Medicaid MO,Medicaid MO,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Medica,Medica,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Tricare,Tricare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,UHC All Payer,UHC All Payer,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,UHC Exchange,UHC Exchange,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicaid,UHC Medicaid,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,UMR CPD,UMR CPD,131.33,,,,,,,per diem,131.33,131.33,"Per diem rate, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,UHC Medicare,UHC Medicare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O ANCA TITER                ,38250827,CDM,302,RC,,,,,,Inpatient,,,131.33,131.33,Wellcare,Wellcare,131.33,,,,,,,case rate,131.33,131.33,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Meritain Health PPO CPD,Meritain Health PPO CPD,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Aetna/Commercial Product,Aetna/Commercial Product,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Meritain Health CPD,Meritain Health CPD,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Starmark CPD,Starmark CPD,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Aetna Medicare,Aetna Medicare,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Ambetter ,Ambetter ,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Blue Access,Anthem Blue Access,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Blue Access Choice,Anthem Blue Access Choice,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Blue Preferred,Anthem Blue Preferred,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Pathway,Anthem Pathway,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Alliance,Anthem Alliance,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Anthem Medicare,Anthem Medicare,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Cigna,Cigna,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Cigna PPO,Cigna PPO,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Cigna Medicare Advantage,Cigna Medicare Advantage,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Essence,Essence,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Healthlink HMO,Healthlink HMO,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Healthlink PPO,Healthlink PPO,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,HomeState Health Plan,HomeState Health Plan,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Humana Gold,Humana Gold,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Medicaid MO,Medicaid MO,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Medica,Medica,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Tricare,Tricare,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,UHC All Payer,UHC All Payer,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,UHC Exchange,UHC Exchange,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,UHC Medicaid,UHC Medicaid,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,UMR CPD,UMR CPD,744.88,,,,,,,per diem,744.88,744.88,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,UHC Medicare,UHC Medicare,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250828,CDM,302,RC,,,,,,Inpatient,,,744.88,744.88,Wellcare,Wellcare,744.88,,,,,,,case rate,744.88,744.88,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O DSDNA IGG IFA             ,38250829,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O SCLER CENTROMERE IFA      ,38250830,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Meritain Health PPO CPD,Meritain Health PPO CPD,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Aetna/Commercial Product,Aetna/Commercial Product,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Meritain Health CPD,Meritain Health CPD,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Starmark CPD,Starmark CPD,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Aetna Medicare,Aetna Medicare,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Ambetter ,Ambetter ,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Blue Access,Anthem Blue Access,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Blue Access Choice,Anthem Blue Access Choice,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Blue Preferred,Anthem Blue Preferred,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Pathway,Anthem Pathway,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Alliance,Anthem Alliance,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Anthem Medicare,Anthem Medicare,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Cigna,Cigna,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Cigna PPO,Cigna PPO,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Cigna Medicare Advantage,Cigna Medicare Advantage,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Essence,Essence,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Healthlink HMO,Healthlink HMO,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Healthlink PPO,Healthlink PPO,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,HomeState Health Plan,HomeState Health Plan,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Humana Gold,Humana Gold,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Medicaid MO,Medicaid MO,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Medica,Medica,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Tricare,Tricare,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,UHC All Payer,UHC All Payer,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,UHC Exchange,UHC Exchange,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,UHC Medicaid,UHC Medicaid,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,UMR CPD,UMR CPD,383.47,,,,,,,per diem,383.47,383.47,"Per diem rate, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,UHC Medicare,UHC Medicare,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O NMDA AB IGG TITER         ,38250831,CDM,302,RC,,,,,,Inpatient,,,383.47,383.47,Wellcare,Wellcare,383.47,,,,,,,case rate,383.47,383.47,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Meritain Health PPO CPD,Meritain Health PPO CPD,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Aetna/Commercial Product,Aetna/Commercial Product,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Meritain Health CPD,Meritain Health CPD,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Starmark CPD,Starmark CPD,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Aetna Medicare,Aetna Medicare,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Ambetter ,Ambetter ,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Blue Access,Anthem Blue Access,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Blue Access Choice,Anthem Blue Access Choice,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Blue Preferred,Anthem Blue Preferred,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Pathway,Anthem Pathway,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Alliance,Anthem Alliance,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Anthem Medicare,Anthem Medicare,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Cigna,Cigna,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Cigna PPO,Cigna PPO,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Cigna Medicare Advantage,Cigna Medicare Advantage,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Essence,Essence,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Healthlink HMO,Healthlink HMO,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Healthlink PPO,Healthlink PPO,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,HomeState Health Plan,HomeState Health Plan,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Humana Gold,Humana Gold,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Medicaid MO,Medicaid MO,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Medica,Medica,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Tricare,Tricare,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,UHC All Payer,UHC All Payer,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,UHC Exchange,UHC Exchange,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,UHC Medicaid,UHC Medicaid,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,UMR CPD,UMR CPD,625.11,,,,,,,per diem,625.11,625.11,"Per diem rate, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,UHC Medicare,UHC Medicare,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AQUPRIN-4 AB TTR RFLX     ,38250832,CDM,302,RC,,,,,,Inpatient,,,625.11,625.11,Wellcare,Wellcare,625.11,,,,,,,case rate,625.11,625.11,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Meritain Health PPO CPD,Meritain Health PPO CPD,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Aetna/Commercial Product,Aetna/Commercial Product,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Meritain Health CPD,Meritain Health CPD,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Starmark CPD,Starmark CPD,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Aetna Medicare,Aetna Medicare,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Ambetter ,Ambetter ,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Blue Access,Anthem Blue Access,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Blue Access Choice,Anthem Blue Access Choice,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Blue Preferred,Anthem Blue Preferred,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Pathway,Anthem Pathway,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Alliance,Anthem Alliance,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Anthem Medicare,Anthem Medicare,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Cigna,Cigna,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Cigna PPO,Cigna PPO,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Cigna Medicare Advantage,Cigna Medicare Advantage,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Essence,Essence,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Healthlink HMO,Healthlink HMO,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Healthlink PPO,Healthlink PPO,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,HomeState Health Plan,HomeState Health Plan,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Humana Gold,Humana Gold,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Medicaid MO,Medicaid MO,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Medica,Medica,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Tricare,Tricare,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,UHC All Payer,UHC All Payer,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,UHC Exchange,UHC Exchange,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,UHC Medicaid,UHC Medicaid,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,UMR CPD,UMR CPD,666.08,,,,,,,per diem,666.08,666.08,"Per diem rate, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,UHC Medicare,UHC Medicare,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O AFB ISOLATION REFLEX      ,38250833,CDM,306,RC,,,,,,Inpatient,,,666.08,666.08,Wellcare,Wellcare,666.08,,,,,,,case rate,666.08,666.08,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR XIII 1:1 MIX       ,38250834,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health PPO CPD,Meritain Health PPO CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna/Commercial Product,Aetna/Commercial Product,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Meritain Health CPD,Meritain Health CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Starmark CPD,Starmark CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Aetna Medicare,Aetna Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Ambetter ,Ambetter ,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access,Anthem Blue Access,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Access Choice,Anthem Blue Access Choice,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Blue Preferred,Anthem Blue Preferred,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Pathway,Anthem Pathway,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Alliance,Anthem Alliance,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Anthem Medicare,Anthem Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna,Cigna,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna PPO,Cigna PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Cigna Medicare Advantage,Cigna Medicare Advantage,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Essence,Essence,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink HMO,Healthlink HMO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Healthlink PPO,Healthlink PPO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,HomeState Health Plan,HomeState Health Plan,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Humana Gold,Humana Gold,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Medicaid MO,Medicaid MO,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Medica,Medica,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Tricare,Tricare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC All Payer,UHC All Payer,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Exchange,UHC Exchange,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicaid,UHC Medicaid,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UMR CPD,UMR CPD,73.54,,,,,,,per diem,73.54,73.54,"Per diem rate, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,UHC Medicare,UHC Medicare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O FACTOR V ACTIVITY         ,38250835,CDM,305,RC,,,,,,Inpatient,,,73.54,73.54,Wellcare,Wellcare,73.54,,,,,,,case rate,73.54,73.54,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSAY PT 1:1 MI     ,38250836,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PT TOTAL     ,38250837,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PT SUBS PLSM FRAC         ,38250838,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health PPO CPD,Meritain Health PPO CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/Commercial Product,Aetna/Commercial Product,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health CPD,Meritain Health CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Starmark CPD,Starmark CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Aetna Medicare,Aetna Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Ambetter ,Ambetter ,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access,Anthem Blue Access,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access Choice,Anthem Blue Access Choice,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Preferred,Anthem Blue Preferred,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Pathway,Anthem Pathway,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Alliance,Anthem Alliance,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Medicare,Anthem Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Cigna,Cigna,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Cigna PPO,Cigna PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Cigna Medicare Advantage,Cigna Medicare Advantage,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Essence,Essence,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink HMO,Healthlink HMO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink PPO,Healthlink PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,HomeState Health Plan,HomeState Health Plan,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Humana Gold,Humana Gold,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Medicaid MO,Medicaid MO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Medica,Medica,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Tricare,Tricare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,UHC All Payer,UHC All Payer,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,UHC Exchange,UHC Exchange,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicaid,UHC Medicaid,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,UMR CPD,UMR CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicare,UHC Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O PTT-D 1:1 MIX RFLX        ,38250839,CDM,305,RC,,,,,,Inpatient,,,133.43,133.43,Wellcare,Wellcare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1:1MIX     ,38250840,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health PPO CPD,Meritain Health PPO CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna/Commercial Product,Aetna/Commercial Product,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Meritain Health CPD,Meritain Health CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Starmark CPD,Starmark CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Aetna Medicare,Aetna Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Ambetter ,Ambetter ,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access,Anthem Blue Access,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Access Choice,Anthem Blue Access Choice,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Blue Preferred,Anthem Blue Preferred,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Pathway,Anthem Pathway,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Alliance,Anthem Alliance,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Anthem Medicare,Anthem Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna,Cigna,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna PPO,Cigna PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Cigna Medicare Advantage,Cigna Medicare Advantage,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Essence,Essence,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink HMO,Healthlink HMO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Healthlink PPO,Healthlink PPO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,HomeState Health Plan,HomeState Health Plan,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Humana Gold,Humana Gold,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medicaid MO,Medicaid MO,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Medica,Medica,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Tricare,Tricare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC All Payer,UHC All Payer,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Exchange,UHC Exchange,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicaid,UHC Medicaid,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UMR CPD,UMR CPD,35.72,,,,,,,per diem,35.72,35.72,"Per diem rate, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,UHC Medicare,UHC Medicare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O INHIB ASSY PTT 1HR        ,38250841,CDM,305,RC,,,,,,Inpatient,,,35.72,35.72,Wellcare,Wellcare,35.72,,,,,,,case rate,35.72,35.72,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health PPO CPD,Meritain Health PPO CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Aetna/Commercial Product,Aetna/Commercial Product,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Meritain Health CPD,Meritain Health CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Starmark CPD,Starmark CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Aetna Medicare,Aetna Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Ambetter ,Ambetter ,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access,Anthem Blue Access,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Access Choice,Anthem Blue Access Choice,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Blue Preferred,Anthem Blue Preferred,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Pathway,Anthem Pathway,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Alliance,Anthem Alliance,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Anthem Medicare,Anthem Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Cigna,Cigna,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Cigna PPO,Cigna PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Cigna Medicare Advantage,Cigna Medicare Advantage,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Essence,Essence,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink HMO,Healthlink HMO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Healthlink PPO,Healthlink PPO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,HomeState Health Plan,HomeState Health Plan,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Humana Gold,Humana Gold,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Medicaid MO,Medicaid MO,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Medica,Medica,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Tricare,Tricare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,UHC All Payer,UHC All Payer,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,UHC Exchange,UHC Exchange,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicaid,UHC Medicaid,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,UMR CPD,UMR CPD,138.68,,,,,,,per diem,138.68,138.68,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,UHC Medicare,UHC Medicare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D 1:1      ,38250842,CDM,305,RC,,,,,,Inpatient,,,138.68,138.68,Wellcare,Wellcare,138.68,,,,,,,case rate,138.68,138.68,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MIXING STUDY PTT TTL      ,38250843,CDM,305,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O PTT SUBS PLSM FRC         ,38250844,CDM,305,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGM        ,38250845,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health PPO CPD,Meritain Health PPO CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/Commercial Product,Aetna/Commercial Product,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health CPD,Meritain Health CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Starmark CPD,Starmark CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna Medicare,Aetna Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Ambetter ,Ambetter ,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access,Anthem Blue Access,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access Choice,Anthem Blue Access Choice,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Preferred,Anthem Blue Preferred,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Pathway,Anthem Pathway,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Alliance,Anthem Alliance,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Medicare,Anthem Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna,Cigna,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna PPO,Cigna PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna Medicare Advantage,Cigna Medicare Advantage,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Essence,Essence,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink HMO,Healthlink HMO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink PPO,Healthlink PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,HomeState Health Plan,HomeState Health Plan,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Humana Gold,Humana Gold,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Medicaid MO,Medicaid MO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Medica,Medica,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Tricare,Tricare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC All Payer,UHC All Payer,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Exchange,UHC Exchange,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicaid,UHC Medicaid,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UMR CPD,UMR CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicare,UHC Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGG        ,38250846,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Wellcare,Wellcare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health PPO CPD,Meritain Health PPO CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/Commercial Product,Aetna/Commercial Product,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health CPD,Meritain Health CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Starmark CPD,Starmark CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Aetna Medicare,Aetna Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Ambetter ,Ambetter ,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access,Anthem Blue Access,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access Choice,Anthem Blue Access Choice,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Preferred,Anthem Blue Preferred,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Pathway,Anthem Pathway,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Alliance,Anthem Alliance,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Medicare,Anthem Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna,Cigna,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna PPO,Cigna PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Cigna Medicare Advantage,Cigna Medicare Advantage,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Essence,Essence,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink HMO,Healthlink HMO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink PPO,Healthlink PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,HomeState Health Plan,HomeState Health Plan,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Humana Gold,Humana Gold,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Medicaid MO,Medicaid MO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Medica,Medica,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Tricare,Tricare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC All Payer,UHC All Payer,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Exchange,UHC Exchange,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicaid,UHC Medicaid,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UMR CPD,UMR CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicare,UHC Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250847,CDM,302,RC,,,,,,Inpatient,,,299.42,299.42,Wellcare,Wellcare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250848,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health PPO CPD,Meritain Health PPO CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna/Commercial Product,Aetna/Commercial Product,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Meritain Health CPD,Meritain Health CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Starmark CPD,Starmark CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Aetna Medicare,Aetna Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Ambetter ,Ambetter ,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access,Anthem Blue Access,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Access Choice,Anthem Blue Access Choice,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Blue Preferred,Anthem Blue Preferred,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Pathway,Anthem Pathway,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Alliance,Anthem Alliance,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Anthem Medicare,Anthem Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna,Cigna,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna PPO,Cigna PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Cigna Medicare Advantage,Cigna Medicare Advantage,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Essence,Essence,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink HMO,Healthlink HMO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Healthlink PPO,Healthlink PPO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,HomeState Health Plan,HomeState Health Plan,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Humana Gold,Humana Gold,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medicaid MO,Medicaid MO,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Medica,Medica,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Tricare,Tricare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC All Payer,UHC All Payer,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Exchange,UHC Exchange,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicaid,UHC Medicaid,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UMR CPD,UMR CPD,106.11,,,,,,,per diem,106.11,106.11,"Per diem rate, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,UHC Medicare,UHC Medicare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O CARDIOLIPIN AB IGA        ,38250849,CDM,302,RC,,,,,,Inpatient,,,106.11,106.11,Wellcare,Wellcare,106.11,,,,,,,case rate,106.11,106.11,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB BY ID      ,38250850,CDM,302,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health PPO CPD,Meritain Health PPO CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/Commercial Product,Aetna/Commercial Product,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health CPD,Meritain Health CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Starmark CPD,Starmark CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Aetna Medicare,Aetna Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Ambetter ,Ambetter ,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access,Anthem Blue Access,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access Choice,Anthem Blue Access Choice,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Preferred,Anthem Blue Preferred,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Pathway,Anthem Pathway,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Alliance,Anthem Alliance,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Medicare,Anthem Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna,Cigna,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna PPO,Cigna PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Cigna Medicare Advantage,Cigna Medicare Advantage,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Essence,Essence,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink HMO,Healthlink HMO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink PPO,Healthlink PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,HomeState Health Plan,HomeState Health Plan,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Humana Gold,Humana Gold,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medicaid MO,Medicaid MO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Medica,Medica,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Tricare,Tricare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC All Payer,UHC All Payer,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Exchange,UHC Exchange,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicaid,UHC Medicaid,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UMR CPD,UMR CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicare,UHC Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O ASPERGILLIS AB CF         ,38250851,CDM,302,RC,,,,,,Inpatient,,,86.15,86.15,Wellcare,Wellcare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O HYPERSEN PNEUM I          ,38250852,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health PPO CPD,Meritain Health PPO CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna/Commercial Product,Aetna/Commercial Product,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Meritain Health CPD,Meritain Health CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Starmark CPD,Starmark CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Aetna Medicare,Aetna Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Ambetter ,Ambetter ,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access,Anthem Blue Access,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Access Choice,Anthem Blue Access Choice,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Blue Preferred,Anthem Blue Preferred,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Pathway,Anthem Pathway,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Alliance,Anthem Alliance,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Anthem Medicare,Anthem Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna,Cigna,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna PPO,Cigna PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Cigna Medicare Advantage,Cigna Medicare Advantage,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Essence,Essence,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink HMO,Healthlink HMO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Healthlink PPO,Healthlink PPO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,HomeState Health Plan,HomeState Health Plan,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Humana Gold,Humana Gold,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medicaid MO,Medicaid MO,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Medica,Medica,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Tricare,Tricare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC All Payer,UHC All Payer,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Exchange,UHC Exchange,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicaid,UHC Medicaid,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UMR CPD,UMR CPD,175.45,,,,,,,per diem,175.45,175.45,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,UHC Medicare,UHC Medicare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250853,CDM,301,RC,,,,,,Inpatient,,,175.45,175.45,Wellcare,Wellcare,175.45,,,,,,,case rate,175.45,175.45,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA SRM     ,38250854,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGG IFA CSF     ,38250855,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health PPO CPD,Meritain Health PPO CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna/Commercial Product,Aetna/Commercial Product,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Meritain Health CPD,Meritain Health CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Starmark CPD,Starmark CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Aetna Medicare,Aetna Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Ambetter ,Ambetter ,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access,Anthem Blue Access,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Access Choice,Anthem Blue Access Choice,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Blue Preferred,Anthem Blue Preferred,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Pathway,Anthem Pathway,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Alliance,Anthem Alliance,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Anthem Medicare,Anthem Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna,Cigna,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna PPO,Cigna PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Cigna Medicare Advantage,Cigna Medicare Advantage,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Essence,Essence,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink HMO,Healthlink HMO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Healthlink PPO,Healthlink PPO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,HomeState Health Plan,HomeState Health Plan,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Humana Gold,Humana Gold,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medicaid MO,Medicaid MO,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Medica,Medica,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Tricare,Tricare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC All Payer,UHC All Payer,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Exchange,UHC Exchange,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicaid,UHC Medicaid,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UMR CPD,UMR CPD,386.62,,,,,,,per diem,386.62,386.62,"Per diem rate, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,UHC Medicare,UHC Medicare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O CALIF ENC IGM IFA CSF     ,38250856,CDM,302,RC,,,,,,Inpatient,,,386.62,386.62,Wellcare,Wellcare,386.62,,,,,,,case rate,386.62,386.62,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM SRM     ,38250857,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGG CSF     ,38250858,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O EAST EQ ENCPH IGM CSF     ,38250859,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O STLOUIS ENCPH IGG CSF     ,38250860,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health PPO CPD,Meritain Health PPO CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/Commercial Product,Aetna/Commercial Product,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health CPD,Meritain Health CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Starmark CPD,Starmark CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna Medicare,Aetna Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Ambetter ,Ambetter ,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access,Anthem Blue Access,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access Choice,Anthem Blue Access Choice,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Preferred,Anthem Blue Preferred,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Pathway,Anthem Pathway,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Alliance,Anthem Alliance,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Medicare,Anthem Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna,Cigna,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna PPO,Cigna PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna Medicare Advantage,Cigna Medicare Advantage,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Essence,Essence,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink HMO,Healthlink HMO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink PPO,Healthlink PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,HomeState Health Plan,HomeState Health Plan,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Humana Gold,Humana Gold,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Medicaid MO,Medicaid MO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Medica,Medica,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Tricare,Tricare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC All Payer,UHC All Payer,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Exchange,UHC Exchange,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicaid,UHC Medicaid,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UMR CPD,UMR CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicare,UHC Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMSRM     ,38250861,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Wellcare,Wellcare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health PPO CPD,Meritain Health PPO CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/Commercial Product,Aetna/Commercial Product,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health CPD,Meritain Health CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Starmark CPD,Starmark CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Aetna Medicare,Aetna Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Ambetter ,Ambetter ,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access,Anthem Blue Access,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access Choice,Anthem Blue Access Choice,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Preferred,Anthem Blue Preferred,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Pathway,Anthem Pathway,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Alliance,Anthem Alliance,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Medicare,Anthem Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna,Cigna,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna PPO,Cigna PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Cigna Medicare Advantage,Cigna Medicare Advantage,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Essence,Essence,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink HMO,Healthlink HMO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink PPO,Healthlink PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,HomeState Health Plan,HomeState Health Plan,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Humana Gold,Humana Gold,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Medicaid MO,Medicaid MO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Medica,Medica,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Tricare,Tricare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC All Payer,UHC All Payer,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Exchange,UHC Exchange,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicaid,UHC Medicaid,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UMR CPD,UMR CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicare,UHC Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O ST LOUIS ENCPH IGMCSF     ,38250862,CDM,302,RC,,,,,,Inpatient,,,91.4,91.4,Wellcare,Wellcare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM CSF     ,38250863,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGG SRM     ,38250864,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O WEST EQ ENCPH IGM SRM     ,38250865,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Meritain Health PPO CPD,Meritain Health PPO CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Aetna/Commercial Product,Aetna/Commercial Product,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Meritain Health CPD,Meritain Health CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Starmark CPD,Starmark CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Aetna Medicare,Aetna Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Ambetter ,Ambetter ,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Access,Anthem Blue Access,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Access Choice,Anthem Blue Access Choice,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Preferred,Anthem Blue Preferred,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Pathway,Anthem Pathway,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Alliance,Anthem Alliance,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Medicare,Anthem Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Cigna,Cigna,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Cigna PPO,Cigna PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Cigna Medicare Advantage,Cigna Medicare Advantage,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Essence,Essence,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Healthlink HMO,Healthlink HMO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Healthlink PPO,Healthlink PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,HomeState Health Plan,HomeState Health Plan,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Humana Gold,Humana Gold,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Medicaid MO,Medicaid MO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Medica,Medica,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Tricare,Tricare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,UHC All Payer,UHC All Payer,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,UHC Exchange,UHC Exchange,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,UHC Medicaid,UHC Medicaid,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,UMR CPD,UMR CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,UHC Medicare,UHC Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B HENSELAE IGG IFA        ,38250866,CDM,302,RC,,,,,,Inpatient,,,42.02,42.02,Wellcare,Wellcare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGG IFA        ,38250867,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O B QUINTANA IGM IFA        ,38250868,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Meritain Health PPO CPD,Meritain Health PPO CPD,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Aetna/Commercial Product,Aetna/Commercial Product,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Meritain Health CPD,Meritain Health CPD,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Starmark CPD,Starmark CPD,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Aetna Medicare,Aetna Medicare,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Ambetter ,Ambetter ,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Blue Access,Anthem Blue Access,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Blue Access Choice,Anthem Blue Access Choice,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Blue Preferred,Anthem Blue Preferred,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Pathway,Anthem Pathway,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Alliance,Anthem Alliance,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Anthem Medicare,Anthem Medicare,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Cigna,Cigna,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Cigna PPO,Cigna PPO,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Cigna Medicare Advantage,Cigna Medicare Advantage,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Essence,Essence,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Healthlink HMO,Healthlink HMO,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Healthlink PPO,Healthlink PPO,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,HomeState Health Plan,HomeState Health Plan,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Humana Gold,Humana Gold,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Medicaid MO,Medicaid MO,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Medica,Medica,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Tricare,Tricare,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,UHC All Payer,UHC All Payer,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,UHC Exchange,UHC Exchange,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,UHC Medicaid,UHC Medicaid,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,UMR CPD,UMR CPD,351.95,,,,,,,per diem,351.95,351.95,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,UHC Medicare,UHC Medicare,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FUNCT HCCL      ,38250869,CDM,305,RC,,,,,,Inpatient,,,351.95,351.95,Wellcare,Wellcare,351.95,,,,,,,case rate,351.95,351.95,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Meritain Health PPO CPD,Meritain Health PPO CPD,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Aetna/Commercial Product,Aetna/Commercial Product,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Meritain Health CPD,Meritain Health CPD,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Starmark CPD,Starmark CPD,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Aetna Medicare,Aetna Medicare,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Ambetter ,Ambetter ,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Blue Access,Anthem Blue Access,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Blue Access Choice,Anthem Blue Access Choice,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Blue Preferred,Anthem Blue Preferred,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Pathway,Anthem Pathway,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Alliance,Anthem Alliance,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Anthem Medicare,Anthem Medicare,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Cigna,Cigna,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Cigna PPO,Cigna PPO,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Cigna Medicare Advantage,Cigna Medicare Advantage,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Essence,Essence,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Healthlink HMO,Healthlink HMO,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Healthlink PPO,Healthlink PPO,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,HomeState Health Plan,HomeState Health Plan,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Humana Gold,Humana Gold,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Medicaid MO,Medicaid MO,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Medica,Medica,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Tricare,Tricare,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,UHC All Payer,UHC All Payer,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,UHC Exchange,UHC Exchange,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,UHC Medicaid,UHC Medicaid,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,UMR CPD,UMR CPD,322.53,,,,,,,per diem,322.53,322.53,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,UHC Medicare,UHC Medicare,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38250870,CDM,305,RC,,,,,,Inpatient,,,322.53,322.53,Wellcare,Wellcare,322.53,,,,,,,case rate,322.53,322.53,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health PPO CPD,Meritain Health PPO CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Aetna/Commercial Product,Aetna/Commercial Product,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Meritain Health CPD,Meritain Health CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Starmark CPD,Starmark CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Aetna Medicare,Aetna Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Ambetter ,Ambetter ,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access,Anthem Blue Access,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Access Choice,Anthem Blue Access Choice,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Blue Preferred,Anthem Blue Preferred,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Pathway,Anthem Pathway,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Alliance,Anthem Alliance,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Anthem Medicare,Anthem Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Cigna,Cigna,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Cigna PPO,Cigna PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Cigna Medicare Advantage,Cigna Medicare Advantage,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Essence,Essence,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink HMO,Healthlink HMO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Healthlink PPO,Healthlink PPO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,HomeState Health Plan,HomeState Health Plan,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Humana Gold,Humana Gold,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Medicaid MO,Medicaid MO,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Medica,Medica,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Tricare,Tricare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,UHC All Payer,UHC All Payer,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,UHC Exchange,UHC Exchange,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicaid,UHC Medicaid,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,UMR CPD,UMR CPD,64.09,,,,,,,per diem,64.09,64.09,"Per diem rate, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,UHC Medicare,UHC Medicare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O PROTEIN S FREE AG         ,38250871,CDM,305,RC,,,,,,Inpatient,,,64.09,64.09,Wellcare,Wellcare,64.09,,,,,,,case rate,64.09,64.09,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health PPO CPD,Meritain Health PPO CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Aetna/Commercial Product,Aetna/Commercial Product,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Meritain Health CPD,Meritain Health CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Starmark CPD,Starmark CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Aetna Medicare,Aetna Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Ambetter ,Ambetter ,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access,Anthem Blue Access,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Access Choice,Anthem Blue Access Choice,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Blue Preferred,Anthem Blue Preferred,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Pathway,Anthem Pathway,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Alliance,Anthem Alliance,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Anthem Medicare,Anthem Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Cigna,Cigna,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Cigna PPO,Cigna PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Cigna Medicare Advantage,Cigna Medicare Advantage,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Essence,Essence,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink HMO,Healthlink HMO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Healthlink PPO,Healthlink PPO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,HomeState Health Plan,HomeState Health Plan,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Humana Gold,Humana Gold,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Medicaid MO,Medicaid MO,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Medica,Medica,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Tricare,Tricare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,UHC All Payer,UHC All Payer,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,UHC Exchange,UHC Exchange,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicaid,UHC Medicaid,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,UMR CPD,UMR CPD,85.1,,,,,,,per diem,85.1,85.1,"Per diem rate, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,UHC Medicare,UHC Medicare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O MTB DNA PROBE REFLEX      ,38250872,CDM,306,RC,,,,,,Inpatient,,,85.1,85.1,Wellcare,Wellcare,85.1,,,,,,,case rate,85.1,85.1,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250873,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health PPO CPD,Meritain Health PPO CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna/Commercial Product,Aetna/Commercial Product,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Meritain Health CPD,Meritain Health CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Starmark CPD,Starmark CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Aetna Medicare,Aetna Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Ambetter ,Ambetter ,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access,Anthem Blue Access,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Access Choice,Anthem Blue Access Choice,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Blue Preferred,Anthem Blue Preferred,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Pathway,Anthem Pathway,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Alliance,Anthem Alliance,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Anthem Medicare,Anthem Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna,Cigna,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna PPO,Cigna PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Cigna Medicare Advantage,Cigna Medicare Advantage,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Essence,Essence,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink HMO,Healthlink HMO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Healthlink PPO,Healthlink PPO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,HomeState Health Plan,HomeState Health Plan,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Humana Gold,Humana Gold,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medicaid MO,Medicaid MO,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Medica,Medica,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Tricare,Tricare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC All Payer,UHC All Payer,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Exchange,UHC Exchange,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicaid,UHC Medicaid,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UMR CPD,UMR CPD,18.91,,,,,,,per diem,18.91,18.91,"Per diem rate, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,UHC Medicare,UHC Medicare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O PHOSPHORUS URINE          ,38250874,CDM,301,RC,,,,,,Inpatient,,,18.91,18.91,Wellcare,Wellcare,18.91,,,,,,,case rate,18.91,18.91,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Meritain Health PPO CPD,Meritain Health PPO CPD,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Aetna/Commercial Product,Aetna/Commercial Product,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Meritain Health CPD,Meritain Health CPD,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Starmark CPD,Starmark CPD,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Aetna Medicare,Aetna Medicare,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Ambetter ,Ambetter ,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Blue Access,Anthem Blue Access,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Blue Access Choice,Anthem Blue Access Choice,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Blue Preferred,Anthem Blue Preferred,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Pathway,Anthem Pathway,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Alliance,Anthem Alliance,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Anthem Medicare,Anthem Medicare,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Cigna,Cigna,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Cigna PPO,Cigna PPO,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Cigna Medicare Advantage,Cigna Medicare Advantage,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Essence,Essence,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Healthlink HMO,Healthlink HMO,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Healthlink PPO,Healthlink PPO,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,HomeState Health Plan,HomeState Health Plan,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Humana Gold,Humana Gold,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Medicaid MO,Medicaid MO,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Medica,Medica,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Tricare,Tricare,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,UHC All Payer,UHC All Payer,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,UHC Exchange,UHC Exchange,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,UHC Medicaid,UHC Medicaid,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,UMR CPD,UMR CPD,143.93,,,,,,,per diem,143.93,143.93,"Per diem rate, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,UHC Medicare,UHC Medicare,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URN URIC ACID RANDOM      ,38250875,CDM,301,RC,,,,,,Inpatient,,,143.93,143.93,Wellcare,Wellcare,143.93,,,,,,,case rate,143.93,143.93,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38250876,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Meritain Health PPO CPD,Meritain Health PPO CPD,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Aetna/Commercial Product,Aetna/Commercial Product,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Meritain Health CPD,Meritain Health CPD,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Starmark CPD,Starmark CPD,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Aetna Medicare,Aetna Medicare,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Ambetter ,Ambetter ,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Blue Access,Anthem Blue Access,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Blue Access Choice,Anthem Blue Access Choice,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Blue Preferred,Anthem Blue Preferred,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Pathway,Anthem Pathway,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Alliance,Anthem Alliance,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Anthem Medicare,Anthem Medicare,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Cigna,Cigna,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Cigna PPO,Cigna PPO,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Cigna Medicare Advantage,Cigna Medicare Advantage,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Essence,Essence,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Healthlink HMO,Healthlink HMO,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Healthlink PPO,Healthlink PPO,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,HomeState Health Plan,HomeState Health Plan,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Humana Gold,Humana Gold,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Medicaid MO,Medicaid MO,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Medica,Medica,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Tricare,Tricare,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,UHC All Payer,UHC All Payer,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,UHC Exchange,UHC Exchange,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,UHC Medicaid,UHC Medicaid,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,UMR CPD,UMR CPD,19.96,,,,,,,per diem,19.96,19.96,"Per diem rate, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,UHC Medicare,UHC Medicare,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O URIC ACID BODY FLUID      ,38250877,CDM,301,RC,,,,,,Inpatient,,,19.96,19.96,Wellcare,Wellcare,19.96,,,,,,,case rate,19.96,19.96,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Meritain Health PPO CPD,Meritain Health PPO CPD,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Aetna/Commercial Product,Aetna/Commercial Product,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Meritain Health CPD,Meritain Health CPD,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Starmark CPD,Starmark CPD,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Aetna Medicare,Aetna Medicare,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Ambetter ,Ambetter ,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Blue Access,Anthem Blue Access,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Blue Access Choice,Anthem Blue Access Choice,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Blue Preferred,Anthem Blue Preferred,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Pathway,Anthem Pathway,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Alliance,Anthem Alliance,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Anthem Medicare,Anthem Medicare,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Cigna,Cigna,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Cigna PPO,Cigna PPO,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Cigna Medicare Advantage,Cigna Medicare Advantage,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Essence,Essence,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Healthlink HMO,Healthlink HMO,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Healthlink PPO,Healthlink PPO,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,HomeState Health Plan,HomeState Health Plan,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Humana Gold,Humana Gold,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Medicaid MO,Medicaid MO,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Medica,Medica,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Tricare,Tricare,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,UHC All Payer,UHC All Payer,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,UHC Exchange,UHC Exchange,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,UHC Medicaid,UHC Medicaid,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,UMR CPD,UMR CPD,361.41,,,,,,,per diem,361.41,361.41,"Per diem rate, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,UHC Medicare,UHC Medicare,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O FACTOR X ACTIVITY         ,38250878,CDM,305,RC,,,,,,Inpatient,,,361.41,361.41,Wellcare,Wellcare,361.41,,,,,,,case rate,361.41,361.41,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Meritain Health PPO CPD,Meritain Health PPO CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna/Commercial Product,Aetna/Commercial Product,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Meritain Health CPD,Meritain Health CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Starmark CPD,Starmark CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna Medicare,Aetna Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Ambetter ,Ambetter ,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Access,Anthem Blue Access,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Access Choice,Anthem Blue Access Choice,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Preferred,Anthem Blue Preferred,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Pathway,Anthem Pathway,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Alliance,Anthem Alliance,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Medicare,Anthem Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna,Cigna,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna PPO,Cigna PPO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna Medicare Advantage,Cigna Medicare Advantage,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Essence,Essence,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthlink HMO,Healthlink HMO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthlink PPO,Healthlink PPO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,HomeState Health Plan,HomeState Health Plan,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Humana Gold,Humana Gold,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Medicaid MO,Medicaid MO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Medica,Medica,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Tricare,Tricare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC All Payer,UHC All Payer,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Exchange,UHC Exchange,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Medicaid,UHC Medicaid,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UMR CPD,UMR CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Medicare,UHC Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O PARVOVIRUS B19 AB         ,38250879,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Wellcare,Wellcare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O FACTOR VII ACTIVITY       ,38250880,CDM,305,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Meritain Health PPO CPD,Meritain Health PPO CPD,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Aetna/Commercial Product,Aetna/Commercial Product,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Meritain Health CPD,Meritain Health CPD,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Starmark CPD,Starmark CPD,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Aetna Medicare,Aetna Medicare,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Ambetter ,Ambetter ,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Blue Access,Anthem Blue Access,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Blue Access Choice,Anthem Blue Access Choice,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Blue Preferred,Anthem Blue Preferred,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Pathway,Anthem Pathway,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Alliance,Anthem Alliance,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Anthem Medicare,Anthem Medicare,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Cigna,Cigna,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Cigna PPO,Cigna PPO,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Cigna Medicare Advantage,Cigna Medicare Advantage,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Essence,Essence,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Healthlink HMO,Healthlink HMO,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Healthlink PPO,Healthlink PPO,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,HomeState Health Plan,HomeState Health Plan,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Humana Gold,Humana Gold,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Medicaid MO,Medicaid MO,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Medica,Medica,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Tricare,Tricare,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,UHC All Payer,UHC All Payer,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,UHC Exchange,UHC Exchange,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,UHC Medicaid,UHC Medicaid,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,UMR CPD,UMR CPD,252.14,,,,,,,per diem,252.14,252.14,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,UHC Medicare,UHC Medicare,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES AB CF         ,38250881,CDM,302,RC,,,,,,Inpatient,,,252.14,252.14,Wellcare,Wellcare,252.14,,,,,,,case rate,252.14,252.14,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Meritain Health PPO CPD,Meritain Health PPO CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna/Commercial Product,Aetna/Commercial Product,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Meritain Health CPD,Meritain Health CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Starmark CPD,Starmark CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Aetna Medicare,Aetna Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Ambetter ,Ambetter ,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Access,Anthem Blue Access,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Access Choice,Anthem Blue Access Choice,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Blue Preferred,Anthem Blue Preferred,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Pathway,Anthem Pathway,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Alliance,Anthem Alliance,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Anthem Medicare,Anthem Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna,Cigna,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna PPO,Cigna PPO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Cigna Medicare Advantage,Cigna Medicare Advantage,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Essence,Essence,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthlink HMO,Healthlink HMO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Healthlink PPO,Healthlink PPO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,HomeState Health Plan,HomeState Health Plan,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Humana Gold,Humana Gold,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Medicaid MO,Medicaid MO,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Medica,Medica,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Tricare,Tricare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC All Payer,UHC All Payer,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Exchange,UHC Exchange,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Medicaid,UHC Medicaid,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UMR CPD,UMR CPD,99.81,,,,,,,per diem,99.81,99.81,"Per diem rate, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,UHC Medicare,UHC Medicare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O BLASTOMYCES CF ID         ,38250882,CDM,302,RC,,,,,,Inpatient,,,99.81,99.81,Wellcare,Wellcare,99.81,,,,,,,case rate,99.81,99.81,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250883,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O HISTOPLASMA AB CF&ID      ,38250884,CDM,302,RC,,,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health PPO CPD,Meritain Health PPO CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/Commercial Product,Aetna/Commercial Product,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health CPD,Meritain Health CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Starmark CPD,Starmark CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna Medicare,Aetna Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Ambetter ,Ambetter ,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access,Anthem Blue Access,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access Choice,Anthem Blue Access Choice,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Preferred,Anthem Blue Preferred,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Pathway,Anthem Pathway,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Alliance,Anthem Alliance,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Medicare,Anthem Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna,Cigna,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna PPO,Cigna PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna Medicare Advantage,Cigna Medicare Advantage,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Essence,Essence,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink HMO,Healthlink HMO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink PPO,Healthlink PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,HomeState Health Plan,HomeState Health Plan,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Humana Gold,Humana Gold,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Medicaid MO,Medicaid MO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Medica,Medica,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Tricare,Tricare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC All Payer,UHC All Payer,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Exchange,UHC Exchange,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicaid,UHC Medicaid,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UMR CPD,UMR CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicare,UHC Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB SRM/PLSM CONF/QNT     ,38250885,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Wellcare,Wellcare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health PPO CPD,Meritain Health PPO CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna/Commercial Product,Aetna/Commercial Product,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Meritain Health CPD,Meritain Health CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Starmark CPD,Starmark CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Aetna Medicare,Aetna Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Ambetter ,Ambetter ,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access,Anthem Blue Access,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Access Choice,Anthem Blue Access Choice,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Blue Preferred,Anthem Blue Preferred,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Pathway,Anthem Pathway,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Alliance,Anthem Alliance,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Anthem Medicare,Anthem Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna,Cigna,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna PPO,Cigna PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Cigna Medicare Advantage,Cigna Medicare Advantage,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Essence,Essence,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink HMO,Healthlink HMO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Healthlink PPO,Healthlink PPO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,HomeState Health Plan,HomeState Health Plan,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Humana Gold,Humana Gold,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Medicaid MO,Medicaid MO,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Medica,Medica,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Tricare,Tricare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC All Payer,UHC All Payer,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Exchange,UHC Exchange,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicaid,UHC Medicaid,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UMR CPD,UMR CPD,502.19,,,,,,,per diem,502.19,502.19,"Per diem rate, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,UHC Medicare,UHC Medicare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O GHB UR CONF/QUNT          ,38250886,CDM,301,RC,,,,,,Inpatient,,,502.19,502.19,Wellcare,Wellcare,502.19,,,,,,,case rate,502.19,502.19,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Meritain Health PPO CPD,Meritain Health PPO CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Aetna/Commercial Product,Aetna/Commercial Product,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Meritain Health CPD,Meritain Health CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Starmark CPD,Starmark CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Aetna Medicare,Aetna Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Ambetter ,Ambetter ,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Blue Access,Anthem Blue Access,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Blue Access Choice,Anthem Blue Access Choice,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Blue Preferred,Anthem Blue Preferred,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Pathway,Anthem Pathway,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Alliance,Anthem Alliance,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Anthem Medicare,Anthem Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Cigna,Cigna,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Cigna PPO,Cigna PPO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Cigna Medicare Advantage,Cigna Medicare Advantage,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Essence,Essence,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Healthlink HMO,Healthlink HMO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Healthlink PPO,Healthlink PPO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,HomeState Health Plan,HomeState Health Plan,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Humana Gold,Humana Gold,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Medicaid MO,Medicaid MO,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Medica,Medica,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Tricare,Tricare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,UHC All Payer,UHC All Payer,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,UHC Exchange,UHC Exchange,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,UHC Medicaid,UHC Medicaid,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,UMR CPD,UMR CPD,521.1,,,,,,,per diem,521.1,521.1,"Per diem rate, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,UHC Medicare,UHC Medicare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
S/O SULFONYLUR HYPOGLY UR     ,38250887,CDM,301,RC,,,,,,Inpatient,,,521.1,521.1,Wellcare,Wellcare,521.1,,,,,,,case rate,521.1,521.1,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG ASPIRIN          ,38250888,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EA AGENT         ,38250889,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET AGG EPI EA           ,38250890,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250891,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250892,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Meritain Health PPO CPD,Meritain Health PPO CPD,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Aetna/Commercial Product,Aetna/Commercial Product,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Meritain Health CPD,Meritain Health CPD,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Starmark CPD,Starmark CPD,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Aetna Medicare,Aetna Medicare,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Ambetter ,Ambetter ,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Blue Access,Anthem Blue Access,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Blue Access Choice,Anthem Blue Access Choice,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Blue Preferred,Anthem Blue Preferred,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Pathway,Anthem Pathway,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Alliance,Anthem Alliance,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Anthem Medicare,Anthem Medicare,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Cigna,Cigna,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Cigna PPO,Cigna PPO,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Cigna Medicare Advantage,Cigna Medicare Advantage,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Essence,Essence,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Healthlink HMO,Healthlink HMO,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Healthlink PPO,Healthlink PPO,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,HomeState Health Plan,HomeState Health Plan,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Humana Gold,Humana Gold,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Medicaid MO,Medicaid MO,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Medica,Medica,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Tricare,Tricare,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,UHC All Payer,UHC All Payer,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,UHC Exchange,UHC Exchange,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,UHC Medicaid,UHC Medicaid,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,UMR CPD,UMR CPD,1168.27,,,,,,,per diem,1168.27,1168.27,"Per diem rate, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,UHC Medicare,UHC Medicare,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
S/O PLATELET AGGREGATION      ,38250893,CDM,305,RC,,,,,,Inpatient,,,1168.27,1168.27,Wellcare,Wellcare,1168.27,,,,,,,case rate,1168.27,1168.27,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250894,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250895,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38250896,CDM,305,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
UA QL/SEMIQT RED SUB          ,38250897,CDM,307,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health PPO CPD,Meritain Health PPO CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/Commercial Product,Aetna/Commercial Product,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health CPD,Meritain Health CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Starmark CPD,Starmark CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Aetna Medicare,Aetna Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Ambetter ,Ambetter ,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access,Anthem Blue Access,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access Choice,Anthem Blue Access Choice,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Preferred,Anthem Blue Preferred,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Pathway,Anthem Pathway,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Alliance,Anthem Alliance,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Medicare,Anthem Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna,Cigna,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna PPO,Cigna PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Cigna Medicare Advantage,Cigna Medicare Advantage,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Essence,Essence,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink HMO,Healthlink HMO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink PPO,Healthlink PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,HomeState Health Plan,HomeState Health Plan,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Humana Gold,Humana Gold,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Medicaid MO,Medicaid MO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Medica,Medica,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Tricare,Tricare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC All Payer,UHC All Payer,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Exchange,UHC Exchange,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicaid,UHC Medicaid,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UMR CPD,UMR CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicare,UHC Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O NEURON SPECIF ENOLASE     ,38250898,CDM,302,RC,,,,,,Inpatient,,,89.3,89.3,Wellcare,Wellcare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O MESOMARK                  ,38250899,CDM,302,RC,,,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Meritain Health PPO CPD,Meritain Health PPO CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Aetna/Commercial Product,Aetna/Commercial Product,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Meritain Health CPD,Meritain Health CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Starmark CPD,Starmark CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Aetna Medicare,Aetna Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Ambetter ,Ambetter ,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Access,Anthem Blue Access,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Access Choice,Anthem Blue Access Choice,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Preferred,Anthem Blue Preferred,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Pathway,Anthem Pathway,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Alliance,Anthem Alliance,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Medicare,Anthem Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Cigna,Cigna,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Cigna PPO,Cigna PPO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Cigna Medicare Advantage,Cigna Medicare Advantage,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Essence,Essence,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Healthlink HMO,Healthlink HMO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Healthlink PPO,Healthlink PPO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,HomeState Health Plan,HomeState Health Plan,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Humana Gold,Humana Gold,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Medicaid MO,Medicaid MO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Medica,Medica,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Tricare,Tricare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,UHC All Payer,UHC All Payer,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,UHC Exchange,UHC Exchange,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,UHC Medicaid,UHC Medicaid,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,UMR CPD,UMR CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,UHC Medicare,UHC Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM               ,38250900,CDM,302,RC,,,,,,Inpatient,,,117.67,117.67,Wellcare,Wellcare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health PPO CPD,Meritain Health PPO CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/Commercial Product,Aetna/Commercial Product,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health CPD,Meritain Health CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Starmark CPD,Starmark CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna Medicare,Aetna Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Ambetter ,Ambetter ,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access,Anthem Blue Access,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access Choice,Anthem Blue Access Choice,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Preferred,Anthem Blue Preferred,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Pathway,Anthem Pathway,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Alliance,Anthem Alliance,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Medicare,Anthem Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna,Cigna,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna PPO,Cigna PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna Medicare Advantage,Cigna Medicare Advantage,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Essence,Essence,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink HMO,Healthlink HMO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink PPO,Healthlink PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,HomeState Health Plan,HomeState Health Plan,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Humana Gold,Humana Gold,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Medicaid MO,Medicaid MO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Medica,Medica,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Tricare,Tricare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC All Payer,UHC All Payer,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Exchange,UHC Exchange,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicaid,UHC Medicaid,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UMR CPD,UMR CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicare,UHC Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGM CSF           ,38250901,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Wellcare,Wellcare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 AB IGG CSF        ,38250902,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health PPO CPD,Meritain Health PPO CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/Commercial Product,Aetna/Commercial Product,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health CPD,Meritain Health CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Starmark CPD,Starmark CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Aetna Medicare,Aetna Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Ambetter ,Ambetter ,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access,Anthem Blue Access,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access Choice,Anthem Blue Access Choice,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Preferred,Anthem Blue Preferred,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Pathway,Anthem Pathway,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Alliance,Anthem Alliance,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Medicare,Anthem Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna,Cigna,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna PPO,Cigna PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Cigna Medicare Advantage,Cigna Medicare Advantage,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Essence,Essence,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink HMO,Healthlink HMO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink PPO,Healthlink PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,HomeState Health Plan,HomeState Health Plan,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Humana Gold,Humana Gold,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Medicaid MO,Medicaid MO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Medica,Medica,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Tricare,Tricare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC All Payer,UHC All Payer,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Exchange,UHC Exchange,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicaid,UHC Medicaid,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UMR CPD,UMR CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicare,UHC Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV1/2 IGG/IGM W RFLX     ,38250903,CDM,302,RC,,,,,,Inpatient,,,121.87,121.87,Wellcare,Wellcare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 IGG               ,38250904,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O TORCH AB IGG              ,38250905,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Meritain Health PPO CPD,Meritain Health PPO CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Aetna/Commercial Product,Aetna/Commercial Product,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Meritain Health CPD,Meritain Health CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Starmark CPD,Starmark CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Aetna Medicare,Aetna Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Ambetter ,Ambetter ,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Access,Anthem Blue Access,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Access Choice,Anthem Blue Access Choice,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Preferred,Anthem Blue Preferred,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Pathway,Anthem Pathway,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Alliance,Anthem Alliance,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Medicare,Anthem Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Cigna,Cigna,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Cigna PPO,Cigna PPO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Cigna Medicare Advantage,Cigna Medicare Advantage,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Essence,Essence,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Healthlink HMO,Healthlink HMO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Healthlink PPO,Healthlink PPO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,HomeState Health Plan,HomeState Health Plan,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Humana Gold,Humana Gold,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Medicaid MO,Medicaid MO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Medica,Medica,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Tricare,Tricare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,UHC All Payer,UHC All Payer,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,UHC Exchange,UHC Exchange,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,UHC Medicaid,UHC Medicaid,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,UMR CPD,UMR CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,UHC Medicare,UHC Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SPECIAL SERUM STUDIES     ,38250906,CDM,302,RC,,,,,,Inpatient,,,190.16,190.16,Wellcare,Wellcare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O KAPPA/LAMBDA QNT UR       ,38250907,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250908,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38250909,CDM,390,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Meritain Health PPO CPD,Meritain Health PPO CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Aetna/Commercial Product,Aetna/Commercial Product,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Meritain Health CPD,Meritain Health CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Starmark CPD,Starmark CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Aetna Medicare,Aetna Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Ambetter ,Ambetter ,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Access,Anthem Blue Access,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Access Choice,Anthem Blue Access Choice,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Blue Preferred,Anthem Blue Preferred,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Pathway,Anthem Pathway,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Alliance,Anthem Alliance,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Anthem Medicare,Anthem Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Cigna,Cigna,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Cigna PPO,Cigna PPO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Cigna Medicare Advantage,Cigna Medicare Advantage,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Essence,Essence,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Healthlink HMO,Healthlink HMO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Healthlink PPO,Healthlink PPO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,HomeState Health Plan,HomeState Health Plan,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Humana Gold,Humana Gold,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Medicaid MO,Medicaid MO,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Medica,Medica,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Tricare,Tricare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,UHC All Payer,UHC All Payer,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,UHC Exchange,UHC Exchange,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,UHC Medicaid,UHC Medicaid,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,UMR CPD,UMR CPD,280.51,,,,,,,per diem,280.51,280.51,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,UHC Medicare,UHC Medicare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38250910,CDM,302,RC,,,,,,Inpatient,,,280.51,280.51,Wellcare,Wellcare,280.51,,,,,,,case rate,280.51,280.51,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38250911,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Meritain Health PPO CPD,Meritain Health PPO CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna/Commercial Product,Aetna/Commercial Product,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Meritain Health CPD,Meritain Health CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Starmark CPD,Starmark CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna Medicare,Aetna Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Ambetter ,Ambetter ,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Access,Anthem Blue Access,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Access Choice,Anthem Blue Access Choice,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Preferred,Anthem Blue Preferred,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Pathway,Anthem Pathway,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Alliance,Anthem Alliance,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Medicare,Anthem Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna,Cigna,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna PPO,Cigna PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna Medicare Advantage,Cigna Medicare Advantage,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Essence,Essence,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthlink HMO,Healthlink HMO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthlink PPO,Healthlink PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,HomeState Health Plan,HomeState Health Plan,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Humana Gold,Humana Gold,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Medicaid MO,Medicaid MO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Medica,Medica,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Tricare,Tricare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC All Payer,UHC All Payer,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Exchange,UHC Exchange,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Medicaid,UHC Medicaid,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UMR CPD,UMR CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Medicare,UHC Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HU TITER/WEST BLT         ,38250912,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Wellcare,Wellcare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Meritain Health PPO CPD,Meritain Health PPO CPD,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Aetna/Commercial Product,Aetna/Commercial Product,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Meritain Health CPD,Meritain Health CPD,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Starmark CPD,Starmark CPD,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Aetna Medicare,Aetna Medicare,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Ambetter ,Ambetter ,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Blue Access,Anthem Blue Access,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Blue Access Choice,Anthem Blue Access Choice,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Blue Preferred,Anthem Blue Preferred,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Pathway,Anthem Pathway,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Alliance,Anthem Alliance,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Anthem Medicare,Anthem Medicare,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Cigna,Cigna,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Cigna PPO,Cigna PPO,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Cigna Medicare Advantage,Cigna Medicare Advantage,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Essence,Essence,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Healthlink HMO,Healthlink HMO,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Healthlink PPO,Healthlink PPO,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,HomeState Health Plan,HomeState Health Plan,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Humana Gold,Humana Gold,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Medicaid MO,Medicaid MO,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Medica,Medica,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Tricare,Tricare,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,UHC All Payer,UHC All Payer,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,UHC Exchange,UHC Exchange,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,UHC Medicaid,UHC Medicaid,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,UMR CPD,UMR CPD,695.5,,,,,,,per diem,695.5,695.5,"Per diem rate, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,UHC Medicare,UHC Medicare,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV 1/2 DNA PCR           ,38250913,CDM,306,RC,,,,,,Inpatient,,,695.5,695.5,Wellcare,Wellcare,695.5,,,,,,,case rate,695.5,695.5,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Meritain Health PPO CPD,Meritain Health PPO CPD,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Aetna/Commercial Product,Aetna/Commercial Product,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Meritain Health CPD,Meritain Health CPD,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Starmark CPD,Starmark CPD,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Aetna Medicare,Aetna Medicare,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Ambetter ,Ambetter ,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Blue Access,Anthem Blue Access,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Blue Access Choice,Anthem Blue Access Choice,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Blue Preferred,Anthem Blue Preferred,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Pathway,Anthem Pathway,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Alliance,Anthem Alliance,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Anthem Medicare,Anthem Medicare,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Cigna,Cigna,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Cigna PPO,Cigna PPO,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Cigna Medicare Advantage,Cigna Medicare Advantage,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Essence,Essence,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Healthlink HMO,Healthlink HMO,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Healthlink PPO,Healthlink PPO,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,HomeState Health Plan,HomeState Health Plan,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Humana Gold,Humana Gold,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Medicaid MO,Medicaid MO,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Medica,Medica,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Tricare,Tricare,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,UHC All Payer,UHC All Payer,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,UHC Exchange,UHC Exchange,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,UHC Medicaid,UHC Medicaid,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,UMR CPD,UMR CPD,841.53,,,,,,,per diem,841.53,841.53,"Per diem rate, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,UHC Medicare,UHC Medicare,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HSV BY PCR                ,38250914,CDM,306,RC,,,,,,Inpatient,,,841.53,841.53,Wellcare,Wellcare,841.53,,,,,,,case rate,841.53,841.53,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Meritain Health PPO CPD,Meritain Health PPO CPD,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Aetna/Commercial Product,Aetna/Commercial Product,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Meritain Health CPD,Meritain Health CPD,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Starmark CPD,Starmark CPD,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Aetna Medicare,Aetna Medicare,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Ambetter ,Ambetter ,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Blue Access,Anthem Blue Access,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Blue Access Choice,Anthem Blue Access Choice,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Blue Preferred,Anthem Blue Preferred,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Pathway,Anthem Pathway,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Alliance,Anthem Alliance,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Anthem Medicare,Anthem Medicare,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Cigna,Cigna,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Cigna PPO,Cigna PPO,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Cigna Medicare Advantage,Cigna Medicare Advantage,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Essence,Essence,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Healthlink HMO,Healthlink HMO,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Healthlink PPO,Healthlink PPO,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,HomeState Health Plan,HomeState Health Plan,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Humana Gold,Humana Gold,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Medicaid MO,Medicaid MO,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Medica,Medica,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Tricare,Tricare,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,UHC All Payer,UHC All Payer,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,UHC Exchange,UHC Exchange,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,UHC Medicaid,UHC Medicaid,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,UMR CPD,UMR CPD,724.91,,,,,,,per diem,724.91,724.91,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,UHC Medicare,UHC Medicare,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250915,CDM,306,RC,,,,,,Inpatient,,,724.91,724.91,Wellcare,Wellcare,724.91,,,,,,,case rate,724.91,724.91,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Meritain Health PPO CPD,Meritain Health PPO CPD,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Aetna/Commercial Product,Aetna/Commercial Product,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Meritain Health CPD,Meritain Health CPD,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Starmark CPD,Starmark CPD,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Aetna Medicare,Aetna Medicare,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Ambetter ,Ambetter ,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Blue Access,Anthem Blue Access,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Blue Access Choice,Anthem Blue Access Choice,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Blue Preferred,Anthem Blue Preferred,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Pathway,Anthem Pathway,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Alliance,Anthem Alliance,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Anthem Medicare,Anthem Medicare,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Cigna,Cigna,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Cigna PPO,Cigna PPO,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Cigna Medicare Advantage,Cigna Medicare Advantage,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Essence,Essence,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Healthlink HMO,Healthlink HMO,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Healthlink PPO,Healthlink PPO,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,HomeState Health Plan,HomeState Health Plan,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Humana Gold,Humana Gold,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Medicaid MO,Medicaid MO,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Medica,Medica,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Tricare,Tricare,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,UHC All Payer,UHC All Payer,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,UHC Exchange,UHC Exchange,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,UHC Medicaid,UHC Medicaid,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,UMR CPD,UMR CPD,723.86,,,,,,,per diem,723.86,723.86,"Per diem rate, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,UHC Medicare,UHC Medicare,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O HERPES BY PCR CSF         ,38250916,CDM,306,RC,,,,,,Inpatient,,,723.86,723.86,Wellcare,Wellcare,723.86,,,,,,,case rate,723.86,723.86,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250917,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O APS AB PANEL              ,38250918,CDM,302,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38250919,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Meritain Health PPO CPD,Meritain Health PPO CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna/Commercial Product,Aetna/Commercial Product,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Meritain Health CPD,Meritain Health CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Starmark CPD,Starmark CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna Medicare,Aetna Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Ambetter ,Ambetter ,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Access,Anthem Blue Access,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Access Choice,Anthem Blue Access Choice,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Preferred,Anthem Blue Preferred,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Pathway,Anthem Pathway,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Alliance,Anthem Alliance,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Medicare,Anthem Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna,Cigna,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna PPO,Cigna PPO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna Medicare Advantage,Cigna Medicare Advantage,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Essence,Essence,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthlink HMO,Healthlink HMO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthlink PPO,Healthlink PPO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,HomeState Health Plan,HomeState Health Plan,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Humana Gold,Humana Gold,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Medicaid MO,Medicaid MO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Medica,Medica,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Tricare,Tricare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC All Payer,UHC All Payer,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Exchange,UHC Exchange,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Medicaid,UHC Medicaid,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UMR CPD,UMR CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Medicare,UHC Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250920,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Wellcare,Wellcare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Meritain Health PPO CPD,Meritain Health PPO CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna/Commercial Product,Aetna/Commercial Product,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Meritain Health CPD,Meritain Health CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Starmark CPD,Starmark CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Aetna Medicare,Aetna Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Ambetter ,Ambetter ,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Access,Anthem Blue Access,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Access Choice,Anthem Blue Access Choice,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Blue Preferred,Anthem Blue Preferred,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Pathway,Anthem Pathway,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Alliance,Anthem Alliance,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Anthem Medicare,Anthem Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna,Cigna,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna PPO,Cigna PPO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Cigna Medicare Advantage,Cigna Medicare Advantage,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Essence,Essence,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthlink HMO,Healthlink HMO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Healthlink PPO,Healthlink PPO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,HomeState Health Plan,HomeState Health Plan,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Humana Gold,Humana Gold,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Medicaid MO,Medicaid MO,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Medica,Medica,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Tricare,Tricare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC All Payer,UHC All Payer,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Exchange,UHC Exchange,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Medicaid,UHC Medicaid,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UMR CPD,UMR CPD,189.11,,,,,,,per diem,189.11,189.11,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,UHC Medicare,UHC Medicare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG I&II          ,38250921,CDM,302,RC,,,,,,Inpatient,,,189.11,189.11,Wellcare,Wellcare,189.11,,,,,,,case rate,189.11,189.11,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O Q FEVER IGG PHASE I       ,38250922,CDM,302,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Meritain Health PPO CPD,Meritain Health PPO CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Aetna/Commercial Product,Aetna/Commercial Product,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Meritain Health CPD,Meritain Health CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Starmark CPD,Starmark CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Aetna Medicare,Aetna Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Ambetter ,Ambetter ,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Access,Anthem Blue Access,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Access Choice,Anthem Blue Access Choice,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Preferred,Anthem Blue Preferred,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Pathway,Anthem Pathway,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Alliance,Anthem Alliance,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Medicare,Anthem Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Cigna,Cigna,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Cigna PPO,Cigna PPO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Cigna Medicare Advantage,Cigna Medicare Advantage,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Essence,Essence,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Healthlink HMO,Healthlink HMO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Healthlink PPO,Healthlink PPO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,HomeState Health Plan,HomeState Health Plan,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Humana Gold,Humana Gold,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Medicaid MO,Medicaid MO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Medica,Medica,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Tricare,Tricare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,UHC All Payer,UHC All Payer,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,UHC Exchange,UHC Exchange,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,UHC Medicaid,UHC Medicaid,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,UMR CPD,UMR CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,UHC Medicare,UHC Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGG CSF      ,38250923,CDM,302,RC,,,,,,Inpatient,,,259.5,259.5,Wellcare,Wellcare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health PPO CPD,Meritain Health PPO CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/Commercial Product,Aetna/Commercial Product,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health CPD,Meritain Health CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Starmark CPD,Starmark CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Aetna Medicare,Aetna Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Ambetter ,Ambetter ,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access,Anthem Blue Access,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access Choice,Anthem Blue Access Choice,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Preferred,Anthem Blue Preferred,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Pathway,Anthem Pathway,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Alliance,Anthem Alliance,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Medicare,Anthem Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna,Cigna,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna PPO,Cigna PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Cigna Medicare Advantage,Cigna Medicare Advantage,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Essence,Essence,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink HMO,Healthlink HMO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink PPO,Healthlink PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,HomeState Health Plan,HomeState Health Plan,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Humana Gold,Humana Gold,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Medicaid MO,Medicaid MO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Medica,Medica,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Tricare,Tricare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC All Payer,UHC All Payer,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Exchange,UHC Exchange,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicaid,UHC Medicaid,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UMR CPD,UMR CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicare,UHC Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O METHADON SRM/PLSM QNT     ,38250924,CDM,301,RC,,,,,,Inpatient,,,216.42,216.42,Wellcare,Wellcare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Meritain Health PPO CPD,Meritain Health PPO CPD,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Aetna/Commercial Product,Aetna/Commercial Product,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Meritain Health CPD,Meritain Health CPD,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Starmark CPD,Starmark CPD,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Aetna Medicare,Aetna Medicare,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Ambetter ,Ambetter ,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Blue Access,Anthem Blue Access,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Blue Access Choice,Anthem Blue Access Choice,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Blue Preferred,Anthem Blue Preferred,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Pathway,Anthem Pathway,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Alliance,Anthem Alliance,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Anthem Medicare,Anthem Medicare,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Cigna,Cigna,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Cigna PPO,Cigna PPO,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Cigna Medicare Advantage,Cigna Medicare Advantage,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Essence,Essence,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Healthlink HMO,Healthlink HMO,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Healthlink PPO,Healthlink PPO,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,HomeState Health Plan,HomeState Health Plan,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Humana Gold,Humana Gold,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Medicaid MO,Medicaid MO,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Medica,Medica,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Tricare,Tricare,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,UHC All Payer,UHC All Payer,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,UHC Exchange,UHC Exchange,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,UHC Medicaid,UHC Medicaid,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,UMR CPD,UMR CPD,172.3,,,,,,,per diem,172.3,172.3,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,UHC Medicare,UHC Medicare,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,38250925,CDM,309,RC,,,,,,Inpatient,,,172.3,172.3,Wellcare,Wellcare,172.3,,,,,,,case rate,172.3,172.3,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health PPO CPD,Meritain Health PPO CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/Commercial Product,Aetna/Commercial Product,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health CPD,Meritain Health CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Starmark CPD,Starmark CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Aetna Medicare,Aetna Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Ambetter ,Ambetter ,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access,Anthem Blue Access,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access Choice,Anthem Blue Access Choice,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Preferred,Anthem Blue Preferred,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Pathway,Anthem Pathway,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Alliance,Anthem Alliance,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Medicare,Anthem Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Cigna,Cigna,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Cigna PPO,Cigna PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Cigna Medicare Advantage,Cigna Medicare Advantage,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Essence,Essence,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink HMO,Healthlink HMO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink PPO,Healthlink PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,HomeState Health Plan,HomeState Health Plan,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Humana Gold,Humana Gold,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Medicaid MO,Medicaid MO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Medica,Medica,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Tricare,Tricare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,UHC All Payer,UHC All Payer,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,UHC Exchange,UHC Exchange,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicaid,UHC Medicaid,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,UMR CPD,UMR CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicare,UHC Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O DIRECT ANTIGLOBUL UBS     ,38250926,CDM,309,RC,,,,,,Inpatient,,,69.34,69.34,Wellcare,Wellcare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health PPO CPD,Meritain Health PPO CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/Commercial Product,Aetna/Commercial Product,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health CPD,Meritain Health CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Starmark CPD,Starmark CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Aetna Medicare,Aetna Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Ambetter ,Ambetter ,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access,Anthem Blue Access,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access Choice,Anthem Blue Access Choice,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Preferred,Anthem Blue Preferred,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Pathway,Anthem Pathway,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Alliance,Anthem Alliance,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Medicare,Anthem Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Cigna,Cigna,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Cigna PPO,Cigna PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Cigna Medicare Advantage,Cigna Medicare Advantage,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Essence,Essence,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink HMO,Healthlink HMO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink PPO,Healthlink PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,HomeState Health Plan,HomeState Health Plan,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Humana Gold,Humana Gold,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Medicaid MO,Medicaid MO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Medica,Medica,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Tricare,Tricare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,UHC All Payer,UHC All Payer,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,UHC Exchange,UHC Exchange,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicaid,UHC Medicaid,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,UMR CPD,UMR CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicare,UHC Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT COMPLEM     ,38250927,CDM,309,RC,,,,,,Inpatient,,,150.24,150.24,Wellcare,Wellcare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health PPO CPD,Meritain Health PPO CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/Commercial Product,Aetna/Commercial Product,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health CPD,Meritain Health CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Starmark CPD,Starmark CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna Medicare,Aetna Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Ambetter ,Ambetter ,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access,Anthem Blue Access,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access Choice,Anthem Blue Access Choice,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Preferred,Anthem Blue Preferred,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Pathway,Anthem Pathway,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Alliance,Anthem Alliance,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Medicare,Anthem Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna,Cigna,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna PPO,Cigna PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna Medicare Advantage,Cigna Medicare Advantage,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Essence,Essence,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink HMO,Healthlink HMO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink PPO,Healthlink PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,HomeState Health Plan,HomeState Health Plan,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Humana Gold,Humana Gold,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Medicaid MO,Medicaid MO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Medica,Medica,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Tricare,Tricare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC All Payer,UHC All Payer,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Exchange,UHC Exchange,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicaid,UHC Medicaid,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UMR CPD,UMR CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicare,UHC Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O COOMBS DIRECT             ,38250928,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Wellcare,Wellcare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O AG RBC NON ABO/RH EA      ,38250929,CDM,309,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING PATIENT     ,38250930,CDM,309,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING RARE PT     ,38250931,CDM,309,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC EXTEND PHENO          ,38250932,CDM,309,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health PPO CPD,Meritain Health PPO CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/Commercial Product,Aetna/Commercial Product,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health CPD,Meritain Health CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Starmark CPD,Starmark CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Aetna Medicare,Aetna Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Ambetter ,Ambetter ,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access,Anthem Blue Access,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access Choice,Anthem Blue Access Choice,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Preferred,Anthem Blue Preferred,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Pathway,Anthem Pathway,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Alliance,Anthem Alliance,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Medicare,Anthem Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna,Cigna,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna PPO,Cigna PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Cigna Medicare Advantage,Cigna Medicare Advantage,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Essence,Essence,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink HMO,Healthlink HMO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink PPO,Healthlink PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,HomeState Health Plan,HomeState Health Plan,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Humana Gold,Humana Gold,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Medicaid MO,Medicaid MO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Medica,Medica,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Tricare,Tricare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC All Payer,UHC All Payer,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Exchange,UHC Exchange,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicaid,UHC Medicaid,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UMR CPD,UMR CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicare,UHC Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O RBC AB ELUTION            ,38250933,CDM,309,RC,,,,,,Inpatient,,,144.98,144.98,Wellcare,Wellcare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Meritain Health PPO CPD,Meritain Health PPO CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna/Commercial Product,Aetna/Commercial Product,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Meritain Health CPD,Meritain Health CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Starmark CPD,Starmark CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Aetna Medicare,Aetna Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Ambetter ,Ambetter ,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Access,Anthem Blue Access,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Access Choice,Anthem Blue Access Choice,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Blue Preferred,Anthem Blue Preferred,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Pathway,Anthem Pathway,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Alliance,Anthem Alliance,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Anthem Medicare,Anthem Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna,Cigna,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna PPO,Cigna PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Cigna Medicare Advantage,Cigna Medicare Advantage,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Essence,Essence,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthlink HMO,Healthlink HMO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Healthlink PPO,Healthlink PPO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,HomeState Health Plan,HomeState Health Plan,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Humana Gold,Humana Gold,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Medicaid MO,Medicaid MO,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Medica,Medica,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Tricare,Tricare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC All Payer,UHC All Payer,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Exchange,UHC Exchange,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Medicaid,UHC Medicaid,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UMR CPD,UMR CPD,434.95,,,,,,,per diem,434.95,434.95,"Per diem rate, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,UHC Medicare,UHC Medicare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O ADSORPTION ALLO           ,38250934,CDM,302,RC,,,,,,Inpatient,,,434.95,434.95,Wellcare,Wellcare,434.95,,,,,,,case rate,434.95,434.95,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Meritain Health PPO CPD,Meritain Health PPO CPD,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Aetna/Commercial Product,Aetna/Commercial Product,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Meritain Health CPD,Meritain Health CPD,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Starmark CPD,Starmark CPD,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Aetna Medicare,Aetna Medicare,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Ambetter ,Ambetter ,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Blue Access,Anthem Blue Access,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Blue Access Choice,Anthem Blue Access Choice,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Blue Preferred,Anthem Blue Preferred,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Pathway,Anthem Pathway,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Alliance,Anthem Alliance,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Anthem Medicare,Anthem Medicare,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Cigna,Cigna,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Cigna PPO,Cigna PPO,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Cigna Medicare Advantage,Cigna Medicare Advantage,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Essence,Essence,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Healthlink HMO,Healthlink HMO,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Healthlink PPO,Healthlink PPO,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,HomeState Health Plan,HomeState Health Plan,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Humana Gold,Humana Gold,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Medicaid MO,Medicaid MO,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Medica,Medica,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Tricare,Tricare,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,UHC All Payer,UHC All Payer,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,UHC Exchange,UHC Exchange,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,UHC Medicaid,UHC Medicaid,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,UMR CPD,UMR CPD,217.47,,,,,,,per diem,217.47,217.47,"Per diem rate, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,UHC Medicare,UHC Medicare,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
S/O RBC AG TYPING DONOR       ,38250935,CDM,309,RC,,,,,,Inpatient,,,217.47,217.47,Wellcare,Wellcare,217.47,,,,,,,case rate,217.47,217.47,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health PPO CPD,Meritain Health PPO CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/Commercial Product,Aetna/Commercial Product,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health CPD,Meritain Health CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Starmark CPD,Starmark CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna Medicare,Aetna Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Ambetter ,Ambetter ,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access,Anthem Blue Access,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access Choice,Anthem Blue Access Choice,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Preferred,Anthem Blue Preferred,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Pathway,Anthem Pathway,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Alliance,Anthem Alliance,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Medicare,Anthem Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna,Cigna,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna PPO,Cigna PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna Medicare Advantage,Cigna Medicare Advantage,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Essence,Essence,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink HMO,Healthlink HMO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink PPO,Healthlink PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,HomeState Health Plan,HomeState Health Plan,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Humana Gold,Humana Gold,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medicaid MO,Medicaid MO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medica,Medica,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Tricare,Tricare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC All Payer,UHC All Payer,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Exchange,UHC Exchange,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicaid,UHC Medicaid,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UMR CPD,UMR CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicare,UHC Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ACT                           ,38250936,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Wellcare,Wellcare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Meritain Health PPO CPD,Meritain Health PPO CPD,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Aetna/Commercial Product,Aetna/Commercial Product,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Meritain Health CPD,Meritain Health CPD,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Starmark CPD,Starmark CPD,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Aetna Medicare,Aetna Medicare,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Ambetter ,Ambetter ,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Blue Access,Anthem Blue Access,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Blue Access Choice,Anthem Blue Access Choice,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Blue Preferred,Anthem Blue Preferred,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Pathway,Anthem Pathway,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Alliance,Anthem Alliance,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Anthem Medicare,Anthem Medicare,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Cigna,Cigna,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Cigna PPO,Cigna PPO,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Cigna Medicare Advantage,Cigna Medicare Advantage,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Essence,Essence,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Healthlink HMO,Healthlink HMO,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Healthlink PPO,Healthlink PPO,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,HomeState Health Plan,HomeState Health Plan,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Humana Gold,Humana Gold,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Medicaid MO,Medicaid MO,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Medica,Medica,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Tricare,Tricare,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,UHC All Payer,UHC All Payer,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,UHC Exchange,UHC Exchange,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,UHC Medicaid,UHC Medicaid,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,UMR CPD,UMR CPD,358.25,,,,,,,per diem,358.25,358.25,"Per diem rate, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,UHC Medicare,UHC Medicare,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
RHOD IMMUNE GLOB 300MCG       ,38250937,CDM,636,RC,,,,,,Inpatient,1,EA,358.25,358.25,Wellcare,Wellcare,358.25,,,,,,,case rate,358.25,358.25,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
CRYOPRECIPITATE EA            ,38250938,CDM,390,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Meritain Health PPO CPD,Meritain Health PPO CPD,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Aetna/Commercial Product,Aetna/Commercial Product,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Meritain Health CPD,Meritain Health CPD,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Starmark CPD,Starmark CPD,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Aetna Medicare,Aetna Medicare,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Ambetter ,Ambetter ,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Blue Access,Anthem Blue Access,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Blue Access Choice,Anthem Blue Access Choice,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Blue Preferred,Anthem Blue Preferred,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Pathway,Anthem Pathway,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Alliance,Anthem Alliance,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Anthem Medicare,Anthem Medicare,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Cigna,Cigna,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Cigna PPO,Cigna PPO,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Cigna Medicare Advantage,Cigna Medicare Advantage,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Essence,Essence,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Healthlink HMO,Healthlink HMO,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Healthlink PPO,Healthlink PPO,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,HomeState Health Plan,HomeState Health Plan,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Humana Gold,Humana Gold,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Medicaid MO,Medicaid MO,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Medica,Medica,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Tricare,Tricare,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,UHC All Payer,UHC All Payer,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,UHC Exchange,UHC Exchange,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,UHC Medicaid,UHC Medicaid,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,UMR CPD,UMR CPD,661.88,,,,,,,per diem,661.88,661.88,"Per diem rate, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,UHC Medicare,UHC Medicare,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FETAL FIBRONECTIN             ,38250939,CDM,301,RC,,,,,,Inpatient,,,661.88,661.88,Wellcare,Wellcare,661.88,,,,,,,case rate,661.88,661.88,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 1 UNIT                    ,38250940,CDM,390,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Meritain Health PPO CPD,Meritain Health PPO CPD,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Aetna/Commercial Product,Aetna/Commercial Product,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Meritain Health CPD,Meritain Health CPD,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Starmark CPD,Starmark CPD,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Aetna Medicare,Aetna Medicare,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Ambetter ,Ambetter ,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Blue Access,Anthem Blue Access,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Blue Access Choice,Anthem Blue Access Choice,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Blue Preferred,Anthem Blue Preferred,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Pathway,Anthem Pathway,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Alliance,Anthem Alliance,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Anthem Medicare,Anthem Medicare,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Cigna,Cigna,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Cigna PPO,Cigna PPO,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Cigna Medicare Advantage,Cigna Medicare Advantage,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Essence,Essence,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Healthlink HMO,Healthlink HMO,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Healthlink PPO,Healthlink PPO,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,HomeState Health Plan,HomeState Health Plan,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Humana Gold,Humana Gold,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Medicaid MO,Medicaid MO,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Medica,Medica,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Tricare,Tricare,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,UHC All Payer,UHC All Payer,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,UHC Exchange,UHC Exchange,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,UHC Medicaid,UHC Medicaid,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,UMR CPD,UMR CPD,303.8,,,,,,,per diem,303.8,303.8,"Per diem rate, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,UHC Medicare,UHC Medicare,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FFP 8-24 HR EA UNIT           ,38250941,CDM,390,RC,,,,,,Inpatient,,,303.8,303.8,Wellcare,Wellcare,303.8,,,,,,,case rate,303.8,303.8,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Meritain Health PPO CPD,Meritain Health PPO CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Aetna/Commercial Product,Aetna/Commercial Product,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Meritain Health CPD,Meritain Health CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Starmark CPD,Starmark CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Aetna Medicare,Aetna Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Ambetter ,Ambetter ,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Access,Anthem Blue Access,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Access Choice,Anthem Blue Access Choice,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Blue Preferred,Anthem Blue Preferred,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Pathway,Anthem Pathway,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Alliance,Anthem Alliance,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Anthem Medicare,Anthem Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Cigna,Cigna,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Cigna PPO,Cigna PPO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Cigna Medicare Advantage,Cigna Medicare Advantage,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Essence,Essence,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Healthlink HMO,Healthlink HMO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Healthlink PPO,Healthlink PPO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,HomeState Health Plan,HomeState Health Plan,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Humana Gold,Humana Gold,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Medicaid MO,Medicaid MO,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Medica,Medica,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Tricare,Tricare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,UHC All Payer,UHC All Payer,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,UHC Exchange,UHC Exchange,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,UHC Medicaid,UHC Medicaid,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,UMR CPD,UMR CPD,76.38,,,,,,,per diem,76.38,76.38,"Per diem rate, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,UHC Medicare,UHC Medicare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
FIBRINOLYSINS INT/RPT         ,38250942,CDM,305,RC,85390,CPT,,,,Inpatient,,,76.38,76.38,Wellcare,Wellcare,76.38,,,,,,,case rate,76.38,76.38,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY DEVICE       ,38250943,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Meritain Health PPO CPD,Meritain Health PPO CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Aetna/Commercial Product,Aetna/Commercial Product,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Meritain Health CPD,Meritain Health CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Starmark CPD,Starmark CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Aetna Medicare,Aetna Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Ambetter ,Ambetter ,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Access,Anthem Blue Access,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Access Choice,Anthem Blue Access Choice,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Preferred,Anthem Blue Preferred,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Pathway,Anthem Pathway,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Alliance,Anthem Alliance,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Medicare,Anthem Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Cigna,Cigna,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Cigna PPO,Cigna PPO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Cigna Medicare Advantage,Cigna Medicare Advantage,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Essence,Essence,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Healthlink HMO,Healthlink HMO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Healthlink PPO,Healthlink PPO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,HomeState Health Plan,HomeState Health Plan,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Humana Gold,Humana Gold,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Medicaid MO,Medicaid MO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Medica,Medica,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Tricare,Tricare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,UHC All Payer,UHC All Payer,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,UHC Exchange,UHC Exchange,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,UHC Medicaid,UHC Medicaid,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,UMR CPD,UMR CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,UHC Medicare,UHC Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
HGB F KLEIHAUER-BETKE         ,38250944,CDM,305,RC,,,,,,Inpatient,,,281.56,281.56,Wellcare,Wellcare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Meritain Health PPO CPD,Meritain Health PPO CPD,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Aetna/Commercial Product,Aetna/Commercial Product,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Meritain Health CPD,Meritain Health CPD,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Starmark CPD,Starmark CPD,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Aetna Medicare,Aetna Medicare,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Ambetter ,Ambetter ,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Blue Access,Anthem Blue Access,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Blue Access Choice,Anthem Blue Access Choice,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Blue Preferred,Anthem Blue Preferred,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Pathway,Anthem Pathway,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Alliance,Anthem Alliance,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Anthem Medicare,Anthem Medicare,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Cigna,Cigna,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Cigna PPO,Cigna PPO,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Cigna Medicare Advantage,Cigna Medicare Advantage,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Essence,Essence,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Healthlink HMO,Healthlink HMO,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Healthlink PPO,Healthlink PPO,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,HomeState Health Plan,HomeState Health Plan,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Humana Gold,Humana Gold,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Medicaid MO,Medicaid MO,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Medica,Medica,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Tricare,Tricare,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,UHC All Payer,UHC All Payer,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,UHC Exchange,UHC Exchange,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,UHC Medicaid,UHC Medicaid,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,UMR CPD,UMR CPD,245.89,,,,,,,per diem,245.89,245.89,"Per diem rate, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,UHC Medicare,UHC Medicare,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
IA HIV1 AG W HIV1&HIV2 AB     ,38250945,CDM,302,RC,,,,,,Inpatient,,,245.89,245.89,Wellcare,Wellcare,245.89,,,,,,,case rate,245.89,245.89,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
AMNIOTIC PROT QL AMNISURE     ,38250946,CDM,301,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Meritain Health PPO CPD,Meritain Health PPO CPD,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Aetna/Commercial Product,Aetna/Commercial Product,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Meritain Health CPD,Meritain Health CPD,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Starmark CPD,Starmark CPD,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Aetna Medicare,Aetna Medicare,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Ambetter ,Ambetter ,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Blue Access,Anthem Blue Access,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Blue Access Choice,Anthem Blue Access Choice,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Blue Preferred,Anthem Blue Preferred,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Pathway,Anthem Pathway,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Alliance,Anthem Alliance,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Anthem Medicare,Anthem Medicare,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Cigna,Cigna,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Cigna PPO,Cigna PPO,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Cigna Medicare Advantage,Cigna Medicare Advantage,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Essence,Essence,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Healthlink HMO,Healthlink HMO,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Healthlink PPO,Healthlink PPO,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,HomeState Health Plan,HomeState Health Plan,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Humana Gold,Humana Gold,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Medicaid MO,Medicaid MO,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Medica,Medica,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Tricare,Tricare,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,UHC All Payer,UHC All Payer,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,UHC Exchange,UHC Exchange,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,UHC Medicaid,UHC Medicaid,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,UMR CPD,UMR CPD,942.39,,,,,,,per diem,942.39,942.39,"Per diem rate, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,UHC Medicare,UHC Medicare,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLATELETS PHER EA             ,38250947,CDM,390,RC,,,,,,Inpatient,,,942.39,942.39,Wellcare,Wellcare,942.39,,,,,,,case rate,942.39,942.39,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Meritain Health PPO CPD,Meritain Health PPO CPD,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Aetna/Commercial Product,Aetna/Commercial Product,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Meritain Health CPD,Meritain Health CPD,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Starmark CPD,Starmark CPD,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Aetna Medicare,Aetna Medicare,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Ambetter ,Ambetter ,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Blue Access,Anthem Blue Access,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Blue Access Choice,Anthem Blue Access Choice,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Blue Preferred,Anthem Blue Preferred,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Pathway,Anthem Pathway,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Alliance,Anthem Alliance,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Anthem Medicare,Anthem Medicare,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Cigna,Cigna,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Cigna PPO,Cigna PPO,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Cigna Medicare Advantage,Cigna Medicare Advantage,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Essence,Essence,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Healthlink HMO,Healthlink HMO,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Healthlink PPO,Healthlink PPO,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,HomeState Health Plan,HomeState Health Plan,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Humana Gold,Humana Gold,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Medicaid MO,Medicaid MO,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Medica,Medica,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Tricare,Tricare,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,UHC All Payer,UHC All Payer,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,UHC Exchange,UHC Exchange,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,UHC Medicaid,UHC Medicaid,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,UMR CPD,UMR CPD,2276.65,,,,,,,per diem,2276.65,2276.65,"Per diem rate, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,UHC Medicare,UHC Medicare,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PLT PHERESIS L/R IRRAD        ,38250948,CDM,390,RC,,,,,,Inpatient,,,2276.65,2276.65,Wellcare,Wellcare,2276.65,,,,,,,case rate,2276.65,2276.65,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health PPO CPD,Meritain Health PPO CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/Commercial Product,Aetna/Commercial Product,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health CPD,Meritain Health CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Starmark CPD,Starmark CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Aetna Medicare,Aetna Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Ambetter ,Ambetter ,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access,Anthem Blue Access,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access Choice,Anthem Blue Access Choice,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Preferred,Anthem Blue Preferred,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Pathway,Anthem Pathway,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Alliance,Anthem Alliance,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Medicare,Anthem Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Cigna,Cigna,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Cigna PPO,Cigna PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Cigna Medicare Advantage,Cigna Medicare Advantage,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Essence,Essence,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink HMO,Healthlink HMO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink PPO,Healthlink PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,HomeState Health Plan,HomeState Health Plan,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Humana Gold,Humana Gold,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Medicaid MO,Medicaid MO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Medica,Medica,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Tricare,Tricare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,UHC All Payer,UHC All Payer,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,UHC Exchange,UHC Exchange,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicaid,UHC Medicaid,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,UMR CPD,UMR CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicare,UHC Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
PREG URINE VISUAL             ,38250949,CDM,307,RC,,,,,,Inpatient,,,246.89,246.89,Wellcare,Wellcare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Meritain Health PPO CPD,Meritain Health PPO CPD,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Aetna/Commercial Product,Aetna/Commercial Product,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Meritain Health CPD,Meritain Health CPD,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Starmark CPD,Starmark CPD,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Aetna Medicare,Aetna Medicare,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Ambetter ,Ambetter ,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Blue Access,Anthem Blue Access,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Blue Access Choice,Anthem Blue Access Choice,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Blue Preferred,Anthem Blue Preferred,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Pathway,Anthem Pathway,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Alliance,Anthem Alliance,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Anthem Medicare,Anthem Medicare,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Cigna,Cigna,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Cigna PPO,Cigna PPO,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Cigna Medicare Advantage,Cigna Medicare Advantage,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Essence,Essence,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Healthlink HMO,Healthlink HMO,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Healthlink PPO,Healthlink PPO,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,HomeState Health Plan,HomeState Health Plan,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Humana Gold,Humana Gold,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Medicaid MO,Medicaid MO,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Medica,Medica,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Tricare,Tricare,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,UHC All Payer,UHC All Payer,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,UHC Exchange,UHC Exchange,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,UHC Medicaid,UHC Medicaid,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,UMR CPD,UMR CPD,373.88,,,,,,,per diem,373.88,373.88,"Per diem rate, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,UHC Medicare,UHC Medicare,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RBC L/R EA AUTO               ,38250950,CDM,390,RC,,,,,,Inpatient,,,373.88,373.88,Wellcare,Wellcare,373.88,,,,,,,case rate,373.88,373.88,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health PPO CPD,Meritain Health PPO CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/Commercial Product,Aetna/Commercial Product,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health CPD,Meritain Health CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Starmark CPD,Starmark CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Aetna Medicare,Aetna Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Ambetter ,Ambetter ,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access,Anthem Blue Access,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access Choice,Anthem Blue Access Choice,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Preferred,Anthem Blue Preferred,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Pathway,Anthem Pathway,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Alliance,Anthem Alliance,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Medicare,Anthem Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Cigna,Cigna,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Cigna PPO,Cigna PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Cigna Medicare Advantage,Cigna Medicare Advantage,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Essence,Essence,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink HMO,Healthlink HMO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink PPO,Healthlink PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,HomeState Health Plan,HomeState Health Plan,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Humana Gold,Humana Gold,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Medicaid MO,Medicaid MO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Medica,Medica,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Tricare,Tricare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,UHC All Payer,UHC All Payer,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,UHC Exchange,UHC Exchange,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicaid,UHC Medicaid,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,UMR CPD,UMR CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicare,UHC Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS EA AUTO             ,38250951,CDM,390,RC,,,,,,Inpatient,,,414.99,414.99,Wellcare,Wellcare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health PPO CPD,Meritain Health PPO CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/Commercial Product,Aetna/Commercial Product,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health CPD,Meritain Health CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Starmark CPD,Starmark CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Aetna Medicare,Aetna Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Ambetter ,Ambetter ,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access,Anthem Blue Access,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access Choice,Anthem Blue Access Choice,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Preferred,Anthem Blue Preferred,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Pathway,Anthem Pathway,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Alliance,Anthem Alliance,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Medicare,Anthem Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Cigna,Cigna,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Cigna PPO,Cigna PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Cigna Medicare Advantage,Cigna Medicare Advantage,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Essence,Essence,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink HMO,Healthlink HMO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink PPO,Healthlink PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,HomeState Health Plan,HomeState Health Plan,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Humana Gold,Humana Gold,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Medicaid MO,Medicaid MO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Medica,Medica,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Tricare,Tricare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,UHC All Payer,UHC All Payer,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,UHC Exchange,UHC Exchange,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicaid,UHC Medicaid,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,UMR CPD,UMR CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicare,UHC Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS PACKED EA           ,38250952,CDM,390,RC,,,,,,Inpatient,,,305.72,305.72,Wellcare,Wellcare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Meritain Health PPO CPD,Meritain Health PPO CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Aetna/Commercial Product,Aetna/Commercial Product,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Meritain Health CPD,Meritain Health CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Starmark CPD,Starmark CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Aetna Medicare,Aetna Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Ambetter ,Ambetter ,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Access,Anthem Blue Access,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Access Choice,Anthem Blue Access Choice,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Preferred,Anthem Blue Preferred,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Pathway,Anthem Pathway,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Alliance,Anthem Alliance,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Medicare,Anthem Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Cigna,Cigna,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Cigna PPO,Cigna PPO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Cigna Medicare Advantage,Cigna Medicare Advantage,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Essence,Essence,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Healthlink HMO,Healthlink HMO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Healthlink PPO,Healthlink PPO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,HomeState Health Plan,HomeState Health Plan,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Humana Gold,Humana Gold,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Medicaid MO,Medicaid MO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Medica,Medica,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Tricare,Tricare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,UHC All Payer,UHC All Payer,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,UHC Exchange,UHC Exchange,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,UHC Medicaid,UHC Medicaid,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,UMR CPD,UMR CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,UHC Medicare,UHC Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
RED CELLS WASHED EA           ,38250953,CDM,390,RC,,,,,,Inpatient,,,346.7,346.7,Wellcare,Wellcare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Meritain Health PPO CPD,Meritain Health PPO CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Aetna/Commercial Product,Aetna/Commercial Product,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Meritain Health CPD,Meritain Health CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Starmark CPD,Starmark CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Aetna Medicare,Aetna Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Ambetter ,Ambetter ,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Access,Anthem Blue Access,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Access Choice,Anthem Blue Access Choice,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Blue Preferred,Anthem Blue Preferred,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Pathway,Anthem Pathway,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Alliance,Anthem Alliance,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Anthem Medicare,Anthem Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Cigna,Cigna,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Cigna PPO,Cigna PPO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Cigna Medicare Advantage,Cigna Medicare Advantage,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Essence,Essence,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Healthlink HMO,Healthlink HMO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Healthlink PPO,Healthlink PPO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,HomeState Health Plan,HomeState Health Plan,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Humana Gold,Humana Gold,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Medicaid MO,Medicaid MO,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Medica,Medica,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Tricare,Tricare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,UHC All Payer,UHC All Payer,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,UHC Exchange,UHC Exchange,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,UHC Medicaid,UHC Medicaid,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,UMR CPD,UMR CPD,389.77,,,,,,,per diem,389.77,389.77,"Per diem rate, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,UHC Medicare,UHC Medicare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD EA                ,38250954,CDM,390,RC,,,,,,Inpatient,,,389.77,389.77,Wellcare,Wellcare,389.77,,,,,,,case rate,389.77,389.77,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Meritain Health PPO CPD,Meritain Health PPO CPD,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Aetna/Commercial Product,Aetna/Commercial Product,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Meritain Health CPD,Meritain Health CPD,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Starmark CPD,Starmark CPD,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Aetna Medicare,Aetna Medicare,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Ambetter ,Ambetter ,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Blue Access,Anthem Blue Access,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Blue Access Choice,Anthem Blue Access Choice,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Blue Preferred,Anthem Blue Preferred,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Pathway,Anthem Pathway,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Alliance,Anthem Alliance,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Anthem Medicare,Anthem Medicare,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Cigna,Cigna,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Cigna PPO,Cigna PPO,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Cigna Medicare Advantage,Cigna Medicare Advantage,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Essence,Essence,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Healthlink HMO,Healthlink HMO,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Healthlink PPO,Healthlink PPO,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,HomeState Health Plan,HomeState Health Plan,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Humana Gold,Humana Gold,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Medicaid MO,Medicaid MO,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Medica,Medica,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Tricare,Tricare,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,UHC All Payer,UHC All Payer,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,UHC Exchange,UHC Exchange,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,UHC Medicaid,UHC Medicaid,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,UMR CPD,UMR CPD,572.58,,,,,,,per diem,572.58,572.58,"Per diem rate, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,UHC Medicare,UHC Medicare,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
WHOLE BLOOD L/R IRRAD EA      ,38250955,CDM,390,RC,,,,,,Inpatient,,,572.58,572.58,Wellcare,Wellcare,572.58,,,,,,,case rate,572.58,572.58,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health PPO CPD,Meritain Health PPO CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/Commercial Product,Aetna/Commercial Product,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health CPD,Meritain Health CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Starmark CPD,Starmark CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna Medicare,Aetna Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Ambetter ,Ambetter ,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access,Anthem Blue Access,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access Choice,Anthem Blue Access Choice,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Preferred,Anthem Blue Preferred,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Pathway,Anthem Pathway,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Alliance,Anthem Alliance,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Medicare,Anthem Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna,Cigna,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna PPO,Cigna PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna Medicare Advantage,Cigna Medicare Advantage,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Essence,Essence,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink HMO,Healthlink HMO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink PPO,Healthlink PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,HomeState Health Plan,HomeState Health Plan,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Humana Gold,Humana Gold,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medicaid MO,Medicaid MO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medica,Medica,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Tricare,Tricare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC All Payer,UHC All Payer,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Exchange,UHC Exchange,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicaid,UHC Medicaid,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UMR CPD,UMR CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicare,UHC Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38250956,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Wellcare,Wellcare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health PPO CPD,Meritain Health PPO CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna/Commercial Product,Aetna/Commercial Product,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Meritain Health CPD,Meritain Health CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Starmark CPD,Starmark CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Aetna Medicare,Aetna Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Ambetter ,Ambetter ,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access,Anthem Blue Access,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Access Choice,Anthem Blue Access Choice,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Blue Preferred,Anthem Blue Preferred,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Pathway,Anthem Pathway,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Alliance,Anthem Alliance,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Anthem Medicare,Anthem Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna,Cigna,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna PPO,Cigna PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Cigna Medicare Advantage,Cigna Medicare Advantage,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Essence,Essence,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink HMO,Healthlink HMO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Healthlink PPO,Healthlink PPO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,HomeState Health Plan,HomeState Health Plan,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Humana Gold,Humana Gold,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Medicaid MO,Medicaid MO,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Medica,Medica,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Tricare,Tricare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC All Payer,UHC All Payer,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Exchange,UHC Exchange,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicaid,UHC Medicaid,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UMR CPD,UMR CPD,94.55,,,,,,,per diem,94.55,94.55,"Per diem rate, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,UHC Medicare,UHC Medicare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O LIPOPROTEIN A             ,38250957,CDM,301,RC,,,,,,Inpatient,,,94.55,94.55,Wellcare,Wellcare,94.55,,,,,,,case rate,94.55,94.55,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EBV EA IGG                ,38250958,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Meritain Health PPO CPD,Meritain Health PPO CPD,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Aetna/Commercial Product,Aetna/Commercial Product,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Meritain Health CPD,Meritain Health CPD,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Starmark CPD,Starmark CPD,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Aetna Medicare,Aetna Medicare,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Ambetter ,Ambetter ,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Blue Access,Anthem Blue Access,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Blue Access Choice,Anthem Blue Access Choice,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Blue Preferred,Anthem Blue Preferred,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Pathway,Anthem Pathway,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Alliance,Anthem Alliance,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Anthem Medicare,Anthem Medicare,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Cigna,Cigna,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Cigna PPO,Cigna PPO,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Cigna Medicare Advantage,Cigna Medicare Advantage,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Essence,Essence,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Healthlink HMO,Healthlink HMO,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Healthlink PPO,Healthlink PPO,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,HomeState Health Plan,HomeState Health Plan,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Humana Gold,Humana Gold,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Medicaid MO,Medicaid MO,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Medica,Medica,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Tricare,Tricare,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,UHC All Payer,UHC All Payer,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,UHC Exchange,UHC Exchange,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,UHC Medicaid,UHC Medicaid,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,UMR CPD,UMR CPD,3683.4,,,,,,,per diem,3683.4,3683.4,"Per diem rate, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,UHC Medicare,UHC Medicare,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O CF MUTATION PNL           ,38250959,CDM,301,RC,,,,,,Inpatient,,,3683.4,3683.4,Wellcare,Wellcare,3683.4,,,,,,,case rate,3683.4,3683.4,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Meritain Health PPO CPD,Meritain Health PPO CPD,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Aetna/Commercial Product,Aetna/Commercial Product,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Meritain Health CPD,Meritain Health CPD,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Starmark CPD,Starmark CPD,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Aetna Medicare,Aetna Medicare,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Ambetter ,Ambetter ,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Blue Access,Anthem Blue Access,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Blue Access Choice,Anthem Blue Access Choice,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Blue Preferred,Anthem Blue Preferred,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Pathway,Anthem Pathway,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Alliance,Anthem Alliance,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Anthem Medicare,Anthem Medicare,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Cigna,Cigna,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Cigna PPO,Cigna PPO,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Cigna Medicare Advantage,Cigna Medicare Advantage,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Essence,Essence,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Healthlink HMO,Healthlink HMO,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Healthlink PPO,Healthlink PPO,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,HomeState Health Plan,HomeState Health Plan,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Humana Gold,Humana Gold,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Medicaid MO,Medicaid MO,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Medica,Medica,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Tricare,Tricare,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,UHC All Payer,UHC All Payer,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,UHC Exchange,UHC Exchange,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,UHC Medicaid,UHC Medicaid,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,UMR CPD,UMR CPD,167.05,,,,,,,per diem,167.05,167.05,"Per diem rate, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,UHC Medicare,UHC Medicare,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O NICOTINE META S/P QNT     ,38250960,CDM,301,RC,,,,,,Inpatient,,,167.05,167.05,Wellcare,Wellcare,167.05,,,,,,,case rate,167.05,167.05,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Meritain Health PPO CPD,Meritain Health PPO CPD,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Aetna/Commercial Product,Aetna/Commercial Product,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Meritain Health CPD,Meritain Health CPD,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Starmark CPD,Starmark CPD,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Aetna Medicare,Aetna Medicare,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Ambetter ,Ambetter ,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Blue Access,Anthem Blue Access,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Blue Access Choice,Anthem Blue Access Choice,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Blue Preferred,Anthem Blue Preferred,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Pathway,Anthem Pathway,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Alliance,Anthem Alliance,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Anthem Medicare,Anthem Medicare,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Cigna,Cigna,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Cigna PPO,Cigna PPO,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Cigna Medicare Advantage,Cigna Medicare Advantage,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Essence,Essence,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Healthlink HMO,Healthlink HMO,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Healthlink PPO,Healthlink PPO,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,HomeState Health Plan,HomeState Health Plan,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Humana Gold,Humana Gold,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Medicaid MO,Medicaid MO,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Medica,Medica,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Tricare,Tricare,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,UHC All Payer,UHC All Payer,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,UHC Exchange,UHC Exchange,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,UHC Medicaid,UHC Medicaid,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,UMR CPD,UMR CPD,395.03,,,,,,,per diem,395.03,395.03,"Per diem rate, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,UHC Medicare,UHC Medicare,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O ENTEROVIRUS BY PCR        ,38250961,CDM,306,RC,,,,,,Inpatient,,,395.03,395.03,Wellcare,Wellcare,395.03,,,,,,,case rate,395.03,395.03,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Meritain Health PPO CPD,Meritain Health PPO CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Aetna/Commercial Product,Aetna/Commercial Product,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Meritain Health CPD,Meritain Health CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Starmark CPD,Starmark CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Aetna Medicare,Aetna Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Ambetter ,Ambetter ,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Access,Anthem Blue Access,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Access Choice,Anthem Blue Access Choice,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Blue Preferred,Anthem Blue Preferred,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Pathway,Anthem Pathway,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Alliance,Anthem Alliance,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Anthem Medicare,Anthem Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Cigna,Cigna,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Cigna PPO,Cigna PPO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Cigna Medicare Advantage,Cigna Medicare Advantage,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Essence,Essence,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Healthlink HMO,Healthlink HMO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Healthlink PPO,Healthlink PPO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,HomeState Health Plan,HomeState Health Plan,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Humana Gold,Humana Gold,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Medicaid MO,Medicaid MO,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Medica,Medica,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Tricare,Tricare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,UHC All Payer,UHC All Payer,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,UHC Exchange,UHC Exchange,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,UHC Medicaid,UHC Medicaid,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,UMR CPD,UMR CPD,281.56,,,,,,,per diem,281.56,281.56,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,UHC Medicare,UHC Medicare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM SRM      ,38250962,CDM,302,RC,,,,,,Inpatient,,,281.56,281.56,Wellcare,Wellcare,281.56,,,,,,,case rate,281.56,281.56,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health PPO CPD,Meritain Health PPO CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/Commercial Product,Aetna/Commercial Product,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health CPD,Meritain Health CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Starmark CPD,Starmark CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Aetna Medicare,Aetna Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Ambetter ,Ambetter ,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access,Anthem Blue Access,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access Choice,Anthem Blue Access Choice,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Preferred,Anthem Blue Preferred,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Pathway,Anthem Pathway,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Alliance,Anthem Alliance,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Medicare,Anthem Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Cigna,Cigna,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Cigna PPO,Cigna PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Cigna Medicare Advantage,Cigna Medicare Advantage,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Essence,Essence,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink HMO,Healthlink HMO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink PPO,Healthlink PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,HomeState Health Plan,HomeState Health Plan,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Humana Gold,Humana Gold,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Medicaid MO,Medicaid MO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Medica,Medica,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Tricare,Tricare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,UHC All Payer,UHC All Payer,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,UHC Exchange,UHC Exchange,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicaid,UHC Medicaid,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,UMR CPD,UMR CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicare,UHC Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O WEST NILE AB IGM CSF      ,38250963,CDM,302,RC,,,,,,Inpatient,,,277.36,277.36,Wellcare,Wellcare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health PPO CPD,Meritain Health PPO CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna/Commercial Product,Aetna/Commercial Product,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Meritain Health CPD,Meritain Health CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Starmark CPD,Starmark CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Aetna Medicare,Aetna Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Ambetter ,Ambetter ,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access,Anthem Blue Access,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Access Choice,Anthem Blue Access Choice,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Blue Preferred,Anthem Blue Preferred,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Pathway,Anthem Pathway,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Alliance,Anthem Alliance,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Anthem Medicare,Anthem Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna,Cigna,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna PPO,Cigna PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Cigna Medicare Advantage,Cigna Medicare Advantage,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Essence,Essence,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink HMO,Healthlink HMO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Healthlink PPO,Healthlink PPO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,HomeState Health Plan,HomeState Health Plan,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Humana Gold,Humana Gold,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medicaid MO,Medicaid MO,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Medica,Medica,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Tricare,Tricare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC All Payer,UHC All Payer,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Exchange,UHC Exchange,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicaid,UHC Medicaid,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UMR CPD,UMR CPD,123.97,,,,,,,per diem,123.97,123.97,"Per diem rate, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,UHC Medicare,UHC Medicare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O INSULIN ANTIBODY          ,38250964,CDM,302,RC,,,,,,Inpatient,,,123.97,123.97,Wellcare,Wellcare,123.97,,,,,,,case rate,123.97,123.97,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health PPO CPD,Meritain Health PPO CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/Commercial Product,Aetna/Commercial Product,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health CPD,Meritain Health CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Starmark CPD,Starmark CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Aetna Medicare,Aetna Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Ambetter ,Ambetter ,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access,Anthem Blue Access,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access Choice,Anthem Blue Access Choice,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Preferred,Anthem Blue Preferred,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Pathway,Anthem Pathway,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Alliance,Anthem Alliance,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Medicare,Anthem Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Cigna,Cigna,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Cigna PPO,Cigna PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Cigna Medicare Advantage,Cigna Medicare Advantage,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Essence,Essence,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink HMO,Healthlink HMO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink PPO,Healthlink PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,HomeState Health Plan,HomeState Health Plan,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Humana Gold,Humana Gold,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Medicaid MO,Medicaid MO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Medica,Medica,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Tricare,Tricare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,UHC All Payer,UHC All Payer,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,UHC Exchange,UHC Exchange,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicaid,UHC Medicaid,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,UMR CPD,UMR CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicare,UHC Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O ACYLCARN QUANT PLASMA     ,38250965,CDM,301,RC,,,,,,Inpatient,,,301.52,301.52,Wellcare,Wellcare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Meritain Health PPO CPD,Meritain Health PPO CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Aetna/Commercial Product,Aetna/Commercial Product,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Meritain Health CPD,Meritain Health CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Starmark CPD,Starmark CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Aetna Medicare,Aetna Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Ambetter ,Ambetter ,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Access,Anthem Blue Access,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Access Choice,Anthem Blue Access Choice,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Blue Preferred,Anthem Blue Preferred,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Pathway,Anthem Pathway,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Alliance,Anthem Alliance,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Anthem Medicare,Anthem Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Cigna,Cigna,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Cigna PPO,Cigna PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Cigna Medicare Advantage,Cigna Medicare Advantage,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Essence,Essence,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Healthlink HMO,Healthlink HMO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Healthlink PPO,Healthlink PPO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,HomeState Health Plan,HomeState Health Plan,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Humana Gold,Humana Gold,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Medicaid MO,Medicaid MO,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Medica,Medica,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Tricare,Tricare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,UHC All Payer,UHC All Payer,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,UHC Exchange,UHC Exchange,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,UHC Medicaid,UHC Medicaid,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,UMR CPD,UMR CPD,77.74,,,,,,,per diem,77.74,77.74,"Per diem rate, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,UHC Medicare,UHC Medicare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O CARNITINE TOTAL           ,38250966,CDM,301,RC,,,,,,Inpatient,,,77.74,77.74,Wellcare,Wellcare,77.74,,,,,,,case rate,77.74,77.74,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health PPO CPD,Meritain Health PPO CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/Commercial Product,Aetna/Commercial Product,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health CPD,Meritain Health CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Starmark CPD,Starmark CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna Medicare,Aetna Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Ambetter ,Ambetter ,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access,Anthem Blue Access,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access Choice,Anthem Blue Access Choice,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Preferred,Anthem Blue Preferred,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Pathway,Anthem Pathway,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Alliance,Anthem Alliance,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Medicare,Anthem Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna,Cigna,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna PPO,Cigna PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna Medicare Advantage,Cigna Medicare Advantage,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Essence,Essence,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink HMO,Healthlink HMO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink PPO,Healthlink PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,HomeState Health Plan,HomeState Health Plan,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Humana Gold,Humana Gold,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medicaid MO,Medicaid MO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medica,Medica,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Tricare,Tricare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC All Payer,UHC All Payer,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Exchange,UHC Exchange,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicaid,UHC Medicaid,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UMR CPD,UMR CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicare,UHC Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O MYCOPHEN AC & MET         ,38250967,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Wellcare,Wellcare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health PPO CPD,Meritain Health PPO CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna/Commercial Product,Aetna/Commercial Product,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Meritain Health CPD,Meritain Health CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Starmark CPD,Starmark CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Aetna Medicare,Aetna Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Ambetter ,Ambetter ,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access,Anthem Blue Access,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Access Choice,Anthem Blue Access Choice,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Blue Preferred,Anthem Blue Preferred,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Pathway,Anthem Pathway,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Alliance,Anthem Alliance,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Anthem Medicare,Anthem Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna,Cigna,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna PPO,Cigna PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Cigna Medicare Advantage,Cigna Medicare Advantage,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Essence,Essence,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink HMO,Healthlink HMO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Healthlink PPO,Healthlink PPO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,HomeState Health Plan,HomeState Health Plan,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Humana Gold,Humana Gold,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medicaid MO,Medicaid MO,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Medica,Medica,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Tricare,Tricare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC All Payer,UHC All Payer,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Exchange,UHC Exchange,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicaid,UHC Medicaid,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UMR CPD,UMR CPD,109.26,,,,,,,per diem,109.26,109.26,"Per diem rate, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,UHC Medicare,UHC Medicare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O PROPOXYPH CONF/QNT UR     ,38250968,CDM,301,RC,,,,,,Inpatient,,,109.26,109.26,Wellcare,Wellcare,109.26,,,,,,,case rate,109.26,109.26,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O SELENIUM SRM/PLASM        ,38250969,CDM,301,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health PPO CPD,Meritain Health PPO CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna/Commercial Product,Aetna/Commercial Product,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Meritain Health CPD,Meritain Health CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Starmark CPD,Starmark CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Aetna Medicare,Aetna Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Ambetter ,Ambetter ,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access,Anthem Blue Access,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Access Choice,Anthem Blue Access Choice,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Blue Preferred,Anthem Blue Preferred,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Pathway,Anthem Pathway,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Alliance,Anthem Alliance,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Anthem Medicare,Anthem Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna,Cigna,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna PPO,Cigna PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Cigna Medicare Advantage,Cigna Medicare Advantage,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Essence,Essence,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink HMO,Healthlink HMO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Healthlink PPO,Healthlink PPO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,HomeState Health Plan,HomeState Health Plan,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Humana Gold,Humana Gold,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medicaid MO,Medicaid MO,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Medica,Medica,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Tricare,Tricare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC All Payer,UHC All Payer,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Exchange,UHC Exchange,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicaid,UHC Medicaid,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UMR CPD,UMR CPD,50.43,,,,,,,per diem,50.43,50.43,"Per diem rate, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,UHC Medicare,UHC Medicare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O ALLERGY FEATHER MIX       ,38250970,CDM,302,RC,,,,,,Inpatient,,,50.43,50.43,Wellcare,Wellcare,50.43,,,,,,,case rate,50.43,50.43,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health PPO CPD,Meritain Health PPO CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/Commercial Product,Aetna/Commercial Product,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health CPD,Meritain Health CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Starmark CPD,Starmark CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Aetna Medicare,Aetna Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Ambetter ,Ambetter ,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access,Anthem Blue Access,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access Choice,Anthem Blue Access Choice,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Preferred,Anthem Blue Preferred,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Pathway,Anthem Pathway,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Alliance,Anthem Alliance,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Medicare,Anthem Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna,Cigna,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna PPO,Cigna PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Cigna Medicare Advantage,Cigna Medicare Advantage,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Essence,Essence,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink HMO,Healthlink HMO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink PPO,Healthlink PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,HomeState Health Plan,HomeState Health Plan,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Humana Gold,Humana Gold,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Medicaid MO,Medicaid MO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Medica,Medica,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Tricare,Tricare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC All Payer,UHC All Payer,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Exchange,UHC Exchange,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicaid,UHC Medicaid,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UMR CPD,UMR CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicare,UHC Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB SERUM CF      ,38250971,CDM,302,RC,,,,,,Inpatient,,,136.58,136.58,Wellcare,Wellcare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG PAPER WASP IGG     ,38250972,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET WHT IGG     ,38250973,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG HORNET YEL IGG     ,38250974,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health PPO CPD,Meritain Health PPO CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna/Commercial Product,Aetna/Commercial Product,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Meritain Health CPD,Meritain Health CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Starmark CPD,Starmark CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Aetna Medicare,Aetna Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Ambetter ,Ambetter ,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access,Anthem Blue Access,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Access Choice,Anthem Blue Access Choice,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Blue Preferred,Anthem Blue Preferred,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Pathway,Anthem Pathway,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Alliance,Anthem Alliance,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Anthem Medicare,Anthem Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna,Cigna,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna PPO,Cigna PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Cigna Medicare Advantage,Cigna Medicare Advantage,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Essence,Essence,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink HMO,Healthlink HMO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Healthlink PPO,Healthlink PPO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,HomeState Health Plan,HomeState Health Plan,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Humana Gold,Humana Gold,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medicaid MO,Medicaid MO,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Medica,Medica,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Tricare,Tricare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC All Payer,UHC All Payer,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Exchange,UHC Exchange,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicaid,UHC Medicaid,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UMR CPD,UMR CPD,107.16,,,,,,,per diem,107.16,107.16,"Per diem rate, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,UHC Medicare,UHC Medicare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O ALLERG YEL JACKET IGG     ,38250975,CDM,302,RC,,,,,,Inpatient,,,107.16,107.16,Wellcare,Wellcare,107.16,,,,,,,case rate,107.16,107.16,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health PPO CPD,Meritain Health PPO CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna/Commercial Product,Aetna/Commercial Product,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Meritain Health CPD,Meritain Health CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Starmark CPD,Starmark CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Aetna Medicare,Aetna Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Ambetter ,Ambetter ,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access,Anthem Blue Access,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Access Choice,Anthem Blue Access Choice,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Blue Preferred,Anthem Blue Preferred,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Pathway,Anthem Pathway,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Alliance,Anthem Alliance,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Anthem Medicare,Anthem Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna,Cigna,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna PPO,Cigna PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Cigna Medicare Advantage,Cigna Medicare Advantage,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Essence,Essence,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink HMO,Healthlink HMO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Healthlink PPO,Healthlink PPO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,HomeState Health Plan,HomeState Health Plan,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Humana Gold,Humana Gold,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medicaid MO,Medicaid MO,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Medica,Medica,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Tricare,Tricare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC All Payer,UHC All Payer,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Exchange,UHC Exchange,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicaid,UHC Medicaid,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UMR CPD,UMR CPD,118.72,,,,,,,per diem,118.72,118.72,"Per diem rate, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,UHC Medicare,UHC Medicare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O C1 ESTERASE INHIB FNC     ,38250976,CDM,302,RC,,,,,,Inpatient,,,118.72,118.72,Wellcare,Wellcare,118.72,,,,,,,case rate,118.72,118.72,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O CAFFEINE SERUM/PLASMA     ,38250977,CDM,301,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O DNASE B ANTIBODY          ,38250978,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Meritain Health PPO CPD,Meritain Health PPO CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Aetna/Commercial Product,Aetna/Commercial Product,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Meritain Health CPD,Meritain Health CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Starmark CPD,Starmark CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Aetna Medicare,Aetna Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Ambetter ,Ambetter ,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Access,Anthem Blue Access,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Access Choice,Anthem Blue Access Choice,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Blue Preferred,Anthem Blue Preferred,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Pathway,Anthem Pathway,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Alliance,Anthem Alliance,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Anthem Medicare,Anthem Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Cigna,Cigna,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Cigna PPO,Cigna PPO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Cigna Medicare Advantage,Cigna Medicare Advantage,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Essence,Essence,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Healthlink HMO,Healthlink HMO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Healthlink PPO,Healthlink PPO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,HomeState Health Plan,HomeState Health Plan,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Humana Gold,Humana Gold,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Medicaid MO,Medicaid MO,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Medica,Medica,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Tricare,Tricare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,UHC All Payer,UHC All Payer,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,UHC Exchange,UHC Exchange,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,UHC Medicaid,UHC Medicaid,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,UMR CPD,UMR CPD,129.22,,,,,,,per diem,129.22,129.22,"Per diem rate, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,UHC Medicare,UHC Medicare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O HEP DELTA AG ELISA        ,38250979,CDM,306,RC,,,,,,Inpatient,,,129.22,129.22,Wellcare,Wellcare,129.22,,,,,,,case rate,129.22,129.22,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health PPO CPD,Meritain Health PPO CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/Commercial Product,Aetna/Commercial Product,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health CPD,Meritain Health CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Starmark CPD,Starmark CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Aetna Medicare,Aetna Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Ambetter ,Ambetter ,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access,Anthem Blue Access,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access Choice,Anthem Blue Access Choice,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Preferred,Anthem Blue Preferred,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Pathway,Anthem Pathway,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Alliance,Anthem Alliance,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Medicare,Anthem Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Cigna,Cigna,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Cigna PPO,Cigna PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Cigna Medicare Advantage,Cigna Medicare Advantage,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Essence,Essence,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink HMO,Healthlink HMO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink PPO,Healthlink PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,HomeState Health Plan,HomeState Health Plan,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Humana Gold,Humana Gold,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Medicaid MO,Medicaid MO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Medica,Medica,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Tricare,Tricare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,UHC All Payer,UHC All Payer,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,UHC Exchange,UHC Exchange,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicaid,UHC Medicaid,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,UMR CPD,UMR CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicare,UHC Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN ANTIGEN      ,38250980,CDM,305,RC,,,,,,Inpatient,,,49.38,49.38,Wellcare,Wellcare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Meritain Health PPO CPD,Meritain Health PPO CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna/Commercial Product,Aetna/Commercial Product,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Meritain Health CPD,Meritain Health CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Starmark CPD,Starmark CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna Medicare,Aetna Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Ambetter ,Ambetter ,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Access,Anthem Blue Access,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Access Choice,Anthem Blue Access Choice,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Preferred,Anthem Blue Preferred,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Pathway,Anthem Pathway,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Alliance,Anthem Alliance,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Medicare,Anthem Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna,Cigna,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna PPO,Cigna PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna Medicare Advantage,Cigna Medicare Advantage,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Essence,Essence,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthlink HMO,Healthlink HMO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthlink PPO,Healthlink PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,HomeState Health Plan,HomeState Health Plan,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Humana Gold,Humana Gold,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Medicaid MO,Medicaid MO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Medica,Medica,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Tricare,Tricare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC All Payer,UHC All Payer,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Exchange,UHC Exchange,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Medicaid,UHC Medicaid,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UMR CPD,UMR CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Medicare,UHC Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT BLOOD      ,38250981,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Wellcare,Wellcare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Meritain Health PPO CPD,Meritain Health PPO CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna/Commercial Product,Aetna/Commercial Product,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Meritain Health CPD,Meritain Health CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Starmark CPD,Starmark CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Aetna Medicare,Aetna Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Ambetter ,Ambetter ,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Access,Anthem Blue Access,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Access Choice,Anthem Blue Access Choice,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Blue Preferred,Anthem Blue Preferred,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Pathway,Anthem Pathway,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Alliance,Anthem Alliance,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Anthem Medicare,Anthem Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna,Cigna,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna PPO,Cigna PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Cigna Medicare Advantage,Cigna Medicare Advantage,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Essence,Essence,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthlink HMO,Healthlink HMO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Healthlink PPO,Healthlink PPO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,HomeState Health Plan,HomeState Health Plan,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Humana Gold,Humana Gold,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Medicaid MO,Medicaid MO,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Medica,Medica,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Tricare,Tricare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC All Payer,UHC All Payer,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Exchange,UHC Exchange,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Medicaid,UHC Medicaid,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UMR CPD,UMR CPD,587.29,,,,,,,per diem,587.29,587.29,"Per diem rate, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,UHC Medicare,UHC Medicare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BK VIRUS QUANT URINE      ,38250982,CDM,306,RC,,,,,,Inpatient,,,587.29,587.29,Wellcare,Wellcare,587.29,,,,,,,case rate,587.29,587.29,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health PPO CPD,Meritain Health PPO CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/Commercial Product,Aetna/Commercial Product,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health CPD,Meritain Health CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Starmark CPD,Starmark CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Aetna Medicare,Aetna Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Ambetter ,Ambetter ,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access,Anthem Blue Access,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access Choice,Anthem Blue Access Choice,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Preferred,Anthem Blue Preferred,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Pathway,Anthem Pathway,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Alliance,Anthem Alliance,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Medicare,Anthem Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Cigna,Cigna,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Cigna PPO,Cigna PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Cigna Medicare Advantage,Cigna Medicare Advantage,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Essence,Essence,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink HMO,Healthlink HMO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink PPO,Healthlink PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,HomeState Health Plan,HomeState Health Plan,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Humana Gold,Humana Gold,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Medicaid MO,Medicaid MO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Medica,Medica,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Tricare,Tricare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,UHC All Payer,UHC All Payer,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,UHC Exchange,UHC Exchange,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicaid,UHC Medicaid,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,UMR CPD,UMR CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicare,UHC Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O BILE ACIDS TOTAL          ,38250983,CDM,301,RC,,,,,,Inpatient,,,71.44,71.44,Wellcare,Wellcare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health PPO CPD,Meritain Health PPO CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/Commercial Product,Aetna/Commercial Product,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health CPD,Meritain Health CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Starmark CPD,Starmark CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna Medicare,Aetna Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Ambetter ,Ambetter ,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access,Anthem Blue Access,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access Choice,Anthem Blue Access Choice,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Preferred,Anthem Blue Preferred,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Pathway,Anthem Pathway,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Alliance,Anthem Alliance,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Medicare,Anthem Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna,Cigna,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna PPO,Cigna PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna Medicare Advantage,Cigna Medicare Advantage,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Essence,Essence,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink HMO,Healthlink HMO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink PPO,Healthlink PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,HomeState Health Plan,HomeState Health Plan,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Humana Gold,Humana Gold,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medicaid MO,Medicaid MO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medica,Medica,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Tricare,Tricare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC All Payer,UHC All Payer,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Exchange,UHC Exchange,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicaid,UHC Medicaid,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UMR CPD,UMR CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicare,UHC Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEXAGONAL PHOSPHOLIP      ,38250984,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Wellcare,Wellcare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Meritain Health PPO CPD,Meritain Health PPO CPD,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Aetna/Commercial Product,Aetna/Commercial Product,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Meritain Health CPD,Meritain Health CPD,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Starmark CPD,Starmark CPD,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Aetna Medicare,Aetna Medicare,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Ambetter ,Ambetter ,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Blue Access,Anthem Blue Access,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Blue Access Choice,Anthem Blue Access Choice,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Blue Preferred,Anthem Blue Preferred,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Pathway,Anthem Pathway,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Alliance,Anthem Alliance,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Anthem Medicare,Anthem Medicare,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Cigna,Cigna,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Cigna PPO,Cigna PPO,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Cigna Medicare Advantage,Cigna Medicare Advantage,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Essence,Essence,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Healthlink HMO,Healthlink HMO,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Healthlink PPO,Healthlink PPO,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,HomeState Health Plan,HomeState Health Plan,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Humana Gold,Humana Gold,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Medicaid MO,Medicaid MO,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Medica,Medica,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Tricare,Tricare,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,UHC All Payer,UHC All Payer,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,UHC Exchange,UHC Exchange,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,UHC Medicaid,UHC Medicaid,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,UMR CPD,UMR CPD,173.35,,,,,,,per diem,173.35,173.35,"Per diem rate, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,UHC Medicare,UHC Medicare,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O MYCOPLASMA PNEUM PCR      ,38250985,CDM,306,RC,,,,,,Inpatient,,,173.35,173.35,Wellcare,Wellcare,173.35,,,,,,,case rate,173.35,173.35,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O INHIBIN A DIMER           ,38250986,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O HOMOVANILLIC ACID UR      ,38250987,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health PPO CPD,Meritain Health PPO CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Aetna/Commercial Product,Aetna/Commercial Product,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Meritain Health CPD,Meritain Health CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Starmark CPD,Starmark CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Aetna Medicare,Aetna Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Ambetter ,Ambetter ,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access,Anthem Blue Access,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Access Choice,Anthem Blue Access Choice,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Blue Preferred,Anthem Blue Preferred,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Pathway,Anthem Pathway,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Alliance,Anthem Alliance,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Anthem Medicare,Anthem Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Cigna,Cigna,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Cigna PPO,Cigna PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Cigna Medicare Advantage,Cigna Medicare Advantage,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Essence,Essence,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink HMO,Healthlink HMO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Healthlink PPO,Healthlink PPO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,HomeState Health Plan,HomeState Health Plan,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Humana Gold,Humana Gold,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Medicaid MO,Medicaid MO,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Medica,Medica,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Tricare,Tricare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,UHC All Payer,UHC All Payer,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,UHC Exchange,UHC Exchange,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicaid,UHC Medicaid,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,UMR CPD,UMR CPD,134.48,,,,,,,per diem,134.48,134.48,"Per diem rate, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,UHC Medicare,UHC Medicare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ESTROGENS FRAC TMS        ,38250988,CDM,301,RC,,,,,,Inpatient,,,134.48,134.48,Wellcare,Wellcare,134.48,,,,,,,case rate,134.48,134.48,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health PPO CPD,Meritain Health PPO CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/Commercial Product,Aetna/Commercial Product,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health CPD,Meritain Health CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Starmark CPD,Starmark CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna Medicare,Aetna Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Ambetter ,Ambetter ,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access,Anthem Blue Access,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access Choice,Anthem Blue Access Choice,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Preferred,Anthem Blue Preferred,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Pathway,Anthem Pathway,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Alliance,Anthem Alliance,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Medicare,Anthem Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna,Cigna,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna PPO,Cigna PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna Medicare Advantage,Cigna Medicare Advantage,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Essence,Essence,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink HMO,Healthlink HMO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink PPO,Healthlink PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,HomeState Health Plan,HomeState Health Plan,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Humana Gold,Humana Gold,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medicaid MO,Medicaid MO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medica,Medica,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Tricare,Tricare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC All Payer,UHC All Payer,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Exchange,UHC Exchange,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicaid,UHC Medicaid,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UMR CPD,UMR CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicare,UHC Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O ADAMTS13 ACTIVITY         ,38250989,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Wellcare,Wellcare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM WHOLE BLOOD      ,38250990,CDM,301,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health PPO CPD,Meritain Health PPO CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/Commercial Product,Aetna/Commercial Product,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health CPD,Meritain Health CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Starmark CPD,Starmark CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Aetna Medicare,Aetna Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Ambetter ,Ambetter ,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access,Anthem Blue Access,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access Choice,Anthem Blue Access Choice,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Preferred,Anthem Blue Preferred,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Pathway,Anthem Pathway,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Alliance,Anthem Alliance,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Medicare,Anthem Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna,Cigna,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna PPO,Cigna PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Cigna Medicare Advantage,Cigna Medicare Advantage,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Essence,Essence,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink HMO,Healthlink HMO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink PPO,Healthlink PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,HomeState Health Plan,HomeState Health Plan,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Humana Gold,Humana Gold,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Medicaid MO,Medicaid MO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Medica,Medica,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Tricare,Tricare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC All Payer,UHC All Payer,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Exchange,UHC Exchange,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicaid,UHC Medicaid,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UMR CPD,UMR CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicare,UHC Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O THALLIUM URINE            ,38250991,CDM,301,RC,,,,,,Inpatient,,,70.39,70.39,Wellcare,Wellcare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Meritain Health PPO CPD,Meritain Health PPO CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Aetna/Commercial Product,Aetna/Commercial Product,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Meritain Health CPD,Meritain Health CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Starmark CPD,Starmark CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Aetna Medicare,Aetna Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Ambetter ,Ambetter ,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Access,Anthem Blue Access,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Access Choice,Anthem Blue Access Choice,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Preferred,Anthem Blue Preferred,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Pathway,Anthem Pathway,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Alliance,Anthem Alliance,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Medicare,Anthem Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Cigna,Cigna,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Cigna PPO,Cigna PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Cigna Medicare Advantage,Cigna Medicare Advantage,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Essence,Essence,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Healthlink HMO,Healthlink HMO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Healthlink PPO,Healthlink PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,HomeState Health Plan,HomeState Health Plan,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Humana Gold,Humana Gold,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Medicaid MO,Medicaid MO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Medica,Medica,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Tricare,Tricare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,UHC All Payer,UHC All Payer,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,UHC Exchange,UHC Exchange,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,UHC Medicaid,UHC Medicaid,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,UMR CPD,UMR CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,UHC Medicare,UHC Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O ALLERG PHOMABETAE IGG     ,38250992,CDM,302,RC,,,,,,Inpatient,,,46.23,46.23,Wellcare,Wellcare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O LIPID ASSOC SIALIC AC     ,38250993,CDM,301,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HERPESVIRUS 6 QNT PCR     ,38250994,CDM,306,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ALLRG TRICHO RUBR IGG     ,38250995,CDM,302,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O ZONISAMIDE                ,38250996,CDM,301,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Meritain Health PPO CPD,Meritain Health PPO CPD,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Aetna/Commercial Product,Aetna/Commercial Product,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Meritain Health CPD,Meritain Health CPD,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Starmark CPD,Starmark CPD,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Aetna Medicare,Aetna Medicare,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Ambetter ,Ambetter ,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Blue Access,Anthem Blue Access,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Blue Access Choice,Anthem Blue Access Choice,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Blue Preferred,Anthem Blue Preferred,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Pathway,Anthem Pathway,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Alliance,Anthem Alliance,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Anthem Medicare,Anthem Medicare,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Cigna,Cigna,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Cigna PPO,Cigna PPO,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Cigna Medicare Advantage,Cigna Medicare Advantage,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Essence,Essence,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Healthlink HMO,Healthlink HMO,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Healthlink PPO,Healthlink PPO,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,HomeState Health Plan,HomeState Health Plan,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Humana Gold,Humana Gold,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Medicaid MO,Medicaid MO,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Medica,Medica,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Tricare,Tricare,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,UHC All Payer,UHC All Payer,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,UHC Exchange,UHC Exchange,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,UHC Medicaid,UHC Medicaid,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,UMR CPD,UMR CPD,359.31,,,,,,,per diem,359.31,359.31,"Per diem rate, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,UHC Medicare,UHC Medicare,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O CHLAM PNEUMONIAE PCR      ,38250997,CDM,306,RC,,,,,,Inpatient,,,359.31,359.31,Wellcare,Wellcare,359.31,,,,,,,case rate,359.31,359.31,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O BOR BURG IGG WEST CSF     ,38250998,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health PPO CPD,Meritain Health PPO CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/Commercial Product,Aetna/Commercial Product,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health CPD,Meritain Health CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Starmark CPD,Starmark CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna Medicare,Aetna Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Ambetter ,Ambetter ,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access,Anthem Blue Access,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access Choice,Anthem Blue Access Choice,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Preferred,Anthem Blue Preferred,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Pathway,Anthem Pathway,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Alliance,Anthem Alliance,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Medicare,Anthem Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna,Cigna,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna PPO,Cigna PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna Medicare Advantage,Cigna Medicare Advantage,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Essence,Essence,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink HMO,Healthlink HMO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink PPO,Healthlink PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,HomeState Health Plan,HomeState Health Plan,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Humana Gold,Humana Gold,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medicaid MO,Medicaid MO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medica,Medica,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Tricare,Tricare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC All Payer,UHC All Payer,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Exchange,UHC Exchange,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicaid,UHC Medicaid,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UMR CPD,UMR CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicare,UHC Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGM WEST BLOT      ,38250999,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Wellcare,Wellcare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health PPO CPD,Meritain Health PPO CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/Commercial Product,Aetna/Commercial Product,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health CPD,Meritain Health CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Starmark CPD,Starmark CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Aetna Medicare,Aetna Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Ambetter ,Ambetter ,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access,Anthem Blue Access,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access Choice,Anthem Blue Access Choice,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Preferred,Anthem Blue Preferred,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Pathway,Anthem Pathway,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Alliance,Anthem Alliance,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Medicare,Anthem Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna,Cigna,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna PPO,Cigna PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Cigna Medicare Advantage,Cigna Medicare Advantage,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Essence,Essence,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink HMO,Healthlink HMO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink PPO,Healthlink PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,HomeState Health Plan,HomeState Health Plan,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Humana Gold,Humana Gold,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medicaid MO,Medicaid MO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Medica,Medica,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Tricare,Tricare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC All Payer,UHC All Payer,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Exchange,UHC Exchange,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicaid,UHC Medicaid,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UMR CPD,UMR CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicare,UHC Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O B BURG IGG WEST BLOT      ,38251000,CDM,302,RC,,,,,,Inpatient,,,67.24,67.24,Wellcare,Wellcare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Meritain Health PPO CPD,Meritain Health PPO CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Aetna/Commercial Product,Aetna/Commercial Product,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Meritain Health CPD,Meritain Health CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Starmark CPD,Starmark CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Aetna Medicare,Aetna Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Ambetter ,Ambetter ,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Blue Access,Anthem Blue Access,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Blue Access Choice,Anthem Blue Access Choice,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Blue Preferred,Anthem Blue Preferred,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Pathway,Anthem Pathway,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Alliance,Anthem Alliance,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Anthem Medicare,Anthem Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Cigna,Cigna,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Cigna PPO,Cigna PPO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Cigna Medicare Advantage,Cigna Medicare Advantage,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Essence,Essence,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Healthlink HMO,Healthlink HMO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Healthlink PPO,Healthlink PPO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,HomeState Health Plan,HomeState Health Plan,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Humana Gold,Humana Gold,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Medicaid MO,Medicaid MO,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Medica,Medica,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Tricare,Tricare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,UHC All Payer,UHC All Payer,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,UHC Exchange,UHC Exchange,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,UHC Medicaid,UHC Medicaid,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,UMR CPD,UMR CPD,152.34,,,,,,,per diem,152.34,152.34,"Per diem rate, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,UHC Medicare,UHC Medicare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O BORRELIA SPECIES PCR      ,38251001,CDM,306,RC,,,,,,Inpatient,,,152.34,152.34,Wellcare,Wellcare,152.34,,,,,,,case rate,152.34,152.34,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O HEP B SURF AG CONF        ,38251002,CDM,306,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O VITAMIN B2 RIBOFLAVIN     ,38251003,CDM,301,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Meritain Health PPO CPD,Meritain Health PPO CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Aetna/Commercial Product,Aetna/Commercial Product,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Meritain Health CPD,Meritain Health CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Starmark CPD,Starmark CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Aetna Medicare,Aetna Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Ambetter ,Ambetter ,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Access,Anthem Blue Access,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Access Choice,Anthem Blue Access Choice,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Blue Preferred,Anthem Blue Preferred,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Pathway,Anthem Pathway,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Alliance,Anthem Alliance,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Anthem Medicare,Anthem Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Cigna,Cigna,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Cigna PPO,Cigna PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Cigna Medicare Advantage,Cigna Medicare Advantage,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Essence,Essence,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Healthlink HMO,Healthlink HMO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Healthlink PPO,Healthlink PPO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,HomeState Health Plan,HomeState Health Plan,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Humana Gold,Humana Gold,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Medicaid MO,Medicaid MO,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Medica,Medica,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Tricare,Tricare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,UHC All Payer,UHC All Payer,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,UHC Exchange,UHC Exchange,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,UHC Medicaid,UHC Medicaid,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,UMR CPD,UMR CPD,46.23,,,,,,,per diem,46.23,46.23,"Per diem rate, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,UHC Medicare,UHC Medicare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
"S/O 1,5 ANHYDROGLU QN S/P     ",38251004,CDM,301,RC,,,,,,Inpatient,,,46.23,46.23,Wellcare,Wellcare,46.23,,,,,,,case rate,46.23,46.23,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META S/P       ,38251005,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O MEPERIDINE META URINE     ,38251006,CDM,301,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health PPO CPD,Meritain Health PPO CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/Commercial Product,Aetna/Commercial Product,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health CPD,Meritain Health CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Starmark CPD,Starmark CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna Medicare,Aetna Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Ambetter ,Ambetter ,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access,Anthem Blue Access,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access Choice,Anthem Blue Access Choice,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Preferred,Anthem Blue Preferred,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Pathway,Anthem Pathway,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Alliance,Anthem Alliance,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Medicare,Anthem Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna,Cigna,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna PPO,Cigna PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna Medicare Advantage,Cigna Medicare Advantage,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Essence,Essence,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink HMO,Healthlink HMO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink PPO,Healthlink PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,HomeState Health Plan,HomeState Health Plan,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Humana Gold,Humana Gold,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medicaid MO,Medicaid MO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medica,Medica,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Tricare,Tricare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC All Payer,UHC All Payer,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Exchange,UHC Exchange,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicaid,UHC Medicaid,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UMR CPD,UMR CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicare,UHC Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR QNT PCR      ,38251007,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Wellcare,Wellcare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health PPO CPD,Meritain Health PPO CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/Commercial Product,Aetna/Commercial Product,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health CPD,Meritain Health CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Starmark CPD,Starmark CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna Medicare,Aetna Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Ambetter ,Ambetter ,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access,Anthem Blue Access,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access Choice,Anthem Blue Access Choice,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Preferred,Anthem Blue Preferred,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Pathway,Anthem Pathway,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Alliance,Anthem Alliance,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Medicare,Anthem Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna,Cigna,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna PPO,Cigna PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna Medicare Advantage,Cigna Medicare Advantage,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Essence,Essence,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink HMO,Healthlink HMO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink PPO,Healthlink PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,HomeState Health Plan,HomeState Health Plan,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Humana Gold,Humana Gold,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medicaid MO,Medicaid MO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medica,Medica,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Tricare,Tricare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC All Payer,UHC All Payer,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Exchange,UHC Exchange,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicaid,UHC Medicaid,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UMR CPD,UMR CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicare,UHC Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O ADENOVIRUS QNT PCR        ,38251008,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Wellcare,Wellcare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Meritain Health PPO CPD,Meritain Health PPO CPD,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Aetna/Commercial Product,Aetna/Commercial Product,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Meritain Health CPD,Meritain Health CPD,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Starmark CPD,Starmark CPD,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Aetna Medicare,Aetna Medicare,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Ambetter ,Ambetter ,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Blue Access,Anthem Blue Access,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Blue Access Choice,Anthem Blue Access Choice,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Blue Preferred,Anthem Blue Preferred,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Pathway,Anthem Pathway,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Alliance,Anthem Alliance,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Anthem Medicare,Anthem Medicare,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Cigna,Cigna,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Cigna PPO,Cigna PPO,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Cigna Medicare Advantage,Cigna Medicare Advantage,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Essence,Essence,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Healthlink HMO,Healthlink HMO,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Healthlink PPO,Healthlink PPO,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,HomeState Health Plan,HomeState Health Plan,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Humana Gold,Humana Gold,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Medicaid MO,Medicaid MO,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Medica,Medica,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Tricare,Tricare,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,UHC All Payer,UHC All Payer,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,UHC Exchange,UHC Exchange,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,UHC Medicaid,UHC Medicaid,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,UMR CPD,UMR CPD,953.94,,,,,,,per diem,953.94,953.94,"Per diem rate, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,UHC Medicare,UHC Medicare,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O HEROIN SRM/PLASM CONF     ,38251009,CDM,301,RC,,,,,,Inpatient,,,953.94,953.94,Wellcare,Wellcare,953.94,,,,,,,case rate,953.94,953.94,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O FACT VIII BETHESD QNT     ,38251010,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health PPO CPD,Meritain Health PPO CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Aetna/Commercial Product,Aetna/Commercial Product,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Meritain Health CPD,Meritain Health CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Starmark CPD,Starmark CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Aetna Medicare,Aetna Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Ambetter ,Ambetter ,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access,Anthem Blue Access,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Access Choice,Anthem Blue Access Choice,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Blue Preferred,Anthem Blue Preferred,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Pathway,Anthem Pathway,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Alliance,Anthem Alliance,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Anthem Medicare,Anthem Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Cigna,Cigna,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Cigna PPO,Cigna PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Cigna Medicare Advantage,Cigna Medicare Advantage,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Essence,Essence,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink HMO,Healthlink HMO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Healthlink PPO,Healthlink PPO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,HomeState Health Plan,HomeState Health Plan,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Humana Gold,Humana Gold,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Medicaid MO,Medicaid MO,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Medica,Medica,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Tricare,Tricare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,UHC All Payer,UHC All Payer,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,UHC Exchange,UHC Exchange,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicaid,UHC Medicaid,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,UMR CPD,UMR CPD,136.58,,,,,,,per diem,136.58,136.58,"Per diem rate, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,UHC Medicare,UHC Medicare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
S/O LIPOPRO ASSOC PHOS A2     ,38251011,CDM,301,RC,,,,,,Inpatient,,,136.58,136.58,Wellcare,Wellcare,136.58,,,,,,,case rate,136.58,136.58,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Meritain Health PPO CPD,Meritain Health PPO CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Aetna/Commercial Product,Aetna/Commercial Product,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Meritain Health CPD,Meritain Health CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Starmark CPD,Starmark CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Aetna Medicare,Aetna Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Ambetter ,Ambetter ,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Access,Anthem Blue Access,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Access Choice,Anthem Blue Access Choice,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Preferred,Anthem Blue Preferred,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Pathway,Anthem Pathway,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Alliance,Anthem Alliance,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Medicare,Anthem Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Cigna,Cigna,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Cigna PPO,Cigna PPO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Cigna Medicare Advantage,Cigna Medicare Advantage,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Essence,Essence,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Healthlink HMO,Healthlink HMO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Healthlink PPO,Healthlink PPO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,HomeState Health Plan,HomeState Health Plan,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Humana Gold,Humana Gold,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Medicaid MO,Medicaid MO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Medica,Medica,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Tricare,Tricare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,UHC All Payer,UHC All Payer,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,UHC Exchange,UHC Exchange,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,UHC Medicaid,UHC Medicaid,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,UMR CPD,UMR CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,UHC Medicare,UHC Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IA INFLUENZA A OR B QL EA     ,38251012,CDM,306,RC,,,,,,Inpatient,,,355.1,355.1,Wellcare,Wellcare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Meritain Health PPO CPD,Meritain Health PPO CPD,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Aetna/Commercial Product,Aetna/Commercial Product,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Meritain Health CPD,Meritain Health CPD,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Starmark CPD,Starmark CPD,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Aetna Medicare,Aetna Medicare,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Ambetter ,Ambetter ,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Blue Access,Anthem Blue Access,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Blue Access Choice,Anthem Blue Access Choice,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Blue Preferred,Anthem Blue Preferred,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Pathway,Anthem Pathway,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Alliance,Anthem Alliance,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Anthem Medicare,Anthem Medicare,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Cigna,Cigna,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Cigna PPO,Cigna PPO,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Cigna Medicare Advantage,Cigna Medicare Advantage,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Essence,Essence,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Healthlink HMO,Healthlink HMO,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Healthlink PPO,Healthlink PPO,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,HomeState Health Plan,HomeState Health Plan,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Humana Gold,Humana Gold,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Medicaid MO,Medicaid MO,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Medica,Medica,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Tricare,Tricare,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,UHC All Payer,UHC All Payer,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,UHC Exchange,UHC Exchange,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,UHC Medicaid,UHC Medicaid,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,UMR CPD,UMR CPD,947.64,,,,,,,per diem,947.64,947.64,"Per diem rate, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,UHC Medicare,UHC Medicare,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
IMMUNOASSAY STREP A           ,38251013,CDM,306,RC,,,,,,Inpatient,,,947.64,947.64,Wellcare,Wellcare,947.64,,,,,,,case rate,947.64,947.64,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O HGB ELECTRO INTERFACE     ,38251014,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Meritain Health PPO CPD,Meritain Health PPO CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna/Commercial Product,Aetna/Commercial Product,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Meritain Health CPD,Meritain Health CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Starmark CPD,Starmark CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Aetna Medicare,Aetna Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Ambetter ,Ambetter ,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Access,Anthem Blue Access,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Access Choice,Anthem Blue Access Choice,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Blue Preferred,Anthem Blue Preferred,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Pathway,Anthem Pathway,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Alliance,Anthem Alliance,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Anthem Medicare,Anthem Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna,Cigna,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna PPO,Cigna PPO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Cigna Medicare Advantage,Cigna Medicare Advantage,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Essence,Essence,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthlink HMO,Healthlink HMO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Healthlink PPO,Healthlink PPO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,HomeState Health Plan,HomeState Health Plan,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Humana Gold,Humana Gold,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Medicaid MO,Medicaid MO,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Medica,Medica,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Tricare,Tricare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC All Payer,UHC All Payer,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Exchange,UHC Exchange,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Medicaid,UHC Medicaid,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UMR CPD,UMR CPD,375.06,,,,,,,per diem,375.06,375.06,"Per diem rate, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,UHC Medicare,UHC Medicare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O FRAGILE X FMR1 W/RFLX     ,38251015,CDM,301,RC,,,,,,Inpatient,,,375.06,375.06,Wellcare,Wellcare,375.06,,,,,,,case rate,375.06,375.06,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Meritain Health PPO CPD,Meritain Health PPO CPD,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Aetna/Commercial Product,Aetna/Commercial Product,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Meritain Health CPD,Meritain Health CPD,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Starmark CPD,Starmark CPD,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Aetna Medicare,Aetna Medicare,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Ambetter ,Ambetter ,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Blue Access,Anthem Blue Access,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Blue Access Choice,Anthem Blue Access Choice,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Blue Preferred,Anthem Blue Preferred,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Pathway,Anthem Pathway,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Alliance,Anthem Alliance,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Anthem Medicare,Anthem Medicare,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Cigna,Cigna,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Cigna PPO,Cigna PPO,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Cigna Medicare Advantage,Cigna Medicare Advantage,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Essence,Essence,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Healthlink HMO,Healthlink HMO,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Healthlink PPO,Healthlink PPO,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,HomeState Health Plan,HomeState Health Plan,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Humana Gold,Humana Gold,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Medicaid MO,Medicaid MO,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Medica,Medica,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Tricare,Tricare,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,UHC All Payer,UHC All Payer,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,UHC Exchange,UHC Exchange,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,UHC Medicaid,UHC Medicaid,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,UMR CPD,UMR CPD,204.87,,,,,,,per diem,204.87,204.87,"Per diem rate, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,UHC Medicare,UHC Medicare,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTINGTON DIS PCR        ,38251016,CDM,301,RC,,,,,,Inpatient,,,204.87,204.87,Wellcare,Wellcare,204.87,,,,,,,case rate,204.87,204.87,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health PPO CPD,Meritain Health PPO CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Aetna/Commercial Product,Aetna/Commercial Product,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Meritain Health CPD,Meritain Health CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Starmark CPD,Starmark CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Aetna Medicare,Aetna Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Ambetter ,Ambetter ,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access,Anthem Blue Access,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Access Choice,Anthem Blue Access Choice,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Blue Preferred,Anthem Blue Preferred,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Pathway,Anthem Pathway,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Alliance,Anthem Alliance,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Anthem Medicare,Anthem Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Cigna,Cigna,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Cigna PPO,Cigna PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Cigna Medicare Advantage,Cigna Medicare Advantage,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Essence,Essence,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink HMO,Healthlink HMO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Healthlink PPO,Healthlink PPO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,HomeState Health Plan,HomeState Health Plan,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Humana Gold,Humana Gold,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Medicaid MO,Medicaid MO,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Medica,Medica,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Tricare,Tricare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,UHC All Payer,UHC All Payer,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,UHC Exchange,UHC Exchange,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicaid,UHC Medicaid,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,UMR CPD,UMR CPD,91.4,,,,,,,per diem,91.4,91.4,"Per diem rate, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,UHC Medicare,UHC Medicare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O HUNTING DIS SOUTH BLT     ,38251017,CDM,301,RC,,,,,,Inpatient,,,91.4,91.4,Wellcare,Wellcare,91.4,,,,,,,case rate,91.4,91.4,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 1 HPA1        ,38251018,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 2 HPA2        ,38251019,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 3 HPA3        ,38251020,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 4 HPA4        ,38251021,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 5 HPA5        ,38251022,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 6 HPA6        ,38251023,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O PLATELET AG 15 HPA15      ,38251024,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Meritain Health PPO CPD,Meritain Health PPO CPD,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Aetna/Commercial Product,Aetna/Commercial Product,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Meritain Health CPD,Meritain Health CPD,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Starmark CPD,Starmark CPD,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Aetna Medicare,Aetna Medicare,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Ambetter ,Ambetter ,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Blue Access,Anthem Blue Access,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Blue Access Choice,Anthem Blue Access Choice,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Blue Preferred,Anthem Blue Preferred,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Pathway,Anthem Pathway,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Alliance,Anthem Alliance,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Anthem Medicare,Anthem Medicare,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Cigna,Cigna,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Cigna PPO,Cigna PPO,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Cigna Medicare Advantage,Cigna Medicare Advantage,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Essence,Essence,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Healthlink HMO,Healthlink HMO,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Healthlink PPO,Healthlink PPO,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,HomeState Health Plan,HomeState Health Plan,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Humana Gold,Humana Gold,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Medicaid MO,Medicaid MO,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Medica,Medica,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Tricare,Tricare,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,UHC All Payer,UHC All Payer,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,UHC Exchange,UHC Exchange,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,UHC Medicaid,UHC Medicaid,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,UMR CPD,UMR CPD,291.02,,,,,,,per diem,291.02,291.02,"Per diem rate, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,UHC Medicare,UHC Medicare,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O APOLIPOPRO E 2 CARDIO     ,38251025,CDM,301,RC,,,,,,Inpatient,,,291.02,291.02,Wellcare,Wellcare,291.02,,,,,,,case rate,291.02,291.02,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Meritain Health PPO CPD,Meritain Health PPO CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Aetna/Commercial Product,Aetna/Commercial Product,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Meritain Health CPD,Meritain Health CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Starmark CPD,Starmark CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Aetna Medicare,Aetna Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Ambetter ,Ambetter ,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Access,Anthem Blue Access,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Access Choice,Anthem Blue Access Choice,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Preferred,Anthem Blue Preferred,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Pathway,Anthem Pathway,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Alliance,Anthem Alliance,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Medicare,Anthem Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Cigna,Cigna,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Cigna PPO,Cigna PPO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Cigna Medicare Advantage,Cigna Medicare Advantage,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Essence,Essence,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Healthlink HMO,Healthlink HMO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Healthlink PPO,Healthlink PPO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,HomeState Health Plan,HomeState Health Plan,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Humana Gold,Humana Gold,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Medicaid MO,Medicaid MO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Medica,Medica,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Tricare,Tricare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,UHC All Payer,UHC All Payer,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,UHC Exchange,UHC Exchange,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,UHC Medicaid,UHC Medicaid,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,UMR CPD,UMR CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,UHC Medicare,UHC Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O HEMOCHROMATOS 3 MUTAT     ,38251026,CDM,301,RC,,,,,,Inpatient,,,331.99,331.99,Wellcare,Wellcare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Meritain Health PPO CPD,Meritain Health PPO CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna/Commercial Product,Aetna/Commercial Product,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Meritain Health CPD,Meritain Health CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Starmark CPD,Starmark CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna Medicare,Aetna Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Ambetter ,Ambetter ,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Access,Anthem Blue Access,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Access Choice,Anthem Blue Access Choice,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Preferred,Anthem Blue Preferred,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Pathway,Anthem Pathway,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Alliance,Anthem Alliance,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Medicare,Anthem Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna,Cigna,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna PPO,Cigna PPO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna Medicare Advantage,Cigna Medicare Advantage,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Essence,Essence,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthlink HMO,Healthlink HMO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthlink PPO,Healthlink PPO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,HomeState Health Plan,HomeState Health Plan,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Humana Gold,Humana Gold,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Medicaid MO,Medicaid MO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Medica,Medica,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Tricare,Tricare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC All Payer,UHC All Payer,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Exchange,UHC Exchange,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Medicaid,UHC Medicaid,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UMR CPD,UMR CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Medicare,UHC Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O PROTHROMB G20210A MUT     ,38251027,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Wellcare,Wellcare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Meritain Health PPO CPD,Meritain Health PPO CPD,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Aetna/Commercial Product,Aetna/Commercial Product,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Meritain Health CPD,Meritain Health CPD,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Starmark CPD,Starmark CPD,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Aetna Medicare,Aetna Medicare,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Ambetter ,Ambetter ,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Blue Access,Anthem Blue Access,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Blue Access Choice,Anthem Blue Access Choice,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Blue Preferred,Anthem Blue Preferred,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Pathway,Anthem Pathway,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Alliance,Anthem Alliance,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Anthem Medicare,Anthem Medicare,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Cigna,Cigna,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Cigna PPO,Cigna PPO,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Cigna Medicare Advantage,Cigna Medicare Advantage,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Essence,Essence,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Healthlink HMO,Healthlink HMO,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Healthlink PPO,Healthlink PPO,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,HomeState Health Plan,HomeState Health Plan,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Humana Gold,Humana Gold,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Medicaid MO,Medicaid MO,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Medica,Medica,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Tricare,Tricare,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,UHC All Payer,UHC All Payer,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,UHC Exchange,UHC Exchange,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,UHC Medicaid,UHC Medicaid,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,UMR CPD,UMR CPD,8018.18,,,,,,,per diem,8018.18,8018.18,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,UHC Medicare,UHC Medicare,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251028,CDM,301,RC,,,,,,Inpatient,,,8018.18,8018.18,Wellcare,Wellcare,8018.18,,,,,,,case rate,8018.18,8018.18,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Meritain Health PPO CPD,Meritain Health PPO CPD,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Aetna/Commercial Product,Aetna/Commercial Product,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Meritain Health CPD,Meritain Health CPD,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Starmark CPD,Starmark CPD,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Aetna Medicare,Aetna Medicare,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Ambetter ,Ambetter ,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Blue Access,Anthem Blue Access,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Blue Access Choice,Anthem Blue Access Choice,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Blue Preferred,Anthem Blue Preferred,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Pathway,Anthem Pathway,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Alliance,Anthem Alliance,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Anthem Medicare,Anthem Medicare,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Cigna,Cigna,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Cigna PPO,Cigna PPO,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Cigna Medicare Advantage,Cigna Medicare Advantage,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Essence,Essence,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Healthlink HMO,Healthlink HMO,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Healthlink PPO,Healthlink PPO,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,HomeState Health Plan,HomeState Health Plan,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Humana Gold,Humana Gold,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Medicaid MO,Medicaid MO,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Medica,Medica,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Tricare,Tricare,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,UHC All Payer,UHC All Payer,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,UHC Exchange,UHC Exchange,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,UHC Medicaid,UHC Medicaid,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,UMR CPD,UMR CPD,1053.75,,,,,,,per diem,1053.75,1053.75,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,UHC Medicare,UHC Medicare,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRANSLOC QNT     ,38251029,CDM,301,RC,,,,,,Inpatient,,,1053.75,1053.75,Wellcare,Wellcare,1053.75,,,,,,,case rate,1053.75,1053.75,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Meritain Health PPO CPD,Meritain Health PPO CPD,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Aetna/Commercial Product,Aetna/Commercial Product,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Meritain Health CPD,Meritain Health CPD,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Starmark CPD,Starmark CPD,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Aetna Medicare,Aetna Medicare,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Ambetter ,Ambetter ,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Blue Access,Anthem Blue Access,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Blue Access Choice,Anthem Blue Access Choice,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Blue Preferred,Anthem Blue Preferred,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Pathway,Anthem Pathway,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Alliance,Anthem Alliance,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Anthem Medicare,Anthem Medicare,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Cigna,Cigna,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Cigna PPO,Cigna PPO,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Cigna Medicare Advantage,Cigna Medicare Advantage,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Essence,Essence,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Healthlink HMO,Healthlink HMO,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Healthlink PPO,Healthlink PPO,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,HomeState Health Plan,HomeState Health Plan,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Humana Gold,Humana Gold,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Medicaid MO,Medicaid MO,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Medica,Medica,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Tricare,Tricare,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,UHC All Payer,UHC All Payer,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,UHC Exchange,UHC Exchange,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,UHC Medicaid,UHC Medicaid,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,UMR CPD,UMR CPD,6558.9,,,,,,,per diem,6558.9,6558.9,"Per diem rate, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,UHC Medicare,UHC Medicare,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O CYTOGENOMIC SNP MICRO     ,38251030,CDM,301,RC,,,,,,Inpatient,,,6558.9,6558.9,Wellcare,Wellcare,6558.9,,,,,,,case rate,6558.9,6558.9,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251031,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Meritain Health PPO CPD,Meritain Health PPO CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna/Commercial Product,Aetna/Commercial Product,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Meritain Health CPD,Meritain Health CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Starmark CPD,Starmark CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna Medicare,Aetna Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Ambetter ,Ambetter ,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Access,Anthem Blue Access,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Access Choice,Anthem Blue Access Choice,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Preferred,Anthem Blue Preferred,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Pathway,Anthem Pathway,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Alliance,Anthem Alliance,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Medicare,Anthem Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna,Cigna,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna PPO,Cigna PPO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna Medicare Advantage,Cigna Medicare Advantage,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Essence,Essence,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthlink HMO,Healthlink HMO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthlink PPO,Healthlink PPO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,HomeState Health Plan,HomeState Health Plan,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Humana Gold,Humana Gold,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Medicaid MO,Medicaid MO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Medica,Medica,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Tricare,Tricare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC All Payer,UHC All Payer,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Exchange,UHC Exchange,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Medicaid,UHC Medicaid,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UMR CPD,UMR CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Medicare,UHC Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251032,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Wellcare,Wellcare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Meritain Health PPO CPD,Meritain Health PPO CPD,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Aetna/Commercial Product,Aetna/Commercial Product,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Meritain Health CPD,Meritain Health CPD,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Starmark CPD,Starmark CPD,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Aetna Medicare,Aetna Medicare,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Ambetter ,Ambetter ,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Blue Access,Anthem Blue Access,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Blue Access Choice,Anthem Blue Access Choice,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Blue Preferred,Anthem Blue Preferred,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Pathway,Anthem Pathway,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Alliance,Anthem Alliance,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Anthem Medicare,Anthem Medicare,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Cigna,Cigna,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Cigna PPO,Cigna PPO,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Cigna Medicare Advantage,Cigna Medicare Advantage,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Essence,Essence,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Healthlink HMO,Healthlink HMO,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Healthlink PPO,Healthlink PPO,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,HomeState Health Plan,HomeState Health Plan,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Humana Gold,Humana Gold,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Medicaid MO,Medicaid MO,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Medica,Medica,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Tricare,Tricare,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,UHC All Payer,UHC All Payer,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,UHC Exchange,UHC Exchange,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,UHC Medicaid,UHC Medicaid,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,UMR CPD,UMR CPD,112.41,,,,,,,per diem,112.41,112.41,"Per diem rate, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,UHC Medicare,UHC Medicare,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O ANGELMAN/P-WILLI SYND     ,38251033,CDM,301,RC,,,,,,Inpatient,,,112.41,112.41,Wellcare,Wellcare,112.41,,,,,,,case rate,112.41,112.41,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health PPO CPD,Meritain Health PPO CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna/Commercial Product,Aetna/Commercial Product,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Meritain Health CPD,Meritain Health CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Starmark CPD,Starmark CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Aetna Medicare,Aetna Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Ambetter ,Ambetter ,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access,Anthem Blue Access,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Access Choice,Anthem Blue Access Choice,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Blue Preferred,Anthem Blue Preferred,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Pathway,Anthem Pathway,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Alliance,Anthem Alliance,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Anthem Medicare,Anthem Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna,Cigna,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna PPO,Cigna PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Cigna Medicare Advantage,Cigna Medicare Advantage,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Essence,Essence,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink HMO,Healthlink HMO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Healthlink PPO,Healthlink PPO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,HomeState Health Plan,HomeState Health Plan,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Humana Gold,Humana Gold,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Medicaid MO,Medicaid MO,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Medica,Medica,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Tricare,Tricare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC All Payer,UHC All Payer,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Exchange,UHC Exchange,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicaid,UHC Medicaid,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UMR CPD,UMR CPD,208.02,,,,,,,per diem,208.02,208.02,"Per diem rate, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,UHC Medicare,UHC Medicare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O NPM1 MUTATON PCR FRAG     ,38251034,CDM,301,RC,,,,,,Inpatient,,,208.02,208.02,Wellcare,Wellcare,208.02,,,,,,,case rate,208.02,208.02,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Meritain Health PPO CPD,Meritain Health PPO CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Aetna/Commercial Product,Aetna/Commercial Product,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Meritain Health CPD,Meritain Health CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Starmark CPD,Starmark CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Aetna Medicare,Aetna Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Ambetter ,Ambetter ,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Access,Anthem Blue Access,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Access Choice,Anthem Blue Access Choice,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Blue Preferred,Anthem Blue Preferred,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Pathway,Anthem Pathway,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Alliance,Anthem Alliance,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Anthem Medicare,Anthem Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Cigna,Cigna,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Cigna PPO,Cigna PPO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Cigna Medicare Advantage,Cigna Medicare Advantage,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Essence,Essence,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Healthlink HMO,Healthlink HMO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Healthlink PPO,Healthlink PPO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,HomeState Health Plan,HomeState Health Plan,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Humana Gold,Humana Gold,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Medicaid MO,Medicaid MO,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Medica,Medica,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Tricare,Tricare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,UHC All Payer,UHC All Payer,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,UHC Exchange,UHC Exchange,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,UHC Medicaid,UHC Medicaid,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,UMR CPD,UMR CPD,331.99,,,,,,,per diem,331.99,331.99,"Per diem rate, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,UHC Medicare,UHC Medicare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O GIARDIA LAMBLIA IFA       ,38251035,CDM,302,RC,,,,,,Inpatient,,,331.99,331.99,Wellcare,Wellcare,331.99,,,,,,,case rate,331.99,331.99,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health PPO CPD,Meritain Health PPO CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/Commercial Product,Aetna/Commercial Product,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health CPD,Meritain Health CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Starmark CPD,Starmark CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna Medicare,Aetna Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Ambetter ,Ambetter ,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access,Anthem Blue Access,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access Choice,Anthem Blue Access Choice,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Preferred,Anthem Blue Preferred,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Pathway,Anthem Pathway,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Alliance,Anthem Alliance,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Medicare,Anthem Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna,Cigna,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna PPO,Cigna PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna Medicare Advantage,Cigna Medicare Advantage,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Essence,Essence,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink HMO,Healthlink HMO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink PPO,Healthlink PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,HomeState Health Plan,HomeState Health Plan,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Humana Gold,Humana Gold,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medicaid MO,Medicaid MO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medica,Medica,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Tricare,Tricare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC All Payer,UHC All Payer,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Exchange,UHC Exchange,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicaid,UHC Medicaid,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UMR CPD,UMR CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicare,UHC Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O FACTOR V LEIDEN R506Q     ,38251036,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Wellcare,Wellcare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Meritain Health PPO CPD,Meritain Health PPO CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Aetna/Commercial Product,Aetna/Commercial Product,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Meritain Health CPD,Meritain Health CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Starmark CPD,Starmark CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Aetna Medicare,Aetna Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Ambetter ,Ambetter ,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Access,Anthem Blue Access,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Access Choice,Anthem Blue Access Choice,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Blue Preferred,Anthem Blue Preferred,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Pathway,Anthem Pathway,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Alliance,Anthem Alliance,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Anthem Medicare,Anthem Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Cigna,Cigna,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Cigna PPO,Cigna PPO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Cigna Medicare Advantage,Cigna Medicare Advantage,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Essence,Essence,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Healthlink HMO,Healthlink HMO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Healthlink PPO,Healthlink PPO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,HomeState Health Plan,HomeState Health Plan,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Humana Gold,Humana Gold,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Medicaid MO,Medicaid MO,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Medica,Medica,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Tricare,Tricare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,UHC All Payer,UHC All Payer,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,UHC Exchange,UHC Exchange,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,UHC Medicaid,UHC Medicaid,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,UMR CPD,UMR CPD,259.5,,,,,,,per diem,259.5,259.5,"Per diem rate, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,UHC Medicare,UHC Medicare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O PYRUVIC ACID              ,38251037,CDM,301,RC,,,,,,Inpatient,,,259.5,259.5,Wellcare,Wellcare,259.5,,,,,,,case rate,259.5,259.5,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O OSMOTIC FRAGIL ERYTHR     ,38251038,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health PPO CPD,Meritain Health PPO CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/Commercial Product,Aetna/Commercial Product,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health CPD,Meritain Health CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Starmark CPD,Starmark CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Aetna Medicare,Aetna Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Ambetter ,Ambetter ,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access,Anthem Blue Access,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access Choice,Anthem Blue Access Choice,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Preferred,Anthem Blue Preferred,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Pathway,Anthem Pathway,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Alliance,Anthem Alliance,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Medicare,Anthem Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Cigna,Cigna,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Cigna PPO,Cigna PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Cigna Medicare Advantage,Cigna Medicare Advantage,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Essence,Essence,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink HMO,Healthlink HMO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink PPO,Healthlink PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,HomeState Health Plan,HomeState Health Plan,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Humana Gold,Humana Gold,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Medicaid MO,Medicaid MO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Medica,Medica,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Tricare,Tricare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,UHC All Payer,UHC All Payer,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,UHC Exchange,UHC Exchange,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicaid,UHC Medicaid,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,UMR CPD,UMR CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicare,UHC Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O PYRUVATE KINASE           ,38251039,CDM,301,RC,,,,,,Inpatient,,,439.15,439.15,Wellcare,Wellcare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Meritain Health PPO CPD,Meritain Health PPO CPD,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Aetna/Commercial Product,Aetna/Commercial Product,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Meritain Health CPD,Meritain Health CPD,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Starmark CPD,Starmark CPD,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Aetna Medicare,Aetna Medicare,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Ambetter ,Ambetter ,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Blue Access,Anthem Blue Access,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Blue Access Choice,Anthem Blue Access Choice,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Blue Preferred,Anthem Blue Preferred,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Pathway,Anthem Pathway,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Alliance,Anthem Alliance,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Anthem Medicare,Anthem Medicare,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Cigna,Cigna,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Cigna PPO,Cigna PPO,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Cigna Medicare Advantage,Cigna Medicare Advantage,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Essence,Essence,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Healthlink HMO,Healthlink HMO,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Healthlink PPO,Healthlink PPO,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,HomeState Health Plan,HomeState Health Plan,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Humana Gold,Humana Gold,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Medicaid MO,Medicaid MO,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Medica,Medica,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Tricare,Tricare,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,UHC All Payer,UHC All Payer,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,UHC Exchange,UHC Exchange,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,UHC Medicaid,UHC Medicaid,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,UMR CPD,UMR CPD,454.91,,,,,,,per diem,454.91,454.91,"Per diem rate, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,UHC Medicare,UHC Medicare,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O ORGANIC ACIDS URINE       ,38251040,CDM,301,RC,,,,,,Inpatient,,,454.91,454.91,Wellcare,Wellcare,454.91,,,,,,,case rate,454.91,454.91,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Meritain Health PPO CPD,Meritain Health PPO CPD,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Aetna/Commercial Product,Aetna/Commercial Product,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Meritain Health CPD,Meritain Health CPD,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Starmark CPD,Starmark CPD,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Aetna Medicare,Aetna Medicare,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Ambetter ,Ambetter ,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Blue Access,Anthem Blue Access,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Blue Access Choice,Anthem Blue Access Choice,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Blue Preferred,Anthem Blue Preferred,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Pathway,Anthem Pathway,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Alliance,Anthem Alliance,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Anthem Medicare,Anthem Medicare,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Cigna,Cigna,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Cigna PPO,Cigna PPO,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Cigna Medicare Advantage,Cigna Medicare Advantage,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Essence,Essence,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Healthlink HMO,Healthlink HMO,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Healthlink PPO,Healthlink PPO,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,HomeState Health Plan,HomeState Health Plan,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Humana Gold,Humana Gold,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Medicaid MO,Medicaid MO,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Medica,Medica,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Tricare,Tricare,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,UHC All Payer,UHC All Payer,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,UHC Exchange,UHC Exchange,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,UHC Medicaid,UHC Medicaid,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,UMR CPD,UMR CPD,1007.53,,,,,,,per diem,1007.53,1007.53,"Per diem rate, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,UHC Medicare,UHC Medicare,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O AMINO ACID QUNT PLASM     ,38251041,CDM,301,RC,,,,,,Inpatient,,,1007.53,1007.53,Wellcare,Wellcare,1007.53,,,,,,,case rate,1007.53,1007.53,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health PPO CPD,Meritain Health PPO CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna/Commercial Product,Aetna/Commercial Product,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Meritain Health CPD,Meritain Health CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Starmark CPD,Starmark CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Aetna Medicare,Aetna Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Ambetter ,Ambetter ,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access,Anthem Blue Access,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Access Choice,Anthem Blue Access Choice,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Blue Preferred,Anthem Blue Preferred,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Pathway,Anthem Pathway,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Alliance,Anthem Alliance,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Anthem Medicare,Anthem Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna,Cigna,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna PPO,Cigna PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Cigna Medicare Advantage,Cigna Medicare Advantage,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Essence,Essence,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink HMO,Healthlink HMO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Healthlink PPO,Healthlink PPO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,HomeState Health Plan,HomeState Health Plan,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Humana Gold,Humana Gold,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medicaid MO,Medicaid MO,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Medica,Medica,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Tricare,Tricare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC All Payer,UHC All Payer,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Exchange,UHC Exchange,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicaid,UHC Medicaid,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UMR CPD,UMR CPD,139.73,,,,,,,per diem,139.73,139.73,"Per diem rate, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,UHC Medicare,UHC Medicare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O CRYOFIBRINOGEN            ,38251042,CDM,301,RC,,,,,,Inpatient,,,139.73,139.73,Wellcare,Wellcare,139.73,,,,,,,case rate,139.73,139.73,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health PPO CPD,Meritain Health PPO CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/Commercial Product,Aetna/Commercial Product,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health CPD,Meritain Health CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Starmark CPD,Starmark CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Aetna Medicare,Aetna Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Ambetter ,Ambetter ,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access,Anthem Blue Access,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access Choice,Anthem Blue Access Choice,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Preferred,Anthem Blue Preferred,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Pathway,Anthem Pathway,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Alliance,Anthem Alliance,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Medicare,Anthem Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Cigna,Cigna,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Cigna PPO,Cigna PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Cigna Medicare Advantage,Cigna Medicare Advantage,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Essence,Essence,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink HMO,Healthlink HMO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink PPO,Healthlink PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,HomeState Health Plan,HomeState Health Plan,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Humana Gold,Humana Gold,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Medicaid MO,Medicaid MO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Medica,Medica,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Tricare,Tricare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,UHC All Payer,UHC All Payer,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,UHC Exchange,UHC Exchange,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicaid,UHC Medicaid,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,UMR CPD,UMR CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicare,UHC Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O COLD AGGLUTININS          ,38251043,CDM,302,RC,,,,,,Inpatient,,,310.98,310.98,Wellcare,Wellcare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O HETEROPHILE AB TITER      ,38251044,CDM,302,RC,,,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health PPO CPD,Meritain Health PPO CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna/Commercial Product,Aetna/Commercial Product,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Meritain Health CPD,Meritain Health CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Starmark CPD,Starmark CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Aetna Medicare,Aetna Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Ambetter ,Ambetter ,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access,Anthem Blue Access,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Access Choice,Anthem Blue Access Choice,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Blue Preferred,Anthem Blue Preferred,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Pathway,Anthem Pathway,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Alliance,Anthem Alliance,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Anthem Medicare,Anthem Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna,Cigna,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna PPO,Cigna PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Cigna Medicare Advantage,Cigna Medicare Advantage,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Essence,Essence,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink HMO,Healthlink HMO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Healthlink PPO,Healthlink PPO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,HomeState Health Plan,HomeState Health Plan,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Humana Gold,Humana Gold,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medicaid MO,Medicaid MO,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Medica,Medica,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Tricare,Tricare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC All Payer,UHC All Payer,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Exchange,UHC Exchange,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicaid,UHC Medicaid,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UMR CPD,UMR CPD,55.68,,,,,,,per diem,55.68,55.68,"Per diem rate, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,UHC Medicare,UHC Medicare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LEISHMANIA AB IGG         ,38251045,CDM,302,RC,,,,,,Inpatient,,,55.68,55.68,Wellcare,Wellcare,55.68,,,,,,,case rate,55.68,55.68,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health PPO CPD,Meritain Health PPO CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna/Commercial Product,Aetna/Commercial Product,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Meritain Health CPD,Meritain Health CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Starmark CPD,Starmark CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Aetna Medicare,Aetna Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Ambetter ,Ambetter ,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access,Anthem Blue Access,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Access Choice,Anthem Blue Access Choice,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Blue Preferred,Anthem Blue Preferred,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Pathway,Anthem Pathway,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Alliance,Anthem Alliance,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Anthem Medicare,Anthem Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna,Cigna,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna PPO,Cigna PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Cigna Medicare Advantage,Cigna Medicare Advantage,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Essence,Essence,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink HMO,Healthlink HMO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Healthlink PPO,Healthlink PPO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,HomeState Health Plan,HomeState Health Plan,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Humana Gold,Humana Gold,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medicaid MO,Medicaid MO,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Medica,Medica,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Tricare,Tricare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC All Payer,UHC All Payer,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Exchange,UHC Exchange,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicaid,UHC Medicaid,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UMR CPD,UMR CPD,337.24,,,,,,,per diem,337.24,337.24,"Per diem rate, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,UHC Medicare,UHC Medicare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O LISTERIA AB CSF CF        ,38251046,CDM,302,RC,,,,,,Inpatient,,,337.24,337.24,Wellcare,Wellcare,337.24,,,,,,,case rate,337.24,337.24,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Meritain Health PPO CPD,Meritain Health PPO CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Aetna/Commercial Product,Aetna/Commercial Product,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Meritain Health CPD,Meritain Health CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Starmark CPD,Starmark CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Aetna Medicare,Aetna Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Ambetter ,Ambetter ,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Blue Access,Anthem Blue Access,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Blue Access Choice,Anthem Blue Access Choice,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Blue Preferred,Anthem Blue Preferred,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Pathway,Anthem Pathway,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Alliance,Anthem Alliance,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Anthem Medicare,Anthem Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Cigna,Cigna,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Cigna PPO,Cigna PPO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Cigna Medicare Advantage,Cigna Medicare Advantage,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Essence,Essence,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Healthlink HMO,Healthlink HMO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Healthlink PPO,Healthlink PPO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,HomeState Health Plan,HomeState Health Plan,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Humana Gold,Humana Gold,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Medicaid MO,Medicaid MO,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Medica,Medica,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Tricare,Tricare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,UHC All Payer,UHC All Payer,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,UHC Exchange,UHC Exchange,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,UHC Medicaid,UHC Medicaid,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,UMR CPD,UMR CPD,81.95,,,,,,,per diem,81.95,81.95,"Per diem rate, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,UHC Medicare,UHC Medicare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O VERY LONG FATTY ACID      ,38251047,CDM,301,RC,,,,,,Inpatient,,,81.95,81.95,Wellcare,Wellcare,81.95,,,,,,,case rate,81.95,81.95,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Meritain Health PPO CPD,Meritain Health PPO CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna/Commercial Product,Aetna/Commercial Product,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Meritain Health CPD,Meritain Health CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Starmark CPD,Starmark CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Aetna Medicare,Aetna Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Ambetter ,Ambetter ,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Access,Anthem Blue Access,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Access Choice,Anthem Blue Access Choice,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Blue Preferred,Anthem Blue Preferred,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Pathway,Anthem Pathway,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Alliance,Anthem Alliance,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Anthem Medicare,Anthem Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna,Cigna,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna PPO,Cigna PPO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Cigna Medicare Advantage,Cigna Medicare Advantage,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Essence,Essence,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthlink HMO,Healthlink HMO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Healthlink PPO,Healthlink PPO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,HomeState Health Plan,HomeState Health Plan,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Humana Gold,Humana Gold,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Medicaid MO,Medicaid MO,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Medica,Medica,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Tricare,Tricare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC All Payer,UHC All Payer,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Exchange,UHC Exchange,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Medicaid,UHC Medicaid,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UMR CPD,UMR CPD,92.45,,,,,,,per diem,92.45,92.45,"Per diem rate, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,UHC Medicare,UHC Medicare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O COBALT SERUM/PLASMA       ,38251048,CDM,301,RC,,,,,,Inpatient,,,92.45,92.45,Wellcare,Wellcare,92.45,,,,,,,case rate,92.45,92.45,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Meritain Health PPO CPD,Meritain Health PPO CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Aetna/Commercial Product,Aetna/Commercial Product,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Meritain Health CPD,Meritain Health CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Starmark CPD,Starmark CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Aetna Medicare,Aetna Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Ambetter ,Ambetter ,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Access,Anthem Blue Access,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Access Choice,Anthem Blue Access Choice,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Preferred,Anthem Blue Preferred,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Pathway,Anthem Pathway,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Alliance,Anthem Alliance,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Medicare,Anthem Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Cigna,Cigna,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Cigna PPO,Cigna PPO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Cigna Medicare Advantage,Cigna Medicare Advantage,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Essence,Essence,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Healthlink HMO,Healthlink HMO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Healthlink PPO,Healthlink PPO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,HomeState Health Plan,HomeState Health Plan,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Humana Gold,Humana Gold,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Medicaid MO,Medicaid MO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Medica,Medica,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Tricare,Tricare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,UHC All Payer,UHC All Payer,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,UHC Exchange,UHC Exchange,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,UHC Medicaid,UHC Medicaid,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,UMR CPD,UMR CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,UHC Medicare,UHC Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O GLUTATHIONE TOTAL         ,38251049,CDM,301,RC,,,,,,Inpatient,,,279.46,279.46,Wellcare,Wellcare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health PPO CPD,Meritain Health PPO CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Aetna/Commercial Product,Aetna/Commercial Product,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Meritain Health CPD,Meritain Health CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Starmark CPD,Starmark CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Aetna Medicare,Aetna Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Ambetter ,Ambetter ,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access,Anthem Blue Access,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Access Choice,Anthem Blue Access Choice,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Blue Preferred,Anthem Blue Preferred,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Pathway,Anthem Pathway,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Alliance,Anthem Alliance,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Anthem Medicare,Anthem Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Cigna,Cigna,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Cigna PPO,Cigna PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Cigna Medicare Advantage,Cigna Medicare Advantage,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Essence,Essence,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink HMO,Healthlink HMO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Healthlink PPO,Healthlink PPO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,HomeState Health Plan,HomeState Health Plan,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Humana Gold,Humana Gold,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Medicaid MO,Medicaid MO,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Medica,Medica,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Tricare,Tricare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,UHC All Payer,UHC All Payer,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,UHC Exchange,UHC Exchange,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicaid,UHC Medicaid,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,UMR CPD,UMR CPD,60.93,,,,,,,per diem,60.93,60.93,"Per diem rate, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,UHC Medicare,UHC Medicare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O FATTY ACIDS FREE          ,38251050,CDM,301,RC,,,,,,Inpatient,,,60.93,60.93,Wellcare,Wellcare,60.93,,,,,,,case rate,60.93,60.93,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Meritain Health PPO CPD,Meritain Health PPO CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna/Commercial Product,Aetna/Commercial Product,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Meritain Health CPD,Meritain Health CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Starmark CPD,Starmark CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna Medicare,Aetna Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Ambetter ,Ambetter ,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Access,Anthem Blue Access,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Access Choice,Anthem Blue Access Choice,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Preferred,Anthem Blue Preferred,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Pathway,Anthem Pathway,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Alliance,Anthem Alliance,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Medicare,Anthem Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna,Cigna,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna PPO,Cigna PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna Medicare Advantage,Cigna Medicare Advantage,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Essence,Essence,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthlink HMO,Healthlink HMO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthlink PPO,Healthlink PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,HomeState Health Plan,HomeState Health Plan,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Humana Gold,Humana Gold,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Medicaid MO,Medicaid MO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Medica,Medica,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Tricare,Tricare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC All Payer,UHC All Payer,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Exchange,UHC Exchange,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Medicaid,UHC Medicaid,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UMR CPD,UMR CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Medicare,UHC Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O CALPROTECTIN FECAL        ,38251051,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Wellcare,Wellcare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Meritain Health PPO CPD,Meritain Health PPO CPD,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Aetna/Commercial Product,Aetna/Commercial Product,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Meritain Health CPD,Meritain Health CPD,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Starmark CPD,Starmark CPD,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Aetna Medicare,Aetna Medicare,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Ambetter ,Ambetter ,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Blue Access,Anthem Blue Access,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Blue Access Choice,Anthem Blue Access Choice,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Blue Preferred,Anthem Blue Preferred,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Pathway,Anthem Pathway,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Alliance,Anthem Alliance,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Anthem Medicare,Anthem Medicare,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Cigna,Cigna,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Cigna PPO,Cigna PPO,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Cigna Medicare Advantage,Cigna Medicare Advantage,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Essence,Essence,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Healthlink HMO,Healthlink HMO,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Healthlink PPO,Healthlink PPO,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,HomeState Health Plan,HomeState Health Plan,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Humana Gold,Humana Gold,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Medicaid MO,Medicaid MO,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Medica,Medica,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Tricare,Tricare,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,UHC All Payer,UHC All Payer,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,UHC Exchange,UHC Exchange,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,UHC Medicaid,UHC Medicaid,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,UMR CPD,UMR CPD,778.49,,,,,,,per diem,778.49,778.49,"Per diem rate, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,UHC Medicare,UHC Medicare,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA GLOBIN SEQUENC      ,38251052,CDM,301,RC,,,,,,Inpatient,,,778.49,778.49,Wellcare,Wellcare,778.49,,,,,,,case rate,778.49,778.49,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Meritain Health PPO CPD,Meritain Health PPO CPD,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Aetna/Commercial Product,Aetna/Commercial Product,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Meritain Health CPD,Meritain Health CPD,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Starmark CPD,Starmark CPD,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Aetna Medicare,Aetna Medicare,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Ambetter ,Ambetter ,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Blue Access,Anthem Blue Access,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Blue Access Choice,Anthem Blue Access Choice,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Blue Preferred,Anthem Blue Preferred,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Pathway,Anthem Pathway,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Alliance,Anthem Alliance,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Anthem Medicare,Anthem Medicare,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Cigna,Cigna,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Cigna PPO,Cigna PPO,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Cigna Medicare Advantage,Cigna Medicare Advantage,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Essence,Essence,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Healthlink HMO,Healthlink HMO,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Healthlink PPO,Healthlink PPO,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,HomeState Health Plan,HomeState Health Plan,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Humana Gold,Humana Gold,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Medicaid MO,Medicaid MO,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Medica,Medica,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Tricare,Tricare,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,UHC All Payer,UHC All Payer,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,UHC Exchange,UHC Exchange,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,UHC Medicaid,UHC Medicaid,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,UMR CPD,UMR CPD,818.42,,,,,,,per diem,818.42,818.42,"Per diem rate, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,UHC Medicare,UHC Medicare,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O ALPHA THALASSEM 7 DEL     ,38251053,CDM,301,RC,,,,,,Inpatient,,,818.42,818.42,Wellcare,Wellcare,818.42,,,,,,,case rate,818.42,818.42,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O APOLIPOPROTEIN B MUT      ,38251054,CDM,301,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Meritain Health PPO CPD,Meritain Health PPO CPD,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Aetna/Commercial Product,Aetna/Commercial Product,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Meritain Health CPD,Meritain Health CPD,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Starmark CPD,Starmark CPD,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Aetna Medicare,Aetna Medicare,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Ambetter ,Ambetter ,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Blue Access,Anthem Blue Access,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Blue Access Choice,Anthem Blue Access Choice,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Blue Preferred,Anthem Blue Preferred,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Pathway,Anthem Pathway,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Alliance,Anthem Alliance,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Anthem Medicare,Anthem Medicare,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Cigna,Cigna,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Cigna PPO,Cigna PPO,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Cigna Medicare Advantage,Cigna Medicare Advantage,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Essence,Essence,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Healthlink HMO,Healthlink HMO,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Healthlink PPO,Healthlink PPO,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,HomeState Health Plan,HomeState Health Plan,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Humana Gold,Humana Gold,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Medicaid MO,Medicaid MO,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Medica,Medica,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Tricare,Tricare,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,UHC All Payer,UHC All Payer,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,UHC Exchange,UHC Exchange,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,UHC Medicaid,UHC Medicaid,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,UMR CPD,UMR CPD,1881.62,,,,,,,per diem,1881.62,1881.62,"Per diem rate, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,UHC Medicare,UHC Medicare,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O TPMT GENOTYPE             ,38251055,CDM,301,RC,,,,,,Inpatient,,,1881.62,1881.62,Wellcare,Wellcare,1881.62,,,,,,,case rate,1881.62,1881.62,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Meritain Health PPO CPD,Meritain Health PPO CPD,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Aetna/Commercial Product,Aetna/Commercial Product,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Meritain Health CPD,Meritain Health CPD,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Starmark CPD,Starmark CPD,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Aetna Medicare,Aetna Medicare,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Ambetter ,Ambetter ,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Blue Access,Anthem Blue Access,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Blue Access Choice,Anthem Blue Access Choice,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Blue Preferred,Anthem Blue Preferred,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Pathway,Anthem Pathway,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Alliance,Anthem Alliance,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Anthem Medicare,Anthem Medicare,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Cigna,Cigna,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Cigna PPO,Cigna PPO,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Cigna Medicare Advantage,Cigna Medicare Advantage,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Essence,Essence,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Healthlink HMO,Healthlink HMO,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Healthlink PPO,Healthlink PPO,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,HomeState Health Plan,HomeState Health Plan,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Humana Gold,Humana Gold,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Medicaid MO,Medicaid MO,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Medica,Medica,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Tricare,Tricare,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,UHC All Payer,UHC All Payer,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,UHC Exchange,UHC Exchange,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,UHC Medicaid,UHC Medicaid,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,UMR CPD,UMR CPD,703.9,,,,,,,per diem,703.9,703.9,"Per diem rate, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,UHC Medicare,UHC Medicare,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O T-CELL CLONALITY PCR      ,38251056,CDM,301,RC,,,,,,Inpatient,,,703.9,703.9,Wellcare,Wellcare,703.9,,,,,,,case rate,703.9,703.9,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Meritain Health PPO CPD,Meritain Health PPO CPD,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Aetna/Commercial Product,Aetna/Commercial Product,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Meritain Health CPD,Meritain Health CPD,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Starmark CPD,Starmark CPD,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Aetna Medicare,Aetna Medicare,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Ambetter ,Ambetter ,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Blue Access,Anthem Blue Access,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Blue Access Choice,Anthem Blue Access Choice,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Blue Preferred,Anthem Blue Preferred,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Pathway,Anthem Pathway,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Alliance,Anthem Alliance,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Anthem Medicare,Anthem Medicare,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Cigna,Cigna,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Cigna PPO,Cigna PPO,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Cigna Medicare Advantage,Cigna Medicare Advantage,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Essence,Essence,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Healthlink HMO,Healthlink HMO,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Healthlink PPO,Healthlink PPO,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,HomeState Health Plan,HomeState Health Plan,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Humana Gold,Humana Gold,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Medicaid MO,Medicaid MO,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Medica,Medica,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Tricare,Tricare,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,UHC All Payer,UHC All Payer,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,UHC Exchange,UHC Exchange,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,UHC Medicaid,UHC Medicaid,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,UMR CPD,UMR CPD,894.06,,,,,,,per diem,894.06,894.06,"Per diem rate, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,UHC Medicare,UHC Medicare,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O CMV ANTI VIRAL SEQ        ,38251057,CDM,306,RC,,,,,,Inpatient,,,894.06,894.06,Wellcare,Wellcare,894.06,,,,,,,case rate,894.06,894.06,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health PPO CPD,Meritain Health PPO CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Aetna/Commercial Product,Aetna/Commercial Product,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Meritain Health CPD,Meritain Health CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Starmark CPD,Starmark CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Aetna Medicare,Aetna Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Ambetter ,Ambetter ,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access,Anthem Blue Access,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Access Choice,Anthem Blue Access Choice,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Blue Preferred,Anthem Blue Preferred,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Pathway,Anthem Pathway,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Alliance,Anthem Alliance,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Anthem Medicare,Anthem Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Cigna,Cigna,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Cigna PPO,Cigna PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Cigna Medicare Advantage,Cigna Medicare Advantage,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Essence,Essence,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink HMO,Healthlink HMO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Healthlink PPO,Healthlink PPO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,HomeState Health Plan,HomeState Health Plan,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Humana Gold,Humana Gold,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Medicaid MO,Medicaid MO,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Medica,Medica,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Tricare,Tricare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,UHC All Payer,UHC All Payer,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,UHC Exchange,UHC Exchange,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicaid,UHC Medicaid,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,UMR CPD,UMR CPD,133.43,,,,,,,per diem,133.43,133.43,"Per diem rate, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,UHC Medicare,UHC Medicare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O 11 DEOXYCORTISOL QNT      ,38251058,CDM,301,RC,,,,,,Inpatient,,,133.43,133.43,Wellcare,Wellcare,133.43,,,,,,,case rate,133.43,133.43,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Meritain Health PPO CPD,Meritain Health PPO CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Aetna/Commercial Product,Aetna/Commercial Product,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Meritain Health CPD,Meritain Health CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Starmark CPD,Starmark CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Aetna Medicare,Aetna Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Ambetter ,Ambetter ,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Access,Anthem Blue Access,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Access Choice,Anthem Blue Access Choice,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Blue Preferred,Anthem Blue Preferred,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Pathway,Anthem Pathway,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Alliance,Anthem Alliance,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Anthem Medicare,Anthem Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Cigna,Cigna,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Cigna PPO,Cigna PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Cigna Medicare Advantage,Cigna Medicare Advantage,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Essence,Essence,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Healthlink HMO,Healthlink HMO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Healthlink PPO,Healthlink PPO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,HomeState Health Plan,HomeState Health Plan,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Humana Gold,Humana Gold,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Medicaid MO,Medicaid MO,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Medica,Medica,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Tricare,Tricare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,UHC All Payer,UHC All Payer,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,UHC Exchange,UHC Exchange,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,UHC Medicaid,UHC Medicaid,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,UMR CPD,UMR CPD,489.58,,,,,,,per diem,489.58,489.58,"Per diem rate, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,UHC Medicare,UHC Medicare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ANGIOTENSIN II PLASMA     ,38251059,CDM,301,RC,,,,,,Inpatient,,,489.58,489.58,Wellcare,Wellcare,489.58,,,,,,,case rate,489.58,489.58,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY CHEDDAR IGG       ,38251060,CDM,302,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O ALLERGY WHOLE EGG IGG     ,38251061,CDM,302,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health PPO CPD,Meritain Health PPO CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Aetna/Commercial Product,Aetna/Commercial Product,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Meritain Health CPD,Meritain Health CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Starmark CPD,Starmark CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Aetna Medicare,Aetna Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Ambetter ,Ambetter ,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access,Anthem Blue Access,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Access Choice,Anthem Blue Access Choice,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Blue Preferred,Anthem Blue Preferred,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Pathway,Anthem Pathway,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Alliance,Anthem Alliance,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Anthem Medicare,Anthem Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Cigna,Cigna,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Cigna PPO,Cigna PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Cigna Medicare Advantage,Cigna Medicare Advantage,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Essence,Essence,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink HMO,Healthlink HMO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Healthlink PPO,Healthlink PPO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,HomeState Health Plan,HomeState Health Plan,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Humana Gold,Humana Gold,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Medicaid MO,Medicaid MO,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Medica,Medica,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Tricare,Tricare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,UHC All Payer,UHC All Payer,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,UHC Exchange,UHC Exchange,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicaid,UHC Medicaid,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,UMR CPD,UMR CPD,305.72,,,,,,,per diem,305.72,305.72,"Per diem rate, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,UHC Medicare,UHC Medicare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O KIT D816V MUTATON PCR     ,38251062,CDM,301,RC,,,,,,Inpatient,,,305.72,305.72,Wellcare,Wellcare,305.72,,,,,,,case rate,305.72,305.72,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Meritain Health PPO CPD,Meritain Health PPO CPD,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Aetna/Commercial Product,Aetna/Commercial Product,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Meritain Health CPD,Meritain Health CPD,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Starmark CPD,Starmark CPD,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Aetna Medicare,Aetna Medicare,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Ambetter ,Ambetter ,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Blue Access,Anthem Blue Access,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Blue Access Choice,Anthem Blue Access Choice,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Blue Preferred,Anthem Blue Preferred,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Pathway,Anthem Pathway,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Alliance,Anthem Alliance,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Anthem Medicare,Anthem Medicare,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Cigna,Cigna,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Cigna PPO,Cigna PPO,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Cigna Medicare Advantage,Cigna Medicare Advantage,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Essence,Essence,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Healthlink HMO,Healthlink HMO,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Healthlink PPO,Healthlink PPO,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,HomeState Health Plan,HomeState Health Plan,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Humana Gold,Humana Gold,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Medicaid MO,Medicaid MO,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Medica,Medica,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Tricare,Tricare,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,UHC All Payer,UHC All Payer,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,UHC Exchange,UHC Exchange,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,UHC Medicaid,UHC Medicaid,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,UMR CPD,UMR CPD,2563.74,,,,,,,per diem,2563.74,2563.74,"Per diem rate, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,UHC Medicare,UHC Medicare,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O CYTOCHROME P450 2C19      ,38251063,CDM,301,RC,,,,,,Inpatient,,,2563.74,2563.74,Wellcare,Wellcare,2563.74,,,,,,,case rate,2563.74,2563.74,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Meritain Health PPO CPD,Meritain Health PPO CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Aetna/Commercial Product,Aetna/Commercial Product,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Meritain Health CPD,Meritain Health CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Starmark CPD,Starmark CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Aetna Medicare,Aetna Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Ambetter ,Ambetter ,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Access,Anthem Blue Access,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Access Choice,Anthem Blue Access Choice,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Blue Preferred,Anthem Blue Preferred,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Pathway,Anthem Pathway,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Alliance,Anthem Alliance,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Anthem Medicare,Anthem Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Cigna,Cigna,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Cigna PPO,Cigna PPO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Cigna Medicare Advantage,Cigna Medicare Advantage,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Essence,Essence,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Healthlink HMO,Healthlink HMO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Healthlink PPO,Healthlink PPO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,HomeState Health Plan,HomeState Health Plan,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Humana Gold,Humana Gold,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Medicaid MO,Medicaid MO,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Medica,Medica,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Tricare,Tricare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,UHC All Payer,UHC All Payer,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,UHC Exchange,UHC Exchange,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,UHC Medicaid,UHC Medicaid,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,UMR CPD,UMR CPD,355.1,,,,,,,per diem,355.1,355.1,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,UHC Medicare,UHC Medicare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 T315I MUT QN     ,38251064,CDM,301,RC,,,,,,Inpatient,,,355.1,355.1,Wellcare,Wellcare,355.1,,,,,,,case rate,355.1,355.1,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Meritain Health PPO CPD,Meritain Health PPO CPD,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Aetna/Commercial Product,Aetna/Commercial Product,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Meritain Health CPD,Meritain Health CPD,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Starmark CPD,Starmark CPD,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Aetna Medicare,Aetna Medicare,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Ambetter ,Ambetter ,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Blue Access,Anthem Blue Access,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Blue Access Choice,Anthem Blue Access Choice,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Blue Preferred,Anthem Blue Preferred,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Pathway,Anthem Pathway,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Alliance,Anthem Alliance,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Anthem Medicare,Anthem Medicare,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Cigna,Cigna,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Cigna PPO,Cigna PPO,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Cigna Medicare Advantage,Cigna Medicare Advantage,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Essence,Essence,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Healthlink HMO,Healthlink HMO,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Healthlink PPO,Healthlink PPO,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,HomeState Health Plan,HomeState Health Plan,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Humana Gold,Humana Gold,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Medicaid MO,Medicaid MO,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Medica,Medica,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Tricare,Tricare,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,UHC All Payer,UHC All Payer,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,UHC Exchange,UHC Exchange,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,UHC Medicaid,UHC Medicaid,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,UMR CPD,UMR CPD,805.81,,,,,,,per diem,805.81,805.81,"Per diem rate, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,UHC Medicare,UHC Medicare,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O BTD 5 MUTATIONS           ,38251065,CDM,301,RC,,,,,,Inpatient,,,805.81,805.81,Wellcare,Wellcare,805.81,,,,,,,case rate,805.81,805.81,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Meritain Health PPO CPD,Meritain Health PPO CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Aetna/Commercial Product,Aetna/Commercial Product,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Meritain Health CPD,Meritain Health CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Starmark CPD,Starmark CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Aetna Medicare,Aetna Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Ambetter ,Ambetter ,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Access,Anthem Blue Access,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Access Choice,Anthem Blue Access Choice,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Blue Preferred,Anthem Blue Preferred,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Pathway,Anthem Pathway,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Alliance,Anthem Alliance,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Anthem Medicare,Anthem Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Cigna,Cigna,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Cigna PPO,Cigna PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Cigna Medicare Advantage,Cigna Medicare Advantage,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Essence,Essence,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Healthlink HMO,Healthlink HMO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Healthlink PPO,Healthlink PPO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,HomeState Health Plan,HomeState Health Plan,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Humana Gold,Humana Gold,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Medicaid MO,Medicaid MO,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Medica,Medica,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Tricare,Tricare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,UHC All Payer,UHC All Payer,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,UHC Exchange,UHC Exchange,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,UHC Medicaid,UHC Medicaid,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,UMR CPD,UMR CPD,243.74,,,,,,,per diem,243.74,243.74,"Per diem rate, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,UHC Medicare,UHC Medicare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O JAKQ EXON12 MUT PCR       ,38251066,CDM,301,RC,,,,,,Inpatient,,,243.74,243.74,Wellcare,Wellcare,243.74,,,,,,,case rate,243.74,243.74,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Meritain Health PPO CPD,Meritain Health PPO CPD,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Aetna/Commercial Product,Aetna/Commercial Product,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Meritain Health CPD,Meritain Health CPD,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Starmark CPD,Starmark CPD,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Aetna Medicare,Aetna Medicare,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Ambetter ,Ambetter ,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Blue Access,Anthem Blue Access,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Blue Access Choice,Anthem Blue Access Choice,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Blue Preferred,Anthem Blue Preferred,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Pathway,Anthem Pathway,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Alliance,Anthem Alliance,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Anthem Medicare,Anthem Medicare,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Cigna,Cigna,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Cigna PPO,Cigna PPO,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Cigna Medicare Advantage,Cigna Medicare Advantage,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Essence,Essence,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Healthlink HMO,Healthlink HMO,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Healthlink PPO,Healthlink PPO,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,HomeState Health Plan,HomeState Health Plan,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Humana Gold,Humana Gold,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Medicaid MO,Medicaid MO,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Medica,Medica,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Tricare,Tricare,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,UHC All Payer,UHC All Payer,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,UHC Exchange,UHC Exchange,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,UHC Medicaid,UHC Medicaid,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,UMR CPD,UMR CPD,406.58,,,,,,,per diem,406.58,406.58,"Per diem rate, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,UHC Medicare,UHC Medicare,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O KIT MUTATION IN AML       ,38251067,CDM,301,RC,,,,,,Inpatient,,,406.58,406.58,Wellcare,Wellcare,406.58,,,,,,,case rate,406.58,406.58,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGG      ,38251068,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANAPLASMA HGA AB IGM      ,38251069,CDM,302,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251070,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251071,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251072,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251073,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O SALMONELLA TYPHI AB       ,38251074,CDM,302,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Meritain Health PPO CPD,Meritain Health PPO CPD,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Aetna/Commercial Product,Aetna/Commercial Product,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Meritain Health CPD,Meritain Health CPD,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Starmark CPD,Starmark CPD,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Aetna Medicare,Aetna Medicare,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Ambetter ,Ambetter ,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Blue Access,Anthem Blue Access,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Blue Access Choice,Anthem Blue Access Choice,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Blue Preferred,Anthem Blue Preferred,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Pathway,Anthem Pathway,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Alliance,Anthem Alliance,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Anthem Medicare,Anthem Medicare,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Cigna,Cigna,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Cigna PPO,Cigna PPO,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Cigna Medicare Advantage,Cigna Medicare Advantage,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Essence,Essence,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Healthlink HMO,Healthlink HMO,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Healthlink PPO,Healthlink PPO,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,HomeState Health Plan,HomeState Health Plan,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Humana Gold,Humana Gold,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Medicaid MO,Medicaid MO,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Medica,Medica,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Tricare,Tricare,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,UHC All Payer,UHC All Payer,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,UHC Exchange,UHC Exchange,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,UHC Medicaid,UHC Medicaid,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,UMR CPD,UMR CPD,1357.38,,,,,,,per diem,1357.38,1357.38,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,UHC Medicare,UHC Medicare,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251075,CDM,301,RC,,,,,,Inpatient,,,1357.38,1357.38,Wellcare,Wellcare,1357.38,,,,,,,case rate,1357.38,1357.38,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O FLT3 MUTATION PCR         ,38251076,CDM,301,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 5         ,38251077,CDM,302,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Meritain Health PPO CPD,Meritain Health PPO CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna/Commercial Product,Aetna/Commercial Product,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Meritain Health CPD,Meritain Health CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Starmark CPD,Starmark CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Aetna Medicare,Aetna Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Ambetter ,Ambetter ,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Access,Anthem Blue Access,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Access Choice,Anthem Blue Access Choice,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Blue Preferred,Anthem Blue Preferred,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Pathway,Anthem Pathway,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Alliance,Anthem Alliance,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Anthem Medicare,Anthem Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna,Cigna,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna PPO,Cigna PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Cigna Medicare Advantage,Cigna Medicare Advantage,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Essence,Essence,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthlink HMO,Healthlink HMO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Healthlink PPO,Healthlink PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,HomeState Health Plan,HomeState Health Plan,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Humana Gold,Humana Gold,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Medicaid MO,Medicaid MO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Medica,Medica,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Tricare,Tricare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC All Payer,UHC All Payer,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Exchange,UHC Exchange,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Medicaid,UHC Medicaid,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UMR CPD,UMR CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,UHC Medicare,UHC Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251078,CDM,311,RC,,,,,,Inpatient,,,157.59,157.59,Wellcare,Wellcare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CHR FISH INTERPH          ,38251079,CDM,311,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health PPO CPD,Meritain Health PPO CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna/Commercial Product,Aetna/Commercial Product,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Meritain Health CPD,Meritain Health CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Starmark CPD,Starmark CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Aetna Medicare,Aetna Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Ambetter ,Ambetter ,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access,Anthem Blue Access,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Access Choice,Anthem Blue Access Choice,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Blue Preferred,Anthem Blue Preferred,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Pathway,Anthem Pathway,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Alliance,Anthem Alliance,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Anthem Medicare,Anthem Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna,Cigna,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna PPO,Cigna PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Cigna Medicare Advantage,Cigna Medicare Advantage,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Essence,Essence,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink HMO,Healthlink HMO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Healthlink PPO,Healthlink PPO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,HomeState Health Plan,HomeState Health Plan,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Humana Gold,Humana Gold,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medicaid MO,Medicaid MO,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Medica,Medica,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Tricare,Tricare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC All Payer,UHC All Payer,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Exchange,UHC Exchange,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicaid,UHC Medicaid,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UMR CPD,UMR CPD,58.83,,,,,,,per diem,58.83,58.83,"Per diem rate, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,UHC Medicare,UHC Medicare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O HEAVY METALS4 BLD         ,38251080,CDM,301,RC,,,,,,Inpatient,,,58.83,58.83,Wellcare,Wellcare,58.83,,,,,,,case rate,58.83,58.83,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health PPO CPD,Meritain Health PPO CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/Commercial Product,Aetna/Commercial Product,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health CPD,Meritain Health CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Starmark CPD,Starmark CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Aetna Medicare,Aetna Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Ambetter ,Ambetter ,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access,Anthem Blue Access,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access Choice,Anthem Blue Access Choice,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Preferred,Anthem Blue Preferred,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Pathway,Anthem Pathway,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Alliance,Anthem Alliance,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Medicare,Anthem Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Cigna,Cigna,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Cigna PPO,Cigna PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Cigna Medicare Advantage,Cigna Medicare Advantage,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Essence,Essence,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink HMO,Healthlink HMO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink PPO,Healthlink PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,HomeState Health Plan,HomeState Health Plan,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Humana Gold,Humana Gold,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Medicaid MO,Medicaid MO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Medica,Medica,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Tricare,Tricare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,UHC All Payer,UHC All Payer,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,UHC Exchange,UHC Exchange,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicaid,UHC Medicaid,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,UMR CPD,UMR CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicare,UHC Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251081,CDM,311,RC,,,,,,Inpatient,,,144.98,144.98,Wellcare,Wellcare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PML-RARA TRN FISH         ,38251082,CDM,311,RC,,,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health PPO CPD,Meritain Health PPO CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/Commercial Product,Aetna/Commercial Product,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health CPD,Meritain Health CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Starmark CPD,Starmark CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna Medicare,Aetna Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Ambetter ,Ambetter ,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access,Anthem Blue Access,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access Choice,Anthem Blue Access Choice,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Preferred,Anthem Blue Preferred,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Pathway,Anthem Pathway,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Alliance,Anthem Alliance,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Medicare,Anthem Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna,Cigna,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna PPO,Cigna PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna Medicare Advantage,Cigna Medicare Advantage,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Essence,Essence,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink HMO,Healthlink HMO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink PPO,Healthlink PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,HomeState Health Plan,HomeState Health Plan,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Humana Gold,Humana Gold,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medicaid MO,Medicaid MO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medica,Medica,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Tricare,Tricare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC All Payer,UHC All Payer,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Exchange,UHC Exchange,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicaid,UHC Medicaid,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UMR CPD,UMR CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicare,UHC Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251083,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Wellcare,Wellcare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health PPO CPD,Meritain Health PPO CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/Commercial Product,Aetna/Commercial Product,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health CPD,Meritain Health CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Starmark CPD,Starmark CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna Medicare,Aetna Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Ambetter ,Ambetter ,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access,Anthem Blue Access,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access Choice,Anthem Blue Access Choice,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Preferred,Anthem Blue Preferred,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Pathway,Anthem Pathway,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Alliance,Anthem Alliance,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Medicare,Anthem Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna,Cigna,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna PPO,Cigna PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna Medicare Advantage,Cigna Medicare Advantage,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Essence,Essence,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink HMO,Healthlink HMO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink PPO,Healthlink PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,HomeState Health Plan,HomeState Health Plan,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Humana Gold,Humana Gold,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medicaid MO,Medicaid MO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medica,Medica,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Tricare,Tricare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC All Payer,UHC All Payer,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Exchange,UHC Exchange,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicaid,UHC Medicaid,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UMR CPD,UMR CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicare,UHC Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251084,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Wellcare,Wellcare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251085,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251086,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251087,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251088,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health PPO CPD,Meritain Health PPO CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna/Commercial Product,Aetna/Commercial Product,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Meritain Health CPD,Meritain Health CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Starmark CPD,Starmark CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Aetna Medicare,Aetna Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Ambetter ,Ambetter ,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access,Anthem Blue Access,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Access Choice,Anthem Blue Access Choice,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Blue Preferred,Anthem Blue Preferred,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Pathway,Anthem Pathway,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Alliance,Anthem Alliance,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Anthem Medicare,Anthem Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna,Cigna,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna PPO,Cigna PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Cigna Medicare Advantage,Cigna Medicare Advantage,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Essence,Essence,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink HMO,Healthlink HMO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Healthlink PPO,Healthlink PPO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,HomeState Health Plan,HomeState Health Plan,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Humana Gold,Humana Gold,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medicaid MO,Medicaid MO,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Medica,Medica,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Tricare,Tricare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC All Payer,UHC All Payer,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Exchange,UHC Exchange,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicaid,UHC Medicaid,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UMR CPD,UMR CPD,88.25,,,,,,,per diem,88.25,88.25,"Per diem rate, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,UHC Medicare,UHC Medicare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O PNH PANEL RBC/WBC         ,38251089,CDM,302,RC,,,,,,Inpatient,,,88.25,88.25,Wellcare,Wellcare,88.25,,,,,,,case rate,88.25,88.25,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O URINE SUPERSAT            ,38251090,CDM,301,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGG     ,38251091,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O EHRLICHIA CHAF AB IGM     ,38251092,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251093,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251094,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251095,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251096,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O LYMPHOCYT AG MITO         ,38251097,CDM,302,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Meritain Health PPO CPD,Meritain Health PPO CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Aetna/Commercial Product,Aetna/Commercial Product,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Meritain Health CPD,Meritain Health CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Starmark CPD,Starmark CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Aetna Medicare,Aetna Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Ambetter ,Ambetter ,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Blue Access,Anthem Blue Access,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Blue Access Choice,Anthem Blue Access Choice,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Blue Preferred,Anthem Blue Preferred,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Pathway,Anthem Pathway,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Alliance,Anthem Alliance,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Anthem Medicare,Anthem Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Cigna,Cigna,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Cigna PPO,Cigna PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Cigna Medicare Advantage,Cigna Medicare Advantage,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Essence,Essence,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Healthlink HMO,Healthlink HMO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Healthlink PPO,Healthlink PPO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,HomeState Health Plan,HomeState Health Plan,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Humana Gold,Humana Gold,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Medicaid MO,Medicaid MO,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Medica,Medica,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Tricare,Tricare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,UHC All Payer,UHC All Payer,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,UHC Exchange,UHC Exchange,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,UHC Medicaid,UHC Medicaid,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,UMR CPD,UMR CPD,321.48,,,,,,,per diem,321.48,321.48,"Per diem rate, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,UHC Medicare,UHC Medicare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O HIV PHENOSENSE GT         ,38251098,CDM,306,RC,,,,,,Inpatient,,,321.48,321.48,Wellcare,Wellcare,321.48,,,,,,,case rate,321.48,321.48,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Meritain Health PPO CPD,Meritain Health PPO CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna/Commercial Product,Aetna/Commercial Product,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Meritain Health CPD,Meritain Health CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Starmark CPD,Starmark CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna Medicare,Aetna Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Ambetter ,Ambetter ,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Access,Anthem Blue Access,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Access Choice,Anthem Blue Access Choice,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Preferred,Anthem Blue Preferred,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Pathway,Anthem Pathway,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Alliance,Anthem Alliance,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Medicare,Anthem Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna,Cigna,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna PPO,Cigna PPO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna Medicare Advantage,Cigna Medicare Advantage,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Essence,Essence,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthlink HMO,Healthlink HMO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthlink PPO,Healthlink PPO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,HomeState Health Plan,HomeState Health Plan,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Humana Gold,Humana Gold,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Medicaid MO,Medicaid MO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Medica,Medica,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Tricare,Tricare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC All Payer,UHC All Payer,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Exchange,UHC Exchange,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Medicaid,UHC Medicaid,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UMR CPD,UMR CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Medicare,UHC Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251099,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Wellcare,Wellcare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Meritain Health PPO CPD,Meritain Health PPO CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna/Commercial Product,Aetna/Commercial Product,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Meritain Health CPD,Meritain Health CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Starmark CPD,Starmark CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Aetna Medicare,Aetna Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Ambetter ,Ambetter ,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Access,Anthem Blue Access,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Access Choice,Anthem Blue Access Choice,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Blue Preferred,Anthem Blue Preferred,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Pathway,Anthem Pathway,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Alliance,Anthem Alliance,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Anthem Medicare,Anthem Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna,Cigna,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna PPO,Cigna PPO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Cigna Medicare Advantage,Cigna Medicare Advantage,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Essence,Essence,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthlink HMO,Healthlink HMO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Healthlink PPO,Healthlink PPO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,HomeState Health Plan,HomeState Health Plan,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Humana Gold,Humana Gold,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Medicaid MO,Medicaid MO,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Medica,Medica,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Tricare,Tricare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC All Payer,UHC All Payer,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Exchange,UHC Exchange,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Medicaid,UHC Medicaid,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UMR CPD,UMR CPD,159.69,,,,,,,per diem,159.69,159.69,"Per diem rate, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,UHC Medicare,UHC Medicare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O WARFARIN SENS 3           ,38251100,CDM,301,RC,,,,,,Inpatient,,,159.69,159.69,Wellcare,Wellcare,159.69,,,,,,,case rate,159.69,159.69,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O INSULIN FREE/TOTAL        ,38251103,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health PPO CPD,Meritain Health PPO CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/Commercial Product,Aetna/Commercial Product,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health CPD,Meritain Health CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Starmark CPD,Starmark CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna Medicare,Aetna Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Ambetter ,Ambetter ,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access,Anthem Blue Access,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access Choice,Anthem Blue Access Choice,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Preferred,Anthem Blue Preferred,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Pathway,Anthem Pathway,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Alliance,Anthem Alliance,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Medicare,Anthem Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna,Cigna,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna PPO,Cigna PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna Medicare Advantage,Cigna Medicare Advantage,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Essence,Essence,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink HMO,Healthlink HMO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink PPO,Healthlink PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,HomeState Health Plan,HomeState Health Plan,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Humana Gold,Humana Gold,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Medicaid MO,Medicaid MO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Medica,Medica,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Tricare,Tricare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC All Payer,UHC All Payer,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Exchange,UHC Exchange,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicaid,UHC Medicaid,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UMR CPD,UMR CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicare,UHC Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251104,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Wellcare,Wellcare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health PPO CPD,Meritain Health PPO CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna/Commercial Product,Aetna/Commercial Product,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Meritain Health CPD,Meritain Health CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Starmark CPD,Starmark CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Aetna Medicare,Aetna Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Ambetter ,Ambetter ,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access,Anthem Blue Access,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Access Choice,Anthem Blue Access Choice,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Blue Preferred,Anthem Blue Preferred,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Pathway,Anthem Pathway,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Alliance,Anthem Alliance,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Anthem Medicare,Anthem Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna,Cigna,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna PPO,Cigna PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Cigna Medicare Advantage,Cigna Medicare Advantage,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Essence,Essence,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink HMO,Healthlink HMO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Healthlink PPO,Healthlink PPO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,HomeState Health Plan,HomeState Health Plan,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Humana Gold,Humana Gold,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Medicaid MO,Medicaid MO,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Medica,Medica,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Tricare,Tricare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC All Payer,UHC All Payer,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Exchange,UHC Exchange,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicaid,UHC Medicaid,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UMR CPD,UMR CPD,423.39,,,,,,,per diem,423.39,423.39,"Per diem rate, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,UHC Medicare,UHC Medicare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O EWSR1 GENE FISH           ,38251105,CDM,312,RC,,,,,,Inpatient,,,423.39,423.39,Wellcare,Wellcare,423.39,,,,,,,case rate,423.39,423.39,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health PPO CPD,Meritain Health PPO CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/Commercial Product,Aetna/Commercial Product,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health CPD,Meritain Health CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Starmark CPD,Starmark CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna Medicare,Aetna Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Ambetter ,Ambetter ,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access,Anthem Blue Access,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access Choice,Anthem Blue Access Choice,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Preferred,Anthem Blue Preferred,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Pathway,Anthem Pathway,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Alliance,Anthem Alliance,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Medicare,Anthem Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna,Cigna,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna PPO,Cigna PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna Medicare Advantage,Cigna Medicare Advantage,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Essence,Essence,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink HMO,Healthlink HMO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink PPO,Healthlink PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,HomeState Health Plan,HomeState Health Plan,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Humana Gold,Humana Gold,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medicaid MO,Medicaid MO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medica,Medica,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Tricare,Tricare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC All Payer,UHC All Payer,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Exchange,UHC Exchange,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicaid,UHC Medicaid,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UMR CPD,UMR CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicare,UHC Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251106,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Wellcare,Wellcare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health PPO CPD,Meritain Health PPO CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/Commercial Product,Aetna/Commercial Product,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health CPD,Meritain Health CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Starmark CPD,Starmark CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna Medicare,Aetna Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Ambetter ,Ambetter ,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access,Anthem Blue Access,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access Choice,Anthem Blue Access Choice,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Preferred,Anthem Blue Preferred,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Pathway,Anthem Pathway,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Alliance,Anthem Alliance,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Medicare,Anthem Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna,Cigna,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna PPO,Cigna PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna Medicare Advantage,Cigna Medicare Advantage,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Essence,Essence,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink HMO,Healthlink HMO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink PPO,Healthlink PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,HomeState Health Plan,HomeState Health Plan,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Humana Gold,Humana Gold,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medicaid MO,Medicaid MO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medica,Medica,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Tricare,Tricare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC All Payer,UHC All Payer,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Exchange,UHC Exchange,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicaid,UHC Medicaid,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UMR CPD,UMR CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicare,UHC Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251107,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Wellcare,Wellcare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health PPO CPD,Meritain Health PPO CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna/Commercial Product,Aetna/Commercial Product,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Meritain Health CPD,Meritain Health CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Starmark CPD,Starmark CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Aetna Medicare,Aetna Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Ambetter ,Ambetter ,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access,Anthem Blue Access,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Access Choice,Anthem Blue Access Choice,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Blue Preferred,Anthem Blue Preferred,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Pathway,Anthem Pathway,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Alliance,Anthem Alliance,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Anthem Medicare,Anthem Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna,Cigna,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna PPO,Cigna PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Cigna Medicare Advantage,Cigna Medicare Advantage,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Essence,Essence,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink HMO,Healthlink HMO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Healthlink PPO,Healthlink PPO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,HomeState Health Plan,HomeState Health Plan,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Humana Gold,Humana Gold,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medicaid MO,Medicaid MO,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Medica,Medica,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Tricare,Tricare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC All Payer,UHC All Payer,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Exchange,UHC Exchange,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicaid,UHC Medicaid,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UMR CPD,UMR CPD,330.94,,,,,,,per diem,330.94,330.94,"Per diem rate, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,UHC Medicare,UHC Medicare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O MISMATCH REPR IHC         ,38251108,CDM,312,RC,,,,,,Inpatient,,,330.94,330.94,Wellcare,Wellcare,330.94,,,,,,,case rate,330.94,330.94,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251109,CDM,305,RC,85441,CPT,30014,HCPCS,27,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health PPO CPD,Meritain Health PPO CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna/Commercial Product,Aetna/Commercial Product,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Meritain Health CPD,Meritain Health CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Starmark CPD,Starmark CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Aetna Medicare,Aetna Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Ambetter ,Ambetter ,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access,Anthem Blue Access,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Access Choice,Anthem Blue Access Choice,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Blue Preferred,Anthem Blue Preferred,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Pathway,Anthem Pathway,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Alliance,Anthem Alliance,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Anthem Medicare,Anthem Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna,Cigna,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna PPO,Cigna PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Cigna Medicare Advantage,Cigna Medicare Advantage,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Essence,Essence,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink HMO,Healthlink HMO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Healthlink PPO,Healthlink PPO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,HomeState Health Plan,HomeState Health Plan,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Humana Gold,Humana Gold,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medicaid MO,Medicaid MO,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Medica,Medica,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Tricare,Tricare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC All Payer,UHC All Payer,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Exchange,UHC Exchange,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicaid,UHC Medicaid,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UMR CPD,UMR CPD,25.21,,,,,,,per diem,25.21,25.21,"Per diem rate, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,UHC Medicare,UHC Medicare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O HEINZ BODY STAIN          ,38251110,CDM,305,RC,,,,,,Inpatient,,,25.21,25.21,Wellcare,Wellcare,25.21,,,,,,,case rate,25.21,25.21,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O VARICELLAZOST DFA WRF     ,38251111,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health PPO CPD,Meritain Health PPO CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/Commercial Product,Aetna/Commercial Product,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health CPD,Meritain Health CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Starmark CPD,Starmark CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna Medicare,Aetna Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Ambetter ,Ambetter ,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access,Anthem Blue Access,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access Choice,Anthem Blue Access Choice,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Preferred,Anthem Blue Preferred,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Pathway,Anthem Pathway,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Alliance,Anthem Alliance,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Medicare,Anthem Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna,Cigna,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna PPO,Cigna PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna Medicare Advantage,Cigna Medicare Advantage,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Essence,Essence,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink HMO,Healthlink HMO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink PPO,Healthlink PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,HomeState Health Plan,HomeState Health Plan,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Humana Gold,Humana Gold,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medicaid MO,Medicaid MO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medica,Medica,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Tricare,Tricare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC All Payer,UHC All Payer,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Exchange,UHC Exchange,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicaid,UHC Medicaid,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UMR CPD,UMR CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicare,UHC Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251112,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Wellcare,Wellcare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health PPO CPD,Meritain Health PPO CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna/Commercial Product,Aetna/Commercial Product,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Meritain Health CPD,Meritain Health CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Starmark CPD,Starmark CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Aetna Medicare,Aetna Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Ambetter ,Ambetter ,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access,Anthem Blue Access,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Access Choice,Anthem Blue Access Choice,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Blue Preferred,Anthem Blue Preferred,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Pathway,Anthem Pathway,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Alliance,Anthem Alliance,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Anthem Medicare,Anthem Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna,Cigna,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna PPO,Cigna PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Cigna Medicare Advantage,Cigna Medicare Advantage,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Essence,Essence,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink HMO,Healthlink HMO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Healthlink PPO,Healthlink PPO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,HomeState Health Plan,HomeState Health Plan,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Humana Gold,Humana Gold,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medicaid MO,Medicaid MO,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Medica,Medica,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Tricare,Tricare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC All Payer,UHC All Payer,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Exchange,UHC Exchange,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicaid,UHC Medicaid,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UMR CPD,UMR CPD,246.89,,,,,,,per diem,246.89,246.89,"Per diem rate, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,UHC Medicare,UHC Medicare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O PNH HIGH SENS RBC         ,38251113,CDM,302,RC,,,,,,Inpatient,,,246.89,246.89,Wellcare,Wellcare,246.89,,,,,,,case rate,246.89,246.89,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health PPO CPD,Meritain Health PPO CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/Commercial Product,Aetna/Commercial Product,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health CPD,Meritain Health CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Starmark CPD,Starmark CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna Medicare,Aetna Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Ambetter ,Ambetter ,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access,Anthem Blue Access,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access Choice,Anthem Blue Access Choice,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Preferred,Anthem Blue Preferred,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Pathway,Anthem Pathway,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Alliance,Anthem Alliance,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Medicare,Anthem Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna,Cigna,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna PPO,Cigna PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna Medicare Advantage,Cigna Medicare Advantage,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Essence,Essence,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink HMO,Healthlink HMO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink PPO,Healthlink PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,HomeState Health Plan,HomeState Health Plan,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Humana Gold,Humana Gold,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medicaid MO,Medicaid MO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medica,Medica,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Tricare,Tricare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC All Payer,UHC All Payer,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Exchange,UHC Exchange,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicaid,UHC Medicaid,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UMR CPD,UMR CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicare,UHC Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O HEX PHOSPHOLIPID RFLX     ,38251114,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Wellcare,Wellcare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PLATELET NEUTRAL RFLX     ,38251115,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O PTT-D HEPARIN RFLX        ,38251116,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O MATERNAL SRM SCREEN       ,38251117,CDM,302,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Meritain Health PPO CPD,Meritain Health PPO CPD,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Aetna/Commercial Product,Aetna/Commercial Product,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Meritain Health CPD,Meritain Health CPD,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Starmark CPD,Starmark CPD,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Aetna Medicare,Aetna Medicare,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Ambetter ,Ambetter ,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Blue Access,Anthem Blue Access,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Blue Access Choice,Anthem Blue Access Choice,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Blue Preferred,Anthem Blue Preferred,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Pathway,Anthem Pathway,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Alliance,Anthem Alliance,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Anthem Medicare,Anthem Medicare,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Cigna,Cigna,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Cigna PPO,Cigna PPO,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Cigna Medicare Advantage,Cigna Medicare Advantage,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Essence,Essence,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Healthlink HMO,Healthlink HMO,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Healthlink PPO,Healthlink PPO,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,HomeState Health Plan,HomeState Health Plan,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Humana Gold,Humana Gold,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Medicaid MO,Medicaid MO,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Medica,Medica,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Tricare,Tricare,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,UHC All Payer,UHC All Payer,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,UHC Exchange,UHC Exchange,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,UHC Medicaid,UHC Medicaid,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,UMR CPD,UMR CPD,1049.55,,,,,,,per diem,1049.55,1049.55,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,UHC Medicare,UHC Medicare,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251118,CDM,301,RC,,,,,,Inpatient,,,1049.55,1049.55,Wellcare,Wellcare,1049.55,,,,,,,case rate,1049.55,1049.55,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Meritain Health PPO CPD,Meritain Health PPO CPD,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Aetna/Commercial Product,Aetna/Commercial Product,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Meritain Health CPD,Meritain Health CPD,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Starmark CPD,Starmark CPD,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Aetna Medicare,Aetna Medicare,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Ambetter ,Ambetter ,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Blue Access,Anthem Blue Access,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Blue Access Choice,Anthem Blue Access Choice,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Blue Preferred,Anthem Blue Preferred,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Pathway,Anthem Pathway,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Alliance,Anthem Alliance,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Anthem Medicare,Anthem Medicare,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Cigna,Cigna,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Cigna PPO,Cigna PPO,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Cigna Medicare Advantage,Cigna Medicare Advantage,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Essence,Essence,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Healthlink HMO,Healthlink HMO,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Healthlink PPO,Healthlink PPO,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,HomeState Health Plan,HomeState Health Plan,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Humana Gold,Humana Gold,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Medicaid MO,Medicaid MO,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Medica,Medica,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Tricare,Tricare,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,UHC All Payer,UHC All Payer,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,UHC Exchange,UHC Exchange,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,UHC Medicaid,UHC Medicaid,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,UMR CPD,UMR CPD,273.16,,,,,,,per diem,273.16,273.16,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,UHC Medicare,UHC Medicare,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251119,CDM,310,RC,,,,,,Inpatient,,,273.16,273.16,Wellcare,Wellcare,273.16,,,,,,,case rate,273.16,273.16,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O KRAS MUTATION             ,38251120,CDM,301,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Meritain Health PPO CPD,Meritain Health PPO CPD,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Aetna/Commercial Product,Aetna/Commercial Product,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Meritain Health CPD,Meritain Health CPD,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Starmark CPD,Starmark CPD,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Aetna Medicare,Aetna Medicare,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Ambetter ,Ambetter ,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Blue Access,Anthem Blue Access,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Blue Access Choice,Anthem Blue Access Choice,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Blue Preferred,Anthem Blue Preferred,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Pathway,Anthem Pathway,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Alliance,Anthem Alliance,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Anthem Medicare,Anthem Medicare,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Cigna,Cigna,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Cigna PPO,Cigna PPO,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Cigna Medicare Advantage,Cigna Medicare Advantage,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Essence,Essence,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Healthlink HMO,Healthlink HMO,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Healthlink PPO,Healthlink PPO,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,HomeState Health Plan,HomeState Health Plan,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Humana Gold,Humana Gold,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Medicaid MO,Medicaid MO,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Medica,Medica,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Tricare,Tricare,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,UHC All Payer,UHC All Payer,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,UHC Exchange,UHC Exchange,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,UHC Medicaid,UHC Medicaid,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,UMR CPD,UMR CPD,689.19,,,,,,,per diem,689.19,689.19,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,UHC Medicare,UHC Medicare,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251121,CDM,301,RC,,,,,,Inpatient,,,689.19,689.19,Wellcare,Wellcare,689.19,,,,,,,case rate,689.19,689.19,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MSI BY PCR                ,38251122,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Meritain Health PPO CPD,Meritain Health PPO CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna/Commercial Product,Aetna/Commercial Product,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Meritain Health CPD,Meritain Health CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Starmark CPD,Starmark CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna Medicare,Aetna Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Ambetter ,Ambetter ,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Access,Anthem Blue Access,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Access Choice,Anthem Blue Access Choice,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Preferred,Anthem Blue Preferred,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Pathway,Anthem Pathway,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Alliance,Anthem Alliance,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Medicare,Anthem Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna,Cigna,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna PPO,Cigna PPO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna Medicare Advantage,Cigna Medicare Advantage,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Essence,Essence,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthlink HMO,Healthlink HMO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthlink PPO,Healthlink PPO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,HomeState Health Plan,HomeState Health Plan,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Humana Gold,Humana Gold,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Medicaid MO,Medicaid MO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Medica,Medica,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Tricare,Tricare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC All Payer,UHC All Payer,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Exchange,UHC Exchange,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Medicaid,UHC Medicaid,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UMR CPD,UMR CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Medicare,UHC Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251123,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Wellcare,Wellcare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 W/RFLX        ,38251124,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Meritain Health PPO CPD,Meritain Health PPO CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Aetna/Commercial Product,Aetna/Commercial Product,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Meritain Health CPD,Meritain Health CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Starmark CPD,Starmark CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Aetna Medicare,Aetna Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Ambetter ,Ambetter ,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Blue Access,Anthem Blue Access,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Blue Access Choice,Anthem Blue Access Choice,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Blue Preferred,Anthem Blue Preferred,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Pathway,Anthem Pathway,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Alliance,Anthem Alliance,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Anthem Medicare,Anthem Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Cigna,Cigna,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Cigna PPO,Cigna PPO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Cigna Medicare Advantage,Cigna Medicare Advantage,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Essence,Essence,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Healthlink HMO,Healthlink HMO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Healthlink PPO,Healthlink PPO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,HomeState Health Plan,HomeState Health Plan,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Humana Gold,Humana Gold,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Medicaid MO,Medicaid MO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Medica,Medica,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Tricare,Tricare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,UHC All Payer,UHC All Payer,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,UHC Exchange,UHC Exchange,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,UHC Medicaid,UHC Medicaid,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,UMR CPD,UMR CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,UHC Medicare,UHC Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O MLH1 PROMOTER METHYL      ,38251125,CDM,301,RC,,,,,,Inpatient,,,206.97,206.97,Wellcare,Wellcare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Meritain Health PPO CPD,Meritain Health PPO CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna/Commercial Product,Aetna/Commercial Product,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Meritain Health CPD,Meritain Health CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Starmark CPD,Starmark CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Aetna Medicare,Aetna Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Ambetter ,Ambetter ,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Access,Anthem Blue Access,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Access Choice,Anthem Blue Access Choice,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Blue Preferred,Anthem Blue Preferred,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Pathway,Anthem Pathway,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Alliance,Anthem Alliance,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Anthem Medicare,Anthem Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna,Cigna,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna PPO,Cigna PPO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Cigna Medicare Advantage,Cigna Medicare Advantage,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Essence,Essence,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthlink HMO,Healthlink HMO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Healthlink PPO,Healthlink PPO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,HomeState Health Plan,HomeState Health Plan,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Humana Gold,Humana Gold,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Medicaid MO,Medicaid MO,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Medica,Medica,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Tricare,Tricare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC All Payer,UHC All Payer,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Exchange,UHC Exchange,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Medicaid,UHC Medicaid,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UMR CPD,UMR CPD,875.15,,,,,,,per diem,875.15,875.15,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,UHC Medicare,UHC Medicare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251126,CDM,301,RC,,,,,,Inpatient,,,875.15,875.15,Wellcare,Wellcare,875.15,,,,,,,case rate,875.15,875.15,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BRAF COD600 PYRO          ,38251127,CDM,310,RC,,,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Meritain Health PPO CPD,Meritain Health PPO CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna/Commercial Product,Aetna/Commercial Product,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Meritain Health CPD,Meritain Health CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Starmark CPD,Starmark CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Aetna Medicare,Aetna Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Ambetter ,Ambetter ,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Access,Anthem Blue Access,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Access Choice,Anthem Blue Access Choice,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Blue Preferred,Anthem Blue Preferred,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Pathway,Anthem Pathway,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Alliance,Anthem Alliance,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Anthem Medicare,Anthem Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna,Cigna,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna PPO,Cigna PPO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Cigna Medicare Advantage,Cigna Medicare Advantage,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Essence,Essence,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthlink HMO,Healthlink HMO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Healthlink PPO,Healthlink PPO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,HomeState Health Plan,HomeState Health Plan,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Humana Gold,Humana Gold,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Medicaid MO,Medicaid MO,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Medica,Medica,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Tricare,Tricare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC All Payer,UHC All Payer,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Exchange,UHC Exchange,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Medicaid,UHC Medicaid,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UMR CPD,UMR CPD,833.13,,,,,,,per diem,833.13,833.13,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,UHC Medicare,UHC Medicare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251128,CDM,301,RC,,,,,,Inpatient,,,833.13,833.13,Wellcare,Wellcare,833.13,,,,,,,case rate,833.13,833.13,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Meritain Health PPO CPD,Meritain Health PPO CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Aetna/Commercial Product,Aetna/Commercial Product,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Meritain Health CPD,Meritain Health CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Starmark CPD,Starmark CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Aetna Medicare,Aetna Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Ambetter ,Ambetter ,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Access,Anthem Blue Access,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Access Choice,Anthem Blue Access Choice,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Preferred,Anthem Blue Preferred,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Pathway,Anthem Pathway,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Alliance,Anthem Alliance,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Medicare,Anthem Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Cigna,Cigna,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Cigna PPO,Cigna PPO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Cigna Medicare Advantage,Cigna Medicare Advantage,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Essence,Essence,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Healthlink HMO,Healthlink HMO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Healthlink PPO,Healthlink PPO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,HomeState Health Plan,HomeState Health Plan,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Humana Gold,Humana Gold,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Medicaid MO,Medicaid MO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Medica,Medica,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Tricare,Tricare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,UHC All Payer,UHC All Payer,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,UHC Exchange,UHC Exchange,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,UHC Medicaid,UHC Medicaid,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,UMR CPD,UMR CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,UHC Medicare,UHC Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 QL WRFLX         ,38251129,CDM,301,RC,,,,,,Inpatient,,,736.47,736.47,Wellcare,Wellcare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MAJOR QUANT      ,38251130,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O BCR-ABL1 MINOR QUANT      ,38251131,CDM,301,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251132,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251133,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251134,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251135,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251136,CDM,311,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O ANEUPLOIDY FISH           ,38251137,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Meritain Health PPO CPD,Meritain Health PPO CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna/Commercial Product,Aetna/Commercial Product,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Meritain Health CPD,Meritain Health CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Starmark CPD,Starmark CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna Medicare,Aetna Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Ambetter ,Ambetter ,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Access,Anthem Blue Access,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Access Choice,Anthem Blue Access Choice,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Preferred,Anthem Blue Preferred,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Pathway,Anthem Pathway,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Alliance,Anthem Alliance,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Medicare,Anthem Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna,Cigna,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna PPO,Cigna PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna Medicare Advantage,Cigna Medicare Advantage,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Essence,Essence,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthlink HMO,Healthlink HMO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthlink PPO,Healthlink PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,HomeState Health Plan,HomeState Health Plan,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Humana Gold,Humana Gold,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Medicaid MO,Medicaid MO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Medica,Medica,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Tricare,Tricare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC All Payer,UHC All Payer,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Exchange,UHC Exchange,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Medicaid,UHC Medicaid,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UMR CPD,UMR CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Medicare,UHC Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251138,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Wellcare,Wellcare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Meritain Health PPO CPD,Meritain Health PPO CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna/Commercial Product,Aetna/Commercial Product,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Meritain Health CPD,Meritain Health CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Starmark CPD,Starmark CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Aetna Medicare,Aetna Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Ambetter ,Ambetter ,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Access,Anthem Blue Access,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Access Choice,Anthem Blue Access Choice,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Blue Preferred,Anthem Blue Preferred,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Pathway,Anthem Pathway,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Alliance,Anthem Alliance,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Anthem Medicare,Anthem Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna,Cigna,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna PPO,Cigna PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Cigna Medicare Advantage,Cigna Medicare Advantage,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Essence,Essence,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthlink HMO,Healthlink HMO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Healthlink PPO,Healthlink PPO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,HomeState Health Plan,HomeState Health Plan,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Humana Gold,Humana Gold,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Medicaid MO,Medicaid MO,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Medica,Medica,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Tricare,Tricare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC All Payer,UHC All Payer,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Exchange,UHC Exchange,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Medicaid,UHC Medicaid,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UMR CPD,UMR CPD,485.38,,,,,,,per diem,485.38,485.38,"Per diem rate, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,UHC Medicare,UHC Medicare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O B-CELL SCRN PCR           ,38251139,CDM,301,RC,,,,,,Inpatient,,,485.38,485.38,Wellcare,Wellcare,485.38,,,,,,,case rate,485.38,485.38,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251140,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251141,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251142,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251143,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health PPO CPD,Meritain Health PPO CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna/Commercial Product,Aetna/Commercial Product,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Meritain Health CPD,Meritain Health CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Starmark CPD,Starmark CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Aetna Medicare,Aetna Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Ambetter ,Ambetter ,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access,Anthem Blue Access,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Access Choice,Anthem Blue Access Choice,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Blue Preferred,Anthem Blue Preferred,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Pathway,Anthem Pathway,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Alliance,Anthem Alliance,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Anthem Medicare,Anthem Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna,Cigna,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna PPO,Cigna PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Cigna Medicare Advantage,Cigna Medicare Advantage,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Essence,Essence,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink HMO,Healthlink HMO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Healthlink PPO,Healthlink PPO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,HomeState Health Plan,HomeState Health Plan,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Humana Gold,Humana Gold,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medicaid MO,Medicaid MO,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Medica,Medica,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Tricare,Tricare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC All Payer,UHC All Payer,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Exchange,UHC Exchange,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicaid,UHC Medicaid,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UMR CPD,UMR CPD,446.51,,,,,,,per diem,446.51,446.51,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,UHC Medicare,UHC Medicare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251144,CDM,301,RC,,,,,,Inpatient,,,446.51,446.51,Wellcare,Wellcare,446.51,,,,,,,case rate,446.51,446.51,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health PPO CPD,Meritain Health PPO CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna/Commercial Product,Aetna/Commercial Product,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Meritain Health CPD,Meritain Health CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Starmark CPD,Starmark CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Aetna Medicare,Aetna Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Ambetter ,Ambetter ,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access,Anthem Blue Access,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Access Choice,Anthem Blue Access Choice,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Blue Preferred,Anthem Blue Preferred,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Pathway,Anthem Pathway,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Alliance,Anthem Alliance,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Anthem Medicare,Anthem Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna,Cigna,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna PPO,Cigna PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Cigna Medicare Advantage,Cigna Medicare Advantage,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Essence,Essence,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink HMO,Healthlink HMO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Healthlink PPO,Healthlink PPO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,HomeState Health Plan,HomeState Health Plan,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Humana Gold,Humana Gold,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Medicaid MO,Medicaid MO,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Medica,Medica,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Tricare,Tricare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC All Payer,UHC All Payer,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Exchange,UHC Exchange,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicaid,UHC Medicaid,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UMR CPD,UMR CPD,414.99,,,,,,,per diem,414.99,414.99,"Per diem rate, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,UHC Medicare,UHC Medicare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O MITOCHROND DISORD         ,38251145,CDM,301,RC,,,,,,Inpatient,,,414.99,414.99,Wellcare,Wellcare,414.99,,,,,,,case rate,414.99,414.99,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Meritain Health PPO CPD,Meritain Health PPO CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna/Commercial Product,Aetna/Commercial Product,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Meritain Health CPD,Meritain Health CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Starmark CPD,Starmark CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Aetna Medicare,Aetna Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Ambetter ,Ambetter ,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Access,Anthem Blue Access,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Access Choice,Anthem Blue Access Choice,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Blue Preferred,Anthem Blue Preferred,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Pathway,Anthem Pathway,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Alliance,Anthem Alliance,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Anthem Medicare,Anthem Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna,Cigna,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna PPO,Cigna PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Cigna Medicare Advantage,Cigna Medicare Advantage,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Essence,Essence,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthlink HMO,Healthlink HMO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Healthlink PPO,Healthlink PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,HomeState Health Plan,HomeState Health Plan,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Humana Gold,Humana Gold,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Medicaid MO,Medicaid MO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Medica,Medica,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Tricare,Tricare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC All Payer,UHC All Payer,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Exchange,UHC Exchange,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Medicaid,UHC Medicaid,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UMR CPD,UMR CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,UHC Medicare,UHC Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O THIOPURIN METABOL         ,38251146,CDM,301,RC,,,,,,Inpatient,,,616.7,616.7,Wellcare,Wellcare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251147,CDM,311,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Meritain Health PPO CPD,Meritain Health PPO CPD,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Aetna/Commercial Product,Aetna/Commercial Product,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Meritain Health CPD,Meritain Health CPD,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Starmark CPD,Starmark CPD,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Aetna Medicare,Aetna Medicare,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Ambetter ,Ambetter ,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Blue Access,Anthem Blue Access,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Blue Access Choice,Anthem Blue Access Choice,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Blue Preferred,Anthem Blue Preferred,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Pathway,Anthem Pathway,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Alliance,Anthem Alliance,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Anthem Medicare,Anthem Medicare,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Cigna,Cigna,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Cigna PPO,Cigna PPO,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Cigna Medicare Advantage,Cigna Medicare Advantage,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Essence,Essence,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Healthlink HMO,Healthlink HMO,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Healthlink PPO,Healthlink PPO,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,HomeState Health Plan,HomeState Health Plan,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Humana Gold,Humana Gold,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Medicaid MO,Medicaid MO,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Medica,Medica,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Tricare,Tricare,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,UHC All Payer,UHC All Payer,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,UHC Exchange,UHC Exchange,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,UHC Medicaid,UHC Medicaid,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,UMR CPD,UMR CPD,939.24,,,,,,,per diem,939.24,939.24,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,UHC Medicare,UHC Medicare,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD W/RFLX        ,38251148,CDM,311,RC,,,,,,Inpatient,,,939.24,939.24,Wellcare,Wellcare,939.24,,,,,,,case rate,939.24,939.24,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Meritain Health PPO CPD,Meritain Health PPO CPD,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Aetna/Commercial Product,Aetna/Commercial Product,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Meritain Health CPD,Meritain Health CPD,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Starmark CPD,Starmark CPD,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Aetna Medicare,Aetna Medicare,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Ambetter ,Ambetter ,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Blue Access,Anthem Blue Access,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Blue Access Choice,Anthem Blue Access Choice,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Blue Preferred,Anthem Blue Preferred,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Pathway,Anthem Pathway,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Alliance,Anthem Alliance,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Anthem Medicare,Anthem Medicare,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Cigna,Cigna,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Cigna PPO,Cigna PPO,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Cigna Medicare Advantage,Cigna Medicare Advantage,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Essence,Essence,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Healthlink HMO,Healthlink HMO,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Healthlink PPO,Healthlink PPO,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,HomeState Health Plan,HomeState Health Plan,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Humana Gold,Humana Gold,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Medicaid MO,Medicaid MO,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Medica,Medica,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Tricare,Tricare,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,UHC All Payer,UHC All Payer,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,UHC Exchange,UHC Exchange,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,UHC Medicaid,UHC Medicaid,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,UMR CPD,UMR CPD,6557.85,,,,,,,per diem,6557.85,6557.85,"Per diem rate, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,UHC Medicare,UHC Medicare,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
S/O CHROM P BLD GEN M ARR     ,38251149,CDM,301,RC,,,,,,Inpatient,,,6557.85,6557.85,Wellcare,Wellcare,6557.85,,,,,,,case rate,6557.85,6557.85,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health PPO CPD,Meritain Health PPO CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/Commercial Product,Aetna/Commercial Product,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health CPD,Meritain Health CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Starmark CPD,Starmark CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna Medicare,Aetna Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Ambetter ,Ambetter ,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access,Anthem Blue Access,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access Choice,Anthem Blue Access Choice,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Preferred,Anthem Blue Preferred,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Pathway,Anthem Pathway,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Alliance,Anthem Alliance,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Medicare,Anthem Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna,Cigna,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna PPO,Cigna PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna Medicare Advantage,Cigna Medicare Advantage,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Essence,Essence,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink HMO,Healthlink HMO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink PPO,Healthlink PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,HomeState Health Plan,HomeState Health Plan,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Humana Gold,Humana Gold,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medicaid MO,Medicaid MO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medica,Medica,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Tricare,Tricare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC All Payer,UHC All Payer,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Exchange,UHC Exchange,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicaid,UHC Medicaid,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UMR CPD,UMR CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicare,UHC Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251150,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Wellcare,Wellcare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health PPO CPD,Meritain Health PPO CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/Commercial Product,Aetna/Commercial Product,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health CPD,Meritain Health CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Starmark CPD,Starmark CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna Medicare,Aetna Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Ambetter ,Ambetter ,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access,Anthem Blue Access,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access Choice,Anthem Blue Access Choice,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Preferred,Anthem Blue Preferred,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Pathway,Anthem Pathway,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Alliance,Anthem Alliance,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Medicare,Anthem Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna,Cigna,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna PPO,Cigna PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna Medicare Advantage,Cigna Medicare Advantage,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Essence,Essence,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink HMO,Healthlink HMO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink PPO,Healthlink PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,HomeState Health Plan,HomeState Health Plan,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Humana Gold,Humana Gold,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medicaid MO,Medicaid MO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medica,Medica,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Tricare,Tricare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC All Payer,UHC All Payer,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Exchange,UHC Exchange,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicaid,UHC Medicaid,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UMR CPD,UMR CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicare,UHC Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251151,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Wellcare,Wellcare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health PPO CPD,Meritain Health PPO CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/Commercial Product,Aetna/Commercial Product,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health CPD,Meritain Health CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Starmark CPD,Starmark CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna Medicare,Aetna Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Ambetter ,Ambetter ,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access,Anthem Blue Access,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access Choice,Anthem Blue Access Choice,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Preferred,Anthem Blue Preferred,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Pathway,Anthem Pathway,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Alliance,Anthem Alliance,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Medicare,Anthem Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna,Cigna,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna PPO,Cigna PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna Medicare Advantage,Cigna Medicare Advantage,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Essence,Essence,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink HMO,Healthlink HMO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink PPO,Healthlink PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,HomeState Health Plan,HomeState Health Plan,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Humana Gold,Humana Gold,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medicaid MO,Medicaid MO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medica,Medica,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Tricare,Tricare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC All Payer,UHC All Payer,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Exchange,UHC Exchange,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicaid,UHC Medicaid,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UMR CPD,UMR CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicare,UHC Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251152,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Wellcare,Wellcare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health PPO CPD,Meritain Health PPO CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/Commercial Product,Aetna/Commercial Product,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health CPD,Meritain Health CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Starmark CPD,Starmark CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna Medicare,Aetna Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Ambetter ,Ambetter ,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access,Anthem Blue Access,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access Choice,Anthem Blue Access Choice,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Preferred,Anthem Blue Preferred,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Pathway,Anthem Pathway,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Alliance,Anthem Alliance,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Medicare,Anthem Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna,Cigna,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna PPO,Cigna PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna Medicare Advantage,Cigna Medicare Advantage,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Essence,Essence,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink HMO,Healthlink HMO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink PPO,Healthlink PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,HomeState Health Plan,HomeState Health Plan,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Humana Gold,Humana Gold,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medicaid MO,Medicaid MO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medica,Medica,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Tricare,Tricare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC All Payer,UHC All Payer,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Exchange,UHC Exchange,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicaid,UHC Medicaid,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UMR CPD,UMR CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicare,UHC Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251153,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Wellcare,Wellcare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health PPO CPD,Meritain Health PPO CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna/Commercial Product,Aetna/Commercial Product,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Meritain Health CPD,Meritain Health CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Starmark CPD,Starmark CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Aetna Medicare,Aetna Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Ambetter ,Ambetter ,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access,Anthem Blue Access,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Access Choice,Anthem Blue Access Choice,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Blue Preferred,Anthem Blue Preferred,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Pathway,Anthem Pathway,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Alliance,Anthem Alliance,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Anthem Medicare,Anthem Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna,Cigna,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna PPO,Cigna PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Cigna Medicare Advantage,Cigna Medicare Advantage,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Essence,Essence,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink HMO,Healthlink HMO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Healthlink PPO,Healthlink PPO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,HomeState Health Plan,HomeState Health Plan,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Humana Gold,Humana Gold,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medicaid MO,Medicaid MO,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Medica,Medica,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Tricare,Tricare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC All Payer,UHC All Payer,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Exchange,UHC Exchange,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicaid,UHC Medicaid,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UMR CPD,UMR CPD,354.05,,,,,,,per diem,354.05,354.05,"Per diem rate, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,UHC Medicare,UHC Medicare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
CRYOPRECIP 5UNIT POOL         ,38251154,CDM,390,RC,,,,,,Inpatient,,,354.05,354.05,Wellcare,Wellcare,354.05,,,,,,,case rate,354.05,354.05,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Meritain Health PPO CPD,Meritain Health PPO CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna/Commercial Product,Aetna/Commercial Product,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Meritain Health CPD,Meritain Health CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Starmark CPD,Starmark CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Aetna Medicare,Aetna Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Ambetter ,Ambetter ,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Access,Anthem Blue Access,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Access Choice,Anthem Blue Access Choice,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Blue Preferred,Anthem Blue Preferred,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Pathway,Anthem Pathway,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Alliance,Anthem Alliance,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Anthem Medicare,Anthem Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna,Cigna,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna PPO,Cigna PPO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Cigna Medicare Advantage,Cigna Medicare Advantage,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Essence,Essence,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthlink HMO,Healthlink HMO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Healthlink PPO,Healthlink PPO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,HomeState Health Plan,HomeState Health Plan,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Humana Gold,Humana Gold,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Medicaid MO,Medicaid MO,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Medica,Medica,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Tricare,Tricare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC All Payer,UHC All Payer,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Exchange,UHC Exchange,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Medicaid,UHC Medicaid,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UMR CPD,UMR CPD,250.04,,,,,,,per diem,250.04,250.04,"Per diem rate, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,UHC Medicare,UHC Medicare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROMBO RISK WRFX         ,38251155,CDM,301,RC,,,,,,Inpatient,,,250.04,250.04,Wellcare,Wellcare,250.04,,,,,,,case rate,250.04,250.04,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health PPO CPD,Meritain Health PPO CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna/Commercial Product,Aetna/Commercial Product,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Meritain Health CPD,Meritain Health CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Starmark CPD,Starmark CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Aetna Medicare,Aetna Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Ambetter ,Ambetter ,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access,Anthem Blue Access,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Access Choice,Anthem Blue Access Choice,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Blue Preferred,Anthem Blue Preferred,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Pathway,Anthem Pathway,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Alliance,Anthem Alliance,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Anthem Medicare,Anthem Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna,Cigna,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna PPO,Cigna PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Cigna Medicare Advantage,Cigna Medicare Advantage,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Essence,Essence,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink HMO,Healthlink HMO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Healthlink PPO,Healthlink PPO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,HomeState Health Plan,HomeState Health Plan,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Humana Gold,Humana Gold,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medicaid MO,Medicaid MO,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Medica,Medica,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Tricare,Tricare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC All Payer,UHC All Payer,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Exchange,UHC Exchange,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicaid,UHC Medicaid,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UMR CPD,UMR CPD,310.98,,,,,,,per diem,310.98,310.98,"Per diem rate, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,UHC Medicare,UHC Medicare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK F5 R506Q       ,38251156,CDM,301,RC,,,,,,Inpatient,,,310.98,310.98,Wellcare,Wellcare,310.98,,,,,,,case rate,310.98,310.98,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health PPO CPD,Meritain Health PPO CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna/Commercial Product,Aetna/Commercial Product,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Meritain Health CPD,Meritain Health CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Starmark CPD,Starmark CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Aetna Medicare,Aetna Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Ambetter ,Ambetter ,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access,Anthem Blue Access,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Access Choice,Anthem Blue Access Choice,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Blue Preferred,Anthem Blue Preferred,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Pathway,Anthem Pathway,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Alliance,Anthem Alliance,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Anthem Medicare,Anthem Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna,Cigna,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna PPO,Cigna PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Cigna Medicare Advantage,Cigna Medicare Advantage,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Essence,Essence,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink HMO,Healthlink HMO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Healthlink PPO,Healthlink PPO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,HomeState Health Plan,HomeState Health Plan,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Humana Gold,Humana Gold,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medicaid MO,Medicaid MO,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Medica,Medica,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Tricare,Tricare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC All Payer,UHC All Payer,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Exchange,UHC Exchange,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicaid,UHC Medicaid,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UMR CPD,UMR CPD,53.58,,,,,,,per diem,53.58,53.58,"Per diem rate, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,UHC Medicare,UHC Medicare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PTT-D NEUT     ,38251157,CDM,305,RC,,,,,,Inpatient,,,53.58,53.58,Wellcare,Wellcare,53.58,,,,,,,case rate,53.58,53.58,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK PLT NEUTRL     ,38251158,CDM,305,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health PPO CPD,Meritain Health PPO CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/Commercial Product,Aetna/Commercial Product,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health CPD,Meritain Health CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Starmark CPD,Starmark CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Aetna Medicare,Aetna Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Ambetter ,Ambetter ,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access,Anthem Blue Access,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access Choice,Anthem Blue Access Choice,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Preferred,Anthem Blue Preferred,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Pathway,Anthem Pathway,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Alliance,Anthem Alliance,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Medicare,Anthem Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna,Cigna,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna PPO,Cigna PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Cigna Medicare Advantage,Cigna Medicare Advantage,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Essence,Essence,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink HMO,Healthlink HMO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink PPO,Healthlink PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,HomeState Health Plan,HomeState Health Plan,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Humana Gold,Humana Gold,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medicaid MO,Medicaid MO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Medica,Medica,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Tricare,Tricare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC All Payer,UHC All Payer,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Exchange,UHC Exchange,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicaid,UHC Medicaid,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UMR CPD,UMR CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicare,UHC Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O THROM RISK HEXA PHOSP     ,38251159,CDM,305,RC,,,,,,Inpatient,,,155.49,155.49,Wellcare,Wellcare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN FIRST      ,38251160,CDM,300,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Meritain Health PPO CPD,Meritain Health PPO CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna/Commercial Product,Aetna/Commercial Product,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Meritain Health CPD,Meritain Health CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Starmark CPD,Starmark CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Aetna Medicare,Aetna Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Ambetter ,Ambetter ,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Access,Anthem Blue Access,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Access Choice,Anthem Blue Access Choice,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Blue Preferred,Anthem Blue Preferred,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Pathway,Anthem Pathway,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Alliance,Anthem Alliance,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Anthem Medicare,Anthem Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna,Cigna,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna PPO,Cigna PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Cigna Medicare Advantage,Cigna Medicare Advantage,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Essence,Essence,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthlink HMO,Healthlink HMO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Healthlink PPO,Healthlink PPO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,HomeState Health Plan,HomeState Health Plan,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Humana Gold,Humana Gold,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Medicaid MO,Medicaid MO,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Medica,Medica,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Tricare,Tricare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC All Payer,UHC All Payer,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Exchange,UHC Exchange,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Medicaid,UHC Medicaid,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UMR CPD,UMR CPD,209.07,,,,,,,per diem,209.07,209.07,"Per diem rate, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,UHC Medicare,UHC Medicare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O FETAL HEMOGLOBIN APT      ,38251161,CDM,301,RC,,,,,,Inpatient,,,209.07,209.07,Wellcare,Wellcare,209.07,,,,,,,case rate,209.07,209.07,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Meritain Health PPO CPD,Meritain Health PPO CPD,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Aetna/Commercial Product,Aetna/Commercial Product,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Meritain Health CPD,Meritain Health CPD,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Starmark CPD,Starmark CPD,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Aetna Medicare,Aetna Medicare,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Ambetter ,Ambetter ,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Blue Access,Anthem Blue Access,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Blue Access Choice,Anthem Blue Access Choice,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Blue Preferred,Anthem Blue Preferred,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Pathway,Anthem Pathway,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Alliance,Anthem Alliance,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Anthem Medicare,Anthem Medicare,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Cigna,Cigna,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Cigna PPO,Cigna PPO,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Cigna Medicare Advantage,Cigna Medicare Advantage,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Essence,Essence,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Healthlink HMO,Healthlink HMO,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Healthlink PPO,Healthlink PPO,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,HomeState Health Plan,HomeState Health Plan,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Humana Gold,Humana Gold,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Medicaid MO,Medicaid MO,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Medica,Medica,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Tricare,Tricare,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,UHC All Payer,UHC All Payer,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,UHC Exchange,UHC Exchange,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,UHC Medicaid,UHC Medicaid,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,UMR CPD,UMR CPD,2776.74,,,,,,,per diem,2776.74,2776.74,"Per diem rate, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,UHC Medicare,UHC Medicare,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 1 HR                  ,38251162,CDM,301,RC,,,,,,Inpatient,,,2776.74,2776.74,Wellcare,Wellcare,2776.74,,,,,,,case rate,2776.74,2776.74,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Meritain Health PPO CPD,Meritain Health PPO CPD,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Aetna/Commercial Product,Aetna/Commercial Product,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Meritain Health CPD,Meritain Health CPD,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Starmark CPD,Starmark CPD,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Aetna Medicare,Aetna Medicare,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Ambetter ,Ambetter ,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Blue Access,Anthem Blue Access,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Blue Access Choice,Anthem Blue Access Choice,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Blue Preferred,Anthem Blue Preferred,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Pathway,Anthem Pathway,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Alliance,Anthem Alliance,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Anthem Medicare,Anthem Medicare,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Cigna,Cigna,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Cigna PPO,Cigna PPO,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Cigna Medicare Advantage,Cigna Medicare Advantage,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Essence,Essence,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Healthlink HMO,Healthlink HMO,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Healthlink PPO,Healthlink PPO,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,HomeState Health Plan,HomeState Health Plan,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Humana Gold,Humana Gold,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Medicaid MO,Medicaid MO,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Medica,Medica,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Tricare,Tricare,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,UHC All Payer,UHC All Payer,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,UHC Exchange,UHC Exchange,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,UHC Medicaid,UHC Medicaid,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,UMR CPD,UMR CPD,912.97,,,,,,,per diem,912.97,912.97,"Per diem rate, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,UHC Medicare,UHC Medicare,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O HLA 2 HR                  ,38251163,CDM,301,RC,,,,,,Inpatient,,,912.97,912.97,Wellcare,Wellcare,912.97,,,,,,,case rate,912.97,912.97,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Meritain Health PPO CPD,Meritain Health PPO CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna/Commercial Product,Aetna/Commercial Product,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Meritain Health CPD,Meritain Health CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Starmark CPD,Starmark CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Aetna Medicare,Aetna Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Ambetter ,Ambetter ,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Access,Anthem Blue Access,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Access Choice,Anthem Blue Access Choice,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Blue Preferred,Anthem Blue Preferred,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Pathway,Anthem Pathway,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Alliance,Anthem Alliance,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Anthem Medicare,Anthem Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna,Cigna,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna PPO,Cigna PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Cigna Medicare Advantage,Cigna Medicare Advantage,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Essence,Essence,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthlink HMO,Healthlink HMO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Healthlink PPO,Healthlink PPO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,HomeState Health Plan,HomeState Health Plan,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Humana Gold,Humana Gold,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Medicaid MO,Medicaid MO,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Medica,Medica,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Tricare,Tricare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC All Payer,UHC All Payer,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Exchange,UHC Exchange,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Medicaid,UHC Medicaid,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UMR CPD,UMR CPD,200.66,,,,,,,per diem,200.66,200.66,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,UHC Medicare,UHC Medicare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODIES           ,38251164,CDM,301,RC,,,,,,Inpatient,,,200.66,200.66,Wellcare,Wellcare,200.66,,,,,,,case rate,200.66,200.66,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Meritain Health PPO CPD,Meritain Health PPO CPD,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Aetna/Commercial Product,Aetna/Commercial Product,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Meritain Health CPD,Meritain Health CPD,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Starmark CPD,Starmark CPD,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Aetna Medicare,Aetna Medicare,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Ambetter ,Ambetter ,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Blue Access,Anthem Blue Access,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Blue Access Choice,Anthem Blue Access Choice,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Blue Preferred,Anthem Blue Preferred,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Pathway,Anthem Pathway,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Alliance,Anthem Alliance,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Anthem Medicare,Anthem Medicare,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Cigna,Cigna,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Cigna PPO,Cigna PPO,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Cigna Medicare Advantage,Cigna Medicare Advantage,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Essence,Essence,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Healthlink HMO,Healthlink HMO,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Healthlink PPO,Healthlink PPO,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,HomeState Health Plan,HomeState Health Plan,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Humana Gold,Humana Gold,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Medicaid MO,Medicaid MO,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Medica,Medica,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Tricare,Tricare,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,UHC All Payer,UHC All Payer,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,UHC Exchange,UHC Exchange,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,UHC Medicaid,UHC Medicaid,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,UMR CPD,UMR CPD,601.99,,,,,,,per diem,601.99,601.99,"Per diem rate, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,UHC Medicare,UHC Medicare,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O HLA ANTIBODY SCREEN       ,38251165,CDM,302,RC,,,,,,Inpatient,,,601.99,601.99,Wellcare,Wellcare,601.99,,,,,,,case rate,601.99,601.99,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Meritain Health PPO CPD,Meritain Health PPO CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Aetna/Commercial Product,Aetna/Commercial Product,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Meritain Health CPD,Meritain Health CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Starmark CPD,Starmark CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Aetna Medicare,Aetna Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Ambetter ,Ambetter ,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Access,Anthem Blue Access,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Access Choice,Anthem Blue Access Choice,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Preferred,Anthem Blue Preferred,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Pathway,Anthem Pathway,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Alliance,Anthem Alliance,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Medicare,Anthem Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Cigna,Cigna,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Cigna PPO,Cigna PPO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Cigna Medicare Advantage,Cigna Medicare Advantage,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Essence,Essence,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Healthlink HMO,Healthlink HMO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Healthlink PPO,Healthlink PPO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,HomeState Health Plan,HomeState Health Plan,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Humana Gold,Humana Gold,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Medicaid MO,Medicaid MO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Medica,Medica,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Tricare,Tricare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,UHC All Payer,UHC All Payer,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,UHC Exchange,UHC Exchange,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,UHC Medicaid,UHC Medicaid,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,UMR CPD,UMR CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,UHC Medicare,UHC Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN NONCRH     ,38251166,CDM,300,RC,,,,,,Inpatient,,,113.46,113.46,Wellcare,Wellcare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health PPO CPD,Meritain Health PPO CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/Commercial Product,Aetna/Commercial Product,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health CPD,Meritain Health CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Starmark CPD,Starmark CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Aetna Medicare,Aetna Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Ambetter ,Ambetter ,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access,Anthem Blue Access,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access Choice,Anthem Blue Access Choice,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Preferred,Anthem Blue Preferred,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Pathway,Anthem Pathway,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Alliance,Anthem Alliance,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Medicare,Anthem Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Cigna,Cigna,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Cigna PPO,Cigna PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Cigna Medicare Advantage,Cigna Medicare Advantage,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Essence,Essence,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink HMO,Healthlink HMO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink PPO,Healthlink PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,HomeState Health Plan,HomeState Health Plan,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Humana Gold,Humana Gold,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Medicaid MO,Medicaid MO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Medica,Medica,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Tricare,Tricare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,UHC All Payer,UHC All Payer,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,UHC Exchange,UHC Exchange,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicaid,UHC Medicaid,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,UMR CPD,UMR CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicare,UHC Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O NEWBORN SCREEN SECOND     ,38251167,CDM,300,RC,,,,,,Inpatient,,,126.07,126.07,Wellcare,Wellcare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Meritain Health PPO CPD,Meritain Health PPO CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna/Commercial Product,Aetna/Commercial Product,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Meritain Health CPD,Meritain Health CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Starmark CPD,Starmark CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Aetna Medicare,Aetna Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Ambetter ,Ambetter ,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Access,Anthem Blue Access,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Access Choice,Anthem Blue Access Choice,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Blue Preferred,Anthem Blue Preferred,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Pathway,Anthem Pathway,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Alliance,Anthem Alliance,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Anthem Medicare,Anthem Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna,Cigna,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna PPO,Cigna PPO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Cigna Medicare Advantage,Cigna Medicare Advantage,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Essence,Essence,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthlink HMO,Healthlink HMO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Healthlink PPO,Healthlink PPO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,HomeState Health Plan,HomeState Health Plan,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Humana Gold,Humana Gold,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Medicaid MO,Medicaid MO,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Medica,Medica,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Tricare,Tricare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC All Payer,UHC All Payer,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Exchange,UHC Exchange,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Medicaid,UHC Medicaid,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UMR CPD,UMR CPD,1323.76,,,,,,,per diem,1323.76,1323.76,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,UHC Medicare,UHC Medicare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD ROUTN         ,38251168,CDM,311,RC,,,,,,Inpatient,,,1323.76,1323.76,Wellcare,Wellcare,1323.76,,,,,,,case rate,1323.76,1323.76,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health PPO CPD,Meritain Health PPO CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/Commercial Product,Aetna/Commercial Product,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health CPD,Meritain Health CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Starmark CPD,Starmark CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna Medicare,Aetna Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Ambetter ,Ambetter ,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access,Anthem Blue Access,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access Choice,Anthem Blue Access Choice,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Preferred,Anthem Blue Preferred,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Pathway,Anthem Pathway,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Alliance,Anthem Alliance,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Medicare,Anthem Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna,Cigna,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna PPO,Cigna PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna Medicare Advantage,Cigna Medicare Advantage,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Essence,Essence,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink HMO,Healthlink HMO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink PPO,Healthlink PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,HomeState Health Plan,HomeState Health Plan,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Humana Gold,Humana Gold,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medicaid MO,Medicaid MO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medica,Medica,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Tricare,Tricare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC All Payer,UHC All Payer,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Exchange,UHC Exchange,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicaid,UHC Medicaid,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UMR CPD,UMR CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicare,UHC Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251169,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Wellcare,Wellcare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health PPO CPD,Meritain Health PPO CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/Commercial Product,Aetna/Commercial Product,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health CPD,Meritain Health CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Starmark CPD,Starmark CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna Medicare,Aetna Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Ambetter ,Ambetter ,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access,Anthem Blue Access,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access Choice,Anthem Blue Access Choice,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Preferred,Anthem Blue Preferred,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Pathway,Anthem Pathway,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Alliance,Anthem Alliance,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Medicare,Anthem Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna,Cigna,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna PPO,Cigna PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna Medicare Advantage,Cigna Medicare Advantage,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Essence,Essence,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink HMO,Healthlink HMO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink PPO,Healthlink PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,HomeState Health Plan,HomeState Health Plan,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Humana Gold,Humana Gold,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medicaid MO,Medicaid MO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medica,Medica,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Tricare,Tricare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC All Payer,UHC All Payer,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Exchange,UHC Exchange,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicaid,UHC Medicaid,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UMR CPD,UMR CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicare,UHC Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251170,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Wellcare,Wellcare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health PPO CPD,Meritain Health PPO CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna/Commercial Product,Aetna/Commercial Product,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Meritain Health CPD,Meritain Health CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Starmark CPD,Starmark CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Aetna Medicare,Aetna Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Ambetter ,Ambetter ,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access,Anthem Blue Access,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Access Choice,Anthem Blue Access Choice,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Blue Preferred,Anthem Blue Preferred,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Pathway,Anthem Pathway,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Alliance,Anthem Alliance,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Anthem Medicare,Anthem Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna,Cigna,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna PPO,Cigna PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Cigna Medicare Advantage,Cigna Medicare Advantage,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Essence,Essence,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink HMO,Healthlink HMO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Healthlink PPO,Healthlink PPO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,HomeState Health Plan,HomeState Health Plan,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Humana Gold,Humana Gold,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medicaid MO,Medicaid MO,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Medica,Medica,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Tricare,Tricare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC All Payer,UHC All Payer,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Exchange,UHC Exchange,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicaid,UHC Medicaid,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UMR CPD,UMR CPD,1229.2,,,,,,,per diem,1229.2,1229.2,"Per diem rate, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,UHC Medicare,UHC Medicare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL AMNIO FLD         ,38251171,CDM,311,RC,,,,,,Inpatient,,,1229.2,1229.2,Wellcare,Wellcare,1229.2,,,,,,,case rate,1229.2,1229.2,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health PPO CPD,Meritain Health PPO CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/Commercial Product,Aetna/Commercial Product,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health CPD,Meritain Health CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Starmark CPD,Starmark CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna Medicare,Aetna Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Ambetter ,Ambetter ,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access,Anthem Blue Access,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access Choice,Anthem Blue Access Choice,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Preferred,Anthem Blue Preferred,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Pathway,Anthem Pathway,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Alliance,Anthem Alliance,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Medicare,Anthem Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna,Cigna,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna PPO,Cigna PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna Medicare Advantage,Cigna Medicare Advantage,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Essence,Essence,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink HMO,Healthlink HMO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink PPO,Healthlink PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,HomeState Health Plan,HomeState Health Plan,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Humana Gold,Humana Gold,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medicaid MO,Medicaid MO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medica,Medica,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Tricare,Tricare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC All Payer,UHC All Payer,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Exchange,UHC Exchange,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicaid,UHC Medicaid,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UMR CPD,UMR CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicare,UHC Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SOLID TUMR        ,38251172,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Wellcare,Wellcare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health PPO CPD,Meritain Health PPO CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/Commercial Product,Aetna/Commercial Product,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health CPD,Meritain Health CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Starmark CPD,Starmark CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna Medicare,Aetna Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Ambetter ,Ambetter ,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access,Anthem Blue Access,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access Choice,Anthem Blue Access Choice,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Preferred,Anthem Blue Preferred,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Pathway,Anthem Pathway,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Alliance,Anthem Alliance,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Medicare,Anthem Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna,Cigna,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna PPO,Cigna PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna Medicare Advantage,Cigna Medicare Advantage,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Essence,Essence,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink HMO,Healthlink HMO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink PPO,Healthlink PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,HomeState Health Plan,HomeState Health Plan,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Humana Gold,Humana Gold,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medicaid MO,Medicaid MO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medica,Medica,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Tricare,Tricare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC All Payer,UHC All Payer,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Exchange,UHC Exchange,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicaid,UHC Medicaid,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UMR CPD,UMR CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicare,UHC Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O CHR ANL SKN BIOPY         ,38251173,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Wellcare,Wellcare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health PPO CPD,Meritain Health PPO CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/Commercial Product,Aetna/Commercial Product,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health CPD,Meritain Health CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Starmark CPD,Starmark CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Aetna Medicare,Aetna Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Ambetter ,Ambetter ,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access,Anthem Blue Access,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access Choice,Anthem Blue Access Choice,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Preferred,Anthem Blue Preferred,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Pathway,Anthem Pathway,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Alliance,Anthem Alliance,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Medicare,Anthem Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Cigna,Cigna,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Cigna PPO,Cigna PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Cigna Medicare Advantage,Cigna Medicare Advantage,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Essence,Essence,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink HMO,Healthlink HMO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink PPO,Healthlink PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,HomeState Health Plan,HomeState Health Plan,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Humana Gold,Humana Gold,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Medicaid MO,Medicaid MO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Medica,Medica,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Tricare,Tricare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,UHC All Payer,UHC All Payer,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,UHC Exchange,UHC Exchange,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicaid,UHC Medicaid,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,UMR CPD,UMR CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicare,UHC Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251174,CDM,311,RC,,,,,,Inpatient,,,168.1,168.1,Wellcare,Wellcare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Meritain Health PPO CPD,Meritain Health PPO CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna/Commercial Product,Aetna/Commercial Product,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Meritain Health CPD,Meritain Health CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Starmark CPD,Starmark CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Aetna Medicare,Aetna Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Ambetter ,Ambetter ,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Access,Anthem Blue Access,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Access Choice,Anthem Blue Access Choice,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Blue Preferred,Anthem Blue Preferred,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Pathway,Anthem Pathway,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Alliance,Anthem Alliance,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Anthem Medicare,Anthem Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna,Cigna,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna PPO,Cigna PPO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Cigna Medicare Advantage,Cigna Medicare Advantage,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Essence,Essence,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthlink HMO,Healthlink HMO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Healthlink PPO,Healthlink PPO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,HomeState Health Plan,HomeState Health Plan,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Humana Gold,Humana Gold,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Medicaid MO,Medicaid MO,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Medica,Medica,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Tricare,Tricare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC All Payer,UHC All Payer,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Exchange,UHC Exchange,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Medicaid,UHC Medicaid,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UMR CPD,UMR CPD,149.19,,,,,,,per diem,149.19,149.19,"Per diem rate, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,UHC Medicare,UHC Medicare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
SO MICRODELTN HI RES          ,38251175,CDM,311,RC,,,,,,Inpatient,,,149.19,149.19,Wellcare,Wellcare,149.19,,,,,,,case rate,149.19,149.19,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health PPO CPD,Meritain Health PPO CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/Commercial Product,Aetna/Commercial Product,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health CPD,Meritain Health CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Starmark CPD,Starmark CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna Medicare,Aetna Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Ambetter ,Ambetter ,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access,Anthem Blue Access,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access Choice,Anthem Blue Access Choice,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Preferred,Anthem Blue Preferred,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Pathway,Anthem Pathway,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Alliance,Anthem Alliance,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Medicare,Anthem Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna,Cigna,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna PPO,Cigna PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna Medicare Advantage,Cigna Medicare Advantage,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Essence,Essence,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink HMO,Healthlink HMO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink PPO,Healthlink PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,HomeState Health Plan,HomeState Health Plan,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Humana Gold,Humana Gold,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Medicaid MO,Medicaid MO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Medica,Medica,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Tricare,Tricare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC All Payer,UHC All Payer,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Exchange,UHC Exchange,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicaid,UHC Medicaid,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UMR CPD,UMR CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicare,UHC Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251176,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Wellcare,Wellcare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health PPO CPD,Meritain Health PPO CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna/Commercial Product,Aetna/Commercial Product,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Meritain Health CPD,Meritain Health CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Starmark CPD,Starmark CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Aetna Medicare,Aetna Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Ambetter ,Ambetter ,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access,Anthem Blue Access,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Access Choice,Anthem Blue Access Choice,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Blue Preferred,Anthem Blue Preferred,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Pathway,Anthem Pathway,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Alliance,Anthem Alliance,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Anthem Medicare,Anthem Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna,Cigna,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna PPO,Cigna PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Cigna Medicare Advantage,Cigna Medicare Advantage,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Essence,Essence,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink HMO,Healthlink HMO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Healthlink PPO,Healthlink PPO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,HomeState Health Plan,HomeState Health Plan,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Humana Gold,Humana Gold,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Medicaid MO,Medicaid MO,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Medica,Medica,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Tricare,Tricare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC All Payer,UHC All Payer,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Exchange,UHC Exchange,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicaid,UHC Medicaid,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UMR CPD,UMR CPD,121.87,,,,,,,per diem,121.87,121.87,"Per diem rate, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,UHC Medicare,UHC Medicare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O PANCREATIC FUNCT          ,38251177,CDM,301,RC,,,,,,Inpatient,,,121.87,121.87,Wellcare,Wellcare,121.87,,,,,,,case rate,121.87,121.87,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Meritain Health PPO CPD,Meritain Health PPO CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Aetna/Commercial Product,Aetna/Commercial Product,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Meritain Health CPD,Meritain Health CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Starmark CPD,Starmark CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Aetna Medicare,Aetna Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Ambetter ,Ambetter ,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Blue Access,Anthem Blue Access,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Blue Access Choice,Anthem Blue Access Choice,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Blue Preferred,Anthem Blue Preferred,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Pathway,Anthem Pathway,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Alliance,Anthem Alliance,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Anthem Medicare,Anthem Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Cigna,Cigna,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Cigna PPO,Cigna PPO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Cigna Medicare Advantage,Cigna Medicare Advantage,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Essence,Essence,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Healthlink HMO,Healthlink HMO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Healthlink PPO,Healthlink PPO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,HomeState Health Plan,HomeState Health Plan,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Humana Gold,Humana Gold,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Medicaid MO,Medicaid MO,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Medica,Medica,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Tricare,Tricare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,UHC All Payer,UHC All Payer,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,UHC Exchange,UHC Exchange,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,UHC Medicaid,UHC Medicaid,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,UMR CPD,UMR CPD,163.89,,,,,,,per diem,163.89,163.89,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,UHC Medicare,UHC Medicare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251178,CDM,311,RC,,,,,,Inpatient,,,163.89,163.89,Wellcare,Wellcare,163.89,,,,,,,case rate,163.89,163.89,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Meritain Health PPO CPD,Meritain Health PPO CPD,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Aetna/Commercial Product,Aetna/Commercial Product,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Meritain Health CPD,Meritain Health CPD,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Starmark CPD,Starmark CPD,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Aetna Medicare,Aetna Medicare,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Ambetter ,Ambetter ,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Blue Access,Anthem Blue Access,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Blue Access Choice,Anthem Blue Access Choice,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Blue Preferred,Anthem Blue Preferred,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Pathway,Anthem Pathway,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Alliance,Anthem Alliance,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Anthem Medicare,Anthem Medicare,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Cigna,Cigna,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Cigna PPO,Cigna PPO,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Cigna Medicare Advantage,Cigna Medicare Advantage,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Essence,Essence,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Healthlink HMO,Healthlink HMO,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Healthlink PPO,Healthlink PPO,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,HomeState Health Plan,HomeState Health Plan,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Humana Gold,Humana Gold,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Medicaid MO,Medicaid MO,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Medica,Medica,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Tricare,Tricare,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,UHC All Payer,UHC All Payer,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,UHC Exchange,UHC Exchange,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,UHC Medicaid,UHC Medicaid,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,UMR CPD,UMR CPD,665.03,,,,,,,per diem,665.03,665.03,"Per diem rate, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,UHC Medicare,UHC Medicare,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR FISH METAPHAS         ,38251179,CDM,311,RC,,,,,,Inpatient,,,665.03,665.03,Wellcare,Wellcare,665.03,,,,,,,case rate,665.03,665.03,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Meritain Health PPO CPD,Meritain Health PPO CPD,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Aetna/Commercial Product,Aetna/Commercial Product,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Meritain Health CPD,Meritain Health CPD,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Starmark CPD,Starmark CPD,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Aetna Medicare,Aetna Medicare,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Ambetter ,Ambetter ,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Blue Access,Anthem Blue Access,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Blue Access Choice,Anthem Blue Access Choice,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Blue Preferred,Anthem Blue Preferred,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Pathway,Anthem Pathway,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Alliance,Anthem Alliance,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Anthem Medicare,Anthem Medicare,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Cigna,Cigna,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Cigna PPO,Cigna PPO,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Cigna Medicare Advantage,Cigna Medicare Advantage,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Essence,Essence,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Healthlink HMO,Healthlink HMO,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Healthlink PPO,Healthlink PPO,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,HomeState Health Plan,HomeState Health Plan,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Humana Gold,Humana Gold,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Medicaid MO,Medicaid MO,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Medica,Medica,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Tricare,Tricare,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,UHC All Payer,UHC All Payer,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,UHC Exchange,UHC Exchange,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,UHC Medicaid,UHC Medicaid,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,UMR CPD,UMR CPD,3168.61,,,,,,,per diem,3168.61,3168.61,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,UHC Medicare,UHC Medicare,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251180,CDM,311,RC,,,,,,Inpatient,,,3168.61,3168.61,Wellcare,Wellcare,3168.61,,,,,,,case rate,3168.61,3168.61,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Meritain Health PPO CPD,Meritain Health PPO CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Aetna/Commercial Product,Aetna/Commercial Product,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Meritain Health CPD,Meritain Health CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Starmark CPD,Starmark CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Aetna Medicare,Aetna Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Ambetter ,Ambetter ,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Access,Anthem Blue Access,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Access Choice,Anthem Blue Access Choice,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Preferred,Anthem Blue Preferred,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Pathway,Anthem Pathway,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Alliance,Anthem Alliance,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Medicare,Anthem Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Cigna,Cigna,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Cigna PPO,Cigna PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Cigna Medicare Advantage,Cigna Medicare Advantage,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Essence,Essence,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Healthlink HMO,Healthlink HMO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Healthlink PPO,Healthlink PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,HomeState Health Plan,HomeState Health Plan,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Humana Gold,Humana Gold,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Medicaid MO,Medicaid MO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Medica,Medica,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Tricare,Tricare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,UHC All Payer,UHC All Payer,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,UHC Exchange,UHC Exchange,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,UHC Medicaid,UHC Medicaid,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,UMR CPD,UMR CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,UHC Medicare,UHC Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O CHR ANL BLD HI RES        ,38251181,CDM,311,RC,,,,,,Inpatient,,,78.8,78.8,Wellcare,Wellcare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
TEG TEST                      ,38251182,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health PPO CPD,Meritain Health PPO CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna/Commercial Product,Aetna/Commercial Product,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Meritain Health CPD,Meritain Health CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Starmark CPD,Starmark CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Aetna Medicare,Aetna Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Ambetter ,Ambetter ,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access,Anthem Blue Access,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Access Choice,Anthem Blue Access Choice,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Blue Preferred,Anthem Blue Preferred,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Pathway,Anthem Pathway,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Alliance,Anthem Alliance,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Anthem Medicare,Anthem Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna,Cigna,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna PPO,Cigna PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Cigna Medicare Advantage,Cigna Medicare Advantage,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Essence,Essence,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink HMO,Healthlink HMO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Healthlink PPO,Healthlink PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,HomeState Health Plan,HomeState Health Plan,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Humana Gold,Humana Gold,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medicaid MO,Medicaid MO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Medica,Medica,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Tricare,Tricare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC All Payer,UHC All Payer,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Exchange,UHC Exchange,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicaid,UHC Medicaid,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UMR CPD,UMR CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,UHC Medicare,UHC Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251183,CDM,305,RC,,,,,,Inpatient,,,79.85,79.85,Wellcare,Wellcare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
PLATELET MAPPING              ,38251184,CDM,305,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Meritain Health PPO CPD,Meritain Health PPO CPD,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Aetna/Commercial Product,Aetna/Commercial Product,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Meritain Health CPD,Meritain Health CPD,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Starmark CPD,Starmark CPD,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Aetna Medicare,Aetna Medicare,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Ambetter ,Ambetter ,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Blue Access,Anthem Blue Access,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Blue Access Choice,Anthem Blue Access Choice,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Blue Preferred,Anthem Blue Preferred,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Pathway,Anthem Pathway,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Alliance,Anthem Alliance,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Anthem Medicare,Anthem Medicare,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Cigna,Cigna,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Cigna PPO,Cigna PPO,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Cigna Medicare Advantage,Cigna Medicare Advantage,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Essence,Essence,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Healthlink HMO,Healthlink HMO,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Healthlink PPO,Healthlink PPO,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,HomeState Health Plan,HomeState Health Plan,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Humana Gold,Humana Gold,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Medicaid MO,Medicaid MO,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Medica,Medica,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Tricare,Tricare,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,UHC All Payer,UHC All Payer,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,UHC Exchange,UHC Exchange,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,UHC Medicaid,UHC Medicaid,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,UMR CPD,UMR CPD,335.14,,,,,,,per diem,335.14,335.14,"Per diem rate, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,UHC Medicare,UHC Medicare,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
S/O FRAGILE X METHYL ANL      ,38251185,CDM,301,RC,,,,,,Inpatient,,,335.14,335.14,Wellcare,Wellcare,335.14,,,,,,,case rate,335.14,335.14,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Meritain Health PPO CPD,Meritain Health PPO CPD,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Aetna/Commercial Product,Aetna/Commercial Product,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Meritain Health CPD,Meritain Health CPD,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Starmark CPD,Starmark CPD,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Aetna Medicare,Aetna Medicare,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Ambetter ,Ambetter ,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Blue Access,Anthem Blue Access,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Blue Access Choice,Anthem Blue Access Choice,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Blue Preferred,Anthem Blue Preferred,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Pathway,Anthem Pathway,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Alliance,Anthem Alliance,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Anthem Medicare,Anthem Medicare,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Cigna,Cigna,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Cigna PPO,Cigna PPO,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Cigna Medicare Advantage,Cigna Medicare Advantage,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Essence,Essence,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Healthlink HMO,Healthlink HMO,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Healthlink PPO,Healthlink PPO,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,HomeState Health Plan,HomeState Health Plan,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Humana Gold,Humana Gold,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Medicaid MO,Medicaid MO,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Medica,Medica,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Tricare,Tricare,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,UHC All Payer,UHC All Payer,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,UHC Exchange,UHC Exchange,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,UHC Medicaid,UHC Medicaid,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,UMR CPD,UMR CPD,489.4,,,,,,,per diem,489.4,489.4,"Per diem rate, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,UHC Medicare,UHC Medicare,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
RED CELLS L/R IRR EA          ,38251186,CDM,390,RC,,,,,,Inpatient,,,489.4,489.4,Wellcare,Wellcare,489.4,,,,,,,case rate,489.4,489.4,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O HBSAG NEUTRALIZATION      ,38251187,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health PPO CPD,Meritain Health PPO CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Aetna/Commercial Product,Aetna/Commercial Product,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Meritain Health CPD,Meritain Health CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Starmark CPD,Starmark CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Aetna Medicare,Aetna Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Ambetter ,Ambetter ,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access,Anthem Blue Access,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Access Choice,Anthem Blue Access Choice,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Blue Preferred,Anthem Blue Preferred,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Pathway,Anthem Pathway,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Alliance,Anthem Alliance,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Anthem Medicare,Anthem Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Cigna,Cigna,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Cigna PPO,Cigna PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Cigna Medicare Advantage,Cigna Medicare Advantage,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Essence,Essence,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink HMO,Healthlink HMO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Healthlink PPO,Healthlink PPO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,HomeState Health Plan,HomeState Health Plan,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Humana Gold,Humana Gold,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Medicaid MO,Medicaid MO,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Medica,Medica,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Tricare,Tricare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,UHC All Payer,UHC All Payer,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,UHC Exchange,UHC Exchange,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicaid,UHC Medicaid,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,UMR CPD,UMR CPD,45.18,,,,,,,per diem,45.18,45.18,"Per diem rate, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,UHC Medicare,UHC Medicare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
S/O ANTITHROMBIN III AG       ,38251188,CDM,305,RC,,,,,,Inpatient,,,45.18,45.18,Wellcare,Wellcare,45.18,,,,,,,case rate,45.18,45.18,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Meritain Health PPO CPD,Meritain Health PPO CPD,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Aetna/Commercial Product,Aetna/Commercial Product,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Meritain Health CPD,Meritain Health CPD,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Starmark CPD,Starmark CPD,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Aetna Medicare,Aetna Medicare,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Ambetter ,Ambetter ,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Blue Access,Anthem Blue Access,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Blue Access Choice,Anthem Blue Access Choice,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Blue Preferred,Anthem Blue Preferred,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Pathway,Anthem Pathway,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Alliance,Anthem Alliance,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Anthem Medicare,Anthem Medicare,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Cigna,Cigna,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Cigna PPO,Cigna PPO,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Cigna Medicare Advantage,Cigna Medicare Advantage,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Essence,Essence,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Healthlink HMO,Healthlink HMO,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Healthlink PPO,Healthlink PPO,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,HomeState Health Plan,HomeState Health Plan,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Humana Gold,Humana Gold,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Medicaid MO,Medicaid MO,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Medica,Medica,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Tricare,Tricare,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,UHC All Payer,UHC All Payer,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,UHC Exchange,UHC Exchange,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,UHC Medicaid,UHC Medicaid,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,UMR CPD,UMR CPD,1603.31,,,,,,,per diem,1603.31,1603.31,"Per diem rate, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,UHC Medicare,UHC Medicare,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
PLATELETS PHER L/R EA         ,38251189,CDM,390,RC,,,,,,Inpatient,,,1603.31,1603.31,Wellcare,Wellcare,1603.31,,,,,,,case rate,1603.31,1603.31,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Meritain Health PPO CPD,Meritain Health PPO CPD,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Aetna/Commercial Product,Aetna/Commercial Product,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Meritain Health CPD,Meritain Health CPD,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Starmark CPD,Starmark CPD,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Aetna Medicare,Aetna Medicare,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Ambetter ,Ambetter ,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Blue Access,Anthem Blue Access,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Blue Access Choice,Anthem Blue Access Choice,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Blue Preferred,Anthem Blue Preferred,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Pathway,Anthem Pathway,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Alliance,Anthem Alliance,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Anthem Medicare,Anthem Medicare,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Cigna,Cigna,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Cigna PPO,Cigna PPO,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Cigna Medicare Advantage,Cigna Medicare Advantage,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Essence,Essence,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Healthlink HMO,Healthlink HMO,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Healthlink PPO,Healthlink PPO,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,HomeState Health Plan,HomeState Health Plan,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Humana Gold,Humana Gold,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Medicaid MO,Medicaid MO,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Medica,Medica,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Tricare,Tricare,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,UHC All Payer,UHC All Payer,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,UHC Exchange,UHC Exchange,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,UHC Medicaid,UHC Medicaid,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,UMR CPD,UMR CPD,332.34,,,,,,,per diem,332.34,332.34,"Per diem rate, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,UHC Medicare,UHC Medicare,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
RED CELLS L/R EA              ,38251190,CDM,390,RC,,,,,,Inpatient,,,332.34,332.34,Wellcare,Wellcare,332.34,,,,,,,case rate,332.34,332.34,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health PPO CPD,Meritain Health PPO CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna/Commercial Product,Aetna/Commercial Product,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Meritain Health CPD,Meritain Health CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Starmark CPD,Starmark CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Aetna Medicare,Aetna Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Ambetter ,Ambetter ,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access,Anthem Blue Access,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Access Choice,Anthem Blue Access Choice,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Blue Preferred,Anthem Blue Preferred,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Pathway,Anthem Pathway,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Alliance,Anthem Alliance,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Anthem Medicare,Anthem Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna,Cigna,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna PPO,Cigna PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Cigna Medicare Advantage,Cigna Medicare Advantage,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Essence,Essence,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink HMO,Healthlink HMO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Healthlink PPO,Healthlink PPO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,HomeState Health Plan,HomeState Health Plan,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Humana Gold,Humana Gold,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medicaid MO,Medicaid MO,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Medica,Medica,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Tricare,Tricare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC All Payer,UHC All Payer,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Exchange,UHC Exchange,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicaid,UHC Medicaid,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UMR CPD,UMR CPD,126.07,,,,,,,per diem,126.07,126.07,"Per diem rate, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,UHC Medicare,UHC Medicare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O DEOXYCORTICOSTERON QN     ,38251191,CDM,301,RC,,,,,,Inpatient,,,126.07,126.07,Wellcare,Wellcare,126.07,,,,,,,case rate,126.07,126.07,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health PPO CPD,Meritain Health PPO CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/Commercial Product,Aetna/Commercial Product,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health CPD,Meritain Health CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Starmark CPD,Starmark CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Aetna Medicare,Aetna Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Ambetter ,Ambetter ,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access,Anthem Blue Access,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access Choice,Anthem Blue Access Choice,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Preferred,Anthem Blue Preferred,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Pathway,Anthem Pathway,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Alliance,Anthem Alliance,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Medicare,Anthem Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Cigna,Cigna,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Cigna PPO,Cigna PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Cigna Medicare Advantage,Cigna Medicare Advantage,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Essence,Essence,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink HMO,Healthlink HMO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink PPO,Healthlink PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,HomeState Health Plan,HomeState Health Plan,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Humana Gold,Humana Gold,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Medicaid MO,Medicaid MO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Medica,Medica,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Tricare,Tricare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,UHC All Payer,UHC All Payer,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,UHC Exchange,UHC Exchange,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicaid,UHC Medicaid,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,UMR CPD,UMR CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicare,UHC Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O ANTI-MYELOPEROXIDASE      ,38251192,CDM,301,RC,,,,,,Inpatient,,,49.38,49.38,Wellcare,Wellcare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Meritain Health PPO CPD,Meritain Health PPO CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Aetna/Commercial Product,Aetna/Commercial Product,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Meritain Health CPD,Meritain Health CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Starmark CPD,Starmark CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Aetna Medicare,Aetna Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Ambetter ,Ambetter ,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Access,Anthem Blue Access,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Access Choice,Anthem Blue Access Choice,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Blue Preferred,Anthem Blue Preferred,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Pathway,Anthem Pathway,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Alliance,Anthem Alliance,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Anthem Medicare,Anthem Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Cigna,Cigna,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Cigna PPO,Cigna PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Cigna Medicare Advantage,Cigna Medicare Advantage,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Essence,Essence,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Healthlink HMO,Healthlink HMO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Healthlink PPO,Healthlink PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,HomeState Health Plan,HomeState Health Plan,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Humana Gold,Humana Gold,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Medicaid MO,Medicaid MO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Medica,Medica,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Tricare,Tricare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,UHC All Payer,UHC All Payer,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,UHC Exchange,UHC Exchange,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,UHC Medicaid,UHC Medicaid,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,UMR CPD,UMR CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,UHC Medicare,UHC Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O LAMELLAR BODY COUNTS      ,38251193,CDM,301,RC,,,,,,Inpatient,,,78.8,78.8,Wellcare,Wellcare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Meritain Health PPO CPD,Meritain Health PPO CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Aetna/Commercial Product,Aetna/Commercial Product,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Meritain Health CPD,Meritain Health CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Starmark CPD,Starmark CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Aetna Medicare,Aetna Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Ambetter ,Ambetter ,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Access,Anthem Blue Access,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Access Choice,Anthem Blue Access Choice,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Preferred,Anthem Blue Preferred,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Pathway,Anthem Pathway,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Alliance,Anthem Alliance,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Anthem Medicare,Anthem Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Cigna,Cigna,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Cigna PPO,Cigna PPO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Cigna Medicare Advantage,Cigna Medicare Advantage,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Essence,Essence,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Healthlink HMO,Healthlink HMO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Healthlink PPO,Healthlink PPO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,HomeState Health Plan,HomeState Health Plan,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Humana Gold,Humana Gold,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Medicaid MO,Medicaid MO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Medica,Medica,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Tricare,Tricare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,UHC All Payer,UHC All Payer,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,UHC Exchange,UHC Exchange,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,UHC Medicaid,UHC Medicaid,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,UMR CPD,UMR CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,UHC Medicare,UHC Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O MOLEC RED CELL PHENO      ,38251194,CDM,301,RC,,,,,,Inpatient,,,1087.37,1087.37,Wellcare,Wellcare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health PPO CPD,Meritain Health PPO CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/Commercial Product,Aetna/Commercial Product,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health CPD,Meritain Health CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Starmark CPD,Starmark CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna Medicare,Aetna Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Ambetter ,Ambetter ,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access,Anthem Blue Access,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access Choice,Anthem Blue Access Choice,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Preferred,Anthem Blue Preferred,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Pathway,Anthem Pathway,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Alliance,Anthem Alliance,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Medicare,Anthem Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna,Cigna,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna PPO,Cigna PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna Medicare Advantage,Cigna Medicare Advantage,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Essence,Essence,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink HMO,Healthlink HMO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink PPO,Healthlink PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,HomeState Health Plan,HomeState Health Plan,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Humana Gold,Humana Gold,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Medicaid MO,Medicaid MO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Medica,Medica,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Tricare,Tricare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC All Payer,UHC All Payer,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Exchange,UHC Exchange,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicaid,UHC Medicaid,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UMR CPD,UMR CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicare,UHC Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O RED CELL SEPARATION       ,38251195,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Wellcare,Wellcare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251196,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O DRUG DEPENDENT AB         ,38251197,CDM,302,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Meritain Health PPO CPD,Meritain Health PPO CPD,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Aetna/Commercial Product,Aetna/Commercial Product,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Meritain Health CPD,Meritain Health CPD,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Starmark CPD,Starmark CPD,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Aetna Medicare,Aetna Medicare,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Ambetter ,Ambetter ,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Blue Access,Anthem Blue Access,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Blue Access Choice,Anthem Blue Access Choice,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Blue Preferred,Anthem Blue Preferred,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Pathway,Anthem Pathway,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Alliance,Anthem Alliance,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Anthem Medicare,Anthem Medicare,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Cigna,Cigna,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Cigna PPO,Cigna PPO,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Cigna Medicare Advantage,Cigna Medicare Advantage,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Essence,Essence,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Healthlink HMO,Healthlink HMO,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Healthlink PPO,Healthlink PPO,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,HomeState Health Plan,HomeState Health Plan,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Humana Gold,Humana Gold,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Medicaid MO,Medicaid MO,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Medica,Medica,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Tricare,Tricare,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,UHC All Payer,UHC All Payer,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,UHC Exchange,UHC Exchange,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,UHC Medicaid,UHC Medicaid,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,UMR CPD,UMR CPD,1050.6,,,,,,,per diem,1050.6,1050.6,"Per diem rate, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,UHC Medicare,UHC Medicare,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O MOLECUL PLATELET GENO     ,38251198,CDM,301,RC,,,,,,Inpatient,,,1050.6,1050.6,Wellcare,Wellcare,1050.6,,,,,,,case rate,1050.6,1050.6,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health PPO CPD,Meritain Health PPO CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna/Commercial Product,Aetna/Commercial Product,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Meritain Health CPD,Meritain Health CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Starmark CPD,Starmark CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Aetna Medicare,Aetna Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Ambetter ,Ambetter ,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access,Anthem Blue Access,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Access Choice,Anthem Blue Access Choice,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Blue Preferred,Anthem Blue Preferred,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Pathway,Anthem Pathway,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Alliance,Anthem Alliance,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Anthem Medicare,Anthem Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna,Cigna,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna PPO,Cigna PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Cigna Medicare Advantage,Cigna Medicare Advantage,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Essence,Essence,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink HMO,Healthlink HMO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Healthlink PPO,Healthlink PPO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,HomeState Health Plan,HomeState Health Plan,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Humana Gold,Humana Gold,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Medicaid MO,Medicaid MO,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Medica,Medica,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Tricare,Tricare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC All Payer,UHC All Payer,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Exchange,UHC Exchange,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicaid,UHC Medicaid,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UMR CPD,UMR CPD,168.1,,,,,,,per diem,168.1,168.1,"Per diem rate, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,UHC Medicare,UHC Medicare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA SEARCH                ,38251199,CDM,300,RC,,,,,,Inpatient,,,168.1,168.1,Wellcare,Wellcare,168.1,,,,,,,case rate,168.1,168.1,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Meritain Health PPO CPD,Meritain Health PPO CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna/Commercial Product,Aetna/Commercial Product,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Meritain Health CPD,Meritain Health CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Starmark CPD,Starmark CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna Medicare,Aetna Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Ambetter ,Ambetter ,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Access,Anthem Blue Access,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Access Choice,Anthem Blue Access Choice,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Preferred,Anthem Blue Preferred,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Pathway,Anthem Pathway,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Alliance,Anthem Alliance,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Medicare,Anthem Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna,Cigna,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna PPO,Cigna PPO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna Medicare Advantage,Cigna Medicare Advantage,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Essence,Essence,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthlink HMO,Healthlink HMO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthlink PPO,Healthlink PPO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,HomeState Health Plan,HomeState Health Plan,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Humana Gold,Humana Gold,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Medicaid MO,Medicaid MO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Medica,Medica,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Tricare,Tricare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC All Payer,UHC All Payer,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Exchange,UHC Exchange,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Medicaid,UHC Medicaid,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UMR CPD,UMR CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Medicare,UHC Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 1         ,38251200,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Wellcare,Wellcare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Meritain Health PPO CPD,Meritain Health PPO CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna/Commercial Product,Aetna/Commercial Product,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Meritain Health CPD,Meritain Health CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Starmark CPD,Starmark CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Aetna Medicare,Aetna Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Ambetter ,Ambetter ,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Access,Anthem Blue Access,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Access Choice,Anthem Blue Access Choice,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Blue Preferred,Anthem Blue Preferred,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Pathway,Anthem Pathway,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Alliance,Anthem Alliance,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Anthem Medicare,Anthem Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna,Cigna,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna PPO,Cigna PPO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Cigna Medicare Advantage,Cigna Medicare Advantage,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Essence,Essence,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthlink HMO,Healthlink HMO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Healthlink PPO,Healthlink PPO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,HomeState Health Plan,HomeState Health Plan,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Humana Gold,Humana Gold,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Medicaid MO,Medicaid MO,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Medica,Medica,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Tricare,Tricare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC All Payer,UHC All Payer,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Exchange,UHC Exchange,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Medicaid,UHC Medicaid,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UMR CPD,UMR CPD,171.25,,,,,,,per diem,171.25,171.25,"Per diem rate, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,UHC Medicare,UHC Medicare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O HLA DONOR MATCH 2         ,38251201,CDM,301,RC,,,,,,Inpatient,,,171.25,171.25,Wellcare,Wellcare,171.25,,,,,,,case rate,171.25,171.25,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Meritain Health PPO CPD,Meritain Health PPO CPD,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Aetna/Commercial Product,Aetna/Commercial Product,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Meritain Health CPD,Meritain Health CPD,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Starmark CPD,Starmark CPD,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Aetna Medicare,Aetna Medicare,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Ambetter ,Ambetter ,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Blue Access,Anthem Blue Access,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Blue Access Choice,Anthem Blue Access Choice,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Blue Preferred,Anthem Blue Preferred,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Pathway,Anthem Pathway,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Alliance,Anthem Alliance,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Anthem Medicare,Anthem Medicare,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Cigna,Cigna,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Cigna PPO,Cigna PPO,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Cigna Medicare Advantage,Cigna Medicare Advantage,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Essence,Essence,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Healthlink HMO,Healthlink HMO,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Healthlink PPO,Healthlink PPO,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,HomeState Health Plan,HomeState Health Plan,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Humana Gold,Humana Gold,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Medicaid MO,Medicaid MO,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Medica,Medica,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Tricare,Tricare,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,UHC All Payer,UHC All Payer,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,UHC Exchange,UHC Exchange,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,UHC Medicaid,UHC Medicaid,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,UMR CPD,UMR CPD,132.38,,,,,,,per diem,132.38,132.38,"Per diem rate, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,UHC Medicare,UHC Medicare,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O REDUCED VOL PLATELETS     ,38251202,CDM,390,RC,,,,,,Inpatient,,,132.38,132.38,Wellcare,Wellcare,132.38,,,,,,,case rate,132.38,132.38,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health PPO CPD,Meritain Health PPO CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna/Commercial Product,Aetna/Commercial Product,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Meritain Health CPD,Meritain Health CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Starmark CPD,Starmark CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Aetna Medicare,Aetna Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Ambetter ,Ambetter ,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access,Anthem Blue Access,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Access Choice,Anthem Blue Access Choice,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Blue Preferred,Anthem Blue Preferred,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Pathway,Anthem Pathway,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Alliance,Anthem Alliance,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Anthem Medicare,Anthem Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna,Cigna,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna PPO,Cigna PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Cigna Medicare Advantage,Cigna Medicare Advantage,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Essence,Essence,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink HMO,Healthlink HMO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Healthlink PPO,Healthlink PPO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,HomeState Health Plan,HomeState Health Plan,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Humana Gold,Humana Gold,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medicaid MO,Medicaid MO,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Medica,Medica,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Tricare,Tricare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC All Payer,UHC All Payer,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Exchange,UHC Exchange,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicaid,UHC Medicaid,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UMR CPD,UMR CPD,182.8,,,,,,,per diem,182.8,182.8,"Per diem rate, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,UHC Medicare,UHC Medicare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O EPSTEIN BARR PCR BLD      ,38251203,CDM,306,RC,,,,,,Inpatient,,,182.8,182.8,Wellcare,Wellcare,182.8,,,,,,,case rate,182.8,182.8,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251204,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 6         ,38251205,CDM,302,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health PPO CPD,Meritain Health PPO CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna/Commercial Product,Aetna/Commercial Product,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Meritain Health CPD,Meritain Health CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Starmark CPD,Starmark CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Aetna Medicare,Aetna Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Ambetter ,Ambetter ,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access,Anthem Blue Access,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Access Choice,Anthem Blue Access Choice,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Blue Preferred,Anthem Blue Preferred,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Pathway,Anthem Pathway,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Alliance,Anthem Alliance,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Anthem Medicare,Anthem Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna,Cigna,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna PPO,Cigna PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Cigna Medicare Advantage,Cigna Medicare Advantage,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Essence,Essence,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink HMO,Healthlink HMO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Healthlink PPO,Healthlink PPO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,HomeState Health Plan,HomeState Health Plan,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Humana Gold,Humana Gold,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medicaid MO,Medicaid MO,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Medica,Medica,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Tricare,Tricare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC All Payer,UHC All Payer,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Exchange,UHC Exchange,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicaid,UHC Medicaid,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UMR CPD,UMR CPD,87.2,,,,,,,per diem,87.2,87.2,"Per diem rate, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,UHC Medicare,UHC Medicare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O NCAPS AB PANEL            ,38251206,CDM,302,RC,,,,,,Inpatient,,,87.2,87.2,Wellcare,Wellcare,87.2,,,,,,,case rate,87.2,87.2,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O HIV-2 AB DIFFERENTIAT     ,38251207,CDM,302,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health PPO CPD,Meritain Health PPO CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna/Commercial Product,Aetna/Commercial Product,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Meritain Health CPD,Meritain Health CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Starmark CPD,Starmark CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Aetna Medicare,Aetna Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Ambetter ,Ambetter ,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access,Anthem Blue Access,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Access Choice,Anthem Blue Access Choice,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Blue Preferred,Anthem Blue Preferred,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Pathway,Anthem Pathway,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Alliance,Anthem Alliance,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Anthem Medicare,Anthem Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna,Cigna,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna PPO,Cigna PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Cigna Medicare Advantage,Cigna Medicare Advantage,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Essence,Essence,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink HMO,Healthlink HMO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Healthlink PPO,Healthlink PPO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,HomeState Health Plan,HomeState Health Plan,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Humana Gold,Humana Gold,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medicaid MO,Medicaid MO,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Medica,Medica,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Tricare,Tricare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC All Payer,UHC All Payer,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Exchange,UHC Exchange,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicaid,UHC Medicaid,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UMR CPD,UMR CPD,1001.22,,,,,,,per diem,1001.22,1001.22,"Per diem rate, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,UHC Medicare,UHC Medicare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O TISS CLT SKIN/OTHER       ,38251208,CDM,311,RC,,,,,,Inpatient,,,1001.22,1001.22,Wellcare,Wellcare,1001.22,,,,,,,case rate,1001.22,1001.22,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251209,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O AFB SUSCEPT REFLX         ,38251210,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Meritain Health PPO CPD,Meritain Health PPO CPD,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Aetna/Commercial Product,Aetna/Commercial Product,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Meritain Health CPD,Meritain Health CPD,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Starmark CPD,Starmark CPD,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Aetna Medicare,Aetna Medicare,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Ambetter ,Ambetter ,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Blue Access,Anthem Blue Access,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Blue Access Choice,Anthem Blue Access Choice,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Blue Preferred,Anthem Blue Preferred,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Pathway,Anthem Pathway,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Alliance,Anthem Alliance,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Anthem Medicare,Anthem Medicare,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Cigna,Cigna,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Cigna PPO,Cigna PPO,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Cigna Medicare Advantage,Cigna Medicare Advantage,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Essence,Essence,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Healthlink HMO,Healthlink HMO,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Healthlink PPO,Healthlink PPO,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,HomeState Health Plan,HomeState Health Plan,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Humana Gold,Humana Gold,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Medicaid MO,Medicaid MO,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Medica,Medica,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Tricare,Tricare,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,UHC All Payer,UHC All Payer,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,UHC Exchange,UHC Exchange,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,UHC Medicaid,UHC Medicaid,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,UMR CPD,UMR CPD,481.17,,,,,,,per diem,481.17,481.17,"Per diem rate, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,UHC Medicare,UHC Medicare,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB DNA SEQUENC RFLX      ,38251211,CDM,306,RC,,,,,,Inpatient,,,481.17,481.17,Wellcare,Wellcare,481.17,,,,,,,case rate,481.17,481.17,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O MTB CPLX SPC/AMP PRBE     ,38251212,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health PPO CPD,Meritain Health PPO CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Aetna/Commercial Product,Aetna/Commercial Product,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Meritain Health CPD,Meritain Health CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Starmark CPD,Starmark CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Aetna Medicare,Aetna Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Ambetter ,Ambetter ,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access,Anthem Blue Access,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Access Choice,Anthem Blue Access Choice,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Blue Preferred,Anthem Blue Preferred,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Pathway,Anthem Pathway,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Alliance,Anthem Alliance,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Anthem Medicare,Anthem Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Cigna,Cigna,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Cigna PPO,Cigna PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Cigna Medicare Advantage,Cigna Medicare Advantage,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Essence,Essence,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink HMO,Healthlink HMO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Healthlink PPO,Healthlink PPO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,HomeState Health Plan,HomeState Health Plan,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Humana Gold,Humana Gold,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Medicaid MO,Medicaid MO,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Medica,Medica,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Tricare,Tricare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,UHC All Payer,UHC All Payer,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,UHC Exchange,UHC Exchange,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicaid,UHC Medicaid,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,UMR CPD,UMR CPD,23.11,,,,,,,per diem,23.11,23.11,"Per diem rate, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,UHC Medicare,UHC Medicare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O AFB ID BY MALDI REFLX     ,38251213,CDM,306,RC,,,,,,Inpatient,,,23.11,23.11,Wellcare,Wellcare,23.11,,,,,,,case rate,23.11,23.11,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Meritain Health PPO CPD,Meritain Health PPO CPD,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Aetna/Commercial Product,Aetna/Commercial Product,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Meritain Health CPD,Meritain Health CPD,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Starmark CPD,Starmark CPD,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Aetna Medicare,Aetna Medicare,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Ambetter ,Ambetter ,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Blue Access,Anthem Blue Access,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Blue Access Choice,Anthem Blue Access Choice,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Blue Preferred,Anthem Blue Preferred,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Pathway,Anthem Pathway,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Alliance,Anthem Alliance,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Anthem Medicare,Anthem Medicare,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Cigna,Cigna,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Cigna PPO,Cigna PPO,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Cigna Medicare Advantage,Cigna Medicare Advantage,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Essence,Essence,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Healthlink HMO,Healthlink HMO,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Healthlink PPO,Healthlink PPO,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,HomeState Health Plan,HomeState Health Plan,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Humana Gold,Humana Gold,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Medicaid MO,Medicaid MO,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Medica,Medica,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Tricare,Tricare,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,UHC All Payer,UHC All Payer,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,UHC Exchange,UHC Exchange,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,UHC Medicaid,UHC Medicaid,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,UMR CPD,UMR CPD,647.17,,,,,,,per diem,647.17,647.17,"Per diem rate, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,UHC Medicare,UHC Medicare,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O ROS1 BY FISH              ,38251214,CDM,312,RC,,,,,,Inpatient,,,647.17,647.17,Wellcare,Wellcare,647.17,,,,,,,case rate,647.17,647.17,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health PPO CPD,Meritain Health PPO CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/Commercial Product,Aetna/Commercial Product,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health CPD,Meritain Health CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Starmark CPD,Starmark CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna Medicare,Aetna Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Ambetter ,Ambetter ,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access,Anthem Blue Access,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access Choice,Anthem Blue Access Choice,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Preferred,Anthem Blue Preferred,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Pathway,Anthem Pathway,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Alliance,Anthem Alliance,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Medicare,Anthem Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna,Cigna,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna PPO,Cigna PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna Medicare Advantage,Cigna Medicare Advantage,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Essence,Essence,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink HMO,Healthlink HMO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink PPO,Healthlink PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,HomeState Health Plan,HomeState Health Plan,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Humana Gold,Humana Gold,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medicaid MO,Medicaid MO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medica,Medica,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Tricare,Tricare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC All Payer,UHC All Payer,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Exchange,UHC Exchange,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicaid,UHC Medicaid,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UMR CPD,UMR CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicare,UHC Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251215,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Wellcare,Wellcare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health PPO CPD,Meritain Health PPO CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna/Commercial Product,Aetna/Commercial Product,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Meritain Health CPD,Meritain Health CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Starmark CPD,Starmark CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Aetna Medicare,Aetna Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Ambetter ,Ambetter ,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access,Anthem Blue Access,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Access Choice,Anthem Blue Access Choice,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Blue Preferred,Anthem Blue Preferred,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Pathway,Anthem Pathway,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Alliance,Anthem Alliance,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Anthem Medicare,Anthem Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna,Cigna,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna PPO,Cigna PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Cigna Medicare Advantage,Cigna Medicare Advantage,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Essence,Essence,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink HMO,Healthlink HMO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Healthlink PPO,Healthlink PPO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,HomeState Health Plan,HomeState Health Plan,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Humana Gold,Humana Gold,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medicaid MO,Medicaid MO,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Medica,Medica,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Tricare,Tricare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC All Payer,UHC All Payer,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Exchange,UHC Exchange,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicaid,UHC Medicaid,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UMR CPD,UMR CPD,317.28,,,,,,,per diem,317.28,317.28,"Per diem rate, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,UHC Medicare,UHC Medicare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O MYELOPROL PNL FISH        ,38251216,CDM,311,RC,,,,,,Inpatient,,,317.28,317.28,Wellcare,Wellcare,317.28,,,,,,,case rate,317.28,317.28,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Meritain Health PPO CPD,Meritain Health PPO CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Aetna/Commercial Product,Aetna/Commercial Product,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Meritain Health CPD,Meritain Health CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Starmark CPD,Starmark CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Aetna Medicare,Aetna Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Ambetter ,Ambetter ,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Access,Anthem Blue Access,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Access Choice,Anthem Blue Access Choice,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Preferred,Anthem Blue Preferred,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Pathway,Anthem Pathway,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Alliance,Anthem Alliance,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Medicare,Anthem Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Cigna,Cigna,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Cigna PPO,Cigna PPO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Cigna Medicare Advantage,Cigna Medicare Advantage,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Essence,Essence,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Healthlink HMO,Healthlink HMO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Healthlink PPO,Healthlink PPO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,HomeState Health Plan,HomeState Health Plan,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Humana Gold,Humana Gold,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Medicaid MO,Medicaid MO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Medica,Medica,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Tricare,Tricare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,UHC All Payer,UHC All Payer,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,UHC Exchange,UHC Exchange,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,UHC Medicaid,UHC Medicaid,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,UMR CPD,UMR CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,UHC Medicare,UHC Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251217,CDM,310,RC,,,,,,Inpatient,,,516.9,516.9,Wellcare,Wellcare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Meritain Health PPO CPD,Meritain Health PPO CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Aetna/Commercial Product,Aetna/Commercial Product,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Meritain Health CPD,Meritain Health CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Starmark CPD,Starmark CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Aetna Medicare,Aetna Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Ambetter ,Ambetter ,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Access,Anthem Blue Access,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Access Choice,Anthem Blue Access Choice,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Blue Preferred,Anthem Blue Preferred,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Pathway,Anthem Pathway,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Alliance,Anthem Alliance,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Anthem Medicare,Anthem Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Cigna,Cigna,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Cigna PPO,Cigna PPO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Cigna Medicare Advantage,Cigna Medicare Advantage,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Essence,Essence,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Healthlink HMO,Healthlink HMO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Healthlink PPO,Healthlink PPO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,HomeState Health Plan,HomeState Health Plan,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Humana Gold,Humana Gold,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Medicaid MO,Medicaid MO,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Medica,Medica,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Tricare,Tricare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,UHC All Payer,UHC All Payer,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,UHC Exchange,UHC Exchange,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,UHC Medicaid,UHC Medicaid,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,UMR CPD,UMR CPD,516.9,,,,,,,per diem,516.9,516.9,"Per diem rate, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,UHC Medicare,UHC Medicare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O NRAS MUT PYROSEQ          ,38251218,CDM,301,RC,,,,,,Inpatient,,,516.9,516.9,Wellcare,Wellcare,516.9,,,,,,,case rate,516.9,516.9,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251219,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251220,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251221,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251222,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251223,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251224,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health PPO CPD,Meritain Health PPO CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna/Commercial Product,Aetna/Commercial Product,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Meritain Health CPD,Meritain Health CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Starmark CPD,Starmark CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Aetna Medicare,Aetna Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Ambetter ,Ambetter ,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access,Anthem Blue Access,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Access Choice,Anthem Blue Access Choice,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Blue Preferred,Anthem Blue Preferred,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Pathway,Anthem Pathway,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Alliance,Anthem Alliance,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Anthem Medicare,Anthem Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna,Cigna,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna PPO,Cigna PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Cigna Medicare Advantage,Cigna Medicare Advantage,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Essence,Essence,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink HMO,Healthlink HMO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Healthlink PPO,Healthlink PPO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,HomeState Health Plan,HomeState Health Plan,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Humana Gold,Humana Gold,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Medicaid MO,Medicaid MO,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Medica,Medica,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Tricare,Tricare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC All Payer,UHC All Payer,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Exchange,UHC Exchange,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicaid,UHC Medicaid,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,UMR CPD,UMR CPD,955,,,,,,,per diem,955,955,"Per diem rate, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,UHC Medicare,UHC Medicare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O THYROID TRANS/MUT         ,38251225,CDM,301,RC,,,,,,Inpatient,,,955,955,Wellcare,Wellcare,955,,,,,,,case rate,955,955,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Meritain Health PPO CPD,Meritain Health PPO CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Aetna/Commercial Product,Aetna/Commercial Product,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Meritain Health CPD,Meritain Health CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Starmark CPD,Starmark CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Aetna Medicare,Aetna Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Ambetter ,Ambetter ,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Access,Anthem Blue Access,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Access Choice,Anthem Blue Access Choice,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Preferred,Anthem Blue Preferred,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Pathway,Anthem Pathway,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Alliance,Anthem Alliance,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Medicare,Anthem Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Cigna,Cigna,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Cigna PPO,Cigna PPO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Cigna Medicare Advantage,Cigna Medicare Advantage,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Essence,Essence,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Healthlink HMO,Healthlink HMO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Healthlink PPO,Healthlink PPO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,HomeState Health Plan,HomeState Health Plan,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Humana Gold,Humana Gold,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Medicaid MO,Medicaid MO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Medica,Medica,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Tricare,Tricare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,UHC All Payer,UHC All Payer,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,UHC Exchange,UHC Exchange,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,UHC Medicaid,UHC Medicaid,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,UMR CPD,UMR CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,UHC Medicare,UHC Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251226,CDM,310,RC,,,,,,Inpatient,,,722.81,722.81,Wellcare,Wellcare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Meritain Health PPO CPD,Meritain Health PPO CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Aetna/Commercial Product,Aetna/Commercial Product,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Meritain Health CPD,Meritain Health CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Starmark CPD,Starmark CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Aetna Medicare,Aetna Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Ambetter ,Ambetter ,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Access,Anthem Blue Access,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Access Choice,Anthem Blue Access Choice,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Blue Preferred,Anthem Blue Preferred,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Pathway,Anthem Pathway,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Alliance,Anthem Alliance,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Anthem Medicare,Anthem Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Cigna,Cigna,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Cigna PPO,Cigna PPO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Cigna Medicare Advantage,Cigna Medicare Advantage,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Essence,Essence,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Healthlink HMO,Healthlink HMO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Healthlink PPO,Healthlink PPO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,HomeState Health Plan,HomeState Health Plan,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Humana Gold,Humana Gold,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Medicaid MO,Medicaid MO,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Medica,Medica,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Tricare,Tricare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,UHC All Payer,UHC All Payer,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,UHC Exchange,UHC Exchange,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,UHC Medicaid,UHC Medicaid,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,UMR CPD,UMR CPD,722.81,,,,,,,per diem,722.81,722.81,"Per diem rate, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,UHC Medicare,UHC Medicare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O HRAS MUT DET PYRO         ,38251227,CDM,301,RC,,,,,,Inpatient,,,722.81,722.81,Wellcare,Wellcare,722.81,,,,,,,case rate,722.81,722.81,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Meritain Health PPO CPD,Meritain Health PPO CPD,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Aetna/Commercial Product,Aetna/Commercial Product,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Meritain Health CPD,Meritain Health CPD,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Starmark CPD,Starmark CPD,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Aetna Medicare,Aetna Medicare,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Ambetter ,Ambetter ,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Blue Access,Anthem Blue Access,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Blue Access Choice,Anthem Blue Access Choice,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Blue Preferred,Anthem Blue Preferred,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Pathway,Anthem Pathway,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Alliance,Anthem Alliance,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Anthem Medicare,Anthem Medicare,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Cigna,Cigna,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Cigna PPO,Cigna PPO,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Cigna Medicare Advantage,Cigna Medicare Advantage,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Essence,Essence,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Healthlink HMO,Healthlink HMO,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Healthlink PPO,Healthlink PPO,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,HomeState Health Plan,HomeState Health Plan,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Humana Gold,Humana Gold,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Medicaid MO,Medicaid MO,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Medica,Medica,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Tricare,Tricare,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,UHC All Payer,UHC All Payer,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,UHC Exchange,UHC Exchange,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,UHC Medicaid,UHC Medicaid,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,UMR CPD,UMR CPD,684.99,,,,,,,per diem,684.99,684.99,"Per diem rate, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,UHC Medicare,UHC Medicare,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O CYST FIBR CFTR 165VAR     ,38251228,CDM,301,RC,,,,,,Inpatient,,,684.99,684.99,Wellcare,Wellcare,684.99,,,,,,,case rate,684.99,684.99,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health PPO CPD,Meritain Health PPO CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/Commercial Product,Aetna/Commercial Product,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health CPD,Meritain Health CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Starmark CPD,Starmark CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Aetna Medicare,Aetna Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Ambetter ,Ambetter ,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access,Anthem Blue Access,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access Choice,Anthem Blue Access Choice,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Preferred,Anthem Blue Preferred,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Pathway,Anthem Pathway,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Alliance,Anthem Alliance,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Medicare,Anthem Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Cigna,Cigna,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Cigna PPO,Cigna PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Cigna Medicare Advantage,Cigna Medicare Advantage,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Essence,Essence,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink HMO,Healthlink HMO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink PPO,Healthlink PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,HomeState Health Plan,HomeState Health Plan,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Humana Gold,Humana Gold,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Medicaid MO,Medicaid MO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Medica,Medica,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Tricare,Tricare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,UHC All Payer,UHC All Payer,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,UHC Exchange,UHC Exchange,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicaid,UHC Medicaid,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,UMR CPD,UMR CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicare,UHC Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251229,CDM,310,RC,,,,,,Inpatient,,,419.19,419.19,Wellcare,Wellcare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health PPO CPD,Meritain Health PPO CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/Commercial Product,Aetna/Commercial Product,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health CPD,Meritain Health CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Starmark CPD,Starmark CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Aetna Medicare,Aetna Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Ambetter ,Ambetter ,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access,Anthem Blue Access,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access Choice,Anthem Blue Access Choice,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Preferred,Anthem Blue Preferred,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Pathway,Anthem Pathway,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Alliance,Anthem Alliance,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Medicare,Anthem Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Cigna,Cigna,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Cigna PPO,Cigna PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Cigna Medicare Advantage,Cigna Medicare Advantage,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Essence,Essence,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink HMO,Healthlink HMO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink PPO,Healthlink PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,HomeState Health Plan,HomeState Health Plan,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Humana Gold,Humana Gold,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Medicaid MO,Medicaid MO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Medica,Medica,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Tricare,Tricare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,UHC All Payer,UHC All Payer,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,UHC Exchange,UHC Exchange,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicaid,UHC Medicaid,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,UMR CPD,UMR CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicare,UHC Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251230,CDM,301,RC,,,,,,Inpatient,,,419.19,419.19,Wellcare,Wellcare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health PPO CPD,Meritain Health PPO CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna/Commercial Product,Aetna/Commercial Product,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Meritain Health CPD,Meritain Health CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Starmark CPD,Starmark CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Aetna Medicare,Aetna Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Ambetter ,Ambetter ,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access,Anthem Blue Access,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Access Choice,Anthem Blue Access Choice,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Blue Preferred,Anthem Blue Preferred,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Pathway,Anthem Pathway,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Alliance,Anthem Alliance,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Anthem Medicare,Anthem Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna,Cigna,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna PPO,Cigna PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Cigna Medicare Advantage,Cigna Medicare Advantage,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Essence,Essence,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink HMO,Healthlink HMO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Healthlink PPO,Healthlink PPO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,HomeState Health Plan,HomeState Health Plan,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Humana Gold,Humana Gold,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Medicaid MO,Medicaid MO,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Medica,Medica,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Tricare,Tricare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC All Payer,UHC All Payer,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Exchange,UHC Exchange,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicaid,UHC Medicaid,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UMR CPD,UMR CPD,419.19,,,,,,,per diem,419.19,419.19,"Per diem rate, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,UHC Medicare,UHC Medicare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
S/O LUNG CANCER PANEL         ,38251231,CDM,312,RC,,,,,,Inpatient,,,419.19,419.19,Wellcare,Wellcare,419.19,,,,,,,case rate,419.19,419.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Meritain Health PPO CPD,Meritain Health PPO CPD,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Aetna/Commercial Product,Aetna/Commercial Product,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Meritain Health CPD,Meritain Health CPD,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Starmark CPD,Starmark CPD,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Aetna Medicare,Aetna Medicare,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Ambetter ,Ambetter ,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Blue Access,Anthem Blue Access,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Blue Access Choice,Anthem Blue Access Choice,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Blue Preferred,Anthem Blue Preferred,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Pathway,Anthem Pathway,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Alliance,Anthem Alliance,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Anthem Medicare,Anthem Medicare,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Cigna,Cigna,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Cigna PPO,Cigna PPO,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Cigna Medicare Advantage,Cigna Medicare Advantage,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Essence,Essence,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Healthlink HMO,Healthlink HMO,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Healthlink PPO,Healthlink PPO,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,HomeState Health Plan,HomeState Health Plan,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Humana Gold,Humana Gold,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Medicaid MO,Medicaid MO,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Medica,Medica,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Tricare,Tricare,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,UHC All Payer,UHC All Payer,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,UHC Exchange,UHC Exchange,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,UHC Medicaid,UHC Medicaid,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,UMR CPD,UMR CPD,7520.19,,,,,,,per diem,7520.19,7520.19,"Per diem rate, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,UHC Medicare,UHC Medicare,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
"S/O BRCA1 & 2 SEQ,DEL/DUP     ",38251232,CDM,301,RC,,,,,,Inpatient,,,7520.19,7520.19,Wellcare,Wellcare,7520.19,,,,,,,case rate,7520.19,7520.19,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health PPO CPD,Meritain Health PPO CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna/Commercial Product,Aetna/Commercial Product,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Meritain Health CPD,Meritain Health CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Starmark CPD,Starmark CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Aetna Medicare,Aetna Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Ambetter ,Ambetter ,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access,Anthem Blue Access,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Access Choice,Anthem Blue Access Choice,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Blue Preferred,Anthem Blue Preferred,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Pathway,Anthem Pathway,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Alliance,Anthem Alliance,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Anthem Medicare,Anthem Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna,Cigna,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna PPO,Cigna PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Cigna Medicare Advantage,Cigna Medicare Advantage,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Essence,Essence,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink HMO,Healthlink HMO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Healthlink PPO,Healthlink PPO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,HomeState Health Plan,HomeState Health Plan,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Humana Gold,Humana Gold,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Medicaid MO,Medicaid MO,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Medica,Medica,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Tricare,Tricare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC All Payer,UHC All Payer,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Exchange,UHC Exchange,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicaid,UHC Medicaid,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UMR CPD,UMR CPD,69.34,,,,,,,per diem,69.34,69.34,"Per diem rate, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,UHC Medicare,UHC Medicare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
S/O EVEROLIMUS BY TMS         ,38251233,CDM,301,RC,,,,,,Inpatient,,,69.34,69.34,Wellcare,Wellcare,69.34,,,,,,,case rate,69.34,69.34,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health PPO CPD,Meritain Health PPO CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/Commercial Product,Aetna/Commercial Product,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health CPD,Meritain Health CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Starmark CPD,Starmark CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna Medicare,Aetna Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Ambetter ,Ambetter ,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access,Anthem Blue Access,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access Choice,Anthem Blue Access Choice,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Preferred,Anthem Blue Preferred,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Pathway,Anthem Pathway,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Alliance,Anthem Alliance,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Medicare,Anthem Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna,Cigna,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna PPO,Cigna PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna Medicare Advantage,Cigna Medicare Advantage,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Essence,Essence,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink HMO,Healthlink HMO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink PPO,Healthlink PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,HomeState Health Plan,HomeState Health Plan,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Humana Gold,Humana Gold,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medicaid MO,Medicaid MO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medica,Medica,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Tricare,Tricare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC All Payer,UHC All Payer,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Exchange,UHC Exchange,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicaid,UHC Medicaid,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UMR CPD,UMR CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicare,UHC Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR STREP                ,38251244,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Wellcare,Wellcare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health PPO CPD,Meritain Health PPO CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/Commercial Product,Aetna/Commercial Product,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health CPD,Meritain Health CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Starmark CPD,Starmark CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna Medicare,Aetna Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Ambetter ,Ambetter ,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access,Anthem Blue Access,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access Choice,Anthem Blue Access Choice,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Preferred,Anthem Blue Preferred,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Pathway,Anthem Pathway,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Alliance,Anthem Alliance,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Medicare,Anthem Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna,Cigna,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna PPO,Cigna PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna Medicare Advantage,Cigna Medicare Advantage,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Essence,Essence,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink HMO,Healthlink HMO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink PPO,Healthlink PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,HomeState Health Plan,HomeState Health Plan,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Humana Gold,Humana Gold,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medicaid MO,Medicaid MO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medica,Medica,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Tricare,Tricare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC All Payer,UHC All Payer,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Exchange,UHC Exchange,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicaid,UHC Medicaid,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UMR CPD,UMR CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicare,UHC Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR YERSINIA             ,38251245,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Wellcare,Wellcare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health PPO CPD,Meritain Health PPO CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/Commercial Product,Aetna/Commercial Product,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health CPD,Meritain Health CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Starmark CPD,Starmark CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna Medicare,Aetna Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Ambetter ,Ambetter ,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access,Anthem Blue Access,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access Choice,Anthem Blue Access Choice,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Preferred,Anthem Blue Preferred,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Pathway,Anthem Pathway,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Alliance,Anthem Alliance,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Medicare,Anthem Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna,Cigna,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna PPO,Cigna PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna Medicare Advantage,Cigna Medicare Advantage,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Essence,Essence,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink HMO,Healthlink HMO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink PPO,Healthlink PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,HomeState Health Plan,HomeState Health Plan,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Humana Gold,Humana Gold,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medicaid MO,Medicaid MO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medica,Medica,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Tricare,Tricare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC All Payer,UHC All Payer,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Exchange,UHC Exchange,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicaid,UHC Medicaid,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UMR CPD,UMR CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicare,UHC Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCRN H PYLORI            ,38251246,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Wellcare,Wellcare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health PPO CPD,Meritain Health PPO CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna/Commercial Product,Aetna/Commercial Product,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Meritain Health CPD,Meritain Health CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Starmark CPD,Starmark CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Aetna Medicare,Aetna Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Ambetter ,Ambetter ,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access,Anthem Blue Access,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Access Choice,Anthem Blue Access Choice,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Blue Preferred,Anthem Blue Preferred,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Pathway,Anthem Pathway,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Alliance,Anthem Alliance,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Anthem Medicare,Anthem Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna,Cigna,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna PPO,Cigna PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Cigna Medicare Advantage,Cigna Medicare Advantage,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Essence,Essence,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink HMO,Healthlink HMO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Healthlink PPO,Healthlink PPO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,HomeState Health Plan,HomeState Health Plan,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Humana Gold,Humana Gold,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medicaid MO,Medicaid MO,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Medica,Medica,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Tricare,Tricare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC All Payer,UHC All Payer,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Exchange,UHC Exchange,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicaid,UHC Medicaid,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UMR CPD,UMR CPD,242.69,,,,,,,per diem,242.69,242.69,"Per diem rate, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,UHC Medicare,UHC Medicare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
CULT SCR MRSA                 ,38251247,CDM,306,RC,,,,,,Inpatient,,,242.69,242.69,Wellcare,Wellcare,242.69,,,,,,,case rate,242.69,242.69,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CORYNEBACT DIPHT CULT     ,38251248,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Meritain Health PPO CPD,Meritain Health PPO CPD,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Aetna/Commercial Product,Aetna/Commercial Product,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Meritain Health CPD,Meritain Health CPD,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Starmark CPD,Starmark CPD,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Aetna Medicare,Aetna Medicare,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Ambetter ,Ambetter ,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Blue Access,Anthem Blue Access,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Blue Access Choice,Anthem Blue Access Choice,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Blue Preferred,Anthem Blue Preferred,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Pathway,Anthem Pathway,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Alliance,Anthem Alliance,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Anthem Medicare,Anthem Medicare,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Cigna,Cigna,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Cigna PPO,Cigna PPO,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Cigna Medicare Advantage,Cigna Medicare Advantage,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Essence,Essence,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Healthlink HMO,Healthlink HMO,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Healthlink PPO,Healthlink PPO,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,HomeState Health Plan,HomeState Health Plan,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Humana Gold,Humana Gold,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Medicaid MO,Medicaid MO,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Medica,Medica,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Tricare,Tricare,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,UHC All Payer,UHC All Payer,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,UHC Exchange,UHC Exchange,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,UHC Medicaid,UHC Medicaid,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,UMR CPD,UMR CPD,646.12,,,,,,,per diem,646.12,646.12,"Per diem rate, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,UHC Medicare,UHC Medicare,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O LEGIONELLA SPECIES        ,38251249,CDM,306,RC,,,,,,Inpatient,,,646.12,646.12,Wellcare,Wellcare,646.12,,,,,,,case rate,646.12,646.12,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health PPO CPD,Meritain Health PPO CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Aetna/Commercial Product,Aetna/Commercial Product,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Meritain Health CPD,Meritain Health CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Starmark CPD,Starmark CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Aetna Medicare,Aetna Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Ambetter ,Ambetter ,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access,Anthem Blue Access,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Access Choice,Anthem Blue Access Choice,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Blue Preferred,Anthem Blue Preferred,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Pathway,Anthem Pathway,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Alliance,Anthem Alliance,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Anthem Medicare,Anthem Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Cigna,Cigna,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Cigna PPO,Cigna PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Cigna Medicare Advantage,Cigna Medicare Advantage,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Essence,Essence,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink HMO,Healthlink HMO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Healthlink PPO,Healthlink PPO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,HomeState Health Plan,HomeState Health Plan,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Humana Gold,Humana Gold,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Medicaid MO,Medicaid MO,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Medica,Medica,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Tricare,Tricare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,UHC All Payer,UHC All Payer,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,UHC Exchange,UHC Exchange,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicaid,UHC Medicaid,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,UMR CPD,UMR CPD,216.42,,,,,,,per diem,216.42,216.42,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,UHC Medicare,UHC Medicare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251250,CDM,306,RC,,,,,,Inpatient,,,216.42,216.42,Wellcare,Wellcare,216.42,,,,,,,case rate,216.42,216.42,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN LEGIONELLA      ,38251251,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT SCRN B PERTUSSIS     ,38251252,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251253,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR LEGIONELLA       ,38251254,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR MRSA             ,38251255,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCR STREP            ,38251256,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCREEN VRE           ,38251257,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN GC              ,38251258,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN PERTUSSIS       ,38251259,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health PPO CPD,Meritain Health PPO CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna/Commercial Product,Aetna/Commercial Product,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Meritain Health CPD,Meritain Health CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Starmark CPD,Starmark CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Aetna Medicare,Aetna Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Ambetter ,Ambetter ,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access,Anthem Blue Access,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Access Choice,Anthem Blue Access Choice,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Blue Preferred,Anthem Blue Preferred,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Pathway,Anthem Pathway,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Alliance,Anthem Alliance,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Anthem Medicare,Anthem Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna,Cigna,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna PPO,Cigna PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Cigna Medicare Advantage,Cigna Medicare Advantage,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Essence,Essence,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink HMO,Healthlink HMO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Healthlink PPO,Healthlink PPO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,HomeState Health Plan,HomeState Health Plan,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Humana Gold,Humana Gold,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medicaid MO,Medicaid MO,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Medica,Medica,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Tricare,Tricare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC All Payer,UHC All Payer,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Exchange,UHC Exchange,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicaid,UHC Medicaid,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UMR CPD,UMR CPD,251.09,,,,,,,per diem,251.09,251.09,"Per diem rate, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,UHC Medicare,UHC Medicare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT SCRN STREP GRP A     ,38251260,CDM,306,RC,,,,,,Inpatient,,,251.09,251.09,Wellcare,Wellcare,251.09,,,,,,,case rate,251.09,251.09,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Meritain Health PPO CPD,Meritain Health PPO CPD,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Aetna/Commercial Product,Aetna/Commercial Product,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Meritain Health CPD,Meritain Health CPD,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Starmark CPD,Starmark CPD,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Aetna Medicare,Aetna Medicare,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Ambetter ,Ambetter ,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Blue Access,Anthem Blue Access,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Blue Access Choice,Anthem Blue Access Choice,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Blue Preferred,Anthem Blue Preferred,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Pathway,Anthem Pathway,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Alliance,Anthem Alliance,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Anthem Medicare,Anthem Medicare,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Cigna,Cigna,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Cigna PPO,Cigna PPO,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Cigna Medicare Advantage,Cigna Medicare Advantage,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Essence,Essence,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Healthlink HMO,Healthlink HMO,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Healthlink PPO,Healthlink PPO,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,HomeState Health Plan,HomeState Health Plan,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Humana Gold,Humana Gold,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Medicaid MO,Medicaid MO,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Medica,Medica,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Tricare,Tricare,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,UHC All Payer,UHC All Payer,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,UHC Exchange,UHC Exchange,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,UHC Medicaid,UHC Medicaid,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,UMR CPD,UMR CPD,234.28,,,,,,,per diem,234.28,234.28,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,UHC Medicare,UHC Medicare,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC OTHER QN     ,38251261,CDM,306,RC,,,,,,Inpatient,,,234.28,234.28,Wellcare,Wellcare,234.28,,,,,,,case rate,234.28,234.28,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Meritain Health PPO CPD,Meritain Health PPO CPD,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Aetna/Commercial Product,Aetna/Commercial Product,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Meritain Health CPD,Meritain Health CPD,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Starmark CPD,Starmark CPD,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Aetna Medicare,Aetna Medicare,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Ambetter ,Ambetter ,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Blue Access,Anthem Blue Access,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Blue Access Choice,Anthem Blue Access Choice,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Blue Preferred,Anthem Blue Preferred,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Pathway,Anthem Pathway,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Alliance,Anthem Alliance,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Anthem Medicare,Anthem Medicare,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Cigna,Cigna,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Cigna PPO,Cigna PPO,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Cigna Medicare Advantage,Cigna Medicare Advantage,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Essence,Essence,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Healthlink HMO,Healthlink HMO,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Healthlink PPO,Healthlink PPO,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,HomeState Health Plan,HomeState Health Plan,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Humana Gold,Humana Gold,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Medicaid MO,Medicaid MO,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Medica,Medica,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Tricare,Tricare,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,UHC All Payer,UHC All Payer,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,UHC Exchange,UHC Exchange,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,UHC Medicaid,UHC Medicaid,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,UMR CPD,UMR CPD,193.31,,,,,,,per diem,193.31,193.31,"Per diem rate, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,UHC Medicare,UHC Medicare,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
SMEAR CRYPTOSPORIDIUM         ,38251262,CDM,306,RC,,,,,,Inpatient,,,193.31,193.31,Wellcare,Wellcare,193.31,,,,,,,case rate,193.31,193.31,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health PPO CPD,Meritain Health PPO CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/Commercial Product,Aetna/Commercial Product,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health CPD,Meritain Health CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Starmark CPD,Starmark CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna Medicare,Aetna Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Ambetter ,Ambetter ,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access,Anthem Blue Access,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access Choice,Anthem Blue Access Choice,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Preferred,Anthem Blue Preferred,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Pathway,Anthem Pathway,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Alliance,Anthem Alliance,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Medicare,Anthem Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna,Cigna,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna PPO,Cigna PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna Medicare Advantage,Cigna Medicare Advantage,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Essence,Essence,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink HMO,Healthlink HMO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink PPO,Healthlink PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,HomeState Health Plan,HomeState Health Plan,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Humana Gold,Humana Gold,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Medicaid MO,Medicaid MO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Medica,Medica,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Tricare,Tricare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC All Payer,UHC All Payer,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Exchange,UHC Exchange,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicaid,UHC Medicaid,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UMR CPD,UMR CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicare,UHC Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251263,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Wellcare,Wellcare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Meritain Health PPO CPD,Meritain Health PPO CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Aetna/Commercial Product,Aetna/Commercial Product,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Meritain Health CPD,Meritain Health CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Starmark CPD,Starmark CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Aetna Medicare,Aetna Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Ambetter ,Ambetter ,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Access,Anthem Blue Access,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Access Choice,Anthem Blue Access Choice,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Blue Preferred,Anthem Blue Preferred,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Pathway,Anthem Pathway,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Alliance,Anthem Alliance,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Anthem Medicare,Anthem Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Cigna,Cigna,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Cigna PPO,Cigna PPO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Cigna Medicare Advantage,Cigna Medicare Advantage,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Essence,Essence,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Healthlink HMO,Healthlink HMO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Healthlink PPO,Healthlink PPO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,HomeState Health Plan,HomeState Health Plan,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Humana Gold,Humana Gold,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Medicaid MO,Medicaid MO,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Medica,Medica,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Tricare,Tricare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,UHC All Payer,UHC All Payer,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,UHC Exchange,UHC Exchange,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,UHC Medicaid,UHC Medicaid,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,UMR CPD,UMR CPD,190.16,,,,,,,per diem,190.16,190.16,"Per diem rate, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,UHC Medicare,UHC Medicare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
S/O SMEAR ACID FAST           ,38251264,CDM,306,RC,,,,,,Inpatient,,,190.16,190.16,Wellcare,Wellcare,190.16,,,,,,,case rate,190.16,190.16,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA I                ,38251265,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health PPO CPD,Meritain Health PPO CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna/Commercial Product,Aetna/Commercial Product,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Meritain Health CPD,Meritain Health CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Starmark CPD,Starmark CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Aetna Medicare,Aetna Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Ambetter ,Ambetter ,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access,Anthem Blue Access,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Access Choice,Anthem Blue Access Choice,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Blue Preferred,Anthem Blue Preferred,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Pathway,Anthem Pathway,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Alliance,Anthem Alliance,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Anthem Medicare,Anthem Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna,Cigna,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna PPO,Cigna PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Cigna Medicare Advantage,Cigna Medicare Advantage,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Essence,Essence,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink HMO,Healthlink HMO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Healthlink PPO,Healthlink PPO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,HomeState Health Plan,HomeState Health Plan,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Humana Gold,Humana Gold,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Medicaid MO,Medicaid MO,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Medica,Medica,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Tricare,Tricare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC All Payer,UHC All Payer,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Exchange,UHC Exchange,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicaid,UHC Medicaid,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UMR CPD,UMR CPD,76.69,,,,,,,per diem,76.69,76.69,"Per diem rate, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,UHC Medicare,UHC Medicare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
IMMUNO SHIGA II               ,38251266,CDM,306,RC,,,,,,Inpatient,,,76.69,76.69,Wellcare,Wellcare,76.69,,,,,,,case rate,76.69,76.69,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Meritain Health PPO CPD,Meritain Health PPO CPD,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Aetna/Commercial Product,Aetna/Commercial Product,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Meritain Health CPD,Meritain Health CPD,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Starmark CPD,Starmark CPD,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Aetna Medicare,Aetna Medicare,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Ambetter ,Ambetter ,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Blue Access,Anthem Blue Access,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Blue Access Choice,Anthem Blue Access Choice,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Blue Preferred,Anthem Blue Preferred,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Pathway,Anthem Pathway,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Alliance,Anthem Alliance,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Anthem Medicare,Anthem Medicare,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Cigna,Cigna,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Cigna PPO,Cigna PPO,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Cigna Medicare Advantage,Cigna Medicare Advantage,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Essence,Essence,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Healthlink HMO,Healthlink HMO,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Healthlink PPO,Healthlink PPO,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,HomeState Health Plan,HomeState Health Plan,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Humana Gold,Humana Gold,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Medicaid MO,Medicaid MO,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Medica,Medica,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Tricare,Tricare,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,UHC All Payer,UHC All Payer,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,UHC Exchange,UHC Exchange,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,UHC Medicaid,UHC Medicaid,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,UMR CPD,UMR CPD,64.99,,,,,,,per diem,64.99,64.99,"Per diem rate, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,UHC Medicare,UHC Medicare,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
S/O CDIFF QK TOX A/B          ,38251267,CDM,306,RC,,,,,,Inpatient,,,64.99,64.99,Wellcare,Wellcare,64.99,,,,,,,case rate,64.99,64.99,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health PPO CPD,Meritain Health PPO CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Aetna/Commercial Product,Aetna/Commercial Product,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Meritain Health CPD,Meritain Health CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Starmark CPD,Starmark CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Aetna Medicare,Aetna Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Ambetter ,Ambetter ,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access,Anthem Blue Access,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Access Choice,Anthem Blue Access Choice,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Blue Preferred,Anthem Blue Preferred,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Pathway,Anthem Pathway,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Alliance,Anthem Alliance,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Anthem Medicare,Anthem Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Cigna,Cigna,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Cigna PPO,Cigna PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Cigna Medicare Advantage,Cigna Medicare Advantage,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Essence,Essence,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink HMO,Healthlink HMO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Healthlink PPO,Healthlink PPO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,HomeState Health Plan,HomeState Health Plan,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Humana Gold,Humana Gold,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Medicaid MO,Medicaid MO,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Medica,Medica,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Tricare,Tricare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,UHC All Payer,UHC All Payer,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,UHC Exchange,UHC Exchange,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicaid,UHC Medicaid,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,UMR CPD,UMR CPD,277.36,,,,,,,per diem,277.36,277.36,"Per diem rate, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,UHC Medicare,UHC Medicare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
SUSCEPT MIC PER PLATE         ,38251268,CDM,306,RC,,,,,,Inpatient,,,277.36,277.36,Wellcare,Wellcare,277.36,,,,,,,case rate,277.36,277.36,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC NONFER     ,38251269,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSC STREPT     ,38251270,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health PPO CPD,Meritain Health PPO CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna/Commercial Product,Aetna/Commercial Product,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Meritain Health CPD,Meritain Health CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Starmark CPD,Starmark CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Aetna Medicare,Aetna Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Ambetter ,Ambetter ,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access,Anthem Blue Access,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Access Choice,Anthem Blue Access Choice,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Blue Preferred,Anthem Blue Preferred,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Pathway,Anthem Pathway,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Alliance,Anthem Alliance,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Anthem Medicare,Anthem Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna,Cigna,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna PPO,Cigna PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Cigna Medicare Advantage,Cigna Medicare Advantage,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Essence,Essence,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink HMO,Healthlink HMO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Healthlink PPO,Healthlink PPO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,HomeState Health Plan,HomeState Health Plan,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Humana Gold,Humana Gold,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medicaid MO,Medicaid MO,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Medica,Medica,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Tricare,Tricare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC All Payer,UHC All Payer,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Exchange,UHC Exchange,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicaid,UHC Medicaid,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UMR CPD,UMR CPD,38.87,,,,,,,per diem,38.87,38.87,"Per diem rate, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,UHC Medicare,UHC Medicare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICROBIAL SUSCEPT     ,38251271,CDM,306,RC,,,,,,Inpatient,,,38.87,38.87,Wellcare,Wellcare,38.87,,,,,,,case rate,38.87,38.87,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health PPO CPD,Meritain Health PPO CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Aetna/Commercial Product,Aetna/Commercial Product,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Meritain Health CPD,Meritain Health CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Starmark CPD,Starmark CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Aetna Medicare,Aetna Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Ambetter ,Ambetter ,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access,Anthem Blue Access,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Access Choice,Anthem Blue Access Choice,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Blue Preferred,Anthem Blue Preferred,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Pathway,Anthem Pathway,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Alliance,Anthem Alliance,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Anthem Medicare,Anthem Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Cigna,Cigna,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Cigna PPO,Cigna PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Cigna Medicare Advantage,Cigna Medicare Advantage,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Essence,Essence,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink HMO,Healthlink HMO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Healthlink PPO,Healthlink PPO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,HomeState Health Plan,HomeState Health Plan,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Humana Gold,Humana Gold,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Medicaid MO,Medicaid MO,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Medica,Medica,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Tricare,Tricare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,UHC All Payer,UHC All Payer,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,UHC Exchange,UHC Exchange,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicaid,UHC Medicaid,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,UMR CPD,UMR CPD,137.63,,,,,,,per diem,137.63,137.63,"Per diem rate, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,UHC Medicare,UHC Medicare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O ANTIMICRO SUSCEPT MAI     ,38251272,CDM,306,RC,,,,,,Inpatient,,,137.63,137.63,Wellcare,Wellcare,137.63,,,,,,,case rate,137.63,137.63,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251273,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Meritain Health PPO CPD,Meritain Health PPO CPD,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Aetna/Commercial Product,Aetna/Commercial Product,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Meritain Health CPD,Meritain Health CPD,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Starmark CPD,Starmark CPD,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Aetna Medicare,Aetna Medicare,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Ambetter ,Ambetter ,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Blue Access,Anthem Blue Access,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Blue Access Choice,Anthem Blue Access Choice,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Blue Preferred,Anthem Blue Preferred,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Pathway,Anthem Pathway,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Alliance,Anthem Alliance,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Anthem Medicare,Anthem Medicare,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Cigna,Cigna,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Cigna PPO,Cigna PPO,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Cigna Medicare Advantage,Cigna Medicare Advantage,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Essence,Essence,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Healthlink HMO,Healthlink HMO,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Healthlink PPO,Healthlink PPO,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,HomeState Health Plan,HomeState Health Plan,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Humana Gold,Humana Gold,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Medicaid MO,Medicaid MO,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Medica,Medica,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Tricare,Tricare,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,UHC All Payer,UHC All Payer,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,UHC Exchange,UHC Exchange,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,UHC Medicaid,UHC Medicaid,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,UMR CPD,UMR CPD,380.32,,,,,,,per diem,380.32,380.32,"Per diem rate, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,UHC Medicare,UHC Medicare,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AFB RIF/EMB COMBO         ,38251274,CDM,306,RC,,,,,,Inpatient,,,380.32,380.32,Wellcare,Wellcare,380.32,,,,,,,case rate,380.32,380.32,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251275,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC YEAST           ,38251276,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251277,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251278,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health PPO CPD,Meritain Health PPO CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna/Commercial Product,Aetna/Commercial Product,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Meritain Health CPD,Meritain Health CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Starmark CPD,Starmark CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Aetna Medicare,Aetna Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Ambetter ,Ambetter ,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access,Anthem Blue Access,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Access Choice,Anthem Blue Access Choice,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Blue Preferred,Anthem Blue Preferred,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Pathway,Anthem Pathway,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Alliance,Anthem Alliance,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Anthem Medicare,Anthem Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna,Cigna,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna PPO,Cigna PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Cigna Medicare Advantage,Cigna Medicare Advantage,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Essence,Essence,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink HMO,Healthlink HMO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Healthlink PPO,Healthlink PPO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,HomeState Health Plan,HomeState Health Plan,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Humana Gold,Humana Gold,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medicaid MO,Medicaid MO,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Medica,Medica,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Tricare,Tricare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC All Payer,UHC All Payer,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Exchange,UHC Exchange,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicaid,UHC Medicaid,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UMR CPD,UMR CPD,479.07,,,,,,,per diem,479.07,479.07,"Per diem rate, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,UHC Medicare,UHC Medicare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O 5CF MIC YEAST             ,38251279,CDM,306,RC,,,,,,Inpatient,,,479.07,479.07,Wellcare,Wellcare,479.07,,,,,,,case rate,479.07,479.07,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Meritain Health PPO CPD,Meritain Health PPO CPD,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Aetna/Commercial Product,Aetna/Commercial Product,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Meritain Health CPD,Meritain Health CPD,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Starmark CPD,Starmark CPD,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Aetna Medicare,Aetna Medicare,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Ambetter ,Ambetter ,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Blue Access,Anthem Blue Access,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Blue Access Choice,Anthem Blue Access Choice,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Blue Preferred,Anthem Blue Preferred,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Pathway,Anthem Pathway,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Alliance,Anthem Alliance,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Anthem Medicare,Anthem Medicare,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Cigna,Cigna,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Cigna PPO,Cigna PPO,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Cigna Medicare Advantage,Cigna Medicare Advantage,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Essence,Essence,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Healthlink HMO,Healthlink HMO,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Healthlink PPO,Healthlink PPO,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,HomeState Health Plan,HomeState Health Plan,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Humana Gold,Humana Gold,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Medicaid MO,Medicaid MO,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Medica,Medica,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Tricare,Tricare,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,UHC All Payer,UHC All Payer,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,UHC Exchange,UHC Exchange,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,UHC Medicaid,UHC Medicaid,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,UMR CPD,UMR CPD,152.86,,,,,,,per diem,152.86,152.86,"Per diem rate, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,UHC Medicare,UHC Medicare,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O SUSCEPT MIC PER PLATE     ,38251280,CDM,306,RC,,,,,,Inpatient,,,152.86,152.86,Wellcare,Wellcare,152.86,,,,,,,case rate,152.86,152.86,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Meritain Health PPO CPD,Meritain Health PPO CPD,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Aetna/Commercial Product,Aetna/Commercial Product,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Meritain Health CPD,Meritain Health CPD,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Starmark CPD,Starmark CPD,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Aetna Medicare,Aetna Medicare,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Ambetter ,Ambetter ,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Blue Access,Anthem Blue Access,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Blue Access Choice,Anthem Blue Access Choice,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Blue Preferred,Anthem Blue Preferred,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Pathway,Anthem Pathway,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Alliance,Anthem Alliance,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Anthem Medicare,Anthem Medicare,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Cigna,Cigna,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Cigna PPO,Cigna PPO,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Cigna Medicare Advantage,Cigna Medicare Advantage,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Essence,Essence,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Healthlink HMO,Healthlink HMO,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Healthlink PPO,Healthlink PPO,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,HomeState Health Plan,HomeState Health Plan,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Humana Gold,Humana Gold,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Medicaid MO,Medicaid MO,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Medica,Medica,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Tricare,Tricare,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,UHC All Payer,UHC All Payer,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,UHC Exchange,UHC Exchange,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,UHC Medicaid,UHC Medicaid,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,UMR CPD,UMR CPD,480.12,,,,,,,per diem,480.12,480.12,"Per diem rate, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,UHC Medicare,UHC Medicare,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O FLU MIC YEAST             ,38251281,CDM,306,RC,,,,,,Inpatient,,,480.12,480.12,Wellcare,Wellcare,480.12,,,,,,,case rate,480.12,480.12,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health PPO CPD,Meritain Health PPO CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/Commercial Product,Aetna/Commercial Product,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health CPD,Meritain Health CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Starmark CPD,Starmark CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna Medicare,Aetna Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Ambetter ,Ambetter ,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access,Anthem Blue Access,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access Choice,Anthem Blue Access Choice,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Preferred,Anthem Blue Preferred,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Pathway,Anthem Pathway,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Alliance,Anthem Alliance,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Medicare,Anthem Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna,Cigna,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna PPO,Cigna PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna Medicare Advantage,Cigna Medicare Advantage,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Essence,Essence,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink HMO,Healthlink HMO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink PPO,Healthlink PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,HomeState Health Plan,HomeState Health Plan,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Humana Gold,Humana Gold,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medicaid MO,Medicaid MO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medica,Medica,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Tricare,Tricare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC All Payer,UHC All Payer,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Exchange,UHC Exchange,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicaid,UHC Medicaid,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UMR CPD,UMR CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicare,UHC Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM3/5 ADDSGL MIC     ,38251283,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Wellcare,Wellcare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Meritain Health PPO CPD,Meritain Health PPO CPD,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Aetna/Commercial Product,Aetna/Commercial Product,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Meritain Health CPD,Meritain Health CPD,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Starmark CPD,Starmark CPD,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Aetna Medicare,Aetna Medicare,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Ambetter ,Ambetter ,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Blue Access,Anthem Blue Access,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Blue Access Choice,Anthem Blue Access Choice,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Blue Preferred,Anthem Blue Preferred,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Pathway,Anthem Pathway,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Alliance,Anthem Alliance,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Anthem Medicare,Anthem Medicare,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Cigna,Cigna,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Cigna PPO,Cigna PPO,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Cigna Medicare Advantage,Cigna Medicare Advantage,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Essence,Essence,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Healthlink HMO,Healthlink HMO,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Healthlink PPO,Healthlink PPO,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,HomeState Health Plan,HomeState Health Plan,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Humana Gold,Humana Gold,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Medicaid MO,Medicaid MO,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Medica,Medica,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Tricare,Tricare,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,UHC All Payer,UHC All Payer,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,UHC Exchange,UHC Exchange,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,UHC Medicaid,UHC Medicaid,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,UMR CPD,UMR CPD,1023.28,,,,,,,per diem,1023.28,1023.28,"Per diem rate, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,UHC Medicare,UHC Medicare,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM4 15 DRUG MIC      ,38251284,CDM,306,RC,,,,,,Inpatient,,,1023.28,1023.28,Wellcare,Wellcare,1023.28,,,,,,,case rate,1023.28,1023.28,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Meritain Health PPO CPD,Meritain Health PPO CPD,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Aetna/Commercial Product,Aetna/Commercial Product,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Meritain Health CPD,Meritain Health CPD,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Starmark CPD,Starmark CPD,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Aetna Medicare,Aetna Medicare,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Ambetter ,Ambetter ,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Blue Access,Anthem Blue Access,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Blue Access Choice,Anthem Blue Access Choice,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Blue Preferred,Anthem Blue Preferred,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Pathway,Anthem Pathway,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Alliance,Anthem Alliance,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Anthem Medicare,Anthem Medicare,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Cigna,Cigna,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Cigna PPO,Cigna PPO,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Cigna Medicare Advantage,Cigna Medicare Advantage,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Essence,Essence,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Healthlink HMO,Healthlink HMO,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Healthlink PPO,Healthlink PPO,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,HomeState Health Plan,HomeState Health Plan,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Humana Gold,Humana Gold,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Medicaid MO,Medicaid MO,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Medica,Medica,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Tricare,Tricare,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,UHC All Payer,UHC All Payer,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,UHC Exchange,UHC Exchange,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,UHC Medicaid,UHC Medicaid,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,UMR CPD,UMR CPD,1433.02,,,,,,,per diem,1433.02,1433.02,"Per diem rate, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,UHC Medicare,UHC Medicare,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM6 20 DRUG MIC      ,38251285,CDM,306,RC,,,,,,Inpatient,,,1433.02,1433.02,Wellcare,Wellcare,1433.02,,,,,,,case rate,1433.02,1433.02,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health PPO CPD,Meritain Health PPO CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Aetna/Commercial Product,Aetna/Commercial Product,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Meritain Health CPD,Meritain Health CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Starmark CPD,Starmark CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Aetna Medicare,Aetna Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Ambetter ,Ambetter ,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access,Anthem Blue Access,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Access Choice,Anthem Blue Access Choice,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Blue Preferred,Anthem Blue Preferred,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Pathway,Anthem Pathway,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Alliance,Anthem Alliance,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Anthem Medicare,Anthem Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Cigna,Cigna,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Cigna PPO,Cigna PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Cigna Medicare Advantage,Cigna Medicare Advantage,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Essence,Essence,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink HMO,Healthlink HMO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Healthlink PPO,Healthlink PPO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,HomeState Health Plan,HomeState Health Plan,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Humana Gold,Humana Gold,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Medicaid MO,Medicaid MO,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Medica,Medica,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Tricare,Tricare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,UHC All Payer,UHC All Payer,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,UHC Exchange,UHC Exchange,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicaid,UHC Medicaid,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,UMR CPD,UMR CPD,349.85,,,,,,,per diem,349.85,349.85,"Per diem rate, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,UHC Medicare,UHC Medicare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-RECOM                 ,38251286,CDM,306,RC,,,,,,Inpatient,,,349.85,349.85,Wellcare,Wellcare,349.85,,,,,,,case rate,349.85,349.85,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health PPO CPD,Meritain Health PPO CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/Commercial Product,Aetna/Commercial Product,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health CPD,Meritain Health CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Starmark CPD,Starmark CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna Medicare,Aetna Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Ambetter ,Ambetter ,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access,Anthem Blue Access,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access Choice,Anthem Blue Access Choice,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Preferred,Anthem Blue Preferred,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Pathway,Anthem Pathway,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Alliance,Anthem Alliance,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Medicare,Anthem Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna,Cigna,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna PPO,Cigna PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna Medicare Advantage,Cigna Medicare Advantage,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Essence,Essence,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink HMO,Healthlink HMO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink PPO,Healthlink PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,HomeState Health Plan,HomeState Health Plan,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Humana Gold,Humana Gold,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medicaid MO,Medicaid MO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medica,Medica,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Tricare,Tricare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC All Payer,UHC All Payer,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Exchange,UHC Exchange,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicaid,UHC Medicaid,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UMR CPD,UMR CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicare,UHC Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251287,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Wellcare,Wellcare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health PPO CPD,Meritain Health PPO CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/Commercial Product,Aetna/Commercial Product,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health CPD,Meritain Health CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Starmark CPD,Starmark CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna Medicare,Aetna Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Ambetter ,Ambetter ,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access,Anthem Blue Access,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access Choice,Anthem Blue Access Choice,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Preferred,Anthem Blue Preferred,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Pathway,Anthem Pathway,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Alliance,Anthem Alliance,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Medicare,Anthem Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna,Cigna,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna PPO,Cigna PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna Medicare Advantage,Cigna Medicare Advantage,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Essence,Essence,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink HMO,Healthlink HMO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink PPO,Healthlink PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,HomeState Health Plan,HomeState Health Plan,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Humana Gold,Humana Gold,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medicaid MO,Medicaid MO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medica,Medica,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Tricare,Tricare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC All Payer,UHC All Payer,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Exchange,UHC Exchange,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicaid,UHC Medicaid,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UMR CPD,UMR CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicare,UHC Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251288,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Wellcare,Wellcare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Meritain Health PPO CPD,Meritain Health PPO CPD,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Aetna/Commercial Product,Aetna/Commercial Product,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Meritain Health CPD,Meritain Health CPD,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Starmark CPD,Starmark CPD,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Aetna Medicare,Aetna Medicare,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Ambetter ,Ambetter ,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Blue Access,Anthem Blue Access,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Blue Access Choice,Anthem Blue Access Choice,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Blue Preferred,Anthem Blue Preferred,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Pathway,Anthem Pathway,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Alliance,Anthem Alliance,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Anthem Medicare,Anthem Medicare,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Cigna,Cigna,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Cigna PPO,Cigna PPO,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Cigna Medicare Advantage,Cigna Medicare Advantage,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Essence,Essence,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Healthlink HMO,Healthlink HMO,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Healthlink PPO,Healthlink PPO,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,HomeState Health Plan,HomeState Health Plan,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Humana Gold,Humana Gold,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Medicaid MO,Medicaid MO,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Medica,Medica,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Tricare,Tricare,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,UHC All Payer,UHC All Payer,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,UHC Exchange,UHC Exchange,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,UHC Medicaid,UHC Medicaid,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,UMR CPD,UMR CPD,715.46,,,,,,,per diem,715.46,715.46,"Per diem rate, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,UHC Medicare,UHC Medicare,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-AFB2 NAAT             ,38251289,CDM,306,RC,,,,,,Inpatient,,,715.46,715.46,Wellcare,Wellcare,715.46,,,,,,,case rate,715.46,715.46,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Meritain Health PPO CPD,Meritain Health PPO CPD,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Aetna/Commercial Product,Aetna/Commercial Product,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Meritain Health CPD,Meritain Health CPD,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Starmark CPD,Starmark CPD,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Aetna Medicare,Aetna Medicare,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Ambetter ,Ambetter ,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Blue Access,Anthem Blue Access,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Blue Access Choice,Anthem Blue Access Choice,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Blue Preferred,Anthem Blue Preferred,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Pathway,Anthem Pathway,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Alliance,Anthem Alliance,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Anthem Medicare,Anthem Medicare,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Cigna,Cigna,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Cigna PPO,Cigna PPO,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Cigna Medicare Advantage,Cigna Medicare Advantage,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Essence,Essence,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Healthlink HMO,Healthlink HMO,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Healthlink PPO,Healthlink PPO,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,HomeState Health Plan,HomeState Health Plan,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Humana Gold,Humana Gold,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Medicaid MO,Medicaid MO,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Medica,Medica,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Tricare,Tricare,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,UHC All Payer,UHC All Payer,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,UHC Exchange,UHC Exchange,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,UHC Medicaid,UHC Medicaid,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,UMR CPD,UMR CPD,374.01,,,,,,,per diem,374.01,374.01,"Per diem rate, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,UHC Medicare,UHC Medicare,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O NJH-MTB7 MTB CPLX ID      ,38251290,CDM,306,RC,,,,,,Inpatient,,,374.01,374.01,Wellcare,Wellcare,374.01,,,,,,,case rate,374.01,374.01,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251291,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA TRACHOMATIS     ,38251292,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA AMP PROBE       ,38251293,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Meritain Health PPO CPD,Meritain Health PPO CPD,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Aetna/Commercial Product,Aetna/Commercial Product,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Meritain Health CPD,Meritain Health CPD,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Starmark CPD,Starmark CPD,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Aetna Medicare,Aetna Medicare,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Ambetter ,Ambetter ,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Blue Access,Anthem Blue Access,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Blue Access Choice,Anthem Blue Access Choice,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Blue Preferred,Anthem Blue Preferred,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Pathway,Anthem Pathway,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Alliance,Anthem Alliance,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Anthem Medicare,Anthem Medicare,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Cigna,Cigna,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Cigna PPO,Cigna PPO,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Cigna Medicare Advantage,Cigna Medicare Advantage,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Essence,Essence,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Healthlink HMO,Healthlink HMO,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Healthlink PPO,Healthlink PPO,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,HomeState Health Plan,HomeState Health Plan,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Humana Gold,Humana Gold,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Medicaid MO,Medicaid MO,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Medica,Medica,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Tricare,Tricare,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,UHC All Payer,UHC All Payer,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,UHC Exchange,UHC Exchange,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,UHC Medicaid,UHC Medicaid,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,UMR CPD,UMR CPD,101.91,,,,,,,per diem,101.91,101.91,"Per diem rate, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,UHC Medicare,UHC Medicare,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
S/O HOMOGENIZATION TISSUE     ,38251294,CDM,306,RC,,,,,,Inpatient,,,101.91,101.91,Wellcare,Wellcare,101.91,,,,,,,case rate,101.91,101.91,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Meritain Health PPO CPD,Meritain Health PPO CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna/Commercial Product,Aetna/Commercial Product,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Meritain Health CPD,Meritain Health CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Starmark CPD,Starmark CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Aetna Medicare,Aetna Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Ambetter ,Ambetter ,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Access,Anthem Blue Access,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Access Choice,Anthem Blue Access Choice,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Blue Preferred,Anthem Blue Preferred,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Pathway,Anthem Pathway,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Alliance,Anthem Alliance,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Anthem Medicare,Anthem Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna,Cigna,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna PPO,Cigna PPO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Cigna Medicare Advantage,Cigna Medicare Advantage,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Essence,Essence,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthlink HMO,Healthlink HMO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Healthlink PPO,Healthlink PPO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,HomeState Health Plan,HomeState Health Plan,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Humana Gold,Humana Gold,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Medicaid MO,Medicaid MO,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Medica,Medica,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Tricare,Tricare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC All Payer,UHC All Payer,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Exchange,UHC Exchange,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Medicaid,UHC Medicaid,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,UMR CPD,UMR CPD,1135.7,,,,,,,per diem,1135.7,1135.7,"Per diem rate, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,UHC Medicare,UHC Medicare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
IA CRYPTOCOCCUS NEOFOR QL     ,38251295,CDM,306,RC,,,,,,Inpatient,,,1135.7,1135.7,Wellcare,Wellcare,1135.7,,,,,,,case rate,1135.7,1135.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Meritain Health PPO CPD,Meritain Health PPO CPD,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Aetna/Commercial Product,Aetna/Commercial Product,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Meritain Health CPD,Meritain Health CPD,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Starmark CPD,Starmark CPD,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Aetna Medicare,Aetna Medicare,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Ambetter ,Ambetter ,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Blue Access,Anthem Blue Access,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Blue Access Choice,Anthem Blue Access Choice,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Blue Preferred,Anthem Blue Preferred,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Pathway,Anthem Pathway,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Alliance,Anthem Alliance,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Anthem Medicare,Anthem Medicare,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Cigna,Cigna,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Cigna PPO,Cigna PPO,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Cigna Medicare Advantage,Cigna Medicare Advantage,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Essence,Essence,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Healthlink HMO,Healthlink HMO,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Healthlink PPO,Healthlink PPO,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,HomeState Health Plan,HomeState Health Plan,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Humana Gold,Humana Gold,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Medicaid MO,Medicaid MO,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Medica,Medica,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Tricare,Tricare,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,UHC All Payer,UHC All Payer,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,UHC Exchange,UHC Exchange,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,UHC Medicaid,UHC Medicaid,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,UMR CPD,UMR CPD,324.64,,,,,,,per diem,324.64,324.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,UHC Medicare,UHC Medicare,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS OTHER         ,38251296,CDM,306,RC,,,,,,Inpatient,,,324.64,324.64,Wellcare,Wellcare,324.64,,,,,,,case rate,324.64,324.64,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT SPUTUM                   ,38251297,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Meritain Health PPO CPD,Meritain Health PPO CPD,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Aetna/Commercial Product,Aetna/Commercial Product,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Meritain Health CPD,Meritain Health CPD,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Starmark CPD,Starmark CPD,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Aetna Medicare,Aetna Medicare,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Ambetter ,Ambetter ,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Blue Access,Anthem Blue Access,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Blue Access Choice,Anthem Blue Access Choice,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Blue Preferred,Anthem Blue Preferred,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Pathway,Anthem Pathway,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Alliance,Anthem Alliance,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Anthem Medicare,Anthem Medicare,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Cigna,Cigna,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Cigna PPO,Cigna PPO,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Cigna Medicare Advantage,Cigna Medicare Advantage,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Essence,Essence,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Healthlink HMO,Healthlink HMO,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Healthlink PPO,Healthlink PPO,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,HomeState Health Plan,HomeState Health Plan,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Humana Gold,Humana Gold,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Medicaid MO,Medicaid MO,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Medica,Medica,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Tricare,Tricare,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,UHC All Payer,UHC All Payer,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,UHC Exchange,UHC Exchange,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,UHC Medicaid,UHC Medicaid,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,UMR CPD,UMR CPD,532.3,,,,,,,per diem,532.3,532.3,"Per diem rate, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,UHC Medicare,UHC Medicare,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT BODY FLUID               ,38251298,CDM,306,RC,,,,,,Inpatient,,,532.3,532.3,Wellcare,Wellcare,532.3,,,,,,,case rate,532.3,532.3,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CATHETER TIP             ,38251299,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT CSF                      ,38251300,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EAR                      ,38251301,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT EYE                      ,38251302,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT GENITAL                  ,38251303,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Meritain Health PPO CPD,Meritain Health PPO CPD,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Aetna/Commercial Product,Aetna/Commercial Product,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Meritain Health CPD,Meritain Health CPD,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Starmark CPD,Starmark CPD,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Aetna Medicare,Aetna Medicare,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Ambetter ,Ambetter ,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Blue Access,Anthem Blue Access,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Blue Access Choice,Anthem Blue Access Choice,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Blue Preferred,Anthem Blue Preferred,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Pathway,Anthem Pathway,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Alliance,Anthem Alliance,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Anthem Medicare,Anthem Medicare,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Cigna,Cigna,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Cigna PPO,Cigna PPO,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Cigna Medicare Advantage,Cigna Medicare Advantage,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Essence,Essence,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Healthlink HMO,Healthlink HMO,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Healthlink PPO,Healthlink PPO,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,HomeState Health Plan,HomeState Health Plan,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Humana Gold,Humana Gold,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Medicaid MO,Medicaid MO,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Medica,Medica,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Tricare,Tricare,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,UHC All Payer,UHC All Payer,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,UHC Exchange,UHC Exchange,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,UHC Medicaid,UHC Medicaid,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,UMR CPD,UMR CPD,377.01,,,,,,,per diem,377.01,377.01,"Per diem rate, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,UHC Medicare,UHC Medicare,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT THROAT                   ,38251304,CDM,306,RC,,,,,,Inpatient,,,377.01,377.01,Wellcare,Wellcare,377.01,,,,,,,case rate,377.01,377.01,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT TISSUE                   ,38251305,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT UTERUS/PLACENTA          ,38251306,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH WASH           ,38251307,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULT NOSE/THROAT              ,38251308,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE NASAL PHARYN          ,38251309,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE OTHER SOURCE          ,38251310,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health PPO CPD,Meritain Health PPO CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna/Commercial Product,Aetna/Commercial Product,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Meritain Health CPD,Meritain Health CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Starmark CPD,Starmark CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Aetna Medicare,Aetna Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Ambetter ,Ambetter ,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access,Anthem Blue Access,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Access Choice,Anthem Blue Access Choice,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Blue Preferred,Anthem Blue Preferred,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Pathway,Anthem Pathway,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Alliance,Anthem Alliance,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Anthem Medicare,Anthem Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna,Cigna,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna PPO,Cigna PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Cigna Medicare Advantage,Cigna Medicare Advantage,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Essence,Essence,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink HMO,Healthlink HMO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Healthlink PPO,Healthlink PPO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,HomeState Health Plan,HomeState Health Plan,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Humana Gold,Humana Gold,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medicaid MO,Medicaid MO,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Medica,Medica,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Tricare,Tricare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC All Payer,UHC All Payer,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Exchange,UHC Exchange,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicaid,UHC Medicaid,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UMR CPD,UMR CPD,535.81,,,,,,,per diem,535.81,535.81,"Per diem rate, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,UHC Medicare,UHC Medicare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
CULTURE BRONCH BRUSH          ,38251311,CDM,306,RC,,,,,,Inpatient,,,535.81,535.81,Wellcare,Wellcare,535.81,,,,,,,case rate,535.81,535.81,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Meritain Health PPO CPD,Meritain Health PPO CPD,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Aetna/Commercial Product,Aetna/Commercial Product,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Meritain Health CPD,Meritain Health CPD,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Starmark CPD,Starmark CPD,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Aetna Medicare,Aetna Medicare,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Ambetter ,Ambetter ,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Blue Access,Anthem Blue Access,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Blue Access Choice,Anthem Blue Access Choice,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Blue Preferred,Anthem Blue Preferred,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Pathway,Anthem Pathway,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Alliance,Anthem Alliance,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Anthem Medicare,Anthem Medicare,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Cigna,Cigna,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Cigna PPO,Cigna PPO,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Cigna Medicare Advantage,Cigna Medicare Advantage,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Essence,Essence,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Healthlink HMO,Healthlink HMO,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Healthlink PPO,Healthlink PPO,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,HomeState Health Plan,HomeState Health Plan,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Humana Gold,Humana Gold,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Medicaid MO,Medicaid MO,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Medica,Medica,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Tricare,Tricare,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,UHC All Payer,UHC All Payer,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,UHC Exchange,UHC Exchange,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,UHC Medicaid,UHC Medicaid,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,UMR CPD,UMR CPD,401.33,,,,,,,per diem,401.33,401.33,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,UHC Medicare,UHC Medicare,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251312,CDM,306,RC,,,,,,Inpatient,,,401.33,401.33,Wellcare,Wellcare,401.33,,,,,,,case rate,401.33,401.33,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BODY FLUID           ,38251313,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT BONE MARROW          ,38251314,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT CSF                  ,38251315,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT GENITAL              ,38251316,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Meritain Health PPO CPD,Meritain Health PPO CPD,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Aetna/Commercial Product,Aetna/Commercial Product,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Meritain Health CPD,Meritain Health CPD,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Starmark CPD,Starmark CPD,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Aetna Medicare,Aetna Medicare,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Ambetter ,Ambetter ,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Blue Access,Anthem Blue Access,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Blue Access Choice,Anthem Blue Access Choice,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Blue Preferred,Anthem Blue Preferred,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Pathway,Anthem Pathway,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Alliance,Anthem Alliance,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Anthem Medicare,Anthem Medicare,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Cigna,Cigna,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Cigna PPO,Cigna PPO,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Cigna Medicare Advantage,Cigna Medicare Advantage,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Essence,Essence,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Healthlink HMO,Healthlink HMO,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Healthlink PPO,Healthlink PPO,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,HomeState Health Plan,HomeState Health Plan,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Humana Gold,Humana Gold,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Medicaid MO,Medicaid MO,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Medica,Medica,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Tricare,Tricare,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,UHC All Payer,UHC All Payer,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,UHC Exchange,UHC Exchange,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,UHC Medicaid,UHC Medicaid,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,UMR CPD,UMR CPD,290.76,,,,,,,per diem,290.76,290.76,"Per diem rate, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,UHC Medicare,UHC Medicare,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT RESPIRATORY          ,38251317,CDM,306,RC,,,,,,Inpatient,,,290.76,290.76,Wellcare,Wellcare,290.76,,,,,,,case rate,290.76,290.76,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health PPO CPD,Meritain Health PPO CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna/Commercial Product,Aetna/Commercial Product,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Meritain Health CPD,Meritain Health CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Starmark CPD,Starmark CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Aetna Medicare,Aetna Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Ambetter ,Ambetter ,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access,Anthem Blue Access,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Access Choice,Anthem Blue Access Choice,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Blue Preferred,Anthem Blue Preferred,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Pathway,Anthem Pathway,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Alliance,Anthem Alliance,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Anthem Medicare,Anthem Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna,Cigna,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna PPO,Cigna PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Cigna Medicare Advantage,Cigna Medicare Advantage,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Essence,Essence,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink HMO,Healthlink HMO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Healthlink PPO,Healthlink PPO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,HomeState Health Plan,HomeState Health Plan,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Humana Gold,Humana Gold,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medicaid MO,Medicaid MO,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Medica,Medica,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Tricare,Tricare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC All Payer,UHC All Payer,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Exchange,UHC Exchange,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicaid,UHC Medicaid,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UMR CPD,UMR CPD,554.72,,,,,,,per diem,554.72,554.72,"Per diem rate, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,UHC Medicare,UHC Medicare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
S/O CULT WOUND                ,38251318,CDM,306,RC,,,,,,Inpatient,,,554.72,554.72,Wellcare,Wellcare,554.72,,,,,,,case rate,554.72,554.72,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Meritain Health PPO CPD,Meritain Health PPO CPD,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Aetna/Commercial Product,Aetna/Commercial Product,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Meritain Health CPD,Meritain Health CPD,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Starmark CPD,Starmark CPD,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Aetna Medicare,Aetna Medicare,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Ambetter ,Ambetter ,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Blue Access,Anthem Blue Access,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Blue Access Choice,Anthem Blue Access Choice,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Blue Preferred,Anthem Blue Preferred,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Pathway,Anthem Pathway,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Alliance,Anthem Alliance,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Anthem Medicare,Anthem Medicare,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Cigna,Cigna,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Cigna PPO,Cigna PPO,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Cigna Medicare Advantage,Cigna Medicare Advantage,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Essence,Essence,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Healthlink HMO,Healthlink HMO,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Healthlink PPO,Healthlink PPO,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,HomeState Health Plan,HomeState Health Plan,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Humana Gold,Humana Gold,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Medicaid MO,Medicaid MO,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Medica,Medica,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Tricare,Tricare,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,UHC All Payer,UHC All Payer,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,UHC Exchange,UHC Exchange,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,UHC Medicaid,UHC Medicaid,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,UMR CPD,UMR CPD,86.17,,,,,,,per diem,86.17,86.17,"Per diem rate, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,UHC Medicare,UHC Medicare,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
CULT AEROBIC ID               ,38251319,CDM,306,RC,,,,,,Inpatient,,,86.17,86.17,Wellcare,Wellcare,86.17,,,,,,,case rate,86.17,86.17,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID           ,38251320,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health PPO CPD,Meritain Health PPO CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Aetna/Commercial Product,Aetna/Commercial Product,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Meritain Health CPD,Meritain Health CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Starmark CPD,Starmark CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Aetna Medicare,Aetna Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Ambetter ,Ambetter ,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access,Anthem Blue Access,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Access Choice,Anthem Blue Access Choice,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Blue Preferred,Anthem Blue Preferred,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Pathway,Anthem Pathway,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Alliance,Anthem Alliance,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Anthem Medicare,Anthem Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Cigna,Cigna,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Cigna PPO,Cigna PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Cigna Medicare Advantage,Cigna Medicare Advantage,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Essence,Essence,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink HMO,Healthlink HMO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Healthlink PPO,Healthlink PPO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,HomeState Health Plan,HomeState Health Plan,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Humana Gold,Humana Gold,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Medicaid MO,Medicaid MO,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Medica,Medica,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Tricare,Tricare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,UHC All Payer,UHC All Payer,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,UHC Exchange,UHC Exchange,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicaid,UHC Medicaid,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,UMR CPD,UMR CPD,144.98,,,,,,,per diem,144.98,144.98,"Per diem rate, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,UHC Medicare,UHC Medicare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O CULT AEROBIC ID           ,38251321,CDM,306,RC,,,,,,Inpatient,,,144.98,144.98,Wellcare,Wellcare,144.98,,,,,,,case rate,144.98,144.98,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health PPO CPD,Meritain Health PPO CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/Commercial Product,Aetna/Commercial Product,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health CPD,Meritain Health CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Starmark CPD,Starmark CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna Medicare,Aetna Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Ambetter ,Ambetter ,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access,Anthem Blue Access,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access Choice,Anthem Blue Access Choice,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Preferred,Anthem Blue Preferred,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Pathway,Anthem Pathway,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Alliance,Anthem Alliance,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Medicare,Anthem Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna,Cigna,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna PPO,Cigna PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna Medicare Advantage,Cigna Medicare Advantage,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Essence,Essence,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink HMO,Healthlink HMO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink PPO,Healthlink PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,HomeState Health Plan,HomeState Health Plan,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Humana Gold,Humana Gold,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Medicaid MO,Medicaid MO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Medica,Medica,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Tricare,Tricare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC All Payer,UHC All Payer,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Exchange,UHC Exchange,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicaid,UHC Medicaid,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UMR CPD,UMR CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicare,UHC Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O NOCARDIA ACTINOMY         ,38251322,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Wellcare,Wellcare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health PPO CPD,Meritain Health PPO CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna/Commercial Product,Aetna/Commercial Product,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Meritain Health CPD,Meritain Health CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Starmark CPD,Starmark CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Aetna Medicare,Aetna Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Ambetter ,Ambetter ,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access,Anthem Blue Access,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Access Choice,Anthem Blue Access Choice,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Blue Preferred,Anthem Blue Preferred,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Pathway,Anthem Pathway,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Alliance,Anthem Alliance,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Anthem Medicare,Anthem Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna,Cigna,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna PPO,Cigna PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Cigna Medicare Advantage,Cigna Medicare Advantage,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Essence,Essence,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink HMO,Healthlink HMO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Healthlink PPO,Healthlink PPO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,HomeState Health Plan,HomeState Health Plan,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Humana Gold,Humana Gold,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Medicaid MO,Medicaid MO,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Medica,Medica,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Tricare,Tricare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC All Payer,UHC All Payer,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Exchange,UHC Exchange,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicaid,UHC Medicaid,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UMR CPD,UMR CPD,439.15,,,,,,,per diem,439.15,439.15,"Per diem rate, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,UHC Medicare,UHC Medicare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULTURE ANAEROBIC         ,38251323,CDM,306,RC,,,,,,Inpatient,,,439.15,439.15,Wellcare,Wellcare,439.15,,,,,,,case rate,439.15,439.15,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Meritain Health PPO CPD,Meritain Health PPO CPD,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Aetna/Commercial Product,Aetna/Commercial Product,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Meritain Health CPD,Meritain Health CPD,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Starmark CPD,Starmark CPD,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Aetna Medicare,Aetna Medicare,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Ambetter ,Ambetter ,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Blue Access,Anthem Blue Access,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Blue Access Choice,Anthem Blue Access Choice,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Blue Preferred,Anthem Blue Preferred,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Pathway,Anthem Pathway,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Alliance,Anthem Alliance,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Anthem Medicare,Anthem Medicare,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Cigna,Cigna,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Cigna PPO,Cigna PPO,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Cigna Medicare Advantage,Cigna Medicare Advantage,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Essence,Essence,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Healthlink HMO,Healthlink HMO,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Healthlink PPO,Healthlink PPO,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,HomeState Health Plan,HomeState Health Plan,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Humana Gold,Humana Gold,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Medicaid MO,Medicaid MO,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Medica,Medica,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Tricare,Tricare,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,UHC All Payer,UHC All Payer,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,UHC Exchange,UHC Exchange,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,UHC Medicaid,UHC Medicaid,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,UMR CPD,UMR CPD,532.65,,,,,,,per diem,532.65,532.65,"Per diem rate, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,UHC Medicare,UHC Medicare,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
S/O CULT BLOOD                ,38251324,CDM,306,RC,,,,,,Inpatient,,,532.65,532.65,Wellcare,Wellcare,532.65,,,,,,,case rate,532.65,532.65,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Meritain Health PPO CPD,Meritain Health PPO CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna/Commercial Product,Aetna/Commercial Product,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Meritain Health CPD,Meritain Health CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Starmark CPD,Starmark CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna Medicare,Aetna Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Ambetter ,Ambetter ,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Access,Anthem Blue Access,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Access Choice,Anthem Blue Access Choice,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Preferred,Anthem Blue Preferred,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Pathway,Anthem Pathway,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Alliance,Anthem Alliance,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Medicare,Anthem Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna,Cigna,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna PPO,Cigna PPO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna Medicare Advantage,Cigna Medicare Advantage,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Essence,Essence,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthlink HMO,Healthlink HMO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthlink PPO,Healthlink PPO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,HomeState Health Plan,HomeState Health Plan,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Humana Gold,Humana Gold,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Medicaid MO,Medicaid MO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Medica,Medica,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Tricare,Tricare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC All Payer,UHC All Payer,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Exchange,UHC Exchange,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Medicaid,UHC Medicaid,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UMR CPD,UMR CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Medicare,UHC Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL E COLI          ,38251325,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Wellcare,Wellcare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Meritain Health PPO CPD,Meritain Health PPO CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna/Commercial Product,Aetna/Commercial Product,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Meritain Health CPD,Meritain Health CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Starmark CPD,Starmark CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Aetna Medicare,Aetna Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Ambetter ,Ambetter ,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Access,Anthem Blue Access,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Access Choice,Anthem Blue Access Choice,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Blue Preferred,Anthem Blue Preferred,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Pathway,Anthem Pathway,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Alliance,Anthem Alliance,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Anthem Medicare,Anthem Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna,Cigna,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna PPO,Cigna PPO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Cigna Medicare Advantage,Cigna Medicare Advantage,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Essence,Essence,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthlink HMO,Healthlink HMO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Healthlink PPO,Healthlink PPO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,HomeState Health Plan,HomeState Health Plan,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Humana Gold,Humana Gold,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Medicaid MO,Medicaid MO,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Medica,Medica,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Tricare,Tricare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC All Payer,UHC All Payer,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Exchange,UHC Exchange,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Medicaid,UHC Medicaid,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UMR CPD,UMR CPD,256.35,,,,,,,per diem,256.35,256.35,"Per diem rate, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,UHC Medicare,UHC Medicare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
CULTURE STOOL CAMPY           ,38251326,CDM,306,RC,,,,,,Inpatient,,,256.35,256.35,Wellcare,Wellcare,256.35,,,,,,,case rate,256.35,256.35,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Meritain Health PPO CPD,Meritain Health PPO CPD,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Aetna/Commercial Product,Aetna/Commercial Product,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Meritain Health CPD,Meritain Health CPD,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Starmark CPD,Starmark CPD,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Aetna Medicare,Aetna Medicare,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Ambetter ,Ambetter ,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Blue Access,Anthem Blue Access,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Blue Access Choice,Anthem Blue Access Choice,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Blue Preferred,Anthem Blue Preferred,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Pathway,Anthem Pathway,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Alliance,Anthem Alliance,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Anthem Medicare,Anthem Medicare,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Cigna,Cigna,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Cigna PPO,Cigna PPO,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Cigna Medicare Advantage,Cigna Medicare Advantage,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Essence,Essence,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Healthlink HMO,Healthlink HMO,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Healthlink PPO,Healthlink PPO,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,HomeState Health Plan,HomeState Health Plan,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Humana Gold,Humana Gold,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Medicaid MO,Medicaid MO,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Medica,Medica,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Tricare,Tricare,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,UHC All Payer,UHC All Payer,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,UHC Exchange,UHC Exchange,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,UHC Medicaid,UHC Medicaid,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,UMR CPD,UMR CPD,9.46,,,,,,,per diem,9.46,9.46,"Per diem rate, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,UHC Medicare,UHC Medicare,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O STOOL CULTURE VIBRIO      ,38251327,CDM,306,RC,,,,,,Inpatient,,,9.46,9.46,Wellcare,Wellcare,9.46,,,,,,,case rate,9.46,9.46,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT STOOL VIBRIO         ,38251328,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health PPO CPD,Meritain Health PPO CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna/Commercial Product,Aetna/Commercial Product,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Meritain Health CPD,Meritain Health CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Starmark CPD,Starmark CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Aetna Medicare,Aetna Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Ambetter ,Ambetter ,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access,Anthem Blue Access,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Access Choice,Anthem Blue Access Choice,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Blue Preferred,Anthem Blue Preferred,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Pathway,Anthem Pathway,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Alliance,Anthem Alliance,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Anthem Medicare,Anthem Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna,Cigna,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna PPO,Cigna PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Cigna Medicare Advantage,Cigna Medicare Advantage,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Essence,Essence,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink HMO,Healthlink HMO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Healthlink PPO,Healthlink PPO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,HomeState Health Plan,HomeState Health Plan,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Humana Gold,Humana Gold,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Medicaid MO,Medicaid MO,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Medica,Medica,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Tricare,Tricare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC All Payer,UHC All Payer,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Exchange,UHC Exchange,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicaid,UHC Medicaid,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UMR CPD,UMR CPD,130.27,,,,,,,per diem,130.27,130.27,"Per diem rate, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,UHC Medicare,UHC Medicare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULT SCR YERSINIA         ,38251329,CDM,306,RC,,,,,,Inpatient,,,130.27,130.27,Wellcare,Wellcare,130.27,,,,,,,case rate,130.27,130.27,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health PPO CPD,Meritain Health PPO CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Aetna/Commercial Product,Aetna/Commercial Product,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Meritain Health CPD,Meritain Health CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Starmark CPD,Starmark CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Aetna Medicare,Aetna Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Ambetter ,Ambetter ,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access,Anthem Blue Access,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Access Choice,Anthem Blue Access Choice,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Blue Preferred,Anthem Blue Preferred,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Pathway,Anthem Pathway,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Alliance,Anthem Alliance,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Anthem Medicare,Anthem Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Cigna,Cigna,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Cigna PPO,Cigna PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Cigna Medicare Advantage,Cigna Medicare Advantage,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Essence,Essence,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink HMO,Healthlink HMO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Healthlink PPO,Healthlink PPO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,HomeState Health Plan,HomeState Health Plan,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Humana Gold,Humana Gold,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Medicaid MO,Medicaid MO,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Medica,Medica,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Tricare,Tricare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,UHC All Payer,UHC All Payer,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,UHC Exchange,UHC Exchange,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicaid,UHC Medicaid,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,UMR CPD,UMR CPD,265.8,,,,,,,per diem,265.8,265.8,"Per diem rate, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,UHC Medicare,UHC Medicare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CULTURE STOOL CAMPY       ,38251330,CDM,306,RC,,,,,,Inpatient,,,265.8,265.8,Wellcare,Wellcare,265.8,,,,,,,case rate,265.8,265.8,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CHLAMYDIA CULTURE         ,38251331,CDM,306,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Meritain Health PPO CPD,Meritain Health PPO CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Aetna/Commercial Product,Aetna/Commercial Product,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Meritain Health CPD,Meritain Health CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Starmark CPD,Starmark CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Aetna Medicare,Aetna Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Ambetter ,Ambetter ,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Access,Anthem Blue Access,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Access Choice,Anthem Blue Access Choice,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Blue Preferred,Anthem Blue Preferred,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Pathway,Anthem Pathway,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Alliance,Anthem Alliance,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Anthem Medicare,Anthem Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Cigna,Cigna,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Cigna PPO,Cigna PPO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Cigna Medicare Advantage,Cigna Medicare Advantage,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Essence,Essence,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Healthlink HMO,Healthlink HMO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Healthlink PPO,Healthlink PPO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,HomeState Health Plan,HomeState Health Plan,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Humana Gold,Humana Gold,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Medicaid MO,Medicaid MO,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Medica,Medica,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Tricare,Tricare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,UHC All Payer,UHC All Payer,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,UHC Exchange,UHC Exchange,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,UHC Medicaid,UHC Medicaid,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,UMR CPD,UMR CPD,227.98,,,,,,,per diem,227.98,227.98,"Per diem rate, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,UHC Medicare,UHC Medicare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O CULT CHLAMYDIA            ,38251332,CDM,306,RC,,,,,,Inpatient,,,227.98,227.98,Wellcare,Wellcare,227.98,,,,,,,case rate,227.98,227.98,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health PPO CPD,Meritain Health PPO CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/Commercial Product,Aetna/Commercial Product,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health CPD,Meritain Health CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Starmark CPD,Starmark CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna Medicare,Aetna Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Ambetter ,Ambetter ,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access,Anthem Blue Access,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access Choice,Anthem Blue Access Choice,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Preferred,Anthem Blue Preferred,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Pathway,Anthem Pathway,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Alliance,Anthem Alliance,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Medicare,Anthem Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna,Cigna,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna PPO,Cigna PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna Medicare Advantage,Cigna Medicare Advantage,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Essence,Essence,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink HMO,Healthlink HMO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink PPO,Healthlink PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,HomeState Health Plan,HomeState Health Plan,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Humana Gold,Humana Gold,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medicaid MO,Medicaid MO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medica,Medica,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Tricare,Tricare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC All Payer,UHC All Payer,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Exchange,UHC Exchange,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicaid,UHC Medicaid,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UMR CPD,UMR CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicare,UHC Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251333,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Wellcare,Wellcare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health PPO CPD,Meritain Health PPO CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/Commercial Product,Aetna/Commercial Product,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health CPD,Meritain Health CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Starmark CPD,Starmark CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna Medicare,Aetna Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Ambetter ,Ambetter ,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access,Anthem Blue Access,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access Choice,Anthem Blue Access Choice,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Preferred,Anthem Blue Preferred,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Pathway,Anthem Pathway,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Alliance,Anthem Alliance,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Medicare,Anthem Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna,Cigna,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna PPO,Cigna PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna Medicare Advantage,Cigna Medicare Advantage,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Essence,Essence,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink HMO,Healthlink HMO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink PPO,Healthlink PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,HomeState Health Plan,HomeState Health Plan,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Humana Gold,Humana Gold,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medicaid MO,Medicaid MO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medica,Medica,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Tricare,Tricare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC All Payer,UHC All Payer,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Exchange,UHC Exchange,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicaid,UHC Medicaid,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UMR CPD,UMR CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicare,UHC Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULT NON-RESP       ,38251334,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Wellcare,Wellcare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health PPO CPD,Meritain Health PPO CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/Commercial Product,Aetna/Commercial Product,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health CPD,Meritain Health CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Starmark CPD,Starmark CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna Medicare,Aetna Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Ambetter ,Ambetter ,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access,Anthem Blue Access,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access Choice,Anthem Blue Access Choice,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Preferred,Anthem Blue Preferred,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Pathway,Anthem Pathway,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Alliance,Anthem Alliance,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Medicare,Anthem Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna,Cigna,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna PPO,Cigna PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna Medicare Advantage,Cigna Medicare Advantage,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Essence,Essence,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink HMO,Healthlink HMO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink PPO,Healthlink PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,HomeState Health Plan,HomeState Health Plan,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Humana Gold,Humana Gold,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medicaid MO,Medicaid MO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medica,Medica,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Tricare,Tricare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC All Payer,UHC All Payer,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Exchange,UHC Exchange,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicaid,UHC Medicaid,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UMR CPD,UMR CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicare,UHC Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251335,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Wellcare,Wellcare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health PPO CPD,Meritain Health PPO CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/Commercial Product,Aetna/Commercial Product,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health CPD,Meritain Health CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Starmark CPD,Starmark CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna Medicare,Aetna Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Ambetter ,Ambetter ,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access,Anthem Blue Access,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access Choice,Anthem Blue Access Choice,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Preferred,Anthem Blue Preferred,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Pathway,Anthem Pathway,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Alliance,Anthem Alliance,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Medicare,Anthem Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna,Cigna,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna PPO,Cigna PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna Medicare Advantage,Cigna Medicare Advantage,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Essence,Essence,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink HMO,Healthlink HMO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink PPO,Healthlink PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,HomeState Health Plan,HomeState Health Plan,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Humana Gold,Humana Gold,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medicaid MO,Medicaid MO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medica,Medica,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Tricare,Tricare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC All Payer,UHC All Payer,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Exchange,UHC Exchange,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicaid,UHC Medicaid,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UMR CPD,UMR CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicare,UHC Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CULTURE RESP        ,38251336,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Wellcare,Wellcare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health PPO CPD,Meritain Health PPO CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/Commercial Product,Aetna/Commercial Product,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health CPD,Meritain Health CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Starmark CPD,Starmark CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna Medicare,Aetna Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Ambetter ,Ambetter ,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access,Anthem Blue Access,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access Choice,Anthem Blue Access Choice,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Preferred,Anthem Blue Preferred,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Pathway,Anthem Pathway,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Alliance,Anthem Alliance,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Medicare,Anthem Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna,Cigna,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna PPO,Cigna PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna Medicare Advantage,Cigna Medicare Advantage,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Essence,Essence,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink HMO,Healthlink HMO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink PPO,Healthlink PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,HomeState Health Plan,HomeState Health Plan,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Humana Gold,Humana Gold,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medicaid MO,Medicaid MO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medica,Medica,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Tricare,Tricare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC All Payer,UHC All Payer,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Exchange,UHC Exchange,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicaid,UHC Medicaid,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UMR CPD,UMR CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicare,UHC Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251337,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Wellcare,Wellcare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251338,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Meritain Health PPO CPD,Meritain Health PPO CPD,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Aetna/Commercial Product,Aetna/Commercial Product,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Meritain Health CPD,Meritain Health CPD,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Starmark CPD,Starmark CPD,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Aetna Medicare,Aetna Medicare,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Ambetter ,Ambetter ,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Blue Access,Anthem Blue Access,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Blue Access Choice,Anthem Blue Access Choice,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Blue Preferred,Anthem Blue Preferred,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Pathway,Anthem Pathway,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Alliance,Anthem Alliance,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Anthem Medicare,Anthem Medicare,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Cigna,Cigna,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Cigna PPO,Cigna PPO,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Cigna Medicare Advantage,Cigna Medicare Advantage,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Essence,Essence,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Healthlink HMO,Healthlink HMO,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Healthlink PPO,Healthlink PPO,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,HomeState Health Plan,HomeState Health Plan,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Humana Gold,Humana Gold,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Medicaid MO,Medicaid MO,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Medica,Medica,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Tricare,Tricare,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,UHC All Payer,UHC All Payer,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,UHC Exchange,UHC Exchange,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,UHC Medicaid,UHC Medicaid,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,UMR CPD,UMR CPD,33.62,,,,,,,per diem,33.62,33.62,"Per diem rate, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,UHC Medicare,UHC Medicare,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
CULT TYP STREP                ,38251339,CDM,306,RC,,,,,,Inpatient,,,33.62,33.62,Wellcare,Wellcare,33.62,,,,,,,case rate,33.62,33.62,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYP SEROLOGICAL      ,38251340,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health PPO CPD,Meritain Health PPO CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna/Commercial Product,Aetna/Commercial Product,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Meritain Health CPD,Meritain Health CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Starmark CPD,Starmark CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Aetna Medicare,Aetna Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Ambetter ,Ambetter ,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access,Anthem Blue Access,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Access Choice,Anthem Blue Access Choice,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Blue Preferred,Anthem Blue Preferred,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Pathway,Anthem Pathway,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Alliance,Anthem Alliance,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Anthem Medicare,Anthem Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna,Cigna,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna PPO,Cigna PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Cigna Medicare Advantage,Cigna Medicare Advantage,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Essence,Essence,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink HMO,Healthlink HMO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Healthlink PPO,Healthlink PPO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,HomeState Health Plan,HomeState Health Plan,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Humana Gold,Humana Gold,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Medicaid MO,Medicaid MO,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Medica,Medica,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Tricare,Tricare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC All Payer,UHC All Payer,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Exchange,UHC Exchange,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicaid,UHC Medicaid,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UMR CPD,UMR CPD,28.37,,,,,,,per diem,28.37,28.37,"Per diem rate, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,UHC Medicare,UHC Medicare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT TYPING STREP         ,38251341,CDM,306,RC,,,,,,Inpatient,,,28.37,28.37,Wellcare,Wellcare,28.37,,,,,,,case rate,28.37,28.37,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Meritain Health PPO CPD,Meritain Health PPO CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Aetna/Commercial Product,Aetna/Commercial Product,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Meritain Health CPD,Meritain Health CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Starmark CPD,Starmark CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Aetna Medicare,Aetna Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Ambetter ,Ambetter ,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Access,Anthem Blue Access,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Access Choice,Anthem Blue Access Choice,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Blue Preferred,Anthem Blue Preferred,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Pathway,Anthem Pathway,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Alliance,Anthem Alliance,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Anthem Medicare,Anthem Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Cigna,Cigna,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Cigna PPO,Cigna PPO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Cigna Medicare Advantage,Cigna Medicare Advantage,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Essence,Essence,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Healthlink HMO,Healthlink HMO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Healthlink PPO,Healthlink PPO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,HomeState Health Plan,HomeState Health Plan,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Humana Gold,Humana Gold,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Medicaid MO,Medicaid MO,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Medica,Medica,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Tricare,Tricare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,UHC All Payer,UHC All Payer,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,UHC Exchange,UHC Exchange,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,UHC Medicaid,UHC Medicaid,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,UMR CPD,UMR CPD,425.49,,,,,,,per diem,425.49,425.49,"Per diem rate, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,UHC Medicare,UHC Medicare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT STOOL SALM/SHIG      ,38251342,CDM,306,RC,,,,,,Inpatient,,,425.49,425.49,Wellcare,Wellcare,425.49,,,,,,,case rate,425.49,425.49,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Meritain Health PPO CPD,Meritain Health PPO CPD,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Aetna/Commercial Product,Aetna/Commercial Product,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Meritain Health CPD,Meritain Health CPD,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Starmark CPD,Starmark CPD,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Aetna Medicare,Aetna Medicare,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Ambetter ,Ambetter ,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Blue Access,Anthem Blue Access,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Blue Access Choice,Anthem Blue Access Choice,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Blue Preferred,Anthem Blue Preferred,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Pathway,Anthem Pathway,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Alliance,Anthem Alliance,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Anthem Medicare,Anthem Medicare,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Cigna,Cigna,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Cigna PPO,Cigna PPO,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Cigna Medicare Advantage,Cigna Medicare Advantage,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Essence,Essence,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Healthlink HMO,Healthlink HMO,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Healthlink PPO,Healthlink PPO,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,HomeState Health Plan,HomeState Health Plan,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Humana Gold,Humana Gold,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Medicaid MO,Medicaid MO,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Medica,Medica,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Tricare,Tricare,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,UHC All Payer,UHC All Payer,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,UHC Exchange,UHC Exchange,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,UHC Medicaid,UHC Medicaid,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,UMR CPD,UMR CPD,650.32,,,,,,,per diem,650.32,650.32,"Per diem rate, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,UHC Medicare,UHC Medicare,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
S/O CULT UR W/COLONY CNT      ,38251343,CDM,306,RC,,,,,,Inpatient,,,650.32,650.32,Wellcare,Wellcare,650.32,,,,,,,case rate,650.32,650.32,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BARBITURATES SCRN NONCHR      ,38251344,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
BENZODIAZEPIN SCRN NONCHR     ,38251345,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
CANNABINOID SCRN NONCHR       ,38251346,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
COCAINE SCRN NONCHR           ,38251347,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHADONE SCRN NONCHR         ,38251348,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
METHAMPHETAM SCRN NONCHR      ,38251349,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OPIATES SCREEN NONCHR         ,38251350,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
OXYCODONE SCREEN NONCHR       ,38251351,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PCP SCREEN NONCHR             ,38251352,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
PROPOXYPHENE SCRN NONCHR      ,38251353,CDM,301,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health PPO CPD,Meritain Health PPO CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Aetna/Commercial Product,Aetna/Commercial Product,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Meritain Health CPD,Meritain Health CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Starmark CPD,Starmark CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Aetna Medicare,Aetna Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Ambetter ,Ambetter ,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access,Anthem Blue Access,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Access Choice,Anthem Blue Access Choice,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Blue Preferred,Anthem Blue Preferred,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Pathway,Anthem Pathway,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Alliance,Anthem Alliance,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Anthem Medicare,Anthem Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Cigna,Cigna,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Cigna PPO,Cigna PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Cigna Medicare Advantage,Cigna Medicare Advantage,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Essence,Essence,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink HMO,Healthlink HMO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Healthlink PPO,Healthlink PPO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,HomeState Health Plan,HomeState Health Plan,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Humana Gold,Humana Gold,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Medicaid MO,Medicaid MO,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Medica,Medica,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Tricare,Tricare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,UHC All Payer,UHC All Payer,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,UHC Exchange,UHC Exchange,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicaid,UHC Medicaid,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,UMR CPD,UMR CPD,301.52,,,,,,,per diem,301.52,301.52,"Per diem rate, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,UHC Medicare,UHC Medicare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
SMEAR WET MOUNT INFECT        ,38251354,CDM,306,RC,,,,,,Inpatient,,,301.52,301.52,Wellcare,Wellcare,301.52,,,,,,,case rate,301.52,301.52,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR INDIA INK           ,38251355,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health PPO CPD,Meritain Health PPO CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna/Commercial Product,Aetna/Commercial Product,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Meritain Health CPD,Meritain Health CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Starmark CPD,Starmark CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Aetna Medicare,Aetna Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Ambetter ,Ambetter ,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access,Anthem Blue Access,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Access Choice,Anthem Blue Access Choice,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Blue Preferred,Anthem Blue Preferred,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Pathway,Anthem Pathway,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Alliance,Anthem Alliance,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Anthem Medicare,Anthem Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna,Cigna,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna PPO,Cigna PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Cigna Medicare Advantage,Cigna Medicare Advantage,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Essence,Essence,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink HMO,Healthlink HMO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Healthlink PPO,Healthlink PPO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,HomeState Health Plan,HomeState Health Plan,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Humana Gold,Humana Gold,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Medicaid MO,Medicaid MO,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Medica,Medica,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Tricare,Tricare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC All Payer,UHC All Payer,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Exchange,UHC Exchange,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicaid,UHC Medicaid,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UMR CPD,UMR CPD,312.03,,,,,,,per diem,312.03,312.03,"Per diem rate, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,UHC Medicare,UHC Medicare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR WET MOUNT INFCT     ,38251356,CDM,306,RC,,,,,,Inpatient,,,312.03,312.03,Wellcare,Wellcare,312.03,,,,,,,case rate,312.03,312.03,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health PPO CPD,Meritain Health PPO CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Aetna/Commercial Product,Aetna/Commercial Product,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Meritain Health CPD,Meritain Health CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Starmark CPD,Starmark CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Aetna Medicare,Aetna Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Ambetter ,Ambetter ,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access,Anthem Blue Access,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Access Choice,Anthem Blue Access Choice,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Blue Preferred,Anthem Blue Preferred,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Pathway,Anthem Pathway,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Alliance,Anthem Alliance,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Anthem Medicare,Anthem Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Cigna,Cigna,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Cigna PPO,Cigna PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Cigna Medicare Advantage,Cigna Medicare Advantage,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Essence,Essence,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink HMO,Healthlink HMO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Healthlink PPO,Healthlink PPO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,HomeState Health Plan,HomeState Health Plan,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Humana Gold,Humana Gold,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Medicaid MO,Medicaid MO,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Medica,Medica,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Tricare,Tricare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,UHC All Payer,UHC All Payer,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,UHC Exchange,UHC Exchange,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicaid,UHC Medicaid,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,UMR CPD,UMR CPD,215.37,,,,,,,per diem,215.37,215.37,"Per diem rate, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,UHC Medicare,UHC Medicare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O SMEAR GRAM/GEIMSA         ,38251357,CDM,306,RC,,,,,,Inpatient,,,215.37,215.37,Wellcare,Wellcare,215.37,,,,,,,case rate,215.37,215.37,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Meritain Health PPO CPD,Meritain Health PPO CPD,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Aetna/Commercial Product,Aetna/Commercial Product,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Meritain Health CPD,Meritain Health CPD,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Starmark CPD,Starmark CPD,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Aetna Medicare,Aetna Medicare,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Ambetter ,Ambetter ,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Blue Access,Anthem Blue Access,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Blue Access Choice,Anthem Blue Access Choice,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Blue Preferred,Anthem Blue Preferred,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Pathway,Anthem Pathway,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Alliance,Anthem Alliance,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Anthem Medicare,Anthem Medicare,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Cigna,Cigna,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Cigna PPO,Cigna PPO,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Cigna Medicare Advantage,Cigna Medicare Advantage,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Essence,Essence,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Healthlink HMO,Healthlink HMO,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Healthlink PPO,Healthlink PPO,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,HomeState Health Plan,HomeState Health Plan,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Humana Gold,Humana Gold,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Medicaid MO,Medicaid MO,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Medica,Medica,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Tricare,Tricare,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,UHC All Payer,UHC All Payer,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,UHC Exchange,UHC Exchange,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,UHC Medicaid,UHC Medicaid,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,UMR CPD,UMR CPD,379.27,,,,,,,per diem,379.27,379.27,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,UHC Medicare,UHC Medicare,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALO RAPID CULT     ,38251358,CDM,306,RC,,,,,,Inpatient,,,379.27,379.27,Wellcare,Wellcare,379.27,,,,,,,case rate,379.27,379.27,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health PPO CPD,Meritain Health PPO CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/Commercial Product,Aetna/Commercial Product,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health CPD,Meritain Health CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Starmark CPD,Starmark CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna Medicare,Aetna Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Ambetter ,Ambetter ,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access,Anthem Blue Access,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access Choice,Anthem Blue Access Choice,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Preferred,Anthem Blue Preferred,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Pathway,Anthem Pathway,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Alliance,Anthem Alliance,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Medicare,Anthem Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna,Cigna,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna PPO,Cigna PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna Medicare Advantage,Cigna Medicare Advantage,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Essence,Essence,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink HMO,Healthlink HMO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink PPO,Healthlink PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,HomeState Health Plan,HomeState Health Plan,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Humana Gold,Humana Gold,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medicaid MO,Medicaid MO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medica,Medica,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Tricare,Tricare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC All Payer,UHC All Payer,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Exchange,UHC Exchange,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicaid,UHC Medicaid,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UMR CPD,UMR CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicare,UHC Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O VIRUS SHELL VIAL ID       ,38251359,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Wellcare,Wellcare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health PPO CPD,Meritain Health PPO CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/Commercial Product,Aetna/Commercial Product,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health CPD,Meritain Health CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Starmark CPD,Starmark CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna Medicare,Aetna Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Ambetter ,Ambetter ,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access,Anthem Blue Access,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access Choice,Anthem Blue Access Choice,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Preferred,Anthem Blue Preferred,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Pathway,Anthem Pathway,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Alliance,Anthem Alliance,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Medicare,Anthem Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna,Cigna,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna PPO,Cigna PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna Medicare Advantage,Cigna Medicare Advantage,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Essence,Essence,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink HMO,Healthlink HMO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink PPO,Healthlink PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,HomeState Health Plan,HomeState Health Plan,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Humana Gold,Humana Gold,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medicaid MO,Medicaid MO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medica,Medica,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Tricare,Tricare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC All Payer,UHC All Payer,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Exchange,UHC Exchange,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicaid,UHC Medicaid,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UMR CPD,UMR CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicare,UHC Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU2         ,38251360,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Wellcare,Wellcare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health PPO CPD,Meritain Health PPO CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/Commercial Product,Aetna/Commercial Product,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health CPD,Meritain Health CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Starmark CPD,Starmark CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna Medicare,Aetna Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Ambetter ,Ambetter ,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access,Anthem Blue Access,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access Choice,Anthem Blue Access Choice,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Preferred,Anthem Blue Preferred,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Pathway,Anthem Pathway,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Alliance,Anthem Alliance,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Medicare,Anthem Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna,Cigna,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna PPO,Cigna PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna Medicare Advantage,Cigna Medicare Advantage,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Essence,Essence,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink HMO,Healthlink HMO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink PPO,Healthlink PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,HomeState Health Plan,HomeState Health Plan,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Humana Gold,Humana Gold,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medicaid MO,Medicaid MO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medica,Medica,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Tricare,Tricare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC All Payer,UHC All Payer,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Exchange,UHC Exchange,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicaid,UHC Medicaid,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UMR CPD,UMR CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicare,UHC Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251361,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Wellcare,Wellcare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health PPO CPD,Meritain Health PPO CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna/Commercial Product,Aetna/Commercial Product,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Meritain Health CPD,Meritain Health CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Starmark CPD,Starmark CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Aetna Medicare,Aetna Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Ambetter ,Ambetter ,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access,Anthem Blue Access,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Access Choice,Anthem Blue Access Choice,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Blue Preferred,Anthem Blue Preferred,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Pathway,Anthem Pathway,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Alliance,Anthem Alliance,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Anthem Medicare,Anthem Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna,Cigna,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna PPO,Cigna PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Cigna Medicare Advantage,Cigna Medicare Advantage,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Essence,Essence,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink HMO,Healthlink HMO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Healthlink PPO,Healthlink PPO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,HomeState Health Plan,HomeState Health Plan,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Humana Gold,Humana Gold,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Medicaid MO,Medicaid MO,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Medica,Medica,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Tricare,Tricare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC All Payer,UHC All Payer,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Exchange,UHC Exchange,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicaid,UHC Medicaid,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UMR CPD,UMR CPD,80.9,,,,,,,per diem,80.9,80.9,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,UHC Medicare,UHC Medicare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU3         ,38251362,CDM,306,RC,,,,,,Inpatient,,,80.9,80.9,Wellcare,Wellcare,80.9,,,,,,,case rate,80.9,80.9,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health PPO CPD,Meritain Health PPO CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/Commercial Product,Aetna/Commercial Product,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health CPD,Meritain Health CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Starmark CPD,Starmark CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna Medicare,Aetna Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Ambetter ,Ambetter ,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access,Anthem Blue Access,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access Choice,Anthem Blue Access Choice,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Preferred,Anthem Blue Preferred,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Pathway,Anthem Pathway,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Alliance,Anthem Alliance,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Medicare,Anthem Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna,Cigna,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna PPO,Cigna PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna Medicare Advantage,Cigna Medicare Advantage,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Essence,Essence,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink HMO,Healthlink HMO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink PPO,Healthlink PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,HomeState Health Plan,HomeState Health Plan,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Humana Gold,Humana Gold,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medicaid MO,Medicaid MO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medica,Medica,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Tricare,Tricare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC All Payer,UHC All Payer,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Exchange,UHC Exchange,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicaid,UHC Medicaid,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UMR CPD,UMR CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicare,UHC Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251363,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Wellcare,Wellcare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU4         ,38251364,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health PPO CPD,Meritain Health PPO CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna/Commercial Product,Aetna/Commercial Product,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Meritain Health CPD,Meritain Health CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Starmark CPD,Starmark CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Aetna Medicare,Aetna Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Ambetter ,Ambetter ,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access,Anthem Blue Access,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Access Choice,Anthem Blue Access Choice,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Blue Preferred,Anthem Blue Preferred,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Pathway,Anthem Pathway,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Alliance,Anthem Alliance,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Anthem Medicare,Anthem Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna,Cigna,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna PPO,Cigna PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Cigna Medicare Advantage,Cigna Medicare Advantage,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Essence,Essence,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink HMO,Healthlink HMO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Healthlink PPO,Healthlink PPO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,HomeState Health Plan,HomeState Health Plan,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Humana Gold,Humana Gold,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medicaid MO,Medicaid MO,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Medica,Medica,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Tricare,Tricare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC All Payer,UHC All Payer,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Exchange,UHC Exchange,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicaid,UHC Medicaid,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UMR CPD,UMR CPD,116.62,,,,,,,per diem,116.62,116.62,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,UHC Medicare,UHC Medicare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251365,CDM,306,RC,,,,,,Inpatient,,,116.62,116.62,Wellcare,Wellcare,116.62,,,,,,,case rate,116.62,116.62,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health PPO CPD,Meritain Health PPO CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna/Commercial Product,Aetna/Commercial Product,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Meritain Health CPD,Meritain Health CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Starmark CPD,Starmark CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Aetna Medicare,Aetna Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Ambetter ,Ambetter ,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access,Anthem Blue Access,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Access Choice,Anthem Blue Access Choice,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Blue Preferred,Anthem Blue Preferred,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Pathway,Anthem Pathway,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Alliance,Anthem Alliance,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Anthem Medicare,Anthem Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna,Cigna,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna PPO,Cigna PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Cigna Medicare Advantage,Cigna Medicare Advantage,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Essence,Essence,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink HMO,Healthlink HMO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Healthlink PPO,Healthlink PPO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,HomeState Health Plan,HomeState Health Plan,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Humana Gold,Humana Gold,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Medicaid MO,Medicaid MO,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Medica,Medica,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Tricare,Tricare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC All Payer,UHC All Payer,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Exchange,UHC Exchange,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicaid,UHC Medicaid,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UMR CPD,UMR CPD,57.78,,,,,,,per diem,57.78,57.78,"Per diem rate, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,UHC Medicare,UHC Medicare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O SHELL VL EA VIRU5         ,38251366,CDM,306,RC,,,,,,Inpatient,,,57.78,57.78,Wellcare,Wellcare,57.78,,,,,,,case rate,57.78,57.78,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health PPO CPD,Meritain Health PPO CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Aetna/Commercial Product,Aetna/Commercial Product,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Meritain Health CPD,Meritain Health CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Starmark CPD,Starmark CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Aetna Medicare,Aetna Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Ambetter ,Ambetter ,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access,Anthem Blue Access,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Access Choice,Anthem Blue Access Choice,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Blue Preferred,Anthem Blue Preferred,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Pathway,Anthem Pathway,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Alliance,Anthem Alliance,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Anthem Medicare,Anthem Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Cigna,Cigna,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Cigna PPO,Cigna PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Cigna Medicare Advantage,Cigna Medicare Advantage,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Essence,Essence,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink HMO,Healthlink HMO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Healthlink PPO,Healthlink PPO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,HomeState Health Plan,HomeState Health Plan,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Humana Gold,Humana Gold,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Medicaid MO,Medicaid MO,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Medica,Medica,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Tricare,Tricare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,UHC All Payer,UHC All Payer,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,UHC Exchange,UHC Exchange,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicaid,UHC Medicaid,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,UMR CPD,UMR CPD,32.57,,,,,,,per diem,32.57,32.57,"Per diem rate, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,UHC Medicare,UHC Medicare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O RESP VIRUS RAPID CULT     ,38251367,CDM,306,RC,,,,,,Inpatient,,,32.57,32.57,Wellcare,Wellcare,32.57,,,,,,,case rate,32.57,32.57,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O V CULT NONRESP CMV        ,38251368,CDM,306,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Meritain Health PPO CPD,Meritain Health PPO CPD,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Aetna/Commercial Product,Aetna/Commercial Product,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Meritain Health CPD,Meritain Health CPD,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Starmark CPD,Starmark CPD,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Aetna Medicare,Aetna Medicare,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Ambetter ,Ambetter ,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Blue Access,Anthem Blue Access,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Blue Access Choice,Anthem Blue Access Choice,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Blue Preferred,Anthem Blue Preferred,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Pathway,Anthem Pathway,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Alliance,Anthem Alliance,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Anthem Medicare,Anthem Medicare,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Cigna,Cigna,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Cigna PPO,Cigna PPO,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Cigna Medicare Advantage,Cigna Medicare Advantage,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Essence,Essence,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Healthlink HMO,Healthlink HMO,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Healthlink PPO,Healthlink PPO,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,HomeState Health Plan,HomeState Health Plan,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Humana Gold,Humana Gold,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Medicaid MO,Medicaid MO,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Medica,Medica,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Tricare,Tricare,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,UHC All Payer,UHC All Payer,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,UHC Exchange,UHC Exchange,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,UHC Medicaid,UHC Medicaid,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,UMR CPD,UMR CPD,261.6,,,,,,,per diem,261.6,261.6,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,UHC Medicare,UHC Medicare,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251369,CDM,306,RC,,,,,,Inpatient,,,261.6,261.6,Wellcare,Wellcare,261.6,,,,,,,case rate,261.6,261.6,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health PPO CPD,Meritain Health PPO CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Aetna/Commercial Product,Aetna/Commercial Product,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Meritain Health CPD,Meritain Health CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Starmark CPD,Starmark CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Aetna Medicare,Aetna Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Ambetter ,Ambetter ,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access,Anthem Blue Access,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Access Choice,Anthem Blue Access Choice,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Blue Preferred,Anthem Blue Preferred,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Pathway,Anthem Pathway,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Alliance,Anthem Alliance,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Anthem Medicare,Anthem Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Cigna,Cigna,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Cigna PPO,Cigna PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Cigna Medicare Advantage,Cigna Medicare Advantage,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Essence,Essence,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink HMO,Healthlink HMO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Healthlink PPO,Healthlink PPO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,HomeState Health Plan,HomeState Health Plan,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Humana Gold,Humana Gold,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Medicaid MO,Medicaid MO,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Medica,Medica,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Tricare,Tricare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,UHC All Payer,UHC All Payer,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,UHC Exchange,UHC Exchange,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicaid,UHC Medicaid,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,UMR CPD,UMR CPD,71.44,,,,,,,per diem,71.44,71.44,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,UHC Medicare,UHC Medicare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251370,CDM,306,RC,,,,,,Inpatient,,,71.44,71.44,Wellcare,Wellcare,71.44,,,,,,,case rate,71.44,71.44,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251371,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health PPO CPD,Meritain Health PPO CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/Commercial Product,Aetna/Commercial Product,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health CPD,Meritain Health CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Starmark CPD,Starmark CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Aetna Medicare,Aetna Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Ambetter ,Ambetter ,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access,Anthem Blue Access,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access Choice,Anthem Blue Access Choice,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Preferred,Anthem Blue Preferred,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Pathway,Anthem Pathway,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Alliance,Anthem Alliance,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Medicare,Anthem Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Cigna,Cigna,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Cigna PPO,Cigna PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Cigna Medicare Advantage,Cigna Medicare Advantage,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Essence,Essence,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink HMO,Healthlink HMO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink PPO,Healthlink PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,HomeState Health Plan,HomeState Health Plan,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Humana Gold,Humana Gold,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Medicaid MO,Medicaid MO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Medica,Medica,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Tricare,Tricare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,UHC All Payer,UHC All Payer,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,UHC Exchange,UHC Exchange,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicaid,UHC Medicaid,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,UMR CPD,UMR CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicare,UHC Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251372,CDM,302,RC,,,,,,Inpatient,,,211.17,211.17,Wellcare,Wellcare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Meritain Health PPO CPD,Meritain Health PPO CPD,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Aetna/Commercial Product,Aetna/Commercial Product,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Meritain Health CPD,Meritain Health CPD,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Starmark CPD,Starmark CPD,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Aetna Medicare,Aetna Medicare,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Ambetter ,Ambetter ,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Blue Access,Anthem Blue Access,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Blue Access Choice,Anthem Blue Access Choice,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Blue Preferred,Anthem Blue Preferred,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Pathway,Anthem Pathway,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Alliance,Anthem Alliance,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Anthem Medicare,Anthem Medicare,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Cigna,Cigna,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Cigna PPO,Cigna PPO,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Cigna Medicare Advantage,Cigna Medicare Advantage,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Essence,Essence,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Healthlink HMO,Healthlink HMO,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Healthlink PPO,Healthlink PPO,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,HomeState Health Plan,HomeState Health Plan,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Humana Gold,Humana Gold,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Medicaid MO,Medicaid MO,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Medica,Medica,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Tricare,Tricare,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,UHC All Payer,UHC All Payer,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,UHC Exchange,UHC Exchange,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,UHC Medicaid,UHC Medicaid,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,UMR CPD,UMR CPD,151.29,,,,,,,per diem,151.29,151.29,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,UHC Medicare,UHC Medicare,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QL            ,38251373,CDM,302,RC,,,,,,Inpatient,,,151.29,151.29,Wellcare,Wellcare,151.29,,,,,,,case rate,151.29,151.29,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251374,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health PPO CPD,Meritain Health PPO CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/Commercial Product,Aetna/Commercial Product,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health CPD,Meritain Health CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Starmark CPD,Starmark CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Aetna Medicare,Aetna Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Ambetter ,Ambetter ,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access,Anthem Blue Access,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access Choice,Anthem Blue Access Choice,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Preferred,Anthem Blue Preferred,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Pathway,Anthem Pathway,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Alliance,Anthem Alliance,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Medicare,Anthem Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Cigna,Cigna,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Cigna PPO,Cigna PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Cigna Medicare Advantage,Cigna Medicare Advantage,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Essence,Essence,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink HMO,Healthlink HMO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink PPO,Healthlink PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,HomeState Health Plan,HomeState Health Plan,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Humana Gold,Humana Gold,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Medicaid MO,Medicaid MO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Medica,Medica,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Tricare,Tricare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,UHC All Payer,UHC All Payer,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,UHC Exchange,UHC Exchange,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicaid,UHC Medicaid,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,UMR CPD,UMR CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicare,UHC Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
SYPHIL VDRL/RPR QN            ,38251375,CDM,302,RC,,,,,,Inpatient,,,97.71,97.71,Wellcare,Wellcare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health PPO CPD,Meritain Health PPO CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna/Commercial Product,Aetna/Commercial Product,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Meritain Health CPD,Meritain Health CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Starmark CPD,Starmark CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Aetna Medicare,Aetna Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Ambetter ,Ambetter ,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access,Anthem Blue Access,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Access Choice,Anthem Blue Access Choice,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Blue Preferred,Anthem Blue Preferred,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Pathway,Anthem Pathway,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Alliance,Anthem Alliance,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Anthem Medicare,Anthem Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna,Cigna,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna PPO,Cigna PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Cigna Medicare Advantage,Cigna Medicare Advantage,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Essence,Essence,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink HMO,Healthlink HMO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Healthlink PPO,Healthlink PPO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,HomeState Health Plan,HomeState Health Plan,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Humana Gold,Humana Gold,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Medicaid MO,Medicaid MO,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Medica,Medica,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Tricare,Tricare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC All Payer,UHC All Payer,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Exchange,UHC Exchange,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicaid,UHC Medicaid,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UMR CPD,UMR CPD,48.33,,,,,,,per diem,48.33,48.33,"Per diem rate, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,UHC Medicare,UHC Medicare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O ACID FAST BACTERIA ID     ,38251376,CDM,306,RC,,,,,,Inpatient,,,48.33,48.33,Wellcare,Wellcare,48.33,,,,,,,case rate,48.33,48.33,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Meritain Health PPO CPD,Meritain Health PPO CPD,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Aetna/Commercial Product,Aetna/Commercial Product,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Meritain Health CPD,Meritain Health CPD,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Starmark CPD,Starmark CPD,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Aetna Medicare,Aetna Medicare,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Ambetter ,Ambetter ,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Blue Access,Anthem Blue Access,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Blue Access Choice,Anthem Blue Access Choice,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Blue Preferred,Anthem Blue Preferred,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Pathway,Anthem Pathway,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Alliance,Anthem Alliance,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Anthem Medicare,Anthem Medicare,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Cigna,Cigna,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Cigna PPO,Cigna PPO,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Cigna Medicare Advantage,Cigna Medicare Advantage,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Essence,Essence,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Healthlink HMO,Healthlink HMO,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Healthlink PPO,Healthlink PPO,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,HomeState Health Plan,HomeState Health Plan,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Humana Gold,Humana Gold,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Medicaid MO,Medicaid MO,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Medica,Medica,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Tricare,Tricare,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,UHC All Payer,UHC All Payer,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,UHC Exchange,UHC Exchange,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,UHC Medicaid,UHC Medicaid,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,UMR CPD,UMR CPD,411.84,,,,,,,per diem,411.84,411.84,"Per diem rate, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,UHC Medicare,UHC Medicare,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O CULTURE AFB/TB/MYCO       ,38251377,CDM,306,RC,,,,,,Inpatient,,,411.84,411.84,Wellcare,Wellcare,411.84,,,,,,,case rate,411.84,411.84,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health PPO CPD,Meritain Health PPO CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/Commercial Product,Aetna/Commercial Product,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health CPD,Meritain Health CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Starmark CPD,Starmark CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Aetna Medicare,Aetna Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Ambetter ,Ambetter ,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access,Anthem Blue Access,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access Choice,Anthem Blue Access Choice,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Preferred,Anthem Blue Preferred,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Pathway,Anthem Pathway,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Alliance,Anthem Alliance,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Medicare,Anthem Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Cigna,Cigna,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Cigna PPO,Cigna PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Cigna Medicare Advantage,Cigna Medicare Advantage,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Essence,Essence,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink HMO,Healthlink HMO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink PPO,Healthlink PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,HomeState Health Plan,HomeState Health Plan,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Humana Gold,Humana Gold,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Medicaid MO,Medicaid MO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Medica,Medica,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Tricare,Tricare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,UHC All Payer,UHC All Payer,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,UHC Exchange,UHC Exchange,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicaid,UHC Medicaid,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,UMR CPD,UMR CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicare,UHC Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O AMPHETAMINES MECONIUM     ,38251378,CDM,301,RC,,,,,,Inpatient,,,72.49,72.49,Wellcare,Wellcare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Meritain Health PPO CPD,Meritain Health PPO CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Aetna/Commercial Product,Aetna/Commercial Product,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Meritain Health CPD,Meritain Health CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Starmark CPD,Starmark CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Aetna Medicare,Aetna Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Ambetter ,Ambetter ,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Access,Anthem Blue Access,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Access Choice,Anthem Blue Access Choice,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Blue Preferred,Anthem Blue Preferred,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Pathway,Anthem Pathway,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Alliance,Anthem Alliance,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Anthem Medicare,Anthem Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Cigna,Cigna,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Cigna PPO,Cigna PPO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Cigna Medicare Advantage,Cigna Medicare Advantage,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Essence,Essence,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Healthlink HMO,Healthlink HMO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Healthlink PPO,Healthlink PPO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,HomeState Health Plan,HomeState Health Plan,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Humana Gold,Humana Gold,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Medicaid MO,Medicaid MO,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Medica,Medica,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Tricare,Tricare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,UHC All Payer,UHC All Payer,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,UHC Exchange,UHC Exchange,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,UHC Medicaid,UHC Medicaid,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,UMR CPD,UMR CPD,113.46,,,,,,,per diem,113.46,113.46,"Per diem rate, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,UHC Medicare,UHC Medicare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
CULT ANAEROBIC ID             ,38251379,CDM,306,RC,,,,,,Inpatient,,,113.46,113.46,Wellcare,Wellcare,113.46,,,,,,,case rate,113.46,113.46,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Meritain Health PPO CPD,Meritain Health PPO CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Aetna/Commercial Product,Aetna/Commercial Product,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Meritain Health CPD,Meritain Health CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Starmark CPD,Starmark CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Aetna Medicare,Aetna Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Ambetter ,Ambetter ,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Access,Anthem Blue Access,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Access Choice,Anthem Blue Access Choice,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Blue Preferred,Anthem Blue Preferred,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Pathway,Anthem Pathway,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Alliance,Anthem Alliance,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Anthem Medicare,Anthem Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Cigna,Cigna,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Cigna PPO,Cigna PPO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Cigna Medicare Advantage,Cigna Medicare Advantage,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Essence,Essence,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Healthlink HMO,Healthlink HMO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Healthlink PPO,Healthlink PPO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,HomeState Health Plan,HomeState Health Plan,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Humana Gold,Humana Gold,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Medicaid MO,Medicaid MO,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Medica,Medica,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Tricare,Tricare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,UHC All Payer,UHC All Payer,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,UHC Exchange,UHC Exchange,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,UHC Medicaid,UHC Medicaid,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,UMR CPD,UMR CPD,117.67,,,,,,,per diem,117.67,117.67,"Per diem rate, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,UHC Medicare,UHC Medicare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O CULT ANAEROBIC ID         ,38251380,CDM,306,RC,,,,,,Inpatient,,,117.67,117.67,Wellcare,Wellcare,117.67,,,,,,,case rate,117.67,117.67,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O BARBITUATES MECONIUM      ,38251381,CDM,301,RC,,,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O CANNABINOIDS MECONIUM     ,38251382,CDM,301,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health PPO CPD,Meritain Health PPO CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna/Commercial Product,Aetna/Commercial Product,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Meritain Health CPD,Meritain Health CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Starmark CPD,Starmark CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Aetna Medicare,Aetna Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Ambetter ,Ambetter ,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access,Anthem Blue Access,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Access Choice,Anthem Blue Access Choice,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Blue Preferred,Anthem Blue Preferred,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Pathway,Anthem Pathway,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Alliance,Anthem Alliance,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Anthem Medicare,Anthem Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna,Cigna,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna PPO,Cigna PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Cigna Medicare Advantage,Cigna Medicare Advantage,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Essence,Essence,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink HMO,Healthlink HMO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Healthlink PPO,Healthlink PPO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,HomeState Health Plan,HomeState Health Plan,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Humana Gold,Humana Gold,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medicaid MO,Medicaid MO,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Medica,Medica,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Tricare,Tricare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC All Payer,UHC All Payer,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Exchange,UHC Exchange,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicaid,UHC Medicaid,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UMR CPD,UMR CPD,54.63,,,,,,,per diem,54.63,54.63,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,UHC Medicare,UHC Medicare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251383,CDM,301,RC,,,,,,Inpatient,,,54.63,54.63,Wellcare,Wellcare,54.63,,,,,,,case rate,54.63,54.63,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health PPO CPD,Meritain Health PPO CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Aetna/Commercial Product,Aetna/Commercial Product,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Meritain Health CPD,Meritain Health CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Starmark CPD,Starmark CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Aetna Medicare,Aetna Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Ambetter ,Ambetter ,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access,Anthem Blue Access,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Access Choice,Anthem Blue Access Choice,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Blue Preferred,Anthem Blue Preferred,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Pathway,Anthem Pathway,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Alliance,Anthem Alliance,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Anthem Medicare,Anthem Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Cigna,Cigna,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Cigna PPO,Cigna PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Cigna Medicare Advantage,Cigna Medicare Advantage,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Essence,Essence,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink HMO,Healthlink HMO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Healthlink PPO,Healthlink PPO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,HomeState Health Plan,HomeState Health Plan,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Humana Gold,Humana Gold,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Medicaid MO,Medicaid MO,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Medica,Medica,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Tricare,Tricare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,UHC All Payer,UHC All Payer,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,UHC Exchange,UHC Exchange,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicaid,UHC Medicaid,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,UMR CPD,UMR CPD,67.24,,,,,,,per diem,67.24,67.24,"Per diem rate, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,UHC Medicare,UHC Medicare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
S/O COCAINE MECONIUM          ,38251384,CDM,301,RC,,,,,,Inpatient,,,67.24,67.24,Wellcare,Wellcare,67.24,,,,,,,case rate,67.24,67.24,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Meritain Health PPO CPD,Meritain Health PPO CPD,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Aetna/Commercial Product,Aetna/Commercial Product,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Meritain Health CPD,Meritain Health CPD,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Starmark CPD,Starmark CPD,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Aetna Medicare,Aetna Medicare,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Ambetter ,Ambetter ,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Blue Access,Anthem Blue Access,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Blue Access Choice,Anthem Blue Access Choice,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Blue Preferred,Anthem Blue Preferred,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Pathway,Anthem Pathway,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Alliance,Anthem Alliance,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Anthem Medicare,Anthem Medicare,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Cigna,Cigna,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Cigna PPO,Cigna PPO,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Cigna Medicare Advantage,Cigna Medicare Advantage,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Essence,Essence,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Healthlink HMO,Healthlink HMO,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Healthlink PPO,Healthlink PPO,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,HomeState Health Plan,HomeState Health Plan,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Humana Gold,Humana Gold,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Medicaid MO,Medicaid MO,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Medica,Medica,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Tricare,Tricare,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,UHC All Payer,UHC All Payer,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,UHC Exchange,UHC Exchange,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,UHC Medicaid,UHC Medicaid,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,UMR CPD,UMR CPD,596.74,,,,,,,per diem,596.74,596.74,"Per diem rate, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,UHC Medicare,UHC Medicare,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
COCCIDIOIDES AB IGM           ,38251385,CDM,302,RC,,,,,,Inpatient,,,596.74,596.74,Wellcare,Wellcare,596.74,,,,,,,case rate,596.74,596.74,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health PPO CPD,Meritain Health PPO CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna/Commercial Product,Aetna/Commercial Product,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Meritain Health CPD,Meritain Health CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Starmark CPD,Starmark CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Aetna Medicare,Aetna Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Ambetter ,Ambetter ,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access,Anthem Blue Access,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Access Choice,Anthem Blue Access Choice,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Blue Preferred,Anthem Blue Preferred,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Pathway,Anthem Pathway,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Alliance,Anthem Alliance,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Anthem Medicare,Anthem Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna,Cigna,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna PPO,Cigna PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Cigna Medicare Advantage,Cigna Medicare Advantage,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Essence,Essence,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink HMO,Healthlink HMO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Healthlink PPO,Healthlink PPO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,HomeState Health Plan,HomeState Health Plan,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Humana Gold,Humana Gold,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medicaid MO,Medicaid MO,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Medica,Medica,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Tricare,Tricare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC All Payer,UHC All Payer,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Exchange,UHC Exchange,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicaid,UHC Medicaid,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UMR CPD,UMR CPD,84.05,,,,,,,per diem,84.05,84.05,"Per diem rate, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,UHC Medicare,UHC Medicare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCI IMM AB IMMUNDIF     ,38251386,CDM,302,RC,,,,,,Inpatient,,,84.05,84.05,Wellcare,Wellcare,84.05,,,,,,,case rate,84.05,84.05,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Meritain Health PPO CPD,Meritain Health PPO CPD,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Aetna/Commercial Product,Aetna/Commercial Product,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Meritain Health CPD,Meritain Health CPD,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Starmark CPD,Starmark CPD,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Aetna Medicare,Aetna Medicare,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Ambetter ,Ambetter ,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Blue Access,Anthem Blue Access,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Blue Access Choice,Anthem Blue Access Choice,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Blue Preferred,Anthem Blue Preferred,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Pathway,Anthem Pathway,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Alliance,Anthem Alliance,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Anthem Medicare,Anthem Medicare,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Cigna,Cigna,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Cigna PPO,Cigna PPO,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Cigna Medicare Advantage,Cigna Medicare Advantage,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Essence,Essence,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Healthlink HMO,Healthlink HMO,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Healthlink PPO,Healthlink PPO,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,HomeState Health Plan,HomeState Health Plan,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Humana Gold,Humana Gold,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Medicaid MO,Medicaid MO,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Medica,Medica,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Tricare,Tricare,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,UHC All Payer,UHC All Payer,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,UHC Exchange,UHC Exchange,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,UHC Medicaid,UHC Medicaid,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,UMR CPD,UMR CPD,746.98,,,,,,,per diem,746.98,746.98,"Per diem rate, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,UHC Medicare,UHC Medicare,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O COCCIDIOIDES AB CF        ,38251387,CDM,302,RC,,,,,,Inpatient,,,746.98,746.98,Wellcare,Wellcare,746.98,,,,,,,case rate,746.98,746.98,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health PPO CPD,Meritain Health PPO CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Aetna/Commercial Product,Aetna/Commercial Product,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Meritain Health CPD,Meritain Health CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Starmark CPD,Starmark CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Aetna Medicare,Aetna Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Ambetter ,Ambetter ,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access,Anthem Blue Access,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Access Choice,Anthem Blue Access Choice,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Blue Preferred,Anthem Blue Preferred,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Pathway,Anthem Pathway,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Alliance,Anthem Alliance,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Anthem Medicare,Anthem Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Cigna,Cigna,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Cigna PPO,Cigna PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Cigna Medicare Advantage,Cigna Medicare Advantage,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Essence,Essence,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink HMO,Healthlink HMO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Healthlink PPO,Healthlink PPO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,HomeState Health Plan,HomeState Health Plan,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Humana Gold,Humana Gold,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Medicaid MO,Medicaid MO,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Medica,Medica,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Tricare,Tricare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,UHC All Payer,UHC All Payer,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,UHC Exchange,UHC Exchange,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicaid,UHC Medicaid,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,UMR CPD,UMR CPD,70.39,,,,,,,per diem,70.39,70.39,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,UHC Medicare,UHC Medicare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID YEAST      ,38251388,CDM,306,RC,,,,,,Inpatient,,,70.39,70.39,Wellcare,Wellcare,70.39,,,,,,,case rate,70.39,70.39,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Meritain Health PPO CPD,Meritain Health PPO CPD,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Aetna/Commercial Product,Aetna/Commercial Product,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Meritain Health CPD,Meritain Health CPD,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Starmark CPD,Starmark CPD,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Aetna Medicare,Aetna Medicare,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Ambetter ,Ambetter ,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Blue Access,Anthem Blue Access,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Blue Access Choice,Anthem Blue Access Choice,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Blue Preferred,Anthem Blue Preferred,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Pathway,Anthem Pathway,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Alliance,Anthem Alliance,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Anthem Medicare,Anthem Medicare,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Cigna,Cigna,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Cigna PPO,Cigna PPO,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Cigna Medicare Advantage,Cigna Medicare Advantage,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Essence,Essence,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Healthlink HMO,Healthlink HMO,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Healthlink PPO,Healthlink PPO,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,HomeState Health Plan,HomeState Health Plan,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Humana Gold,Humana Gold,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Medicaid MO,Medicaid MO,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Medica,Medica,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Tricare,Tricare,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,UHC All Payer,UHC All Payer,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,UHC Exchange,UHC Exchange,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,UHC Medicaid,UHC Medicaid,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,UMR CPD,UMR CPD,19.83,,,,,,,per diem,19.83,19.83,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,UHC Medicare,UHC Medicare,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251389,CDM,306,RC,,,,,,Inpatient,,,19.83,19.83,Wellcare,Wellcare,19.83,,,,,,,case rate,19.83,19.83,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health PPO CPD,Meritain Health PPO CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Aetna/Commercial Product,Aetna/Commercial Product,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Meritain Health CPD,Meritain Health CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Starmark CPD,Starmark CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Aetna Medicare,Aetna Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Ambetter ,Ambetter ,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access,Anthem Blue Access,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Access Choice,Anthem Blue Access Choice,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Blue Preferred,Anthem Blue Preferred,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Pathway,Anthem Pathway,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Alliance,Anthem Alliance,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Anthem Medicare,Anthem Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Cigna,Cigna,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Cigna PPO,Cigna PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Cigna Medicare Advantage,Cigna Medicare Advantage,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Essence,Essence,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink HMO,Healthlink HMO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Healthlink PPO,Healthlink PPO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,HomeState Health Plan,HomeState Health Plan,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Humana Gold,Humana Gold,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Medicaid MO,Medicaid MO,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Medica,Medica,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Tricare,Tricare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,UHC All Payer,UHC All Payer,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,UHC Exchange,UHC Exchange,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicaid,UHC Medicaid,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,UMR CPD,UMR CPD,30.47,,,,,,,per diem,30.47,30.47,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,UHC Medicare,UHC Medicare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251390,CDM,306,RC,,,,,,Inpatient,,,30.47,30.47,Wellcare,Wellcare,30.47,,,,,,,case rate,30.47,30.47,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Meritain Health PPO CPD,Meritain Health PPO CPD,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Aetna/Commercial Product,Aetna/Commercial Product,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Meritain Health CPD,Meritain Health CPD,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Starmark CPD,Starmark CPD,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Aetna Medicare,Aetna Medicare,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Ambetter ,Ambetter ,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Blue Access,Anthem Blue Access,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Blue Access Choice,Anthem Blue Access Choice,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Blue Preferred,Anthem Blue Preferred,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Pathway,Anthem Pathway,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Alliance,Anthem Alliance,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Anthem Medicare,Anthem Medicare,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Cigna,Cigna,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Cigna PPO,Cigna PPO,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Cigna Medicare Advantage,Cigna Medicare Advantage,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Essence,Essence,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Healthlink HMO,Healthlink HMO,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Healthlink PPO,Healthlink PPO,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,HomeState Health Plan,HomeState Health Plan,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Humana Gold,Humana Gold,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Medicaid MO,Medicaid MO,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Medica,Medica,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Tricare,Tricare,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,UHC All Payer,UHC All Payer,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,UHC Exchange,UHC Exchange,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,UHC Medicaid,UHC Medicaid,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,UMR CPD,UMR CPD,141.99,,,,,,,per diem,141.99,141.99,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,UHC Medicare,UHC Medicare,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251391,CDM,306,RC,,,,,,Inpatient,,,141.99,141.99,Wellcare,Wellcare,141.99,,,,,,,case rate,141.99,141.99,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUS DNA/BP BPP         ,38251392,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Meritain Health PPO CPD,Meritain Health PPO CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Aetna/Commercial Product,Aetna/Commercial Product,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Meritain Health CPD,Meritain Health CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Starmark CPD,Starmark CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Aetna Medicare,Aetna Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Ambetter ,Ambetter ,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Access,Anthem Blue Access,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Access Choice,Anthem Blue Access Choice,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Blue Preferred,Anthem Blue Preferred,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Pathway,Anthem Pathway,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Alliance,Anthem Alliance,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Anthem Medicare,Anthem Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Cigna,Cigna,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Cigna PPO,Cigna PPO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Cigna Medicare Advantage,Cigna Medicare Advantage,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Essence,Essence,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Healthlink HMO,Healthlink HMO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Healthlink PPO,Healthlink PPO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,HomeState Health Plan,HomeState Health Plan,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Humana Gold,Humana Gold,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Medicaid MO,Medicaid MO,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Medica,Medica,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Tricare,Tricare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,UHC All Payer,UHC All Payer,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,UHC Exchange,UHC Exchange,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,UHC Medicaid,UHC Medicaid,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,UMR CPD,UMR CPD,161.79,,,,,,,per diem,161.79,161.79,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,UHC Medicare,UHC Medicare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251393,CDM,306,RC,,,,,,Inpatient,,,161.79,161.79,Wellcare,Wellcare,161.79,,,,,,,case rate,161.79,161.79,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Meritain Health PPO CPD,Meritain Health PPO CPD,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Aetna/Commercial Product,Aetna/Commercial Product,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Meritain Health CPD,Meritain Health CPD,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Starmark CPD,Starmark CPD,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Aetna Medicare,Aetna Medicare,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Ambetter ,Ambetter ,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Blue Access,Anthem Blue Access,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Blue Access Choice,Anthem Blue Access Choice,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Blue Preferred,Anthem Blue Preferred,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Pathway,Anthem Pathway,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Alliance,Anthem Alliance,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Anthem Medicare,Anthem Medicare,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Cigna,Cigna,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Cigna PPO,Cigna PPO,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Cigna Medicare Advantage,Cigna Medicare Advantage,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Essence,Essence,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Healthlink HMO,Healthlink HMO,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Healthlink PPO,Healthlink PPO,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,HomeState Health Plan,HomeState Health Plan,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Humana Gold,Humana Gold,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Medicaid MO,Medicaid MO,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Medica,Medica,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Tricare,Tricare,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,UHC All Payer,UHC All Payer,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,UHC Exchange,UHC Exchange,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,UHC Medicaid,UHC Medicaid,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,UMR CPD,UMR CPD,155.5,,,,,,,per diem,155.5,155.5,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,UHC Medicare,UHC Medicare,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251394,CDM,306,RC,,,,,,Inpatient,,,155.5,155.5,Wellcare,Wellcare,155.5,,,,,,,case rate,155.5,155.5,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251395,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA PCR         ,38251396,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Meritain Health PPO CPD,Meritain Health PPO CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna/Commercial Product,Aetna/Commercial Product,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Meritain Health CPD,Meritain Health CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Starmark CPD,Starmark CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Aetna Medicare,Aetna Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Ambetter ,Ambetter ,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Access,Anthem Blue Access,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Access Choice,Anthem Blue Access Choice,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Blue Preferred,Anthem Blue Preferred,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Pathway,Anthem Pathway,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Alliance,Anthem Alliance,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Anthem Medicare,Anthem Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna,Cigna,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna PPO,Cigna PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Cigna Medicare Advantage,Cigna Medicare Advantage,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Essence,Essence,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthlink HMO,Healthlink HMO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Healthlink PPO,Healthlink PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,HomeState Health Plan,HomeState Health Plan,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Humana Gold,Humana Gold,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Medicaid MO,Medicaid MO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Medica,Medica,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Tricare,Tricare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC All Payer,UHC All Payer,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Exchange,UHC Exchange,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Medicaid,UHC Medicaid,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UMR CPD,UMR CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,UHC Medicare,UHC Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251397,CDM,301,RC,,,,,,Inpatient,,,90.35,90.35,Wellcare,Wellcare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health PPO CPD,Meritain Health PPO CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Aetna/Commercial Product,Aetna/Commercial Product,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Meritain Health CPD,Meritain Health CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Starmark CPD,Starmark CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Aetna Medicare,Aetna Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Ambetter ,Ambetter ,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access,Anthem Blue Access,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Access Choice,Anthem Blue Access Choice,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Blue Preferred,Anthem Blue Preferred,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Pathway,Anthem Pathway,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Alliance,Anthem Alliance,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Anthem Medicare,Anthem Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Cigna,Cigna,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Cigna PPO,Cigna PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Cigna Medicare Advantage,Cigna Medicare Advantage,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Essence,Essence,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink HMO,Healthlink HMO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Healthlink PPO,Healthlink PPO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,HomeState Health Plan,HomeState Health Plan,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Humana Gold,Humana Gold,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Medicaid MO,Medicaid MO,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Medica,Medica,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Tricare,Tricare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,UHC All Payer,UHC All Payer,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,UHC Exchange,UHC Exchange,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicaid,UHC Medicaid,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,UMR CPD,UMR CPD,61.99,,,,,,,per diem,61.99,61.99,"Per diem rate, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,UHC Medicare,UHC Medicare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
S/O PHENCYCLIDIN MECONIUM     ,38251398,CDM,301,RC,,,,,,Inpatient,,,61.99,61.99,Wellcare,Wellcare,61.99,,,,,,,case rate,61.99,61.99,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health PPO CPD,Meritain Health PPO CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/Commercial Product,Aetna/Commercial Product,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health CPD,Meritain Health CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Starmark CPD,Starmark CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna Medicare,Aetna Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Ambetter ,Ambetter ,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access,Anthem Blue Access,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access Choice,Anthem Blue Access Choice,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Preferred,Anthem Blue Preferred,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Pathway,Anthem Pathway,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Alliance,Anthem Alliance,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Medicare,Anthem Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna,Cigna,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna PPO,Cigna PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna Medicare Advantage,Cigna Medicare Advantage,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Essence,Essence,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink HMO,Healthlink HMO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink PPO,Healthlink PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,HomeState Health Plan,HomeState Health Plan,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Humana Gold,Humana Gold,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medicaid MO,Medicaid MO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medica,Medica,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Tricare,Tricare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC All Payer,UHC All Payer,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Exchange,UHC Exchange,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicaid,UHC Medicaid,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UMR CPD,UMR CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicare,UHC Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
OVA & PARASITES               ,38251399,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Wellcare,Wellcare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health PPO CPD,Meritain Health PPO CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Aetna/Commercial Product,Aetna/Commercial Product,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Meritain Health CPD,Meritain Health CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Starmark CPD,Starmark CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Aetna Medicare,Aetna Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Ambetter ,Ambetter ,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access,Anthem Blue Access,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Access Choice,Anthem Blue Access Choice,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Blue Preferred,Anthem Blue Preferred,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Pathway,Anthem Pathway,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Alliance,Anthem Alliance,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Anthem Medicare,Anthem Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Cigna,Cigna,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Cigna PPO,Cigna PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Cigna Medicare Advantage,Cigna Medicare Advantage,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Essence,Essence,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink HMO,Healthlink HMO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Healthlink PPO,Healthlink PPO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,HomeState Health Plan,HomeState Health Plan,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Humana Gold,Humana Gold,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Medicaid MO,Medicaid MO,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Medica,Medica,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Tricare,Tricare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,UHC All Payer,UHC All Payer,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,UHC Exchange,UHC Exchange,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicaid,UHC Medicaid,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,UMR CPD,UMR CPD,74.59,,,,,,,per diem,74.59,74.59,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,UHC Medicare,UHC Medicare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES           ,38251400,CDM,306,RC,,,,,,Inpatient,,,74.59,74.59,Wellcare,Wellcare,74.59,,,,,,,case rate,74.59,74.59,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health PPO CPD,Meritain Health PPO CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna/Commercial Product,Aetna/Commercial Product,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Meritain Health CPD,Meritain Health CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Starmark CPD,Starmark CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Aetna Medicare,Aetna Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Ambetter ,Ambetter ,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access,Anthem Blue Access,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Access Choice,Anthem Blue Access Choice,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Blue Preferred,Anthem Blue Preferred,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Pathway,Anthem Pathway,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Alliance,Anthem Alliance,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Anthem Medicare,Anthem Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna,Cigna,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna PPO,Cigna PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Cigna Medicare Advantage,Cigna Medicare Advantage,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Essence,Essence,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink HMO,Healthlink HMO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Healthlink PPO,Healthlink PPO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,HomeState Health Plan,HomeState Health Plan,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Humana Gold,Humana Gold,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Medicaid MO,Medicaid MO,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Medica,Medica,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Tricare,Tricare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC All Payer,UHC All Payer,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Exchange,UHC Exchange,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicaid,UHC Medicaid,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UMR CPD,UMR CPD,65.14,,,,,,,per diem,65.14,65.14,"Per diem rate, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,UHC Medicare,UHC Medicare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O OVA & PARASITES HCCL      ,38251401,CDM,306,RC,,,,,,Inpatient,,,65.14,65.14,Wellcare,Wellcare,65.14,,,,,,,case rate,65.14,65.14,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Meritain Health PPO CPD,Meritain Health PPO CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Aetna/Commercial Product,Aetna/Commercial Product,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Meritain Health CPD,Meritain Health CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Starmark CPD,Starmark CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Aetna Medicare,Aetna Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Ambetter ,Ambetter ,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Access,Anthem Blue Access,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Access Choice,Anthem Blue Access Choice,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Blue Preferred,Anthem Blue Preferred,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Pathway,Anthem Pathway,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Alliance,Anthem Alliance,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Anthem Medicare,Anthem Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Cigna,Cigna,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Cigna PPO,Cigna PPO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Cigna Medicare Advantage,Cigna Medicare Advantage,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Essence,Essence,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Healthlink HMO,Healthlink HMO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Healthlink PPO,Healthlink PPO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,HomeState Health Plan,HomeState Health Plan,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Humana Gold,Humana Gold,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Medicaid MO,Medicaid MO,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Medica,Medica,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Tricare,Tricare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,UHC All Payer,UHC All Payer,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,UHC Exchange,UHC Exchange,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,UHC Medicaid,UHC Medicaid,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,UMR CPD,UMR CPD,279.46,,,,,,,per diem,279.46,279.46,"Per diem rate, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,UHC Medicare,UHC Medicare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O TISS EXAM FUNG/ECTOPR     ,38251402,CDM,306,RC,,,,,,Inpatient,,,279.46,279.46,Wellcare,Wellcare,279.46,,,,,,,case rate,279.46,279.46,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health PPO CPD,Meritain Health PPO CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna/Commercial Product,Aetna/Commercial Product,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Meritain Health CPD,Meritain Health CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Starmark CPD,Starmark CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Aetna Medicare,Aetna Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Ambetter ,Ambetter ,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access,Anthem Blue Access,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Access Choice,Anthem Blue Access Choice,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Blue Preferred,Anthem Blue Preferred,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Pathway,Anthem Pathway,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Alliance,Anthem Alliance,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Anthem Medicare,Anthem Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna,Cigna,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna PPO,Cigna PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Cigna Medicare Advantage,Cigna Medicare Advantage,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Essence,Essence,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink HMO,Healthlink HMO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Healthlink PPO,Healthlink PPO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,HomeState Health Plan,HomeState Health Plan,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Humana Gold,Humana Gold,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medicaid MO,Medicaid MO,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Medica,Medica,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Tricare,Tricare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC All Payer,UHC All Payer,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Exchange,UHC Exchange,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicaid,UHC Medicaid,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UMR CPD,UMR CPD,56.73,,,,,,,per diem,56.73,56.73,"Per diem rate, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,UHC Medicare,UHC Medicare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O ELECTROLYTE FECAL         ,38251403,CDM,301,RC,,,,,,Inpatient,,,56.73,56.73,Wellcare,Wellcare,56.73,,,,,,,case rate,56.73,56.73,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health PPO CPD,Meritain Health PPO CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna/Commercial Product,Aetna/Commercial Product,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Meritain Health CPD,Meritain Health CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Starmark CPD,Starmark CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Aetna Medicare,Aetna Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Ambetter ,Ambetter ,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access,Anthem Blue Access,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Access Choice,Anthem Blue Access Choice,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Blue Preferred,Anthem Blue Preferred,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Pathway,Anthem Pathway,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Alliance,Anthem Alliance,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Anthem Medicare,Anthem Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna,Cigna,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna PPO,Cigna PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Cigna Medicare Advantage,Cigna Medicare Advantage,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Essence,Essence,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink HMO,Healthlink HMO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Healthlink PPO,Healthlink PPO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,HomeState Health Plan,HomeState Health Plan,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Humana Gold,Humana Gold,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Medicaid MO,Medicaid MO,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Medica,Medica,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Tricare,Tricare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC All Payer,UHC All Payer,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Exchange,UHC Exchange,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicaid,UHC Medicaid,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UMR CPD,UMR CPD,169.15,,,,,,,per diem,169.15,169.15,"Per diem rate, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,UHC Medicare,UHC Medicare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O CYTOMEGALOVIRUS PCR       ,38251404,CDM,306,RC,,,,,,Inpatient,,,169.15,169.15,Wellcare,Wellcare,169.15,,,,,,,case rate,169.15,169.15,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O OPIATES MECONIUM          ,38251405,CDM,301,RC,,,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health PPO CPD,Meritain Health PPO CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna/Commercial Product,Aetna/Commercial Product,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Meritain Health CPD,Meritain Health CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Starmark CPD,Starmark CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Aetna Medicare,Aetna Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Ambetter ,Ambetter ,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access,Anthem Blue Access,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Access Choice,Anthem Blue Access Choice,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Blue Preferred,Anthem Blue Preferred,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Pathway,Anthem Pathway,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Alliance,Anthem Alliance,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Anthem Medicare,Anthem Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna,Cigna,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna PPO,Cigna PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Cigna Medicare Advantage,Cigna Medicare Advantage,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Essence,Essence,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink HMO,Healthlink HMO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Healthlink PPO,Healthlink PPO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,HomeState Health Plan,HomeState Health Plan,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Humana Gold,Humana Gold,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Medicaid MO,Medicaid MO,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Medica,Medica,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Tricare,Tricare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC All Payer,UHC All Payer,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Exchange,UHC Exchange,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicaid,UHC Medicaid,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UMR CPD,UMR CPD,86.15,,,,,,,per diem,86.15,86.15,"Per diem rate, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,UHC Medicare,UHC Medicare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O BENZODIAZEP MECONIUM      ,38251406,CDM,301,RC,,,,,,Inpatient,,,86.15,86.15,Wellcare,Wellcare,86.15,,,,,,,case rate,86.15,86.15,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health PPO CPD,Meritain Health PPO CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna/Commercial Product,Aetna/Commercial Product,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Meritain Health CPD,Meritain Health CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Starmark CPD,Starmark CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Aetna Medicare,Aetna Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Ambetter ,Ambetter ,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access,Anthem Blue Access,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Access Choice,Anthem Blue Access Choice,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Blue Preferred,Anthem Blue Preferred,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Pathway,Anthem Pathway,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Alliance,Anthem Alliance,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Anthem Medicare,Anthem Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna,Cigna,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna PPO,Cigna PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Cigna Medicare Advantage,Cigna Medicare Advantage,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Essence,Essence,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink HMO,Healthlink HMO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Healthlink PPO,Healthlink PPO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,HomeState Health Plan,HomeState Health Plan,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Humana Gold,Humana Gold,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medicaid MO,Medicaid MO,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Medica,Medica,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Tricare,Tricare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC All Payer,UHC All Payer,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Exchange,UHC Exchange,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicaid,UHC Medicaid,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UMR CPD,UMR CPD,36.77,,,,,,,per diem,36.77,36.77,"Per diem rate, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,UHC Medicare,UHC Medicare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O PARASIT STAIN MAF         ,38251407,CDM,306,RC,,,,,,Inpatient,,,36.77,36.77,Wellcare,Wellcare,36.77,,,,,,,case rate,36.77,36.77,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O MICROSPORIDIA STN         ,38251408,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health PPO CPD,Meritain Health PPO CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna/Commercial Product,Aetna/Commercial Product,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Meritain Health CPD,Meritain Health CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Starmark CPD,Starmark CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Aetna Medicare,Aetna Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Ambetter ,Ambetter ,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access,Anthem Blue Access,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Access Choice,Anthem Blue Access Choice,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Blue Preferred,Anthem Blue Preferred,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Pathway,Anthem Pathway,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Alliance,Anthem Alliance,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Anthem Medicare,Anthem Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna,Cigna,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna PPO,Cigna PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Cigna Medicare Advantage,Cigna Medicare Advantage,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Essence,Essence,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink HMO,Healthlink HMO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Healthlink PPO,Healthlink PPO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,HomeState Health Plan,HomeState Health Plan,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Humana Gold,Humana Gold,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medicaid MO,Medicaid MO,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Medica,Medica,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Tricare,Tricare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC All Payer,UHC All Payer,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Exchange,UHC Exchange,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicaid,UHC Medicaid,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UMR CPD,UMR CPD,27.32,,,,,,,per diem,27.32,27.32,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,UHC Medicare,UHC Medicare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251409,CDM,306,RC,,,,,,Inpatient,,,27.32,27.32,Wellcare,Wellcare,27.32,,,,,,,case rate,27.32,27.32,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Meritain Health PPO CPD,Meritain Health PPO CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Aetna/Commercial Product,Aetna/Commercial Product,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Meritain Health CPD,Meritain Health CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Starmark CPD,Starmark CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Aetna Medicare,Aetna Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Ambetter ,Ambetter ,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access,Anthem Blue Access,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Blue Access Choice,Anthem Blue Access Choice,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Blue Preferred,Anthem Blue Preferred,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Pathway,Anthem Pathway,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Alliance,Anthem Alliance,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Anthem Medicare,Anthem Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Cigna,Cigna,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Cigna PPO,Cigna PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Cigna Medicare Advantage,Cigna Medicare Advantage,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Essence,Essence,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Healthlink HMO,Healthlink HMO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Healthlink PPO,Healthlink PPO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,HomeState Health Plan,HomeState Health Plan,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Humana Gold,Humana Gold,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Medicaid MO,Medicaid MO,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Medica,Medica,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Tricare,Tricare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,UHC All Payer,UHC All Payer,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,UHC Exchange,UHC Exchange,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,UHC Medicaid,UHC Medicaid,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,UMR CPD,UMR CPD,83,,,,,,,per diem,83,83,"Per diem rate, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,UHC Medicare,UHC Medicare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O CONCENTRATION ANY         ,38251410,CDM,306,RC,,,,,,Inpatient,,,83,83,Wellcare,Wellcare,83,,,,,,,case rate,83,83,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health PPO CPD,Meritain Health PPO CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna/Commercial Product,Aetna/Commercial Product,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Meritain Health CPD,Meritain Health CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Starmark CPD,Starmark CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Aetna Medicare,Aetna Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Ambetter ,Ambetter ,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access,Anthem Blue Access,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Access Choice,Anthem Blue Access Choice,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Blue Preferred,Anthem Blue Preferred,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Pathway,Anthem Pathway,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Alliance,Anthem Alliance,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Anthem Medicare,Anthem Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna,Cigna,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna PPO,Cigna PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Cigna Medicare Advantage,Cigna Medicare Advantage,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Essence,Essence,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink HMO,Healthlink HMO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Healthlink PPO,Healthlink PPO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,HomeState Health Plan,HomeState Health Plan,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Humana Gold,Humana Gold,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medicaid MO,Medicaid MO,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Medica,Medica,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Tricare,Tricare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC All Payer,UHC All Payer,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Exchange,UHC Exchange,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicaid,UHC Medicaid,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UMR CPD,UMR CPD,26.27,,,,,,,per diem,26.27,26.27,"Per diem rate, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,UHC Medicare,UHC Medicare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O SUSCEPT B-LACTAM EA       ,38251411,CDM,306,RC,,,,,,Inpatient,,,26.27,26.27,Wellcare,Wellcare,26.27,,,,,,,case rate,26.27,26.27,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Meritain Health PPO CPD,Meritain Health PPO CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Aetna/Commercial Product,Aetna/Commercial Product,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Meritain Health CPD,Meritain Health CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Starmark CPD,Starmark CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Aetna Medicare,Aetna Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Ambetter ,Ambetter ,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Access,Anthem Blue Access,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Access Choice,Anthem Blue Access Choice,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Blue Preferred,Anthem Blue Preferred,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Pathway,Anthem Pathway,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Alliance,Anthem Alliance,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Anthem Medicare,Anthem Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Cigna,Cigna,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Cigna PPO,Cigna PPO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Cigna Medicare Advantage,Cigna Medicare Advantage,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Essence,Essence,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Healthlink HMO,Healthlink HMO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Healthlink PPO,Healthlink PPO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,HomeState Health Plan,HomeState Health Plan,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Humana Gold,Humana Gold,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Medicaid MO,Medicaid MO,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Medica,Medica,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Tricare,Tricare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,UHC All Payer,UHC All Payer,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,UHC Exchange,UHC Exchange,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,UHC Medicaid,UHC Medicaid,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,UMR CPD,UMR CPD,346.7,,,,,,,per diem,346.7,346.7,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,UHC Medicare,UHC Medicare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS BLOOD         ,38251412,CDM,306,RC,,,,,,Inpatient,,,346.7,346.7,Wellcare,Wellcare,346.7,,,,,,,case rate,346.7,346.7,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Meritain Health PPO CPD,Meritain Health PPO CPD,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Aetna/Commercial Product,Aetna/Commercial Product,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Meritain Health CPD,Meritain Health CPD,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Starmark CPD,Starmark CPD,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Aetna Medicare,Aetna Medicare,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Ambetter ,Ambetter ,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Blue Access,Anthem Blue Access,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Blue Access Choice,Anthem Blue Access Choice,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Blue Preferred,Anthem Blue Preferred,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Pathway,Anthem Pathway,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Alliance,Anthem Alliance,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Anthem Medicare,Anthem Medicare,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Cigna,Cigna,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Cigna PPO,Cigna PPO,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Cigna Medicare Advantage,Cigna Medicare Advantage,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Essence,Essence,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Healthlink HMO,Healthlink HMO,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Healthlink PPO,Healthlink PPO,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,HomeState Health Plan,HomeState Health Plan,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Humana Gold,Humana Gold,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Medicaid MO,Medicaid MO,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Medica,Medica,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Tricare,Tricare,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,UHC All Payer,UHC All Payer,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,UHC Exchange,UHC Exchange,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,UHC Medicaid,UHC Medicaid,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,UMR CPD,UMR CPD,463.31,,,,,,,per diem,463.31,463.31,"Per diem rate, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,UHC Medicare,UHC Medicare,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O AFB 10 DRUG PLUS          ,38251413,CDM,306,RC,,,,,,Inpatient,,,463.31,463.31,Wellcare,Wellcare,463.31,,,,,,,case rate,463.31,463.31,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Meritain Health PPO CPD,Meritain Health PPO CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Aetna/Commercial Product,Aetna/Commercial Product,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Meritain Health CPD,Meritain Health CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Starmark CPD,Starmark CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Aetna Medicare,Aetna Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Ambetter ,Ambetter ,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Access,Anthem Blue Access,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Access Choice,Anthem Blue Access Choice,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Blue Preferred,Anthem Blue Preferred,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Pathway,Anthem Pathway,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Alliance,Anthem Alliance,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Anthem Medicare,Anthem Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Cigna,Cigna,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Cigna PPO,Cigna PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Cigna Medicare Advantage,Cigna Medicare Advantage,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Essence,Essence,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Healthlink HMO,Healthlink HMO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Healthlink PPO,Healthlink PPO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,HomeState Health Plan,HomeState Health Plan,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Humana Gold,Humana Gold,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Medicaid MO,Medicaid MO,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Medica,Medica,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Tricare,Tricare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,UHC All Payer,UHC All Payer,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,UHC Exchange,UHC Exchange,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,UHC Medicaid,UHC Medicaid,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,UMR CPD,UMR CPD,42.02,,,,,,,per diem,42.02,42.02,"Per diem rate, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,UHC Medicare,UHC Medicare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O SUSCEPT AGAR              ,38251414,CDM,306,RC,,,,,,Inpatient,,,42.02,42.02,Wellcare,Wellcare,42.02,,,,,,,case rate,42.02,42.02,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health PPO CPD,Meritain Health PPO CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna/Commercial Product,Aetna/Commercial Product,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Meritain Health CPD,Meritain Health CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Starmark CPD,Starmark CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Aetna Medicare,Aetna Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Ambetter ,Ambetter ,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access,Anthem Blue Access,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Access Choice,Anthem Blue Access Choice,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Blue Preferred,Anthem Blue Preferred,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Pathway,Anthem Pathway,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Alliance,Anthem Alliance,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Anthem Medicare,Anthem Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna,Cigna,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna PPO,Cigna PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Cigna Medicare Advantage,Cigna Medicare Advantage,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Essence,Essence,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink HMO,Healthlink HMO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Healthlink PPO,Healthlink PPO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,HomeState Health Plan,HomeState Health Plan,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Humana Gold,Humana Gold,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medicaid MO,Medicaid MO,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Medica,Medica,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Tricare,Tricare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC All Payer,UHC All Payer,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Exchange,UHC Exchange,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicaid,UHC Medicaid,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UMR CPD,UMR CPD,441.25,,,,,,,per diem,441.25,441.25,"Per diem rate, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,UHC Medicare,UHC Medicare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
S/O NJH-NTM10 10 MIC          ,38251415,CDM,306,RC,,,,,,Inpatient,,,441.25,441.25,Wellcare,Wellcare,441.25,,,,,,,case rate,441.25,441.25,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health PPO CPD,Meritain Health PPO CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Aetna/Commercial Product,Aetna/Commercial Product,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Meritain Health CPD,Meritain Health CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Starmark CPD,Starmark CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Aetna Medicare,Aetna Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Ambetter ,Ambetter ,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access,Anthem Blue Access,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Access Choice,Anthem Blue Access Choice,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Blue Preferred,Anthem Blue Preferred,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Pathway,Anthem Pathway,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Alliance,Anthem Alliance,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Anthem Medicare,Anthem Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Cigna,Cigna,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Cigna PPO,Cigna PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Cigna Medicare Advantage,Cigna Medicare Advantage,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Essence,Essence,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink HMO,Healthlink HMO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Healthlink PPO,Healthlink PPO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,HomeState Health Plan,HomeState Health Plan,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Humana Gold,Humana Gold,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Medicaid MO,Medicaid MO,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Medica,Medica,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Tricare,Tricare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,UHC All Payer,UHC All Payer,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,UHC Exchange,UHC Exchange,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicaid,UHC Medicaid,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,UMR CPD,UMR CPD,153.39,,,,,,,per diem,153.39,153.39,"Per diem rate, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,UHC Medicare,UHC Medicare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
VERIGENE ID BY DNA            ,38251416,CDM,306,RC,,,,,,Inpatient,,,153.39,153.39,Wellcare,Wellcare,153.39,,,,,,,case rate,153.39,153.39,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Meritain Health PPO CPD,Meritain Health PPO CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Aetna/Commercial Product,Aetna/Commercial Product,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Meritain Health CPD,Meritain Health CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Starmark CPD,Starmark CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Aetna Medicare,Aetna Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Ambetter ,Ambetter ,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Blue Access,Anthem Blue Access,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Blue Access Choice,Anthem Blue Access Choice,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Blue Preferred,Anthem Blue Preferred,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Pathway,Anthem Pathway,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Alliance,Anthem Alliance,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Anthem Medicare,Anthem Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Cigna,Cigna,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Cigna PPO,Cigna PPO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Cigna Medicare Advantage,Cigna Medicare Advantage,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Essence,Essence,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Healthlink HMO,Healthlink HMO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Healthlink PPO,Healthlink PPO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,HomeState Health Plan,HomeState Health Plan,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Humana Gold,Humana Gold,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Medicaid MO,Medicaid MO,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Medica,Medica,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Tricare,Tricare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,UHC All Payer,UHC All Payer,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,UHC Exchange,UHC Exchange,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,UHC Medicaid,UHC Medicaid,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,UMR CPD,UMR CPD,237.44,,,,,,,per diem,237.44,237.44,"Per diem rate, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,UHC Medicare,UHC Medicare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O COCCI IMMITIS ID DNA      ,38251417,CDM,306,RC,,,,,,Inpatient,,,237.44,237.44,Wellcare,Wellcare,237.44,,,,,,,case rate,237.44,237.44,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health PPO CPD,Meritain Health PPO CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna/Commercial Product,Aetna/Commercial Product,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Meritain Health CPD,Meritain Health CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Starmark CPD,Starmark CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Aetna Medicare,Aetna Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Ambetter ,Ambetter ,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access,Anthem Blue Access,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Access Choice,Anthem Blue Access Choice,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Blue Preferred,Anthem Blue Preferred,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Pathway,Anthem Pathway,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Alliance,Anthem Alliance,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Anthem Medicare,Anthem Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna,Cigna,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna PPO,Cigna PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Cigna Medicare Advantage,Cigna Medicare Advantage,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Essence,Essence,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink HMO,Healthlink HMO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Healthlink PPO,Healthlink PPO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,HomeState Health Plan,HomeState Health Plan,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Humana Gold,Humana Gold,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Medicaid MO,Medicaid MO,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Medica,Medica,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Tricare,Tricare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC All Payer,UHC All Payer,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Exchange,UHC Exchange,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicaid,UHC Medicaid,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UMR CPD,UMR CPD,211.17,,,,,,,per diem,211.17,211.17,"Per diem rate, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,UHC Medicare,UHC Medicare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MTB DNA PROBE      ,38251418,CDM,306,RC,,,,,,Inpatient,,,211.17,211.17,Wellcare,Wellcare,211.17,,,,,,,case rate,211.17,211.17,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health PPO CPD,Meritain Health PPO CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/Commercial Product,Aetna/Commercial Product,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health CPD,Meritain Health CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Starmark CPD,Starmark CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna Medicare,Aetna Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Ambetter ,Ambetter ,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access,Anthem Blue Access,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access Choice,Anthem Blue Access Choice,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Preferred,Anthem Blue Preferred,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Pathway,Anthem Pathway,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Alliance,Anthem Alliance,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Medicare,Anthem Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna,Cigna,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna PPO,Cigna PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna Medicare Advantage,Cigna Medicare Advantage,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Essence,Essence,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink HMO,Healthlink HMO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink PPO,Healthlink PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,HomeState Health Plan,HomeState Health Plan,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Humana Gold,Humana Gold,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medicaid MO,Medicaid MO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medica,Medica,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Tricare,Tricare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC All Payer,UHC All Payer,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Exchange,UHC Exchange,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicaid,UHC Medicaid,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UMR CPD,UMR CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicare,UHC Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MAI DNA PROBE      ,38251419,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Wellcare,Wellcare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health PPO CPD,Meritain Health PPO CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna/Commercial Product,Aetna/Commercial Product,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Meritain Health CPD,Meritain Health CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Starmark CPD,Starmark CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Aetna Medicare,Aetna Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Ambetter ,Ambetter ,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access,Anthem Blue Access,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Access Choice,Anthem Blue Access Choice,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Blue Preferred,Anthem Blue Preferred,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Pathway,Anthem Pathway,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Alliance,Anthem Alliance,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Anthem Medicare,Anthem Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna,Cigna,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna PPO,Cigna PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Cigna Medicare Advantage,Cigna Medicare Advantage,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Essence,Essence,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink HMO,Healthlink HMO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Healthlink PPO,Healthlink PPO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,HomeState Health Plan,HomeState Health Plan,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Humana Gold,Humana Gold,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medicaid MO,Medicaid MO,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Medica,Medica,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Tricare,Tricare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC All Payer,UHC All Payer,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Exchange,UHC Exchange,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicaid,UHC Medicaid,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UMR CPD,UMR CPD,162.84,,,,,,,per diem,162.84,162.84,"Per diem rate, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,UHC Medicare,UHC Medicare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O AFB ID MYCO SPECI DNA     ,38251420,CDM,306,RC,,,,,,Inpatient,,,162.84,162.84,Wellcare,Wellcare,162.84,,,,,,,case rate,162.84,162.84,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health PPO CPD,Meritain Health PPO CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/Commercial Product,Aetna/Commercial Product,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health CPD,Meritain Health CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Starmark CPD,Starmark CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna Medicare,Aetna Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Ambetter ,Ambetter ,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access,Anthem Blue Access,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access Choice,Anthem Blue Access Choice,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Preferred,Anthem Blue Preferred,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Pathway,Anthem Pathway,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Alliance,Anthem Alliance,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Medicare,Anthem Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna,Cigna,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna PPO,Cigna PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna Medicare Advantage,Cigna Medicare Advantage,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Essence,Essence,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink HMO,Healthlink HMO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink PPO,Healthlink PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,HomeState Health Plan,HomeState Health Plan,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Humana Gold,Humana Gold,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medicaid MO,Medicaid MO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medica,Medica,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Tricare,Tricare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC All Payer,UHC All Payer,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Exchange,UHC Exchange,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicaid,UHC Medicaid,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UMR CPD,UMR CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicare,UHC Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM NEG         ,38251421,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Wellcare,Wellcare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health PPO CPD,Meritain Health PPO CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/Commercial Product,Aetna/Commercial Product,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health CPD,Meritain Health CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Starmark CPD,Starmark CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna Medicare,Aetna Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Ambetter ,Ambetter ,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access,Anthem Blue Access,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access Choice,Anthem Blue Access Choice,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Preferred,Anthem Blue Preferred,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Pathway,Anthem Pathway,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Alliance,Anthem Alliance,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Medicare,Anthem Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna,Cigna,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna PPO,Cigna PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna Medicare Advantage,Cigna Medicare Advantage,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Essence,Essence,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink HMO,Healthlink HMO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink PPO,Healthlink PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,HomeState Health Plan,HomeState Health Plan,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Humana Gold,Humana Gold,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medicaid MO,Medicaid MO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medica,Medica,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Tricare,Tricare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC All Payer,UHC All Payer,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Exchange,UHC Exchange,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicaid,UHC Medicaid,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UMR CPD,UMR CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicare,UHC Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O CULT TYP ID DIRT ORG      ,38251422,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Wellcare,Wellcare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Meritain Health PPO CPD,Meritain Health PPO CPD,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Aetna/Commercial Product,Aetna/Commercial Product,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Meritain Health CPD,Meritain Health CPD,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Starmark CPD,Starmark CPD,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Aetna Medicare,Aetna Medicare,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Ambetter ,Ambetter ,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Blue Access,Anthem Blue Access,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Blue Access Choice,Anthem Blue Access Choice,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Blue Preferred,Anthem Blue Preferred,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Pathway,Anthem Pathway,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Alliance,Anthem Alliance,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Anthem Medicare,Anthem Medicare,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Cigna,Cigna,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Cigna PPO,Cigna PPO,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Cigna Medicare Advantage,Cigna Medicare Advantage,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Essence,Essence,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Healthlink HMO,Healthlink HMO,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Healthlink PPO,Healthlink PPO,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,HomeState Health Plan,HomeState Health Plan,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Humana Gold,Humana Gold,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Medicaid MO,Medicaid MO,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Medica,Medica,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Tricare,Tricare,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,UHC All Payer,UHC All Payer,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,UHC Exchange,UHC Exchange,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,UHC Medicaid,UHC Medicaid,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,UMR CPD,UMR CPD,68.87,,,,,,,per diem,68.87,68.87,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,UHC Medicare,UHC Medicare,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251423,CDM,306,RC,,,,,,Inpatient,,,68.87,68.87,Wellcare,Wellcare,68.87,,,,,,,case rate,68.87,68.87,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Meritain Health PPO CPD,Meritain Health PPO CPD,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Aetna/Commercial Product,Aetna/Commercial Product,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Meritain Health CPD,Meritain Health CPD,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Starmark CPD,Starmark CPD,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Aetna Medicare,Aetna Medicare,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Ambetter ,Ambetter ,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Blue Access,Anthem Blue Access,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Blue Access Choice,Anthem Blue Access Choice,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Blue Preferred,Anthem Blue Preferred,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Pathway,Anthem Pathway,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Alliance,Anthem Alliance,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Anthem Medicare,Anthem Medicare,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Cigna,Cigna,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Cigna PPO,Cigna PPO,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Cigna Medicare Advantage,Cigna Medicare Advantage,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Essence,Essence,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Healthlink HMO,Healthlink HMO,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Healthlink PPO,Healthlink PPO,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,HomeState Health Plan,HomeState Health Plan,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Humana Gold,Humana Gold,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Medicaid MO,Medicaid MO,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Medica,Medica,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Tricare,Tricare,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,UHC All Payer,UHC All Payer,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,UHC Exchange,UHC Exchange,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,UHC Medicaid,UHC Medicaid,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,UMR CPD,UMR CPD,71.52,,,,,,,per diem,71.52,71.52,"Per diem rate, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,UHC Medicare,UHC Medicare,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O VERIGENE GRAM POS         ,38251424,CDM,306,RC,,,,,,Inpatient,,,71.52,71.52,Wellcare,Wellcare,71.52,,,,,,,case rate,71.52,71.52,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health PPO CPD,Meritain Health PPO CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Aetna/Commercial Product,Aetna/Commercial Product,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Meritain Health CPD,Meritain Health CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Starmark CPD,Starmark CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Aetna Medicare,Aetna Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Ambetter ,Ambetter ,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access,Anthem Blue Access,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Access Choice,Anthem Blue Access Choice,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Blue Preferred,Anthem Blue Preferred,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Pathway,Anthem Pathway,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Alliance,Anthem Alliance,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Anthem Medicare,Anthem Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Cigna,Cigna,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Cigna PPO,Cigna PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Cigna Medicare Advantage,Cigna Medicare Advantage,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Essence,Essence,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink HMO,Healthlink HMO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Healthlink PPO,Healthlink PPO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,HomeState Health Plan,HomeState Health Plan,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Humana Gold,Humana Gold,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Medicaid MO,Medicaid MO,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Medica,Medica,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Tricare,Tricare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,UHC All Payer,UHC All Payer,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,UHC Exchange,UHC Exchange,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicaid,UHC Medicaid,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,UMR CPD,UMR CPD,29.42,,,,,,,per diem,29.42,29.42,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,UHC Medicare,UHC Medicare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251425,CDM,306,RC,,,,,,Inpatient,,,29.42,29.42,Wellcare,Wellcare,29.42,,,,,,,case rate,29.42,29.42,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Meritain Health PPO CPD,Meritain Health PPO CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Aetna/Commercial Product,Aetna/Commercial Product,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Meritain Health CPD,Meritain Health CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Starmark CPD,Starmark CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Aetna Medicare,Aetna Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Ambetter ,Ambetter ,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Access,Anthem Blue Access,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Access Choice,Anthem Blue Access Choice,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Preferred,Anthem Blue Preferred,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Pathway,Anthem Pathway,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Alliance,Anthem Alliance,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Medicare,Anthem Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Cigna,Cigna,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Cigna PPO,Cigna PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Cigna Medicare Advantage,Cigna Medicare Advantage,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Essence,Essence,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Healthlink HMO,Healthlink HMO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Healthlink PPO,Healthlink PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,HomeState Health Plan,HomeState Health Plan,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Humana Gold,Humana Gold,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Medicaid MO,Medicaid MO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Medica,Medica,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Tricare,Tricare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,UHC All Payer,UHC All Payer,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,UHC Exchange,UHC Exchange,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,UHC Medicaid,UHC Medicaid,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,UMR CPD,UMR CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,UHC Medicare,UHC Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O CULT TYPE IF HSV          ,38251426,CDM,306,RC,,,,,,Inpatient,,,100.86,100.86,Wellcare,Wellcare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health PPO CPD,Meritain Health PPO CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna/Commercial Product,Aetna/Commercial Product,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Meritain Health CPD,Meritain Health CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Starmark CPD,Starmark CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Aetna Medicare,Aetna Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Ambetter ,Ambetter ,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access,Anthem Blue Access,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Access Choice,Anthem Blue Access Choice,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Blue Preferred,Anthem Blue Preferred,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Pathway,Anthem Pathway,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Alliance,Anthem Alliance,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Anthem Medicare,Anthem Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna,Cigna,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna PPO,Cigna PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Cigna Medicare Advantage,Cigna Medicare Advantage,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Essence,Essence,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink HMO,Healthlink HMO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Healthlink PPO,Healthlink PPO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,HomeState Health Plan,HomeState Health Plan,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Humana Gold,Humana Gold,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medicaid MO,Medicaid MO,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Medica,Medica,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Tricare,Tricare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC All Payer,UHC All Payer,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Exchange,UHC Exchange,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicaid,UHC Medicaid,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UMR CPD,UMR CPD,24.16,,,,,,,per diem,24.16,24.16,"Per diem rate, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,UHC Medicare,UHC Medicare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RHEUTAMOID FACTOR BLD     ,38251427,CDM,302,RC,,,,,,Inpatient,,,24.16,24.16,Wellcare,Wellcare,24.16,,,,,,,case rate,24.16,24.16,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health PPO CPD,Meritain Health PPO CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna/Commercial Product,Aetna/Commercial Product,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Meritain Health CPD,Meritain Health CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Starmark CPD,Starmark CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Aetna Medicare,Aetna Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Ambetter ,Ambetter ,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access,Anthem Blue Access,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Access Choice,Anthem Blue Access Choice,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Blue Preferred,Anthem Blue Preferred,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Pathway,Anthem Pathway,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Alliance,Anthem Alliance,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Anthem Medicare,Anthem Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna,Cigna,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna PPO,Cigna PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Cigna Medicare Advantage,Cigna Medicare Advantage,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Essence,Essence,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink HMO,Healthlink HMO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Healthlink PPO,Healthlink PPO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,HomeState Health Plan,HomeState Health Plan,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Humana Gold,Humana Gold,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medicaid MO,Medicaid MO,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Medica,Medica,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Tricare,Tricare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC All Payer,UHC All Payer,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Exchange,UHC Exchange,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicaid,UHC Medicaid,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UMR CPD,UMR CPD,158.64,,,,,,,per diem,158.64,158.64,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,UHC Medicare,UHC Medicare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251428,CDM,306,RC,,,,,,Inpatient,,,158.64,158.64,Wellcare,Wellcare,158.64,,,,,,,case rate,158.64,158.64,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Meritain Health PPO CPD,Meritain Health PPO CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Aetna/Commercial Product,Aetna/Commercial Product,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Meritain Health CPD,Meritain Health CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Starmark CPD,Starmark CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Aetna Medicare,Aetna Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Ambetter ,Ambetter ,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Access,Anthem Blue Access,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Access Choice,Anthem Blue Access Choice,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Blue Preferred,Anthem Blue Preferred,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Pathway,Anthem Pathway,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Alliance,Anthem Alliance,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Anthem Medicare,Anthem Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Cigna,Cigna,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Cigna PPO,Cigna PPO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Cigna Medicare Advantage,Cigna Medicare Advantage,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Essence,Essence,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Healthlink HMO,Healthlink HMO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Healthlink PPO,Healthlink PPO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,HomeState Health Plan,HomeState Health Plan,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Humana Gold,Humana Gold,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Medicaid MO,Medicaid MO,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Medica,Medica,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Tricare,Tricare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,UHC All Payer,UHC All Payer,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,UHC Exchange,UHC Exchange,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,UHC Medicaid,UHC Medicaid,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,UMR CPD,UMR CPD,214.32,,,,,,,per diem,214.32,214.32,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,UHC Medicare,UHC Medicare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251429,CDM,306,RC,,,,,,Inpatient,,,214.32,214.32,Wellcare,Wellcare,214.32,,,,,,,case rate,214.32,214.32,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health PPO CPD,Meritain Health PPO CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/Commercial Product,Aetna/Commercial Product,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health CPD,Meritain Health CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Starmark CPD,Starmark CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna Medicare,Aetna Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Ambetter ,Ambetter ,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access,Anthem Blue Access,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access Choice,Anthem Blue Access Choice,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Preferred,Anthem Blue Preferred,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Pathway,Anthem Pathway,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Alliance,Anthem Alliance,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Medicare,Anthem Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna,Cigna,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna PPO,Cigna PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna Medicare Advantage,Cigna Medicare Advantage,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Essence,Essence,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink HMO,Healthlink HMO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink PPO,Healthlink PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,HomeState Health Plan,HomeState Health Plan,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Humana Gold,Humana Gold,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Medicaid MO,Medicaid MO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Medica,Medica,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Tricare,Tricare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC All Payer,UHC All Payer,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Exchange,UHC Exchange,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicaid,UHC Medicaid,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UMR CPD,UMR CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicare,UHC Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251430,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Wellcare,Wellcare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Meritain Health PPO CPD,Meritain Health PPO CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Aetna/Commercial Product,Aetna/Commercial Product,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Meritain Health CPD,Meritain Health CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Starmark CPD,Starmark CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Aetna Medicare,Aetna Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Ambetter ,Ambetter ,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Blue Access,Anthem Blue Access,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Blue Access Choice,Anthem Blue Access Choice,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Blue Preferred,Anthem Blue Preferred,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Pathway,Anthem Pathway,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Alliance,Anthem Alliance,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Anthem Medicare,Anthem Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Cigna,Cigna,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Cigna PPO,Cigna PPO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Cigna Medicare Advantage,Cigna Medicare Advantage,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Essence,Essence,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Healthlink HMO,Healthlink HMO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Healthlink PPO,Healthlink PPO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,HomeState Health Plan,HomeState Health Plan,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Humana Gold,Humana Gold,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Medicaid MO,Medicaid MO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Medica,Medica,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Tricare,Tricare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,UHC All Payer,UHC All Payer,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,UHC Exchange,UHC Exchange,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,UHC Medicaid,UHC Medicaid,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,UMR CPD,UMR CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,UHC Medicare,UHC Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT NRESP DEFIF     ,38251431,CDM,306,RC,,,,,,Inpatient,,,108.21,108.21,Wellcare,Wellcare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health PPO CPD,Meritain Health PPO CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/Commercial Product,Aetna/Commercial Product,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health CPD,Meritain Health CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Starmark CPD,Starmark CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna Medicare,Aetna Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Ambetter ,Ambetter ,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access,Anthem Blue Access,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access Choice,Anthem Blue Access Choice,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Preferred,Anthem Blue Preferred,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Pathway,Anthem Pathway,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Alliance,Anthem Alliance,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Medicare,Anthem Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna,Cigna,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna PPO,Cigna PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna Medicare Advantage,Cigna Medicare Advantage,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Essence,Essence,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink HMO,Healthlink HMO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink PPO,Healthlink PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,HomeState Health Plan,HomeState Health Plan,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Humana Gold,Humana Gold,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medicaid MO,Medicaid MO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medica,Medica,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Tricare,Tricare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC All Payer,UHC All Payer,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Exchange,UHC Exchange,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicaid,UHC Medicaid,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UMR CPD,UMR CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicare,UHC Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE DFA           ,38251432,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Wellcare,Wellcare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health PPO CPD,Meritain Health PPO CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/Commercial Product,Aetna/Commercial Product,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health CPD,Meritain Health CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Starmark CPD,Starmark CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna Medicare,Aetna Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Ambetter ,Ambetter ,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access,Anthem Blue Access,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access Choice,Anthem Blue Access Choice,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Preferred,Anthem Blue Preferred,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Pathway,Anthem Pathway,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Alliance,Anthem Alliance,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Medicare,Anthem Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna,Cigna,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna PPO,Cigna PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna Medicare Advantage,Cigna Medicare Advantage,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Essence,Essence,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink HMO,Healthlink HMO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink PPO,Healthlink PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,HomeState Health Plan,HomeState Health Plan,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Humana Gold,Humana Gold,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medicaid MO,Medicaid MO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medica,Medica,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Tricare,Tricare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC All Payer,UHC All Payer,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Exchange,UHC Exchange,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicaid,UHC Medicaid,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UMR CPD,UMR CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicare,UHC Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O VIRAL CLT RESP DEF IF     ,38251433,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Wellcare,Wellcare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health PPO CPD,Meritain Health PPO CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna/Commercial Product,Aetna/Commercial Product,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Meritain Health CPD,Meritain Health CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Starmark CPD,Starmark CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Aetna Medicare,Aetna Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Ambetter ,Ambetter ,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access,Anthem Blue Access,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Access Choice,Anthem Blue Access Choice,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Blue Preferred,Anthem Blue Preferred,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Pathway,Anthem Pathway,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Alliance,Anthem Alliance,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Anthem Medicare,Anthem Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna,Cigna,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna PPO,Cigna PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Cigna Medicare Advantage,Cigna Medicare Advantage,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Essence,Essence,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink HMO,Healthlink HMO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Healthlink PPO,Healthlink PPO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,HomeState Health Plan,HomeState Health Plan,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Humana Gold,Humana Gold,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medicaid MO,Medicaid MO,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Medica,Medica,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Tricare,Tricare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC All Payer,UHC All Payer,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Exchange,UHC Exchange,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicaid,UHC Medicaid,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UMR CPD,UMR CPD,140.78,,,,,,,per diem,140.78,140.78,"Per diem rate, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,UHC Medicare,UHC Medicare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O HSV CULTURE               ,38251434,CDM,306,RC,,,,,,Inpatient,,,140.78,140.78,Wellcare,Wellcare,140.78,,,,,,,case rate,140.78,140.78,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health PPO CPD,Meritain Health PPO CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Aetna/Commercial Product,Aetna/Commercial Product,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Meritain Health CPD,Meritain Health CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Starmark CPD,Starmark CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Aetna Medicare,Aetna Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Ambetter ,Ambetter ,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access,Anthem Blue Access,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Access Choice,Anthem Blue Access Choice,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Blue Preferred,Anthem Blue Preferred,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Pathway,Anthem Pathway,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Alliance,Anthem Alliance,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Anthem Medicare,Anthem Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Cigna,Cigna,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Cigna PPO,Cigna PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Cigna Medicare Advantage,Cigna Medicare Advantage,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Essence,Essence,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink HMO,Healthlink HMO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Healthlink PPO,Healthlink PPO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,HomeState Health Plan,HomeState Health Plan,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Humana Gold,Humana Gold,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Medicaid MO,Medicaid MO,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Medica,Medica,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Tricare,Tricare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,UHC All Payer,UHC All Payer,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,UHC Exchange,UHC Exchange,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicaid,UHC Medicaid,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,UMR CPD,UMR CPD,59.88,,,,,,,per diem,59.88,59.88,"Per diem rate, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,UHC Medicare,UHC Medicare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O V CULT NRESP CMV DFID     ,38251435,CDM,306,RC,,,,,,Inpatient,,,59.88,59.88,Wellcare,Wellcare,59.88,,,,,,,case rate,59.88,59.88,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health PPO CPD,Meritain Health PPO CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna/Commercial Product,Aetna/Commercial Product,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Meritain Health CPD,Meritain Health CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Starmark CPD,Starmark CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Aetna Medicare,Aetna Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Ambetter ,Ambetter ,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access,Anthem Blue Access,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Access Choice,Anthem Blue Access Choice,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Blue Preferred,Anthem Blue Preferred,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Pathway,Anthem Pathway,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Alliance,Anthem Alliance,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Anthem Medicare,Anthem Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna,Cigna,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna PPO,Cigna PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Cigna Medicare Advantage,Cigna Medicare Advantage,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Essence,Essence,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink HMO,Healthlink HMO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Healthlink PPO,Healthlink PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,HomeState Health Plan,HomeState Health Plan,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Humana Gold,Humana Gold,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medicaid MO,Medicaid MO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Medica,Medica,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Tricare,Tricare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC All Payer,UHC All Payer,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Exchange,UHC Exchange,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicaid,UHC Medicaid,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UMR CPD,UMR CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,UHC Medicare,UHC Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251436,CDM,306,RC,,,,,,Inpatient,,,141.83,141.83,Wellcare,Wellcare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health PPO CPD,Meritain Health PPO CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna/Commercial Product,Aetna/Commercial Product,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Meritain Health CPD,Meritain Health CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Starmark CPD,Starmark CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Aetna Medicare,Aetna Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Ambetter ,Ambetter ,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access,Anthem Blue Access,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Access Choice,Anthem Blue Access Choice,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Blue Preferred,Anthem Blue Preferred,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Pathway,Anthem Pathway,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Alliance,Anthem Alliance,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Anthem Medicare,Anthem Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna,Cigna,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna PPO,Cigna PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Cigna Medicare Advantage,Cigna Medicare Advantage,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Essence,Essence,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink HMO,Healthlink HMO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Healthlink PPO,Healthlink PPO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,HomeState Health Plan,HomeState Health Plan,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Humana Gold,Humana Gold,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Medicaid MO,Medicaid MO,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Medica,Medica,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Tricare,Tricare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC All Payer,UHC All Payer,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Exchange,UHC Exchange,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicaid,UHC Medicaid,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UMR CPD,UMR CPD,89.3,,,,,,,per diem,89.3,89.3,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,UHC Medicare,UHC Medicare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251437,CDM,306,RC,,,,,,Inpatient,,,89.3,89.3,Wellcare,Wellcare,89.3,,,,,,,case rate,89.3,89.3,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health PPO CPD,Meritain Health PPO CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Aetna/Commercial Product,Aetna/Commercial Product,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Meritain Health CPD,Meritain Health CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Starmark CPD,Starmark CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Aetna Medicare,Aetna Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Ambetter ,Ambetter ,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access,Anthem Blue Access,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Access Choice,Anthem Blue Access Choice,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Blue Preferred,Anthem Blue Preferred,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Pathway,Anthem Pathway,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Alliance,Anthem Alliance,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Anthem Medicare,Anthem Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Cigna,Cigna,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Cigna PPO,Cigna PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Cigna Medicare Advantage,Cigna Medicare Advantage,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Essence,Essence,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink HMO,Healthlink HMO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Healthlink PPO,Healthlink PPO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,HomeState Health Plan,HomeState Health Plan,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Humana Gold,Humana Gold,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Medicaid MO,Medicaid MO,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Medica,Medica,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Tricare,Tricare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,UHC All Payer,UHC All Payer,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,UHC Exchange,UHC Exchange,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicaid,UHC Medicaid,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,UMR CPD,UMR CPD,155.49,,,,,,,per diem,155.49,155.49,"Per diem rate, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,UHC Medicare,UHC Medicare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O SHIGA TOXIN TEST          ,38251438,CDM,306,RC,,,,,,Inpatient,,,155.49,155.49,Wellcare,Wellcare,155.49,,,,,,,case rate,155.49,155.49,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health PPO CPD,Meritain Health PPO CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Aetna/Commercial Product,Aetna/Commercial Product,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Meritain Health CPD,Meritain Health CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Starmark CPD,Starmark CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Aetna Medicare,Aetna Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Ambetter ,Ambetter ,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access,Anthem Blue Access,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Access Choice,Anthem Blue Access Choice,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Blue Preferred,Anthem Blue Preferred,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Pathway,Anthem Pathway,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Alliance,Anthem Alliance,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Anthem Medicare,Anthem Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Cigna,Cigna,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Cigna PPO,Cigna PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Cigna Medicare Advantage,Cigna Medicare Advantage,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Essence,Essence,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink HMO,Healthlink HMO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Healthlink PPO,Healthlink PPO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,HomeState Health Plan,HomeState Health Plan,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Humana Gold,Humana Gold,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Medicaid MO,Medicaid MO,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Medica,Medica,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Tricare,Tricare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,UHC All Payer,UHC All Payer,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,UHC Exchange,UHC Exchange,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicaid,UHC Medicaid,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,UMR CPD,UMR CPD,299.42,,,,,,,per diem,299.42,299.42,"Per diem rate, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,UHC Medicare,UHC Medicare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O CLOS DIF TOX AMP PROB     ,38251439,CDM,306,RC,,,,,,Inpatient,,,299.42,299.42,Wellcare,Wellcare,299.42,,,,,,,case rate,299.42,299.42,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O OCCULT BLOOD FECES QL     ,38251440,CDM,301,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O METHADONE MECONIUM        ,38251441,CDM,301,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Meritain Health PPO CPD,Meritain Health PPO CPD,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Aetna/Commercial Product,Aetna/Commercial Product,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Meritain Health CPD,Meritain Health CPD,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Starmark CPD,Starmark CPD,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Aetna Medicare,Aetna Medicare,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Ambetter ,Ambetter ,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Blue Access,Anthem Blue Access,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Blue Access Choice,Anthem Blue Access Choice,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Blue Preferred,Anthem Blue Preferred,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Pathway,Anthem Pathway,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Alliance,Anthem Alliance,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Anthem Medicare,Anthem Medicare,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Cigna,Cigna,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Cigna PPO,Cigna PPO,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Cigna Medicare Advantage,Cigna Medicare Advantage,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Essence,Essence,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Healthlink HMO,Healthlink HMO,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Healthlink PPO,Healthlink PPO,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,HomeState Health Plan,HomeState Health Plan,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Humana Gold,Humana Gold,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Medicaid MO,Medicaid MO,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Medica,Medica,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Tricare,Tricare,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,UHC All Payer,UHC All Payer,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,UHC Exchange,UHC Exchange,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,UHC Medicaid,UHC Medicaid,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,UMR CPD,UMR CPD,315.18,,,,,,,per diem,315.18,315.18,"Per diem rate, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,UHC Medicare,UHC Medicare,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
ASO SCREEN                    ,38251442,CDM,302,RC,,,,,,Inpatient,,,315.18,315.18,Wellcare,Wellcare,315.18,,,,,,,case rate,315.18,315.18,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
CULT FUNGUS ID MOLD           ,38251443,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Meritain Health PPO CPD,Meritain Health PPO CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Aetna/Commercial Product,Aetna/Commercial Product,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Meritain Health CPD,Meritain Health CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Starmark CPD,Starmark CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Aetna Medicare,Aetna Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Ambetter ,Ambetter ,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Access,Anthem Blue Access,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Access Choice,Anthem Blue Access Choice,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Blue Preferred,Anthem Blue Preferred,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Pathway,Anthem Pathway,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Alliance,Anthem Alliance,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Anthem Medicare,Anthem Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Cigna,Cigna,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Cigna PPO,Cigna PPO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Cigna Medicare Advantage,Cigna Medicare Advantage,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Essence,Essence,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Healthlink HMO,Healthlink HMO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Healthlink PPO,Healthlink PPO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,HomeState Health Plan,HomeState Health Plan,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Humana Gold,Humana Gold,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Medicaid MO,Medicaid MO,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Medica,Medica,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Tricare,Tricare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,UHC All Payer,UHC All Payer,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,UHC Exchange,UHC Exchange,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,UHC Medicaid,UHC Medicaid,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,UMR CPD,UMR CPD,222.73,,,,,,,per diem,222.73,222.73,"Per diem rate, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,UHC Medicare,UHC Medicare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
IA ROTAVIRUS QL               ,38251444,CDM,306,RC,,,,,,Inpatient,,,222.73,222.73,Wellcare,Wellcare,222.73,,,,,,,case rate,222.73,222.73,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Meritain Health PPO CPD,Meritain Health PPO CPD,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Aetna/Commercial Product,Aetna/Commercial Product,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Meritain Health CPD,Meritain Health CPD,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Starmark CPD,Starmark CPD,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Aetna Medicare,Aetna Medicare,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Ambetter ,Ambetter ,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Blue Access,Anthem Blue Access,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Blue Access Choice,Anthem Blue Access Choice,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Blue Preferred,Anthem Blue Preferred,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Pathway,Anthem Pathway,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Alliance,Anthem Alliance,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Anthem Medicare,Anthem Medicare,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Cigna,Cigna,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Cigna PPO,Cigna PPO,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Cigna Medicare Advantage,Cigna Medicare Advantage,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Essence,Essence,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Healthlink HMO,Healthlink HMO,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Healthlink PPO,Healthlink PPO,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,HomeState Health Plan,HomeState Health Plan,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Humana Gold,Humana Gold,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Medicaid MO,Medicaid MO,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Medica,Medica,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Tricare,Tricare,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,UHC All Payer,UHC All Payer,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,UHC Exchange,UHC Exchange,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,UHC Medicaid,UHC Medicaid,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,UMR CPD,UMR CPD,275.26,,,,,,,per diem,275.26,275.26,"Per diem rate, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,UHC Medicare,UHC Medicare,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
MACRO EXAM ARTHROPOD          ,38251445,CDM,306,RC,,,,,,Inpatient,,,275.26,275.26,Wellcare,Wellcare,275.26,,,,,,,case rate,275.26,275.26,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O LEGIONELL SPEC QL PCR     ,38251446,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health PPO CPD,Meritain Health PPO CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna/Commercial Product,Aetna/Commercial Product,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Meritain Health CPD,Meritain Health CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Starmark CPD,Starmark CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Aetna Medicare,Aetna Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Ambetter ,Ambetter ,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access,Anthem Blue Access,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Access Choice,Anthem Blue Access Choice,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Blue Preferred,Anthem Blue Preferred,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Pathway,Anthem Pathway,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Alliance,Anthem Alliance,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Anthem Medicare,Anthem Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna,Cigna,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna PPO,Cigna PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Cigna Medicare Advantage,Cigna Medicare Advantage,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Essence,Essence,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink HMO,Healthlink HMO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Healthlink PPO,Healthlink PPO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,HomeState Health Plan,HomeState Health Plan,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Humana Gold,Humana Gold,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medicaid MO,Medicaid MO,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Medica,Medica,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Tricare,Tricare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC All Payer,UHC All Payer,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Exchange,UHC Exchange,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicaid,UHC Medicaid,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UMR CPD,UMR CPD,66.19,,,,,,,per diem,66.19,66.19,"Per diem rate, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,UHC Medicare,UHC Medicare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O PHOSPHATIDYLGLYCEROL      ,38251447,CDM,301,RC,,,,,,Inpatient,,,66.19,66.19,Wellcare,Wellcare,66.19,,,,,,,case rate,66.19,66.19,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health PPO CPD,Meritain Health PPO CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Aetna/Commercial Product,Aetna/Commercial Product,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Meritain Health CPD,Meritain Health CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Starmark CPD,Starmark CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Aetna Medicare,Aetna Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Ambetter ,Ambetter ,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access,Anthem Blue Access,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Access Choice,Anthem Blue Access Choice,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Blue Preferred,Anthem Blue Preferred,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Pathway,Anthem Pathway,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Alliance,Anthem Alliance,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Anthem Medicare,Anthem Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Cigna,Cigna,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Cigna PPO,Cigna PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Cigna Medicare Advantage,Cigna Medicare Advantage,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Essence,Essence,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink HMO,Healthlink HMO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Healthlink PPO,Healthlink PPO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,HomeState Health Plan,HomeState Health Plan,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Humana Gold,Humana Gold,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Medicaid MO,Medicaid MO,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Medica,Medica,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Tricare,Tricare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,UHC All Payer,UHC All Payer,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,UHC Exchange,UHC Exchange,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicaid,UHC Medicaid,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,UMR CPD,UMR CPD,93.5,,,,,,,per diem,93.5,93.5,"Per diem rate, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,UHC Medicare,UHC Medicare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CHYLOMICRON SCRN BF       ,38251448,CDM,301,RC,,,,,,Inpatient,,,93.5,93.5,Wellcare,Wellcare,93.5,,,,,,,case rate,93.5,93.5,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O CULT AETOBIC ID SEQ       ,38251449,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Meritain Health PPO CPD,Meritain Health PPO CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna/Commercial Product,Aetna/Commercial Product,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Meritain Health CPD,Meritain Health CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Starmark CPD,Starmark CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna Medicare,Aetna Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Ambetter ,Ambetter ,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Access,Anthem Blue Access,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Access Choice,Anthem Blue Access Choice,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Preferred,Anthem Blue Preferred,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Pathway,Anthem Pathway,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Alliance,Anthem Alliance,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Medicare,Anthem Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna,Cigna,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna PPO,Cigna PPO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna Medicare Advantage,Cigna Medicare Advantage,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Essence,Essence,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthlink HMO,Healthlink HMO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthlink PPO,Healthlink PPO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,HomeState Health Plan,HomeState Health Plan,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Humana Gold,Humana Gold,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Medicaid MO,Medicaid MO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Medica,Medica,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Tricare,Tricare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC All Payer,UHC All Payer,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Exchange,UHC Exchange,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Medicaid,UHC Medicaid,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UMR CPD,UMR CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Medicare,UHC Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O AFB ID BY SEQUENCING      ,38251450,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Wellcare,Wellcare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Meritain Health PPO CPD,Meritain Health PPO CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Aetna/Commercial Product,Aetna/Commercial Product,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Meritain Health CPD,Meritain Health CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Starmark CPD,Starmark CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Aetna Medicare,Aetna Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Ambetter ,Ambetter ,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Blue Access,Anthem Blue Access,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Blue Access Choice,Anthem Blue Access Choice,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Blue Preferred,Anthem Blue Preferred,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Pathway,Anthem Pathway,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Alliance,Anthem Alliance,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Anthem Medicare,Anthem Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Cigna,Cigna,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Cigna PPO,Cigna PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Cigna Medicare Advantage,Cigna Medicare Advantage,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Essence,Essence,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Healthlink HMO,Healthlink HMO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Healthlink PPO,Healthlink PPO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,HomeState Health Plan,HomeState Health Plan,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Humana Gold,Humana Gold,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Medicaid MO,Medicaid MO,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Medica,Medica,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Tricare,Tricare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,UHC All Payer,UHC All Payer,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,UHC Exchange,UHC Exchange,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,UHC Medicaid,UHC Medicaid,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,UMR CPD,UMR CPD,196.46,,,,,,,per diem,196.46,196.46,"Per diem rate, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,UHC Medicare,UHC Medicare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O 14-3-3 PROTEIN CSF        ,38251451,CDM,301,RC,,,,,,Inpatient,,,196.46,196.46,Wellcare,Wellcare,196.46,,,,,,,case rate,196.46,196.46,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health PPO CPD,Meritain Health PPO CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/Commercial Product,Aetna/Commercial Product,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health CPD,Meritain Health CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Starmark CPD,Starmark CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna Medicare,Aetna Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Ambetter ,Ambetter ,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access,Anthem Blue Access,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access Choice,Anthem Blue Access Choice,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Preferred,Anthem Blue Preferred,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Pathway,Anthem Pathway,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Alliance,Anthem Alliance,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Medicare,Anthem Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna,Cigna,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna PPO,Cigna PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna Medicare Advantage,Cigna Medicare Advantage,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Essence,Essence,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink HMO,Healthlink HMO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink PPO,Healthlink PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,HomeState Health Plan,HomeState Health Plan,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Humana Gold,Humana Gold,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medicaid MO,Medicaid MO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medica,Medica,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Tricare,Tricare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC All Payer,UHC All Payer,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Exchange,UHC Exchange,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicaid,UHC Medicaid,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UMR CPD,UMR CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicare,UHC Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251452,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Wellcare,Wellcare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health PPO CPD,Meritain Health PPO CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/Commercial Product,Aetna/Commercial Product,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health CPD,Meritain Health CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Starmark CPD,Starmark CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna Medicare,Aetna Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Ambetter ,Ambetter ,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access,Anthem Blue Access,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access Choice,Anthem Blue Access Choice,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Preferred,Anthem Blue Preferred,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Pathway,Anthem Pathway,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Alliance,Anthem Alliance,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Medicare,Anthem Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna,Cigna,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna PPO,Cigna PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna Medicare Advantage,Cigna Medicare Advantage,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Essence,Essence,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink HMO,Healthlink HMO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink PPO,Healthlink PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,HomeState Health Plan,HomeState Health Plan,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Humana Gold,Humana Gold,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medicaid MO,Medicaid MO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medica,Medica,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Tricare,Tricare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC All Payer,UHC All Payer,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Exchange,UHC Exchange,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicaid,UHC Medicaid,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UMR CPD,UMR CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicare,UHC Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251453,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Wellcare,Wellcare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health PPO CPD,Meritain Health PPO CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna/Commercial Product,Aetna/Commercial Product,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Meritain Health CPD,Meritain Health CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Starmark CPD,Starmark CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Aetna Medicare,Aetna Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Ambetter ,Ambetter ,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access,Anthem Blue Access,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Access Choice,Anthem Blue Access Choice,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Blue Preferred,Anthem Blue Preferred,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Pathway,Anthem Pathway,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Alliance,Anthem Alliance,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Anthem Medicare,Anthem Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna,Cigna,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna PPO,Cigna PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Cigna Medicare Advantage,Cigna Medicare Advantage,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Essence,Essence,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink HMO,Healthlink HMO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Healthlink PPO,Healthlink PPO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,HomeState Health Plan,HomeState Health Plan,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Humana Gold,Humana Gold,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medicaid MO,Medicaid MO,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Medica,Medica,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Tricare,Tricare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC All Payer,UHC All Payer,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Exchange,UHC Exchange,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicaid,UHC Medicaid,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UMR CPD,UMR CPD,122.92,,,,,,,per diem,122.92,122.92,"Per diem rate, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,UHC Medicare,UHC Medicare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O LYMPHOCY SUBSET 4         ,38251454,CDM,302,RC,,,,,,Inpatient,,,122.92,122.92,Wellcare,Wellcare,122.92,,,,,,,case rate,122.92,122.92,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health PPO CPD,Meritain Health PPO CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/Commercial Product,Aetna/Commercial Product,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health CPD,Meritain Health CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Starmark CPD,Starmark CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna Medicare,Aetna Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Ambetter ,Ambetter ,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access,Anthem Blue Access,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access Choice,Anthem Blue Access Choice,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Preferred,Anthem Blue Preferred,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Pathway,Anthem Pathway,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Alliance,Anthem Alliance,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Medicare,Anthem Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna,Cigna,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna PPO,Cigna PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna Medicare Advantage,Cigna Medicare Advantage,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Essence,Essence,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink HMO,Healthlink HMO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink PPO,Healthlink PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,HomeState Health Plan,HomeState Health Plan,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Humana Gold,Humana Gold,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Medicaid MO,Medicaid MO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Medica,Medica,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Tricare,Tricare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC All Payer,UHC All Payer,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Exchange,UHC Exchange,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicaid,UHC Medicaid,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UMR CPD,UMR CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicare,UHC Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251455,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Wellcare,Wellcare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health PPO CPD,Meritain Health PPO CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna/Commercial Product,Aetna/Commercial Product,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Meritain Health CPD,Meritain Health CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Starmark CPD,Starmark CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Aetna Medicare,Aetna Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Ambetter ,Ambetter ,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access,Anthem Blue Access,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Access Choice,Anthem Blue Access Choice,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Blue Preferred,Anthem Blue Preferred,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Pathway,Anthem Pathway,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Alliance,Anthem Alliance,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Anthem Medicare,Anthem Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna,Cigna,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna PPO,Cigna PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Cigna Medicare Advantage,Cigna Medicare Advantage,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Essence,Essence,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink HMO,Healthlink HMO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Healthlink PPO,Healthlink PPO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,HomeState Health Plan,HomeState Health Plan,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Humana Gold,Humana Gold,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Medicaid MO,Medicaid MO,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Medica,Medica,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Tricare,Tricare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC All Payer,UHC All Payer,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Exchange,UHC Exchange,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicaid,UHC Medicaid,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UMR CPD,UMR CPD,49.38,,,,,,,per diem,49.38,49.38,"Per diem rate, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,UHC Medicare,UHC Medicare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O HSV DFA W/REFLEX          ,38251456,CDM,306,RC,,,,,,Inpatient,,,49.38,49.38,Wellcare,Wellcare,49.38,,,,,,,case rate,49.38,49.38,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O CG TMA                    ,38251457,CDM,306,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251458,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251459,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O VAG PATH DNA DP           ,38251460,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251461,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health PPO CPD,Meritain Health PPO CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna/Commercial Product,Aetna/Commercial Product,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Meritain Health CPD,Meritain Health CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Starmark CPD,Starmark CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Aetna Medicare,Aetna Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Ambetter ,Ambetter ,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access,Anthem Blue Access,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Access Choice,Anthem Blue Access Choice,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Blue Preferred,Anthem Blue Preferred,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Pathway,Anthem Pathway,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Alliance,Anthem Alliance,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Anthem Medicare,Anthem Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna,Cigna,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna PPO,Cigna PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Cigna Medicare Advantage,Cigna Medicare Advantage,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Essence,Essence,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink HMO,Healthlink HMO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Healthlink PPO,Healthlink PPO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,HomeState Health Plan,HomeState Health Plan,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Humana Gold,Humana Gold,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medicaid MO,Medicaid MO,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Medica,Medica,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Tricare,Tricare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC All Payer,UHC All Payer,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Exchange,UHC Exchange,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicaid,UHC Medicaid,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UMR CPD,UMR CPD,775.34,,,,,,,per diem,775.34,775.34,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,UHC Medicare,UHC Medicare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251462,CDM,306,RC,,,,,,Inpatient,,,775.34,775.34,Wellcare,Wellcare,775.34,,,,,,,case rate,775.34,775.34,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Meritain Health PPO CPD,Meritain Health PPO CPD,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Aetna/Commercial Product,Aetna/Commercial Product,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Meritain Health CPD,Meritain Health CPD,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Starmark CPD,Starmark CPD,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Aetna Medicare,Aetna Medicare,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Ambetter ,Ambetter ,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Blue Access,Anthem Blue Access,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Blue Access Choice,Anthem Blue Access Choice,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Blue Preferred,Anthem Blue Preferred,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Pathway,Anthem Pathway,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Alliance,Anthem Alliance,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Anthem Medicare,Anthem Medicare,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Cigna,Cigna,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Cigna PPO,Cigna PPO,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Cigna Medicare Advantage,Cigna Medicare Advantage,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Essence,Essence,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Healthlink HMO,Healthlink HMO,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Healthlink PPO,Healthlink PPO,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,HomeState Health Plan,HomeState Health Plan,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Humana Gold,Humana Gold,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Medicaid MO,Medicaid MO,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Medica,Medica,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Tricare,Tricare,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,UHC All Payer,UHC All Payer,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,UHC Exchange,UHC Exchange,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,UHC Medicaid,UHC Medicaid,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,UMR CPD,UMR CPD,416.04,,,,,,,per diem,416.04,416.04,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,UHC Medicare,UHC Medicare,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251463,CDM,306,RC,,,,,,Inpatient,,,416.04,416.04,Wellcare,Wellcare,416.04,,,,,,,case rate,416.04,416.04,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O RESP VIR DFA WRFX         ,38251464,CDM,306,RC,,,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Meritain Health PPO CPD,Meritain Health PPO CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Aetna/Commercial Product,Aetna/Commercial Product,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Meritain Health CPD,Meritain Health CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Starmark CPD,Starmark CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Aetna Medicare,Aetna Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Ambetter ,Ambetter ,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Access,Anthem Blue Access,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Access Choice,Anthem Blue Access Choice,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Blue Preferred,Anthem Blue Preferred,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Pathway,Anthem Pathway,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Alliance,Anthem Alliance,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Anthem Medicare,Anthem Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Cigna,Cigna,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Cigna PPO,Cigna PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Cigna Medicare Advantage,Cigna Medicare Advantage,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Essence,Essence,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Healthlink HMO,Healthlink HMO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Healthlink PPO,Healthlink PPO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,HomeState Health Plan,HomeState Health Plan,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Humana Gold,Humana Gold,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Medicaid MO,Medicaid MO,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Medica,Medica,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Tricare,Tricare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,UHC All Payer,UHC All Payer,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,UHC Exchange,UHC Exchange,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,UHC Medicaid,UHC Medicaid,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,UMR CPD,UMR CPD,100.86,,,,,,,per diem,100.86,100.86,"Per diem rate, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,UHC Medicare,UHC Medicare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O L/S RATIO                 ,38251465,CDM,301,RC,,,,,,Inpatient,,,100.86,100.86,Wellcare,Wellcare,100.86,,,,,,,case rate,100.86,100.86,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF POLYVL MULT ORG AG     ,38251466,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O VIRUS ISOLATION HSV       ,38251467,CDM,306,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health PPO CPD,Meritain Health PPO CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna/Commercial Product,Aetna/Commercial Product,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Meritain Health CPD,Meritain Health CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Starmark CPD,Starmark CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Aetna Medicare,Aetna Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Ambetter ,Ambetter ,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access,Anthem Blue Access,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Access Choice,Anthem Blue Access Choice,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Blue Preferred,Anthem Blue Preferred,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Pathway,Anthem Pathway,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Alliance,Anthem Alliance,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Anthem Medicare,Anthem Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna,Cigna,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna PPO,Cigna PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Cigna Medicare Advantage,Cigna Medicare Advantage,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Essence,Essence,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink HMO,Healthlink HMO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Healthlink PPO,Healthlink PPO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,HomeState Health Plan,HomeState Health Plan,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Humana Gold,Humana Gold,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Medicaid MO,Medicaid MO,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Medica,Medica,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Tricare,Tricare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC All Payer,UHC All Payer,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Exchange,UHC Exchange,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicaid,UHC Medicaid,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UMR CPD,UMR CPD,68.29,,,,,,,per diem,68.29,68.29,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,UHC Medicare,UHC Medicare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251468,CDM,306,RC,,,,,,Inpatient,,,68.29,68.29,Wellcare,Wellcare,68.29,,,,,,,case rate,68.29,68.29,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health PPO CPD,Meritain Health PPO CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna/Commercial Product,Aetna/Commercial Product,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Meritain Health CPD,Meritain Health CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Starmark CPD,Starmark CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Aetna Medicare,Aetna Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Ambetter ,Ambetter ,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access,Anthem Blue Access,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Access Choice,Anthem Blue Access Choice,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Blue Preferred,Anthem Blue Preferred,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Pathway,Anthem Pathway,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Alliance,Anthem Alliance,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Anthem Medicare,Anthem Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna,Cigna,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna PPO,Cigna PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Cigna Medicare Advantage,Cigna Medicare Advantage,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Essence,Essence,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink HMO,Healthlink HMO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Healthlink PPO,Healthlink PPO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,HomeState Health Plan,HomeState Health Plan,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Humana Gold,Humana Gold,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medicaid MO,Medicaid MO,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Medica,Medica,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Tricare,Tricare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC All Payer,UHC All Payer,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Exchange,UHC Exchange,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicaid,UHC Medicaid,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UMR CPD,UMR CPD,146.03,,,,,,,per diem,146.03,146.03,"Per diem rate, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,UHC Medicare,UHC Medicare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O NEISSERIA AMP PROBE       ,38251469,CDM,306,RC,,,,,,Inpatient,,,146.03,146.03,Wellcare,Wellcare,146.03,,,,,,,case rate,146.03,146.03,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health PPO CPD,Meritain Health PPO CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna/Commercial Product,Aetna/Commercial Product,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Meritain Health CPD,Meritain Health CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Starmark CPD,Starmark CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Aetna Medicare,Aetna Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Ambetter ,Ambetter ,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access,Anthem Blue Access,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Access Choice,Anthem Blue Access Choice,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Blue Preferred,Anthem Blue Preferred,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Pathway,Anthem Pathway,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Alliance,Anthem Alliance,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Anthem Medicare,Anthem Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna,Cigna,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna PPO,Cigna PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Cigna Medicare Advantage,Cigna Medicare Advantage,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Essence,Essence,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink HMO,Healthlink HMO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Healthlink PPO,Healthlink PPO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,HomeState Health Plan,HomeState Health Plan,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Humana Gold,Humana Gold,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Medicaid MO,Medicaid MO,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Medica,Medica,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Tricare,Tricare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC All Payer,UHC All Payer,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Exchange,UHC Exchange,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicaid,UHC Medicaid,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UMR CPD,UMR CPD,34.67,,,,,,,per diem,34.67,34.67,"Per diem rate, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,UHC Medicare,UHC Medicare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O PERTUSSIS DFA             ,38251470,CDM,306,RC,,,,,,Inpatient,,,34.67,34.67,Wellcare,Wellcare,34.67,,,,,,,case rate,34.67,34.67,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251471,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AZOLE MIC MOLD            ,38251472,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Meritain Health PPO CPD,Meritain Health PPO CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna/Commercial Product,Aetna/Commercial Product,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Meritain Health CPD,Meritain Health CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Starmark CPD,Starmark CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna Medicare,Aetna Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Ambetter ,Ambetter ,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Access,Anthem Blue Access,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Access Choice,Anthem Blue Access Choice,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Preferred,Anthem Blue Preferred,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Pathway,Anthem Pathway,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Alliance,Anthem Alliance,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Medicare,Anthem Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna,Cigna,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna PPO,Cigna PPO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna Medicare Advantage,Cigna Medicare Advantage,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Essence,Essence,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthlink HMO,Healthlink HMO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthlink PPO,Healthlink PPO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,HomeState Health Plan,HomeState Health Plan,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Humana Gold,Humana Gold,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Medicaid MO,Medicaid MO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Medica,Medica,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Tricare,Tricare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC All Payer,UHC All Payer,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Exchange,UHC Exchange,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Medicaid,UHC Medicaid,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UMR CPD,UMR CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Medicare,UHC Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC YEAST        ,38251473,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Wellcare,Wellcare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251474,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Meritain Health PPO CPD,Meritain Health PPO CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna/Commercial Product,Aetna/Commercial Product,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Meritain Health CPD,Meritain Health CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Starmark CPD,Starmark CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Aetna Medicare,Aetna Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Ambetter ,Ambetter ,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Access,Anthem Blue Access,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Access Choice,Anthem Blue Access Choice,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Blue Preferred,Anthem Blue Preferred,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Pathway,Anthem Pathway,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Alliance,Anthem Alliance,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Anthem Medicare,Anthem Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna,Cigna,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna PPO,Cigna PPO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Cigna Medicare Advantage,Cigna Medicare Advantage,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Essence,Essence,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthlink HMO,Healthlink HMO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Healthlink PPO,Healthlink PPO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,HomeState Health Plan,HomeState Health Plan,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Humana Gold,Humana Gold,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Medicaid MO,Medicaid MO,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Medica,Medica,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Tricare,Tricare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC All Payer,UHC All Payer,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Exchange,UHC Exchange,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Medicaid,UHC Medicaid,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UMR CPD,UMR CPD,181.75,,,,,,,per diem,181.75,181.75,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,UHC Medicare,UHC Medicare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251475,CDM,306,RC,,,,,,Inpatient,,,181.75,181.75,Wellcare,Wellcare,181.75,,,,,,,case rate,181.75,181.75,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O AMB/CAND MIC MOLD         ,38251476,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251477,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 2 DRUGS          ,38251478,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251479,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 3 DRUGS          ,38251480,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251481,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 4 DRUGS          ,38251482,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251483,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Meritain Health PPO CPD,Meritain Health PPO CPD,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Aetna/Commercial Product,Aetna/Commercial Product,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Meritain Health CPD,Meritain Health CPD,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Starmark CPD,Starmark CPD,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Aetna Medicare,Aetna Medicare,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Ambetter ,Ambetter ,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Blue Access,Anthem Blue Access,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Blue Access Choice,Anthem Blue Access Choice,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Blue Preferred,Anthem Blue Preferred,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Pathway,Anthem Pathway,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Alliance,Anthem Alliance,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Anthem Medicare,Anthem Medicare,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Cigna,Cigna,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Cigna PPO,Cigna PPO,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Cigna Medicare Advantage,Cigna Medicare Advantage,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Essence,Essence,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Healthlink HMO,Healthlink HMO,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Healthlink PPO,Healthlink PPO,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,HomeState Health Plan,HomeState Health Plan,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Humana Gold,Humana Gold,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Medicaid MO,Medicaid MO,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Medica,Medica,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Tricare,Tricare,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,UHC All Payer,UHC All Payer,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,UHC Exchange,UHC Exchange,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,UHC Medicaid,UHC Medicaid,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,UMR CPD,UMR CPD,208.75,,,,,,,per diem,208.75,208.75,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,UHC Medicare,UHC Medicare,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 5 DRUGS          ,38251484,CDM,306,RC,,,,,,Inpatient,,,208.75,208.75,Wellcare,Wellcare,208.75,,,,,,,case rate,208.75,208.75,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251485,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC 6 DRUGS          ,38251486,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health PPO CPD,Meritain Health PPO CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna/Commercial Product,Aetna/Commercial Product,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Meritain Health CPD,Meritain Health CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Starmark CPD,Starmark CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Aetna Medicare,Aetna Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Ambetter ,Ambetter ,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access,Anthem Blue Access,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Access Choice,Anthem Blue Access Choice,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Blue Preferred,Anthem Blue Preferred,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Pathway,Anthem Pathway,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Alliance,Anthem Alliance,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Anthem Medicare,Anthem Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna,Cigna,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna PPO,Cigna PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Cigna Medicare Advantage,Cigna Medicare Advantage,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Essence,Essence,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink HMO,Healthlink HMO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Healthlink PPO,Healthlink PPO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,HomeState Health Plan,HomeState Health Plan,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Humana Gold,Humana Gold,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Medicaid MO,Medicaid MO,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Medica,Medica,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Tricare,Tricare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC All Payer,UHC All Payer,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Exchange,UHC Exchange,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicaid,UHC Medicaid,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UMR CPD,UMR CPD,75.64,,,,,,,per diem,75.64,75.64,"Per diem rate, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,UHC Medicare,UHC Medicare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O CULT FUNGUS ID MOLD       ,38251487,CDM,306,RC,,,,,,Inpatient,,,75.64,75.64,Wellcare,Wellcare,75.64,,,,,,,case rate,75.64,75.64,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O MOLD MIC SINGLE DRUG      ,38251488,CDM,306,RC,,,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Meritain Health PPO CPD,Meritain Health PPO CPD,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Aetna/Commercial Product,Aetna/Commercial Product,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Meritain Health CPD,Meritain Health CPD,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Starmark CPD,Starmark CPD,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Aetna Medicare,Aetna Medicare,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Ambetter ,Ambetter ,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Blue Access,Anthem Blue Access,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Blue Access Choice,Anthem Blue Access Choice,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Blue Preferred,Anthem Blue Preferred,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Pathway,Anthem Pathway,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Alliance,Anthem Alliance,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Anthem Medicare,Anthem Medicare,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Cigna,Cigna,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Cigna PPO,Cigna PPO,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Cigna Medicare Advantage,Cigna Medicare Advantage,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Essence,Essence,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Healthlink HMO,Healthlink HMO,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Healthlink PPO,Healthlink PPO,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,HomeState Health Plan,HomeState Health Plan,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Humana Gold,Humana Gold,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Medicaid MO,Medicaid MO,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Medica,Medica,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Tricare,Tricare,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,UHC All Payer,UHC All Payer,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,UHC Exchange,UHC Exchange,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,UHC Medicaid,UHC Medicaid,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,UMR CPD,UMR CPD,1788.12,,,,,,,per diem,1788.12,1788.12,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,UHC Medicare,UHC Medicare,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251489,CDM,306,RC,,,,,,Inpatient,,,1788.12,1788.12,Wellcare,Wellcare,1788.12,,,,,,,case rate,1788.12,1788.12,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health PPO CPD,Meritain Health PPO CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/Commercial Product,Aetna/Commercial Product,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health CPD,Meritain Health CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Starmark CPD,Starmark CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna Medicare,Aetna Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Ambetter ,Ambetter ,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access,Anthem Blue Access,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access Choice,Anthem Blue Access Choice,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Preferred,Anthem Blue Preferred,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Pathway,Anthem Pathway,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Alliance,Anthem Alliance,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Medicare,Anthem Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna,Cigna,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna PPO,Cigna PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna Medicare Advantage,Cigna Medicare Advantage,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Essence,Essence,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink HMO,Healthlink HMO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink PPO,Healthlink PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,HomeState Health Plan,HomeState Health Plan,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Humana Gold,Humana Gold,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Medicaid MO,Medicaid MO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Medica,Medica,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Tricare,Tricare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC All Payer,UHC All Payer,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Exchange,UHC Exchange,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicaid,UHC Medicaid,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UMR CPD,UMR CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicare,UHC Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251490,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Wellcare,Wellcare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health PPO CPD,Meritain Health PPO CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna/Commercial Product,Aetna/Commercial Product,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Meritain Health CPD,Meritain Health CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Starmark CPD,Starmark CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Aetna Medicare,Aetna Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Ambetter ,Ambetter ,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access,Anthem Blue Access,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Access Choice,Anthem Blue Access Choice,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Blue Preferred,Anthem Blue Preferred,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Pathway,Anthem Pathway,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Alliance,Anthem Alliance,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Anthem Medicare,Anthem Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna,Cigna,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna PPO,Cigna PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Cigna Medicare Advantage,Cigna Medicare Advantage,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Essence,Essence,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink HMO,Healthlink HMO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Healthlink PPO,Healthlink PPO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,HomeState Health Plan,HomeState Health Plan,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Humana Gold,Humana Gold,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Medicaid MO,Medicaid MO,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Medica,Medica,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Tricare,Tricare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC All Payer,UHC All Payer,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Exchange,UHC Exchange,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicaid,UHC Medicaid,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UMR CPD,UMR CPD,150.24,,,,,,,per diem,150.24,150.24,"Per diem rate, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,UHC Medicare,UHC Medicare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O RESP MULTI PNL NP         ,38251491,CDM,306,RC,,,,,,Inpatient,,,150.24,150.24,Wellcare,Wellcare,150.24,,,,,,,case rate,150.24,150.24,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Meritain Health PPO CPD,Meritain Health PPO CPD,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Aetna/Commercial Product,Aetna/Commercial Product,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Meritain Health CPD,Meritain Health CPD,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Starmark CPD,Starmark CPD,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Aetna Medicare,Aetna Medicare,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Ambetter ,Ambetter ,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Blue Access,Anthem Blue Access,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Blue Access Choice,Anthem Blue Access Choice,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Blue Preferred,Anthem Blue Preferred,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Pathway,Anthem Pathway,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Alliance,Anthem Alliance,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Anthem Medicare,Anthem Medicare,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Cigna,Cigna,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Cigna PPO,Cigna PPO,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Cigna Medicare Advantage,Cigna Medicare Advantage,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Essence,Essence,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Healthlink HMO,Healthlink HMO,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Healthlink PPO,Healthlink PPO,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,HomeState Health Plan,HomeState Health Plan,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Humana Gold,Humana Gold,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Medicaid MO,Medicaid MO,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Medica,Medica,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Tricare,Tricare,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,UHC All Payer,UHC All Payer,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,UHC Exchange,UHC Exchange,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,UHC Medicaid,UHC Medicaid,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,UMR CPD,UMR CPD,37.82,,,,,,,per diem,37.82,37.82,"Per diem rate, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,UHC Medicare,UHC Medicare,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O CULTURE TYPING OTHER      ,38251492,CDM,306,RC,,,,,,Inpatient,,,37.82,37.82,Wellcare,Wellcare,37.82,,,,,,,case rate,37.82,37.82,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health PPO CPD,Meritain Health PPO CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Aetna/Commercial Product,Aetna/Commercial Product,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Meritain Health CPD,Meritain Health CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Starmark CPD,Starmark CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Aetna Medicare,Aetna Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Ambetter ,Ambetter ,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access,Anthem Blue Access,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Access Choice,Anthem Blue Access Choice,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Blue Preferred,Anthem Blue Preferred,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Pathway,Anthem Pathway,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Alliance,Anthem Alliance,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Anthem Medicare,Anthem Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Cigna,Cigna,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Cigna PPO,Cigna PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Cigna Medicare Advantage,Cigna Medicare Advantage,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Essence,Essence,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink HMO,Healthlink HMO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Healthlink PPO,Healthlink PPO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,HomeState Health Plan,HomeState Health Plan,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Humana Gold,Humana Gold,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Medicaid MO,Medicaid MO,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Medica,Medica,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Tricare,Tricare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,UHC All Payer,UHC All Payer,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,UHC Exchange,UHC Exchange,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicaid,UHC Medicaid,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,UMR CPD,UMR CPD,160.74,,,,,,,per diem,160.74,160.74,"Per diem rate, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,UHC Medicare,UHC Medicare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF B PERTUSSIS AG         ,38251493,CDM,306,RC,,,,,,Inpatient,,,160.74,160.74,Wellcare,Wellcare,160.74,,,,,,,case rate,160.74,160.74,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health PPO CPD,Meritain Health PPO CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Aetna/Commercial Product,Aetna/Commercial Product,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Meritain Health CPD,Meritain Health CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Starmark CPD,Starmark CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Aetna Medicare,Aetna Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Ambetter ,Ambetter ,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access,Anthem Blue Access,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Access Choice,Anthem Blue Access Choice,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Blue Preferred,Anthem Blue Preferred,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Pathway,Anthem Pathway,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Alliance,Anthem Alliance,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Anthem Medicare,Anthem Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Cigna,Cigna,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Cigna PPO,Cigna PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Cigna Medicare Advantage,Cigna Medicare Advantage,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Essence,Essence,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink HMO,Healthlink HMO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Healthlink PPO,Healthlink PPO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,HomeState Health Plan,HomeState Health Plan,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Humana Gold,Humana Gold,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Medicaid MO,Medicaid MO,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Medica,Medica,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Tricare,Tricare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,UHC All Payer,UHC All Payer,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,UHC Exchange,UHC Exchange,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicaid,UHC Medicaid,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,UMR CPD,UMR CPD,195.41,,,,,,,per diem,195.41,195.41,"Per diem rate, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,UHC Medicare,UHC Medicare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF HERPES TYPE 2 AG       ,38251494,CDM,306,RC,,,,,,Inpatient,,,195.41,195.41,Wellcare,Wellcare,195.41,,,,,,,case rate,195.41,195.41,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health PPO CPD,Meritain Health PPO CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Aetna/Commercial Product,Aetna/Commercial Product,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Meritain Health CPD,Meritain Health CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Starmark CPD,Starmark CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Aetna Medicare,Aetna Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Ambetter ,Ambetter ,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access,Anthem Blue Access,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Access Choice,Anthem Blue Access Choice,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Blue Preferred,Anthem Blue Preferred,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Pathway,Anthem Pathway,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Alliance,Anthem Alliance,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Anthem Medicare,Anthem Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Cigna,Cigna,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Cigna PPO,Cigna PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Cigna Medicare Advantage,Cigna Medicare Advantage,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Essence,Essence,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink HMO,Healthlink HMO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Healthlink PPO,Healthlink PPO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,HomeState Health Plan,HomeState Health Plan,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Humana Gold,Humana Gold,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Medicaid MO,Medicaid MO,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Medica,Medica,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Tricare,Tricare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,UHC All Payer,UHC All Payer,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,UHC Exchange,UHC Exchange,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicaid,UHC Medicaid,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,UMR CPD,UMR CPD,97.71,,,,,,,per diem,97.71,97.71,"Per diem rate, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,UHC Medicare,UHC Medicare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O IF VARICLLA-ZOSTR AG      ,38251495,CDM,306,RC,,,,,,Inpatient,,,97.71,97.71,Wellcare,Wellcare,97.71,,,,,,,case rate,97.71,97.71,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Meritain Health PPO CPD,Meritain Health PPO CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna/Commercial Product,Aetna/Commercial Product,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Meritain Health CPD,Meritain Health CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Starmark CPD,Starmark CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Aetna Medicare,Aetna Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Ambetter ,Ambetter ,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Access,Anthem Blue Access,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Access Choice,Anthem Blue Access Choice,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Blue Preferred,Anthem Blue Preferred,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Pathway,Anthem Pathway,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Alliance,Anthem Alliance,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Anthem Medicare,Anthem Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna,Cigna,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna PPO,Cigna PPO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Cigna Medicare Advantage,Cigna Medicare Advantage,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Essence,Essence,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthlink HMO,Healthlink HMO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Healthlink PPO,Healthlink PPO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,HomeState Health Plan,HomeState Health Plan,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Humana Gold,Humana Gold,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Medicaid MO,Medicaid MO,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Medica,Medica,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Tricare,Tricare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC All Payer,UHC All Payer,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Exchange,UHC Exchange,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Medicaid,UHC Medicaid,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UMR CPD,UMR CPD,223.78,,,,,,,per diem,223.78,223.78,"Per diem rate, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,UHC Medicare,UHC Medicare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O NOCARDIA PCR ID REFLX     ,38251496,CDM,306,RC,,,,,,Inpatient,,,223.78,223.78,Wellcare,Wellcare,223.78,,,,,,,case rate,223.78,223.78,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251497,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health PPO CPD,Meritain Health PPO CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/Commercial Product,Aetna/Commercial Product,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health CPD,Meritain Health CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Starmark CPD,Starmark CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna Medicare,Aetna Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Ambetter ,Ambetter ,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access,Anthem Blue Access,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access Choice,Anthem Blue Access Choice,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Preferred,Anthem Blue Preferred,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Pathway,Anthem Pathway,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Alliance,Anthem Alliance,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Medicare,Anthem Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna,Cigna,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna PPO,Cigna PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna Medicare Advantage,Cigna Medicare Advantage,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Essence,Essence,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink HMO,Healthlink HMO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink PPO,Healthlink PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,HomeState Health Plan,HomeState Health Plan,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Humana Gold,Humana Gold,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Medicaid MO,Medicaid MO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Medica,Medica,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Tricare,Tricare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC All Payer,UHC All Payer,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Exchange,UHC Exchange,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicaid,UHC Medicaid,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UMR CPD,UMR CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicare,UHC Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251498,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Wellcare,Wellcare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health PPO CPD,Meritain Health PPO CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna/Commercial Product,Aetna/Commercial Product,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Meritain Health CPD,Meritain Health CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Starmark CPD,Starmark CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Aetna Medicare,Aetna Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Ambetter ,Ambetter ,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access,Anthem Blue Access,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Access Choice,Anthem Blue Access Choice,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Blue Preferred,Anthem Blue Preferred,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Pathway,Anthem Pathway,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Alliance,Anthem Alliance,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Anthem Medicare,Anthem Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna,Cigna,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna PPO,Cigna PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Cigna Medicare Advantage,Cigna Medicare Advantage,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Essence,Essence,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink HMO,Healthlink HMO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Healthlink PPO,Healthlink PPO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,HomeState Health Plan,HomeState Health Plan,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Humana Gold,Humana Gold,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medicaid MO,Medicaid MO,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Medica,Medica,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Tricare,Tricare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC All Payer,UHC All Payer,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Exchange,UHC Exchange,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicaid,UHC Medicaid,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UMR CPD,UMR CPD,148.13,,,,,,,per diem,148.13,148.13,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,UHC Medicare,UHC Medicare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251499,CDM,306,RC,,,,,,Inpatient,,,148.13,148.13,Wellcare,Wellcare,148.13,,,,,,,case rate,148.13,148.13,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health PPO CPD,Meritain Health PPO CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna/Commercial Product,Aetna/Commercial Product,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Meritain Health CPD,Meritain Health CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Starmark CPD,Starmark CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Aetna Medicare,Aetna Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Ambetter ,Ambetter ,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access,Anthem Blue Access,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Access Choice,Anthem Blue Access Choice,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Blue Preferred,Anthem Blue Preferred,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Pathway,Anthem Pathway,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Alliance,Anthem Alliance,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Anthem Medicare,Anthem Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna,Cigna,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna PPO,Cigna PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Cigna Medicare Advantage,Cigna Medicare Advantage,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Essence,Essence,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink HMO,Healthlink HMO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Healthlink PPO,Healthlink PPO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,HomeState Health Plan,HomeState Health Plan,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Humana Gold,Humana Gold,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Medicaid MO,Medicaid MO,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Medica,Medica,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Tricare,Tricare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC All Payer,UHC All Payer,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Exchange,UHC Exchange,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicaid,UHC Medicaid,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UMR CPD,UMR CPD,72.49,,,,,,,per diem,72.49,72.49,"Per diem rate, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,UHC Medicare,UHC Medicare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O RESP MULTIPLX N/P         ,38251500,CDM,306,RC,,,,,,Inpatient,,,72.49,72.49,Wellcare,Wellcare,72.49,,,,,,,case rate,72.49,72.49,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Meritain Health PPO CPD,Meritain Health PPO CPD,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Aetna/Commercial Product,Aetna/Commercial Product,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Meritain Health CPD,Meritain Health CPD,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Starmark CPD,Starmark CPD,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Aetna Medicare,Aetna Medicare,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Ambetter ,Ambetter ,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Blue Access,Anthem Blue Access,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Blue Access Choice,Anthem Blue Access Choice,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Blue Preferred,Anthem Blue Preferred,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Pathway,Anthem Pathway,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Alliance,Anthem Alliance,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Anthem Medicare,Anthem Medicare,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Cigna,Cigna,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Cigna PPO,Cigna PPO,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Cigna Medicare Advantage,Cigna Medicare Advantage,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Essence,Essence,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Healthlink HMO,Healthlink HMO,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Healthlink PPO,Healthlink PPO,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,HomeState Health Plan,HomeState Health Plan,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Humana Gold,Humana Gold,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Medicaid MO,Medicaid MO,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Medica,Medica,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Tricare,Tricare,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,UHC All Payer,UHC All Payer,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,UHC Exchange,UHC Exchange,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,UHC Medicaid,UHC Medicaid,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,UMR CPD,UMR CPD,361.69,,,,,,,per diem,361.69,361.69,"Per diem rate, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,UHC Medicare,UHC Medicare,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O GI PNL BIOFRE FLM ARR     ,38251501,CDM,306,RC,,,,,,Inpatient,,,361.69,361.69,Wellcare,Wellcare,361.69,,,,,,,case rate,361.69,361.69,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Meritain Health PPO CPD,Meritain Health PPO CPD,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Aetna/Commercial Product,Aetna/Commercial Product,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Meritain Health CPD,Meritain Health CPD,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Starmark CPD,Starmark CPD,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Aetna Medicare,Aetna Medicare,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Ambetter ,Ambetter ,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Blue Access,Anthem Blue Access,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Blue Access Choice,Anthem Blue Access Choice,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Blue Preferred,Anthem Blue Preferred,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Pathway,Anthem Pathway,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Alliance,Anthem Alliance,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Anthem Medicare,Anthem Medicare,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Cigna,Cigna,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Cigna PPO,Cigna PPO,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Cigna Medicare Advantage,Cigna Medicare Advantage,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Essence,Essence,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Healthlink HMO,Healthlink HMO,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Healthlink PPO,Healthlink PPO,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,HomeState Health Plan,HomeState Health Plan,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Humana Gold,Humana Gold,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Medicaid MO,Medicaid MO,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Medica,Medica,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Tricare,Tricare,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,UHC All Payer,UHC All Payer,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,UHC Exchange,UHC Exchange,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,UHC Medicaid,UHC Medicaid,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,UMR CPD,UMR CPD,1119.94,,,,,,,per diem,1119.94,1119.94,"Per diem rate, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,UHC Medicare,UHC Medicare,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
S/O NJH-AFB4 AFB ID           ,38251502,CDM,306,RC,,,,,,Inpatient,,,1119.94,1119.94,Wellcare,Wellcare,1119.94,,,,,,,case rate,1119.94,1119.94,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Meritain Health PPO CPD,Meritain Health PPO CPD,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Aetna/Commercial Product,Aetna/Commercial Product,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Meritain Health CPD,Meritain Health CPD,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Starmark CPD,Starmark CPD,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Aetna Medicare,Aetna Medicare,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Ambetter ,Ambetter ,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Blue Access,Anthem Blue Access,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Blue Access Choice,Anthem Blue Access Choice,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Blue Preferred,Anthem Blue Preferred,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Pathway,Anthem Pathway,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Alliance,Anthem Alliance,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Anthem Medicare,Anthem Medicare,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Cigna,Cigna,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Cigna PPO,Cigna PPO,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Cigna Medicare Advantage,Cigna Medicare Advantage,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Essence,Essence,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Healthlink HMO,Healthlink HMO,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Healthlink PPO,Healthlink PPO,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,HomeState Health Plan,HomeState Health Plan,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Humana Gold,Humana Gold,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Medicaid MO,Medicaid MO,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Medica,Medica,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Tricare,Tricare,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,UHC All Payer,UHC All Payer,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,UHC Exchange,UHC Exchange,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,UHC Medicaid,UHC Medicaid,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,UMR CPD,UMR CPD,25.75,,,,,,,per diem,25.75,25.75,"Per diem rate, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,UHC Medicare,UHC Medicare,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
VENIPUNCTURE FOR COLLECT      ,38251511,CDM,300,RC,36415,CPT,,,,Inpatient,,,25.75,25.75,Wellcare,Wellcare,25.75,,,,,,,case rate,25.75,25.75,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Meritain Health PPO CPD,Meritain Health PPO CPD,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Aetna/Commercial Product,Aetna/Commercial Product,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Meritain Health CPD,Meritain Health CPD,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Starmark CPD,Starmark CPD,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Aetna Medicare,Aetna Medicare,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Ambetter ,Ambetter ,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Blue Access,Anthem Blue Access,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Blue Access Choice,Anthem Blue Access Choice,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Blue Preferred,Anthem Blue Preferred,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Pathway,Anthem Pathway,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Alliance,Anthem Alliance,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Anthem Medicare,Anthem Medicare,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Cigna,Cigna,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Cigna PPO,Cigna PPO,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Cigna Medicare Advantage,Cigna Medicare Advantage,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Essence,Essence,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Healthlink HMO,Healthlink HMO,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Healthlink PPO,Healthlink PPO,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,HomeState Health Plan,HomeState Health Plan,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Humana Gold,Humana Gold,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Medicaid MO,Medicaid MO,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Medica,Medica,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Tricare,Tricare,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,UHC All Payer,UHC All Payer,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,UHC Exchange,UHC Exchange,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,UHC Medicaid,UHC Medicaid,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,UMR CPD,UMR CPD,385.64,,,,,,,per diem,385.64,385.64,"Per diem rate, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,UHC Medicare,UHC Medicare,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
CYCLOSPORINE A                ,38251512,CDM,300,RC,80158,CPT,,,,Inpatient,,,385.64,385.64,Wellcare,Wellcare,385.64,,,,,,,case rate,385.64,385.64,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Meritain Health PPO CPD,Meritain Health PPO CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Aetna/Commercial Product,Aetna/Commercial Product,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Meritain Health CPD,Meritain Health CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Starmark CPD,Starmark CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Aetna Medicare,Aetna Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Ambetter ,Ambetter ,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Access,Anthem Blue Access,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Access Choice,Anthem Blue Access Choice,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Preferred,Anthem Blue Preferred,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Pathway,Anthem Pathway,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Alliance,Anthem Alliance,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Anthem Medicare,Anthem Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Cigna,Cigna,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Cigna PPO,Cigna PPO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Cigna Medicare Advantage,Cigna Medicare Advantage,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Essence,Essence,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Healthlink HMO,Healthlink HMO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Healthlink PPO,Healthlink PPO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,HomeState Health Plan,HomeState Health Plan,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Humana Gold,Humana Gold,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Medicaid MO,Medicaid MO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Medica,Medica,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Tricare,Tricare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,UHC All Payer,UHC All Payer,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,UHC Exchange,UHC Exchange,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,UHC Medicaid,UHC Medicaid,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,UMR CPD,UMR CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,UHC Medicare,UHC Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
VANCOMYCIN TROUGH             ,38251513,CDM,300,RC,80202,CPT,,,,Inpatient,,,248.25,248.25,Wellcare,Wellcare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
AMIODARONE SERUM              ,38251514,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Meritain Health PPO CPD,Meritain Health PPO CPD,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Aetna/Commercial Product,Aetna/Commercial Product,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Meritain Health CPD,Meritain Health CPD,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Starmark CPD,Starmark CPD,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Aetna Medicare,Aetna Medicare,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Ambetter ,Ambetter ,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Blue Access,Anthem Blue Access,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Blue Access Choice,Anthem Blue Access Choice,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Blue Preferred,Anthem Blue Preferred,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Pathway,Anthem Pathway,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Alliance,Anthem Alliance,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Anthem Medicare,Anthem Medicare,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Cigna,Cigna,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Cigna PPO,Cigna PPO,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Cigna Medicare Advantage,Cigna Medicare Advantage,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Essence,Essence,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Healthlink HMO,Healthlink HMO,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Healthlink PPO,Healthlink PPO,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,HomeState Health Plan,HomeState Health Plan,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Humana Gold,Humana Gold,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Medicaid MO,Medicaid MO,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Medica,Medica,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Tricare,Tricare,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,UHC All Payer,UHC All Payer,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,UHC Exchange,UHC Exchange,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,UHC Medicaid,UHC Medicaid,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,UMR CPD,UMR CPD,334.75,,,,,,,per diem,334.75,334.75,"Per diem rate, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,UHC Medicare,UHC Medicare,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
"VITAMIN D, 25-HYDROXY         ",38251515,CDM,300,RC,82306,CPT,,,,Inpatient,,,334.75,334.75,Wellcare,Wellcare,334.75,,,,,,,case rate,334.75,334.75,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Meritain Health PPO CPD,Meritain Health PPO CPD,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Aetna/Commercial Product,Aetna/Commercial Product,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Meritain Health CPD,Meritain Health CPD,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Starmark CPD,Starmark CPD,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Aetna Medicare,Aetna Medicare,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Ambetter ,Ambetter ,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Blue Access,Anthem Blue Access,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Blue Access Choice,Anthem Blue Access Choice,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Blue Preferred,Anthem Blue Preferred,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Pathway,Anthem Pathway,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Alliance,Anthem Alliance,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Anthem Medicare,Anthem Medicare,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Cigna,Cigna,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Cigna PPO,Cigna PPO,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Cigna Medicare Advantage,Cigna Medicare Advantage,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Essence,Essence,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Healthlink HMO,Healthlink HMO,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Healthlink PPO,Healthlink PPO,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,HomeState Health Plan,HomeState Health Plan,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Humana Gold,Humana Gold,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Medicaid MO,Medicaid MO,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Medica,Medica,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Tricare,Tricare,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,UHC All Payer,UHC All Payer,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,UHC Exchange,UHC Exchange,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,UHC Medicaid,UHC Medicaid,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,UMR CPD,UMR CPD,189.52,,,,,,,per diem,189.52,189.52,"Per diem rate, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,UHC Medicare,UHC Medicare,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
VITAMIN B-12                  ,38251516,CDM,300,RC,82607,CPT,,,,Inpatient,,,189.52,189.52,Wellcare,Wellcare,189.52,,,,,,,case rate,189.52,189.52,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health PPO CPD,Meritain Health PPO CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Aetna/Commercial Product,Aetna/Commercial Product,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health CPD,Meritain Health CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Starmark CPD,Starmark CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Aetna Medicare,Aetna Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Ambetter ,Ambetter ,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access,Anthem Blue Access,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access Choice,Anthem Blue Access Choice,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Preferred,Anthem Blue Preferred,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Pathway,Anthem Pathway,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Alliance,Anthem Alliance,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Anthem Medicare,Anthem Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Cigna,Cigna,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Cigna PPO,Cigna PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Cigna Medicare Advantage,Cigna Medicare Advantage,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Essence,Essence,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Healthlink HMO,Healthlink HMO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Healthlink PPO,Healthlink PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,HomeState Health Plan,HomeState Health Plan,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Humana Gold,Humana Gold,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Medicaid MO,Medicaid MO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Medica,Medica,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Tricare,Tricare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,UHC All Payer,UHC All Payer,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,UHC Exchange,UHC Exchange,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicaid,UHC Medicaid,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,UMR CPD,UMR CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicare,UHC Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
FOLATE SERUM                  ,38251517,CDM,300,RC,82746,CPT,,,,Inpatient,,,181.41,181.41,Wellcare,Wellcare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health PPO CPD,Meritain Health PPO CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna/Commercial Product,Aetna/Commercial Product,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Meritain Health CPD,Meritain Health CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Starmark CPD,Starmark CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Aetna Medicare,Aetna Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Ambetter ,Ambetter ,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access,Anthem Blue Access,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Access Choice,Anthem Blue Access Choice,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Blue Preferred,Anthem Blue Preferred,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Pathway,Anthem Pathway,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Alliance,Anthem Alliance,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Anthem Medicare,Anthem Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna,Cigna,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna PPO,Cigna PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Cigna Medicare Advantage,Cigna Medicare Advantage,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Essence,Essence,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthlink HMO,Healthlink HMO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Healthlink PPO,Healthlink PPO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,HomeState Health Plan,HomeState Health Plan,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Humana Gold,Humana Gold,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Medicaid MO,Medicaid MO,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Medica,Medica,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Tricare,Tricare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC All Payer,UHC All Payer,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Exchange,UHC Exchange,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicaid,UHC Medicaid,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UMR CPD,UMR CPD,167.62,,,,,,,per diem,167.62,167.62,"Per diem rate, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,UHC Medicare,UHC Medicare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
LACTIC ACID                   ,38251518,CDM,300,RC,83605,CPT,,,,Inpatient,,,167.62,167.62,Wellcare,Wellcare,167.62,,,,,,,case rate,167.62,167.62,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Meritain Health PPO CPD,Meritain Health PPO CPD,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Aetna/Commercial Product,Aetna/Commercial Product,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Meritain Health CPD,Meritain Health CPD,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Starmark CPD,Starmark CPD,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Aetna Medicare,Aetna Medicare,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Ambetter ,Ambetter ,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Blue Access,Anthem Blue Access,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Blue Access Choice,Anthem Blue Access Choice,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Blue Preferred,Anthem Blue Preferred,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Pathway,Anthem Pathway,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Alliance,Anthem Alliance,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Anthem Medicare,Anthem Medicare,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Cigna,Cigna,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Cigna PPO,Cigna PPO,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Cigna Medicare Advantage,Cigna Medicare Advantage,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Essence,Essence,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Healthlink HMO,Healthlink HMO,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Healthlink PPO,Healthlink PPO,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,HomeState Health Plan,HomeState Health Plan,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Humana Gold,Humana Gold,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Medicaid MO,Medicaid MO,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Medica,Medica,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Tricare,Tricare,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,UHC All Payer,UHC All Payer,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,UHC Exchange,UHC Exchange,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,UHC Medicaid,UHC Medicaid,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,UMR CPD,UMR CPD,63.28,,,,,,,per diem,63.28,63.28,"Per diem rate, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,UHC Medicare,UHC Medicare,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
"TRIIODOTHYRONINE, REVERSE     ",38251519,CDM,300,RC,84482,CPT,,,,Inpatient,,,63.28,63.28,Wellcare,Wellcare,63.28,,,,,,,case rate,63.28,63.28,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Meritain Health PPO CPD,Meritain Health PPO CPD,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Aetna/Commercial Product,Aetna/Commercial Product,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Meritain Health CPD,Meritain Health CPD,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Starmark CPD,Starmark CPD,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Aetna Medicare,Aetna Medicare,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Ambetter ,Ambetter ,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Blue Access,Anthem Blue Access,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Blue Access Choice,Anthem Blue Access Choice,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Blue Preferred,Anthem Blue Preferred,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Pathway,Anthem Pathway,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Alliance,Anthem Alliance,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Anthem Medicare,Anthem Medicare,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Cigna,Cigna,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Cigna PPO,Cigna PPO,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Cigna Medicare Advantage,Cigna Medicare Advantage,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Essence,Essence,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Healthlink HMO,Healthlink HMO,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Healthlink PPO,Healthlink PPO,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,HomeState Health Plan,HomeState Health Plan,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Humana Gold,Humana Gold,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Medicaid MO,Medicaid MO,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Medica,Medica,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Tricare,Tricare,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,UHC All Payer,UHC All Payer,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,UHC Exchange,UHC Exchange,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,UHC Medicaid,UHC Medicaid,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,UMR CPD,UMR CPD,175.05,,,,,,,per diem,175.05,175.05,"Per diem rate, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,UHC Medicare,UHC Medicare,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
AB SCREEN IGG                 ,38251520,CDM,300,RC,86850,CPT,,,,Inpatient,,,175.05,175.05,Wellcare,Wellcare,175.05,,,,,,,case rate,175.05,175.05,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Meritain Health PPO CPD,Meritain Health PPO CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Aetna/Commercial Product,Aetna/Commercial Product,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Meritain Health CPD,Meritain Health CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Starmark CPD,Starmark CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Aetna Medicare,Aetna Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Ambetter ,Ambetter ,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Access,Anthem Blue Access,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Access Choice,Anthem Blue Access Choice,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Blue Preferred,Anthem Blue Preferred,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Pathway,Anthem Pathway,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Alliance,Anthem Alliance,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Anthem Medicare,Anthem Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Cigna,Cigna,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Cigna PPO,Cigna PPO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Cigna Medicare Advantage,Cigna Medicare Advantage,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Essence,Essence,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Healthlink HMO,Healthlink HMO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Healthlink PPO,Healthlink PPO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,HomeState Health Plan,HomeState Health Plan,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Humana Gold,Humana Gold,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Medicaid MO,Medicaid MO,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Medica,Medica,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Tricare,Tricare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,UHC All Payer,UHC All Payer,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,UHC Exchange,UHC Exchange,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,UHC Medicaid,UHC Medicaid,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,UMR CPD,UMR CPD,104.03,,,,,,,per diem,104.03,104.03,"Per diem rate, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,UHC Medicare,UHC Medicare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
ABO ONLY                      ,38251521,CDM,300,RC,86900,CPT,,,,Inpatient,,,104.03,104.03,Wellcare,Wellcare,104.03,,,,,,,case rate,104.03,104.03,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Meritain Health PPO CPD,Meritain Health PPO CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Aetna/Commercial Product,Aetna/Commercial Product,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Meritain Health CPD,Meritain Health CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Starmark CPD,Starmark CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Aetna Medicare,Aetna Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Ambetter ,Ambetter ,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Access,Anthem Blue Access,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Access Choice,Anthem Blue Access Choice,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Blue Preferred,Anthem Blue Preferred,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Pathway,Anthem Pathway,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Alliance,Anthem Alliance,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Anthem Medicare,Anthem Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Cigna,Cigna,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Cigna PPO,Cigna PPO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Cigna Medicare Advantage,Cigna Medicare Advantage,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Essence,Essence,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Healthlink HMO,Healthlink HMO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Healthlink PPO,Healthlink PPO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,HomeState Health Plan,HomeState Health Plan,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Humana Gold,Humana Gold,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Medicaid MO,Medicaid MO,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Medica,Medica,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Tricare,Tricare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,UHC All Payer,UHC All Payer,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,UHC Exchange,UHC Exchange,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,UHC Medicaid,UHC Medicaid,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,UMR CPD,UMR CPD,84.46,,,,,,,per diem,84.46,84.46,"Per diem rate, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,UHC Medicare,UHC Medicare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
RH TYPE ONLY                  ,38251522,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.46,84.46,Wellcare,Wellcare,84.46,,,,,,,case rate,84.46,84.46,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Meritain Health PPO CPD,Meritain Health PPO CPD,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Aetna/Commercial Product,Aetna/Commercial Product,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Meritain Health CPD,Meritain Health CPD,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Starmark CPD,Starmark CPD,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Aetna Medicare,Aetna Medicare,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Ambetter ,Ambetter ,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Blue Access,Anthem Blue Access,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Blue Access Choice,Anthem Blue Access Choice,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Blue Preferred,Anthem Blue Preferred,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Pathway,Anthem Pathway,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Alliance,Anthem Alliance,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Anthem Medicare,Anthem Medicare,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Cigna,Cigna,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Cigna PPO,Cigna PPO,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Cigna Medicare Advantage,Cigna Medicare Advantage,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Essence,Essence,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Healthlink HMO,Healthlink HMO,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Healthlink PPO,Healthlink PPO,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,HomeState Health Plan,HomeState Health Plan,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Humana Gold,Humana Gold,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Medicaid MO,Medicaid MO,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Medica,Medica,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Tricare,Tricare,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,UHC All Payer,UHC All Payer,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,UHC Exchange,UHC Exchange,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,UHC Medicaid,UHC Medicaid,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,UMR CPD,UMR CPD,187.17,,,,,,,per diem,187.17,187.17,"Per diem rate, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,UHC Medicare,UHC Medicare,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
ELECTRONIC CROSSMATCH         ,38251523,CDM,300,RC,86923,CPT,,,,Inpatient,,,187.17,187.17,Wellcare,Wellcare,187.17,,,,,,,case rate,187.17,187.17,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Meritain Health PPO CPD,Meritain Health PPO CPD,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Aetna/Commercial Product,Aetna/Commercial Product,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Meritain Health CPD,Meritain Health CPD,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Starmark CPD,Starmark CPD,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Aetna Medicare,Aetna Medicare,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Ambetter ,Ambetter ,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Blue Access,Anthem Blue Access,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Blue Access Choice,Anthem Blue Access Choice,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Blue Preferred,Anthem Blue Preferred,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Pathway,Anthem Pathway,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Alliance,Anthem Alliance,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Anthem Medicare,Anthem Medicare,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Cigna,Cigna,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Cigna PPO,Cigna PPO,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Cigna Medicare Advantage,Cigna Medicare Advantage,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Essence,Essence,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Healthlink HMO,Healthlink HMO,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Healthlink PPO,Healthlink PPO,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,HomeState Health Plan,HomeState Health Plan,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Humana Gold,Humana Gold,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Medicaid MO,Medicaid MO,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Medica,Medica,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Tricare,Tricare,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,UHC All Payer,UHC All Payer,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,UHC Exchange,UHC Exchange,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,UHC Medicaid,UHC Medicaid,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,UMR CPD,UMR CPD,224.82,,,,,,,per diem,224.82,224.82,"Per diem rate, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,UHC Medicare,UHC Medicare,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
BASIC METABOLIC PANEL         ,38251524,CDM,301,RC,80048,CPT,,,,Inpatient,,,224.82,224.82,Wellcare,Wellcare,224.82,,,,,,,case rate,224.82,224.82,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Meritain Health PPO CPD,Meritain Health PPO CPD,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Aetna/Commercial Product,Aetna/Commercial Product,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Meritain Health CPD,Meritain Health CPD,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Starmark CPD,Starmark CPD,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Aetna Medicare,Aetna Medicare,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Ambetter ,Ambetter ,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Blue Access,Anthem Blue Access,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Blue Access Choice,Anthem Blue Access Choice,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Blue Preferred,Anthem Blue Preferred,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Pathway,Anthem Pathway,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Alliance,Anthem Alliance,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Anthem Medicare,Anthem Medicare,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Cigna,Cigna,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Cigna PPO,Cigna PPO,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Cigna Medicare Advantage,Cigna Medicare Advantage,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Essence,Essence,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Healthlink HMO,Healthlink HMO,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Healthlink PPO,Healthlink PPO,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,HomeState Health Plan,HomeState Health Plan,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Humana Gold,Humana Gold,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Medicaid MO,Medicaid MO,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Medica,Medica,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Tricare,Tricare,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,UHC All Payer,UHC All Payer,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,UHC Exchange,UHC Exchange,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,UHC Medicaid,UHC Medicaid,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,UMR CPD,UMR CPD,267.8,,,,,,,per diem,267.8,267.8,"Per diem rate, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,UHC Medicare,UHC Medicare,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
COMP METABOLIC PANEL          ,38251525,CDM,301,RC,80053,CPT,,,,Inpatient,,,267.8,267.8,Wellcare,Wellcare,267.8,,,,,,,case rate,267.8,267.8,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
LIPID PROFILE                 ,38251526,CDM,301,RC,80061,CPT,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Meritain Health PPO CPD,Meritain Health PPO CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Aetna/Commercial Product,Aetna/Commercial Product,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Meritain Health CPD,Meritain Health CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Starmark CPD,Starmark CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Aetna Medicare,Aetna Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Ambetter ,Ambetter ,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Access,Anthem Blue Access,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Access Choice,Anthem Blue Access Choice,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Blue Preferred,Anthem Blue Preferred,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Pathway,Anthem Pathway,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Alliance,Anthem Alliance,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Anthem Medicare,Anthem Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Cigna,Cigna,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Cigna PPO,Cigna PPO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Cigna Medicare Advantage,Cigna Medicare Advantage,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Essence,Essence,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Healthlink HMO,Healthlink HMO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Healthlink PPO,Healthlink PPO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,HomeState Health Plan,HomeState Health Plan,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Humana Gold,Humana Gold,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Medicaid MO,Medicaid MO,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Medica,Medica,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Tricare,Tricare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,UHC All Payer,UHC All Payer,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,UHC Exchange,UHC Exchange,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,UHC Medicaid,UHC Medicaid,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,UMR CPD,UMR CPD,283.25,,,,,,,per diem,283.25,283.25,"Per diem rate, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,UHC Medicare,UHC Medicare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
RENAL PANEL                   ,38251527,CDM,301,RC,80069,CPT,,,,Inpatient,,,283.25,283.25,Wellcare,Wellcare,283.25,,,,,,,case rate,283.25,283.25,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Meritain Health PPO CPD,Meritain Health PPO CPD,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Aetna/Commercial Product,Aetna/Commercial Product,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Meritain Health CPD,Meritain Health CPD,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Starmark CPD,Starmark CPD,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Aetna Medicare,Aetna Medicare,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Ambetter ,Ambetter ,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Blue Access,Anthem Blue Access,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Blue Access Choice,Anthem Blue Access Choice,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Blue Preferred,Anthem Blue Preferred,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Pathway,Anthem Pathway,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Alliance,Anthem Alliance,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Anthem Medicare,Anthem Medicare,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Cigna,Cigna,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Cigna PPO,Cigna PPO,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Cigna Medicare Advantage,Cigna Medicare Advantage,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Essence,Essence,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Healthlink HMO,Healthlink HMO,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Healthlink PPO,Healthlink PPO,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,HomeState Health Plan,HomeState Health Plan,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Humana Gold,Humana Gold,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Medicaid MO,Medicaid MO,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Medica,Medica,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Tricare,Tricare,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,UHC All Payer,UHC All Payer,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,UHC Exchange,UHC Exchange,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,UHC Medicaid,UHC Medicaid,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,UMR CPD,UMR CPD,311.38,,,,,,,per diem,311.38,311.38,"Per diem rate, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,UHC Medicare,UHC Medicare,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
HEPATIC FUNCTION PANEL        ,38251528,CDM,301,RC,80076,CPT,,,,Inpatient,,,311.38,311.38,Wellcare,Wellcare,311.38,,,,,,,case rate,311.38,311.38,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health PPO CPD,Meritain Health PPO CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna/Commercial Product,Aetna/Commercial Product,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health CPD,Meritain Health CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Starmark CPD,Starmark CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Aetna Medicare,Aetna Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Ambetter ,Ambetter ,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access,Anthem Blue Access,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access Choice,Anthem Blue Access Choice,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Preferred,Anthem Blue Preferred,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Pathway,Anthem Pathway,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Alliance,Anthem Alliance,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Anthem Medicare,Anthem Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna,Cigna,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna PPO,Cigna PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Cigna Medicare Advantage,Cigna Medicare Advantage,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Essence,Essence,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthlink HMO,Healthlink HMO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Healthlink PPO,Healthlink PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,HomeState Health Plan,HomeState Health Plan,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Humana Gold,Humana Gold,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Medicaid MO,Medicaid MO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Medica,Medica,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Tricare,Tricare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC All Payer,UHC All Payer,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Exchange,UHC Exchange,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicaid,UHC Medicaid,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UMR CPD,UMR CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicare,UHC Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
DIGOXIN                       ,38251529,CDM,301,RC,80162,CPT,,,,Inpatient,,,176.11,176.11,Wellcare,Wellcare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Meritain Health PPO CPD,Meritain Health PPO CPD,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Aetna/Commercial Product,Aetna/Commercial Product,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Meritain Health CPD,Meritain Health CPD,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Starmark CPD,Starmark CPD,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Aetna Medicare,Aetna Medicare,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Ambetter ,Ambetter ,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Blue Access,Anthem Blue Access,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Blue Access Choice,Anthem Blue Access Choice,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Blue Preferred,Anthem Blue Preferred,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Pathway,Anthem Pathway,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Alliance,Anthem Alliance,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Anthem Medicare,Anthem Medicare,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Cigna,Cigna,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Cigna PPO,Cigna PPO,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Cigna Medicare Advantage,Cigna Medicare Advantage,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Essence,Essence,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Healthlink HMO,Healthlink HMO,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Healthlink PPO,Healthlink PPO,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,HomeState Health Plan,HomeState Health Plan,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Humana Gold,Humana Gold,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Medicaid MO,Medicaid MO,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Medica,Medica,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Tricare,Tricare,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,UHC All Payer,UHC All Payer,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,UHC Exchange,UHC Exchange,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,UHC Medicaid,UHC Medicaid,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,UMR CPD,UMR CPD,2088.64,,,,,,,per diem,2088.64,2088.64,"Per diem rate, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,UHC Medicare,UHC Medicare,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
PHENYTOIN TOTAL               ,38251530,CDM,301,RC,80185,CPT,,,,Inpatient,,,2088.64,2088.64,Wellcare,Wellcare,2088.64,,,,,,,case rate,2088.64,2088.64,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Meritain Health PPO CPD,Meritain Health PPO CPD,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Aetna/Commercial Product,Aetna/Commercial Product,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Meritain Health CPD,Meritain Health CPD,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Starmark CPD,Starmark CPD,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Aetna Medicare,Aetna Medicare,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Ambetter ,Ambetter ,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Blue Access,Anthem Blue Access,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Blue Access Choice,Anthem Blue Access Choice,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Blue Preferred,Anthem Blue Preferred,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Pathway,Anthem Pathway,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Alliance,Anthem Alliance,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Anthem Medicare,Anthem Medicare,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Cigna,Cigna,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Cigna PPO,Cigna PPO,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Cigna Medicare Advantage,Cigna Medicare Advantage,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Essence,Essence,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Healthlink HMO,Healthlink HMO,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Healthlink PPO,Healthlink PPO,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,HomeState Health Plan,HomeState Health Plan,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Humana Gold,Humana Gold,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Medicaid MO,Medicaid MO,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Medica,Medica,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Tricare,Tricare,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,UHC All Payer,UHC All Payer,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,UHC Exchange,UHC Exchange,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,UHC Medicaid,UHC Medicaid,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,UMR CPD,UMR CPD,191.23,,,,,,,per diem,191.23,191.23,"Per diem rate, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,UHC Medicare,UHC Medicare,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
THEOPHYLLINE                  ,38251531,CDM,301,RC,80198,CPT,,,,Inpatient,,,191.23,191.23,Wellcare,Wellcare,191.23,,,,,,,case rate,191.23,191.23,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health PPO CPD,Meritain Health PPO CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna/Commercial Product,Aetna/Commercial Product,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Meritain Health CPD,Meritain Health CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Starmark CPD,Starmark CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Aetna Medicare,Aetna Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Ambetter ,Ambetter ,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access,Anthem Blue Access,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Access Choice,Anthem Blue Access Choice,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Blue Preferred,Anthem Blue Preferred,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Pathway,Anthem Pathway,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Alliance,Anthem Alliance,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Anthem Medicare,Anthem Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna,Cigna,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna PPO,Cigna PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Cigna Medicare Advantage,Cigna Medicare Advantage,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Essence,Essence,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthlink HMO,Healthlink HMO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Healthlink PPO,Healthlink PPO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,HomeState Health Plan,HomeState Health Plan,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Humana Gold,Humana Gold,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Medicaid MO,Medicaid MO,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Medica,Medica,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Tricare,Tricare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC All Payer,UHC All Payer,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Exchange,UHC Exchange,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicaid,UHC Medicaid,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UMR CPD,UMR CPD,71.08,,,,,,,per diem,71.08,71.08,"Per diem rate, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,UHC Medicare,UHC Medicare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
URINALYSIS MACRO ONLY         ,38251532,CDM,301,RC,81003,CPT,,,,Inpatient,,,71.08,71.08,Wellcare,Wellcare,71.08,,,,,,,case rate,71.08,71.08,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Meritain Health PPO CPD,Meritain Health PPO CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Aetna/Commercial Product,Aetna/Commercial Product,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Meritain Health CPD,Meritain Health CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Starmark CPD,Starmark CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Aetna Medicare,Aetna Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Ambetter ,Ambetter ,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Access,Anthem Blue Access,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Access Choice,Anthem Blue Access Choice,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Blue Preferred,Anthem Blue Preferred,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Pathway,Anthem Pathway,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Alliance,Anthem Alliance,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Anthem Medicare,Anthem Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Cigna,Cigna,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Cigna PPO,Cigna PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Cigna Medicare Advantage,Cigna Medicare Advantage,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Essence,Essence,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Healthlink HMO,Healthlink HMO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Healthlink PPO,Healthlink PPO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,HomeState Health Plan,HomeState Health Plan,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Humana Gold,Humana Gold,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Medicaid MO,Medicaid MO,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Medica,Medica,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Tricare,Tricare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,UHC All Payer,UHC All Payer,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,UHC Exchange,UHC Exchange,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,UHC Medicaid,UHC Medicaid,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,UMR CPD,UMR CPD,75.32,,,,,,,per diem,75.32,75.32,"Per diem rate, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,UHC Medicare,UHC Medicare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
ALBUMIN SERUM                 ,38251533,CDM,301,RC,82040,CPT,,,,Inpatient,,,75.32,75.32,Wellcare,Wellcare,75.32,,,,,,,case rate,75.32,75.32,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Meritain Health PPO CPD,Meritain Health PPO CPD,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Aetna/Commercial Product,Aetna/Commercial Product,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Meritain Health CPD,Meritain Health CPD,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Starmark CPD,Starmark CPD,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Aetna Medicare,Aetna Medicare,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Ambetter ,Ambetter ,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Blue Access,Anthem Blue Access,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Blue Access Choice,Anthem Blue Access Choice,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Blue Preferred,Anthem Blue Preferred,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Pathway,Anthem Pathway,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Alliance,Anthem Alliance,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Anthem Medicare,Anthem Medicare,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Cigna,Cigna,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Cigna PPO,Cigna PPO,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Cigna Medicare Advantage,Cigna Medicare Advantage,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Essence,Essence,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Healthlink HMO,Healthlink HMO,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Healthlink PPO,Healthlink PPO,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,HomeState Health Plan,HomeState Health Plan,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Humana Gold,Humana Gold,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Medicaid MO,Medicaid MO,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Medica,Medica,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Tricare,Tricare,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,UHC All Payer,UHC All Payer,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,UHC Exchange,UHC Exchange,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,UHC Medicaid,UHC Medicaid,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,UMR CPD,UMR CPD,180.25,,,,,,,per diem,180.25,180.25,"Per diem rate, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,UHC Medicare,UHC Medicare,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMMONIA BLOOD                 ,38251534,CDM,301,RC,82140,CPT,,,,Inpatient,,,180.25,180.25,Wellcare,Wellcare,180.25,,,,,,,case rate,180.25,180.25,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Meritain Health PPO CPD,Meritain Health PPO CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Aetna/Commercial Product,Aetna/Commercial Product,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Meritain Health CPD,Meritain Health CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Starmark CPD,Starmark CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Aetna Medicare,Aetna Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Ambetter ,Ambetter ,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Access,Anthem Blue Access,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Access Choice,Anthem Blue Access Choice,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Blue Preferred,Anthem Blue Preferred,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Pathway,Anthem Pathway,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Alliance,Anthem Alliance,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Anthem Medicare,Anthem Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Cigna,Cigna,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Cigna PPO,Cigna PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Cigna Medicare Advantage,Cigna Medicare Advantage,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Essence,Essence,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Healthlink HMO,Healthlink HMO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Healthlink PPO,Healthlink PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,HomeState Health Plan,HomeState Health Plan,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Humana Gold,Humana Gold,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Medicaid MO,Medicaid MO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Medica,Medica,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Tricare,Tricare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,UHC All Payer,UHC All Payer,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,UHC Exchange,UHC Exchange,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,UHC Medicaid,UHC Medicaid,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,UMR CPD,UMR CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,UHC Medicare,UHC Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
AMYLASE SERUM                 ,38251535,CDM,301,RC,82150,CPT,,,,Inpatient,,,133.9,133.9,Wellcare,Wellcare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Meritain Health PPO CPD,Meritain Health PPO CPD,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Aetna/Commercial Product,Aetna/Commercial Product,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Meritain Health CPD,Meritain Health CPD,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Starmark CPD,Starmark CPD,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Aetna Medicare,Aetna Medicare,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Ambetter ,Ambetter ,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Blue Access,Anthem Blue Access,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Blue Access Choice,Anthem Blue Access Choice,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Blue Preferred,Anthem Blue Preferred,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Pathway,Anthem Pathway,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Alliance,Anthem Alliance,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Anthem Medicare,Anthem Medicare,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Cigna,Cigna,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Cigna PPO,Cigna PPO,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Cigna Medicare Advantage,Cigna Medicare Advantage,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Essence,Essence,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Healthlink HMO,Healthlink HMO,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Healthlink PPO,Healthlink PPO,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,HomeState Health Plan,HomeState Health Plan,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Humana Gold,Humana Gold,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Medicaid MO,Medicaid MO,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Medica,Medica,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Tricare,Tricare,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,UHC All Payer,UHC All Payer,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,UHC Exchange,UHC Exchange,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,UHC Medicaid,UHC Medicaid,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,UMR CPD,UMR CPD,122.27,,,,,,,per diem,122.27,122.27,"Per diem rate, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,UHC Medicare,UHC Medicare,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN TOT                 ,38251536,CDM,301,RC,82247,CPT,,,,Inpatient,,,122.27,122.27,Wellcare,Wellcare,122.27,,,,,,,case rate,122.27,122.27,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Meritain Health PPO CPD,Meritain Health PPO CPD,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Aetna/Commercial Product,Aetna/Commercial Product,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Meritain Health CPD,Meritain Health CPD,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Starmark CPD,Starmark CPD,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Aetna Medicare,Aetna Medicare,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Ambetter ,Ambetter ,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Blue Access,Anthem Blue Access,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Blue Access Choice,Anthem Blue Access Choice,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Blue Preferred,Anthem Blue Preferred,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Pathway,Anthem Pathway,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Alliance,Anthem Alliance,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Anthem Medicare,Anthem Medicare,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Cigna,Cigna,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Cigna PPO,Cigna PPO,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Cigna Medicare Advantage,Cigna Medicare Advantage,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Essence,Essence,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Healthlink HMO,Healthlink HMO,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Healthlink PPO,Healthlink PPO,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,HomeState Health Plan,HomeState Health Plan,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Humana Gold,Humana Gold,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Medicaid MO,Medicaid MO,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Medica,Medica,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Tricare,Tricare,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,UHC All Payer,UHC All Payer,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,UHC Exchange,UHC Exchange,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,UHC Medicaid,UHC Medicaid,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,UMR CPD,UMR CPD,187.51,,,,,,,per diem,187.51,187.51,"Per diem rate, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,UHC Medicare,UHC Medicare,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
BILIRUBIN DIR                 ,38251537,CDM,301,RC,82248,CPT,,,,Inpatient,,,187.51,187.51,Wellcare,Wellcare,187.51,,,,,,,case rate,187.51,187.51,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Meritain Health PPO CPD,Meritain Health PPO CPD,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Aetna/Commercial Product,Aetna/Commercial Product,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Meritain Health CPD,Meritain Health CPD,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Starmark CPD,Starmark CPD,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Aetna Medicare,Aetna Medicare,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Ambetter ,Ambetter ,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Blue Access,Anthem Blue Access,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Blue Access Choice,Anthem Blue Access Choice,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Blue Preferred,Anthem Blue Preferred,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Pathway,Anthem Pathway,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Alliance,Anthem Alliance,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Anthem Medicare,Anthem Medicare,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Cigna,Cigna,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Cigna PPO,Cigna PPO,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Cigna Medicare Advantage,Cigna Medicare Advantage,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Essence,Essence,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Healthlink HMO,Healthlink HMO,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Healthlink PPO,Healthlink PPO,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,HomeState Health Plan,HomeState Health Plan,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Humana Gold,Humana Gold,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Medicaid MO,Medicaid MO,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Medica,Medica,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Tricare,Tricare,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,UHC All Payer,UHC All Payer,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,UHC Exchange,UHC Exchange,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,UHC Medicaid,UHC Medicaid,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,UMR CPD,UMR CPD,61.29,,,,,,,per diem,61.29,61.29,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,UHC Medicare,UHC Medicare,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERMIN     ,38251538,CDM,301,RC,82274,CPT,,,,Inpatient,,,61.29,61.29,Wellcare,Wellcare,61.29,,,,,,,case rate,61.29,61.29,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health PPO CPD,Meritain Health PPO CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna/Commercial Product,Aetna/Commercial Product,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health CPD,Meritain Health CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Starmark CPD,Starmark CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Aetna Medicare,Aetna Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Ambetter ,Ambetter ,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access,Anthem Blue Access,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access Choice,Anthem Blue Access Choice,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Preferred,Anthem Blue Preferred,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Pathway,Anthem Pathway,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Alliance,Anthem Alliance,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Anthem Medicare,Anthem Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna,Cigna,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna PPO,Cigna PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Cigna Medicare Advantage,Cigna Medicare Advantage,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Essence,Essence,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthlink HMO,Healthlink HMO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Healthlink PPO,Healthlink PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,HomeState Health Plan,HomeState Health Plan,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Humana Gold,Humana Gold,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Medicaid MO,Medicaid MO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Medica,Medica,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Tricare,Tricare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC All Payer,UHC All Payer,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Exchange,UHC Exchange,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicaid,UHC Medicaid,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UMR CPD,UMR CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicare,UHC Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
IONIZED CALCIUM WHOLE BLD     ,38251539,CDM,301,RC,82330,CPT,,,,Inpatient,,,181.41,181.41,Wellcare,Wellcare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health PPO CPD,Meritain Health PPO CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna/Commercial Product,Aetna/Commercial Product,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health CPD,Meritain Health CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Starmark CPD,Starmark CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Aetna Medicare,Aetna Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Ambetter ,Ambetter ,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access,Anthem Blue Access,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access Choice,Anthem Blue Access Choice,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Preferred,Anthem Blue Preferred,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Pathway,Anthem Pathway,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Alliance,Anthem Alliance,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Anthem Medicare,Anthem Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna,Cigna,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna PPO,Cigna PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Cigna Medicare Advantage,Cigna Medicare Advantage,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Essence,Essence,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthlink HMO,Healthlink HMO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Healthlink PPO,Healthlink PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,HomeState Health Plan,HomeState Health Plan,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Humana Gold,Humana Gold,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Medicaid MO,Medicaid MO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Medica,Medica,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Tricare,Tricare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC All Payer,UHC All Payer,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Exchange,UHC Exchange,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicaid,UHC Medicaid,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UMR CPD,UMR CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicare,UHC Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CPK TOTAL                     ,38251540,CDM,301,RC,82550,CPT,,,,Inpatient,,,116.7,116.7,Wellcare,Wellcare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health PPO CPD,Meritain Health PPO CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Aetna/Commercial Product,Aetna/Commercial Product,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health CPD,Meritain Health CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Starmark CPD,Starmark CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Aetna Medicare,Aetna Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Ambetter ,Ambetter ,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access,Anthem Blue Access,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access Choice,Anthem Blue Access Choice,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Preferred,Anthem Blue Preferred,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Pathway,Anthem Pathway,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Alliance,Anthem Alliance,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Anthem Medicare,Anthem Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Cigna,Cigna,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Cigna PPO,Cigna PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Cigna Medicare Advantage,Cigna Medicare Advantage,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Essence,Essence,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Healthlink HMO,Healthlink HMO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Healthlink PPO,Healthlink PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,HomeState Health Plan,HomeState Health Plan,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Humana Gold,Humana Gold,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Medicaid MO,Medicaid MO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Medica,Medica,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Tricare,Tricare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,UHC All Payer,UHC All Payer,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,UHC Exchange,UHC Exchange,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicaid,UHC Medicaid,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,UMR CPD,UMR CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicare,UHC Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CK-MB                         ,38251541,CDM,301,RC,82553,CPT,,,,Inpatient,,,186.72,186.72,Wellcare,Wellcare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREATININE SERU               ,38251542,CDM,301,RC,82565,CPT,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CREAT URN RAND                ,38251543,CDM,301,RC,82570,CPT,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Meritain Health PPO CPD,Meritain Health PPO CPD,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Aetna/Commercial Product,Aetna/Commercial Product,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Meritain Health CPD,Meritain Health CPD,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Starmark CPD,Starmark CPD,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Aetna Medicare,Aetna Medicare,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Ambetter ,Ambetter ,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Blue Access,Anthem Blue Access,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Blue Access Choice,Anthem Blue Access Choice,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Blue Preferred,Anthem Blue Preferred,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Pathway,Anthem Pathway,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Alliance,Anthem Alliance,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Anthem Medicare,Anthem Medicare,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Cigna,Cigna,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Cigna PPO,Cigna PPO,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Cigna Medicare Advantage,Cigna Medicare Advantage,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Essence,Essence,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Healthlink HMO,Healthlink HMO,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Healthlink PPO,Healthlink PPO,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,HomeState Health Plan,HomeState Health Plan,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Humana Gold,Humana Gold,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Medicaid MO,Medicaid MO,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Medica,Medica,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Tricare,Tricare,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,UHC All Payer,UHC All Payer,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,UHC Exchange,UHC Exchange,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,UHC Medicaid,UHC Medicaid,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,UMR CPD,UMR CPD,207.41,,,,,,,per diem,207.41,207.41,"Per diem rate, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,UHC Medicare,UHC Medicare,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
FERRITIN                      ,38251544,CDM,301,RC,82728,CPT,,,,Inpatient,,,207.41,207.41,Wellcare,Wellcare,207.41,,,,,,,case rate,207.41,207.41,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Meritain Health PPO CPD,Meritain Health PPO CPD,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Aetna/Commercial Product,Aetna/Commercial Product,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Meritain Health CPD,Meritain Health CPD,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Starmark CPD,Starmark CPD,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Aetna Medicare,Aetna Medicare,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Ambetter ,Ambetter ,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Blue Access,Anthem Blue Access,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Blue Access Choice,Anthem Blue Access Choice,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Blue Preferred,Anthem Blue Preferred,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Pathway,Anthem Pathway,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Alliance,Anthem Alliance,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Anthem Medicare,Anthem Medicare,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Cigna,Cigna,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Cigna PPO,Cigna PPO,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Cigna Medicare Advantage,Cigna Medicare Advantage,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Essence,Essence,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Healthlink HMO,Healthlink HMO,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Healthlink PPO,Healthlink PPO,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,HomeState Health Plan,HomeState Health Plan,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Humana Gold,Humana Gold,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Medicaid MO,Medicaid MO,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Medica,Medica,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Tricare,Tricare,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,UHC All Payer,UHC All Payer,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,UHC Exchange,UHC Exchange,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,UHC Medicaid,UHC Medicaid,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,UMR CPD,UMR CPD,66.91,,,,,,,per diem,66.91,66.91,"Per diem rate, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,UHC Medicare,UHC Medicare,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
"BLOOD GASES, MIXED            ",38251545,CDM,301,RC,82803,CPT,,,,Inpatient,,,66.91,66.91,Wellcare,Wellcare,66.91,,,,,,,case rate,66.91,66.91,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health PPO CPD,Meritain Health PPO CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Aetna/Commercial Product,Aetna/Commercial Product,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health CPD,Meritain Health CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Starmark CPD,Starmark CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Aetna Medicare,Aetna Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Ambetter ,Ambetter ,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access,Anthem Blue Access,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access Choice,Anthem Blue Access Choice,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Preferred,Anthem Blue Preferred,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Pathway,Anthem Pathway,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Alliance,Anthem Alliance,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Anthem Medicare,Anthem Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Cigna,Cigna,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Cigna PPO,Cigna PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Cigna Medicare Advantage,Cigna Medicare Advantage,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Essence,Essence,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Healthlink HMO,Healthlink HMO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Healthlink PPO,Healthlink PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,HomeState Health Plan,HomeState Health Plan,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Humana Gold,Humana Gold,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Medicaid MO,Medicaid MO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Medica,Medica,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Tricare,Tricare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,UHC All Payer,UHC All Payer,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,UHC Exchange,UHC Exchange,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicaid,UHC Medicaid,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,UMR CPD,UMR CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicare,UHC Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GGT                           ,38251546,CDM,301,RC,82977,CPT,,,,Inpatient,,,105.03,105.03,Wellcare,Wellcare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Meritain Health PPO CPD,Meritain Health PPO CPD,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Aetna/Commercial Product,Aetna/Commercial Product,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Meritain Health CPD,Meritain Health CPD,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Starmark CPD,Starmark CPD,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Aetna Medicare,Aetna Medicare,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Ambetter ,Ambetter ,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Blue Access,Anthem Blue Access,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Blue Access Choice,Anthem Blue Access Choice,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Blue Preferred,Anthem Blue Preferred,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Pathway,Anthem Pathway,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Alliance,Anthem Alliance,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Anthem Medicare,Anthem Medicare,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Cigna,Cigna,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Cigna PPO,Cigna PPO,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Cigna Medicare Advantage,Cigna Medicare Advantage,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Essence,Essence,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Healthlink HMO,Healthlink HMO,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Healthlink PPO,Healthlink PPO,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,HomeState Health Plan,HomeState Health Plan,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Humana Gold,Humana Gold,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Medicaid MO,Medicaid MO,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Medica,Medica,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Tricare,Tricare,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,UHC All Payer,UHC All Payer,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,UHC Exchange,UHC Exchange,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,UHC Medicaid,UHC Medicaid,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,UMR CPD,UMR CPD,173.72,,,,,,,per diem,173.72,173.72,"Per diem rate, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,UHC Medicare,UHC Medicare,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
GLYCO HGB                     ,38251547,CDM,301,RC,83036,CPT,,,,Inpatient,,,173.72,173.72,Wellcare,Wellcare,173.72,,,,,,,case rate,173.72,173.72,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Meritain Health PPO CPD,Meritain Health PPO CPD,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Aetna/Commercial Product,Aetna/Commercial Product,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Meritain Health CPD,Meritain Health CPD,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Starmark CPD,Starmark CPD,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Aetna Medicare,Aetna Medicare,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Ambetter ,Ambetter ,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Blue Access,Anthem Blue Access,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Blue Access Choice,Anthem Blue Access Choice,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Blue Preferred,Anthem Blue Preferred,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Pathway,Anthem Pathway,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Alliance,Anthem Alliance,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Anthem Medicare,Anthem Medicare,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Cigna,Cigna,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Cigna PPO,Cigna PPO,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Cigna Medicare Advantage,Cigna Medicare Advantage,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Essence,Essence,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Healthlink HMO,Healthlink HMO,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Healthlink PPO,Healthlink PPO,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,HomeState Health Plan,HomeState Health Plan,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Humana Gold,Humana Gold,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Medicaid MO,Medicaid MO,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Medica,Medica,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Tricare,Tricare,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,UHC All Payer,UHC All Payer,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,UHC Exchange,UHC Exchange,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,UHC Medicaid,UHC Medicaid,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,UMR CPD,UMR CPD,119.48,,,,,,,per diem,119.48,119.48,"Per diem rate, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,UHC Medicare,UHC Medicare,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON SERUM                    ,38251548,CDM,301,RC,83540,CPT,,,,Inpatient,,,119.48,119.48,Wellcare,Wellcare,119.48,,,,,,,case rate,119.48,119.48,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Meritain Health PPO CPD,Meritain Health PPO CPD,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Aetna/Commercial Product,Aetna/Commercial Product,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Meritain Health CPD,Meritain Health CPD,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Starmark CPD,Starmark CPD,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Aetna Medicare,Aetna Medicare,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Ambetter ,Ambetter ,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Blue Access,Anthem Blue Access,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Blue Access Choice,Anthem Blue Access Choice,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Blue Preferred,Anthem Blue Preferred,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Pathway,Anthem Pathway,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Alliance,Anthem Alliance,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Anthem Medicare,Anthem Medicare,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Cigna,Cigna,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Cigna PPO,Cigna PPO,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Cigna Medicare Advantage,Cigna Medicare Advantage,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Essence,Essence,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Healthlink HMO,Healthlink HMO,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Healthlink PPO,Healthlink PPO,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,HomeState Health Plan,HomeState Health Plan,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Humana Gold,Humana Gold,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Medicaid MO,Medicaid MO,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Medica,Medica,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Tricare,Tricare,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,UHC All Payer,UHC All Payer,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,UHC Exchange,UHC Exchange,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,UHC Medicaid,UHC Medicaid,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,UMR CPD,UMR CPD,42.73,,,,,,,per diem,42.73,42.73,"Per diem rate, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,UHC Medicare,UHC Medicare,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
IRON BINDING CAPACITY         ,38251549,CDM,301,RC,83550,CPT,,,,Inpatient,,,42.73,42.73,Wellcare,Wellcare,42.73,,,,,,,case rate,42.73,42.73,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LDH                           ,38251550,CDM,301,RC,83615,CPT,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Meritain Health PPO CPD,Meritain Health PPO CPD,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Aetna/Commercial Product,Aetna/Commercial Product,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Meritain Health CPD,Meritain Health CPD,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Starmark CPD,Starmark CPD,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Aetna Medicare,Aetna Medicare,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Ambetter ,Ambetter ,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Blue Access,Anthem Blue Access,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Blue Access Choice,Anthem Blue Access Choice,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Blue Preferred,Anthem Blue Preferred,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Pathway,Anthem Pathway,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Alliance,Anthem Alliance,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Anthem Medicare,Anthem Medicare,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Cigna,Cigna,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Cigna PPO,Cigna PPO,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Cigna Medicare Advantage,Cigna Medicare Advantage,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Essence,Essence,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Healthlink HMO,Healthlink HMO,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Healthlink PPO,Healthlink PPO,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,HomeState Health Plan,HomeState Health Plan,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Humana Gold,Humana Gold,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Medicaid MO,Medicaid MO,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Medica,Medica,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Tricare,Tricare,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,UHC All Payer,UHC All Payer,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,UHC Exchange,UHC Exchange,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,UHC Medicaid,UHC Medicaid,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,UMR CPD,UMR CPD,153.47,,,,,,,per diem,153.47,153.47,"Per diem rate, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,UHC Medicare,UHC Medicare,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
LIPASE                        ,38251551,CDM,301,RC,83690,CPT,,,,Inpatient,,,153.47,153.47,Wellcare,Wellcare,153.47,,,,,,,case rate,153.47,153.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Meritain Health PPO CPD,Meritain Health PPO CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Aetna/Commercial Product,Aetna/Commercial Product,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Meritain Health CPD,Meritain Health CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Starmark CPD,Starmark CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Aetna Medicare,Aetna Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Ambetter ,Ambetter ,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Access,Anthem Blue Access,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Access Choice,Anthem Blue Access Choice,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Blue Preferred,Anthem Blue Preferred,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Pathway,Anthem Pathway,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Alliance,Anthem Alliance,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Anthem Medicare,Anthem Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Cigna,Cigna,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Cigna PPO,Cigna PPO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Cigna Medicare Advantage,Cigna Medicare Advantage,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Essence,Essence,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Healthlink HMO,Healthlink HMO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Healthlink PPO,Healthlink PPO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,HomeState Health Plan,HomeState Health Plan,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Humana Gold,Humana Gold,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Medicaid MO,Medicaid MO,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Medica,Medica,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Tricare,Tricare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,UHC All Payer,UHC All Payer,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,UHC Exchange,UHC Exchange,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,UHC Medicaid,UHC Medicaid,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,UMR CPD,UMR CPD,125.47,,,,,,,per diem,125.47,125.47,"Per diem rate, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,UHC Medicare,UHC Medicare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MAGNESIUM                     ,38251552,CDM,301,RC,83735,CPT,,,,Inpatient,,,125.47,125.47,Wellcare,Wellcare,125.47,,,,,,,case rate,125.47,125.47,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Meritain Health PPO CPD,Meritain Health PPO CPD,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Aetna/Commercial Product,Aetna/Commercial Product,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Meritain Health CPD,Meritain Health CPD,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Starmark CPD,Starmark CPD,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Aetna Medicare,Aetna Medicare,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Ambetter ,Ambetter ,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Blue Access,Anthem Blue Access,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Blue Access Choice,Anthem Blue Access Choice,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Blue Preferred,Anthem Blue Preferred,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Pathway,Anthem Pathway,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Alliance,Anthem Alliance,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Anthem Medicare,Anthem Medicare,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Cigna,Cigna,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Cigna PPO,Cigna PPO,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Cigna Medicare Advantage,Cigna Medicare Advantage,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Essence,Essence,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Healthlink HMO,Healthlink HMO,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Healthlink PPO,Healthlink PPO,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,HomeState Health Plan,HomeState Health Plan,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Humana Gold,Humana Gold,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Medicaid MO,Medicaid MO,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Medica,Medica,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Tricare,Tricare,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,UHC All Payer,UHC All Payer,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,UHC Exchange,UHC Exchange,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,UHC Medicaid,UHC Medicaid,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,UMR CPD,UMR CPD,96.28,,,,,,,per diem,96.28,96.28,"Per diem rate, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,UHC Medicare,UHC Medicare,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
MYOGLOBIN                     ,38251553,CDM,301,RC,83874,CPT,,,,Inpatient,,,96.28,96.28,Wellcare,Wellcare,96.28,,,,,,,case rate,96.28,96.28,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Meritain Health PPO CPD,Meritain Health PPO CPD,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Aetna/Commercial Product,Aetna/Commercial Product,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Meritain Health CPD,Meritain Health CPD,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Starmark CPD,Starmark CPD,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Aetna Medicare,Aetna Medicare,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Ambetter ,Ambetter ,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Blue Access,Anthem Blue Access,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Blue Access Choice,Anthem Blue Access Choice,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Blue Preferred,Anthem Blue Preferred,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Pathway,Anthem Pathway,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Alliance,Anthem Alliance,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Anthem Medicare,Anthem Medicare,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Cigna,Cigna,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Cigna PPO,Cigna PPO,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Cigna Medicare Advantage,Cigna Medicare Advantage,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Essence,Essence,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Healthlink HMO,Healthlink HMO,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Healthlink PPO,Healthlink PPO,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,HomeState Health Plan,HomeState Health Plan,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Humana Gold,Humana Gold,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Medicaid MO,Medicaid MO,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Medica,Medica,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Tricare,Tricare,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,UHC All Payer,UHC All Payer,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,UHC Exchange,UHC Exchange,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,UHC Medicaid,UHC Medicaid,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,UMR CPD,UMR CPD,254.41,,,,,,,per diem,254.41,254.41,"Per diem rate, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,UHC Medicare,UHC Medicare,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
B-TYPE NATRIURETIC PEPTID     ,38251554,CDM,301,RC,83880,CPT,,,,Inpatient,,,254.41,254.41,Wellcare,Wellcare,254.41,,,,,,,case rate,254.41,254.41,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Meritain Health PPO CPD,Meritain Health PPO CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Aetna/Commercial Product,Aetna/Commercial Product,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Meritain Health CPD,Meritain Health CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Starmark CPD,Starmark CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Aetna Medicare,Aetna Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Ambetter ,Ambetter ,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Access,Anthem Blue Access,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Access Choice,Anthem Blue Access Choice,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Blue Preferred,Anthem Blue Preferred,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Pathway,Anthem Pathway,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Alliance,Anthem Alliance,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Anthem Medicare,Anthem Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Cigna,Cigna,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Cigna PPO,Cigna PPO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Cigna Medicare Advantage,Cigna Medicare Advantage,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Essence,Essence,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Healthlink HMO,Healthlink HMO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Healthlink PPO,Healthlink PPO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,HomeState Health Plan,HomeState Health Plan,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Humana Gold,Humana Gold,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Medicaid MO,Medicaid MO,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Medica,Medica,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Tricare,Tricare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,UHC All Payer,UHC All Payer,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,UHC Exchange,UHC Exchange,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,UHC Medicaid,UHC Medicaid,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,UMR CPD,UMR CPD,114.58,,,,,,,per diem,114.58,114.58,"Per diem rate, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,UHC Medicare,UHC Medicare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY SERUM              ,38251555,CDM,301,RC,83930,CPT,,,,Inpatient,,,114.58,114.58,Wellcare,Wellcare,114.58,,,,,,,case rate,114.58,114.58,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health PPO CPD,Meritain Health PPO CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna/Commercial Product,Aetna/Commercial Product,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Meritain Health CPD,Meritain Health CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Starmark CPD,Starmark CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Aetna Medicare,Aetna Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Ambetter ,Ambetter ,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access,Anthem Blue Access,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Access Choice,Anthem Blue Access Choice,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Blue Preferred,Anthem Blue Preferred,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Pathway,Anthem Pathway,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Alliance,Anthem Alliance,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Anthem Medicare,Anthem Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna,Cigna,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna PPO,Cigna PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Cigna Medicare Advantage,Cigna Medicare Advantage,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Essence,Essence,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthlink HMO,Healthlink HMO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Healthlink PPO,Healthlink PPO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,HomeState Health Plan,HomeState Health Plan,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Humana Gold,Humana Gold,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Medicaid MO,Medicaid MO,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Medica,Medica,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Tricare,Tricare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC All Payer,UHC All Payer,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Exchange,UHC Exchange,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicaid,UHC Medicaid,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UMR CPD,UMR CPD,109.27,,,,,,,per diem,109.27,109.27,"Per diem rate, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,UHC Medicare,UHC Medicare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
OSMOLALITY URIN               ,38251556,CDM,301,RC,83935,CPT,,,,Inpatient,,,109.27,109.27,Wellcare,Wellcare,109.27,,,,,,,case rate,109.27,109.27,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Meritain Health PPO CPD,Meritain Health PPO CPD,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Aetna/Commercial Product,Aetna/Commercial Product,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Meritain Health CPD,Meritain Health CPD,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Starmark CPD,Starmark CPD,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Aetna Medicare,Aetna Medicare,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Ambetter ,Ambetter ,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Blue Access,Anthem Blue Access,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Blue Access Choice,Anthem Blue Access Choice,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Blue Preferred,Anthem Blue Preferred,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Pathway,Anthem Pathway,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Alliance,Anthem Alliance,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Anthem Medicare,Anthem Medicare,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Cigna,Cigna,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Cigna PPO,Cigna PPO,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Cigna Medicare Advantage,Cigna Medicare Advantage,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Essence,Essence,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Healthlink HMO,Healthlink HMO,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Healthlink PPO,Healthlink PPO,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,HomeState Health Plan,HomeState Health Plan,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Humana Gold,Humana Gold,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Medicaid MO,Medicaid MO,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Medica,Medica,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Tricare,Tricare,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,UHC All Payer,UHC All Payer,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,UHC Exchange,UHC Exchange,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,UHC Medicaid,UHC Medicaid,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,UMR CPD,UMR CPD,376.62,,,,,,,per diem,376.62,376.62,"Per diem rate, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,UHC Medicare,UHC Medicare,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
INTACT PARATHYROID HORMON     ,38251557,CDM,301,RC,83970,CPT,,,,Inpatient,,,376.62,376.62,Wellcare,Wellcare,376.62,,,,,,,case rate,376.62,376.62,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Meritain Health PPO CPD,Meritain Health PPO CPD,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Aetna/Commercial Product,Aetna/Commercial Product,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Meritain Health CPD,Meritain Health CPD,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Starmark CPD,Starmark CPD,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Aetna Medicare,Aetna Medicare,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Ambetter ,Ambetter ,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Blue Access,Anthem Blue Access,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Blue Access Choice,Anthem Blue Access Choice,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Blue Preferred,Anthem Blue Preferred,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Pathway,Anthem Pathway,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Alliance,Anthem Alliance,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Anthem Medicare,Anthem Medicare,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Cigna,Cigna,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Cigna PPO,Cigna PPO,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Cigna Medicare Advantage,Cigna Medicare Advantage,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Essence,Essence,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Healthlink HMO,Healthlink HMO,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Healthlink PPO,Healthlink PPO,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,HomeState Health Plan,HomeState Health Plan,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Humana Gold,Humana Gold,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Medicaid MO,Medicaid MO,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Medica,Medica,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Tricare,Tricare,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,UHC All Payer,UHC All Payer,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,UHC Exchange,UHC Exchange,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,UHC Medicaid,UHC Medicaid,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,UMR CPD,UMR CPD,93.73,,,,,,,per diem,93.73,93.73,"Per diem rate, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,UHC Medicare,UHC Medicare,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
PHOSPHATE INORG               ,38251558,CDM,301,RC,84100,CPT,,,,Inpatient,,,93.73,93.73,Wellcare,Wellcare,93.73,,,,,,,case rate,93.73,93.73,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health PPO CPD,Meritain Health PPO CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna/Commercial Product,Aetna/Commercial Product,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Meritain Health CPD,Meritain Health CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Starmark CPD,Starmark CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Aetna Medicare,Aetna Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Ambetter ,Ambetter ,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access,Anthem Blue Access,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Access Choice,Anthem Blue Access Choice,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Blue Preferred,Anthem Blue Preferred,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Pathway,Anthem Pathway,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Alliance,Anthem Alliance,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Anthem Medicare,Anthem Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna,Cigna,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna PPO,Cigna PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Cigna Medicare Advantage,Cigna Medicare Advantage,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Essence,Essence,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthlink HMO,Healthlink HMO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Healthlink PPO,Healthlink PPO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,HomeState Health Plan,HomeState Health Plan,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Humana Gold,Humana Gold,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Medicaid MO,Medicaid MO,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Medica,Medica,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Tricare,Tricare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC All Payer,UHC All Payer,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Exchange,UHC Exchange,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicaid,UHC Medicaid,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UMR CPD,UMR CPD,58.35,,,,,,,per diem,58.35,58.35,"Per diem rate, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,UHC Medicare,UHC Medicare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
POTASSIUM SERUM K             ,38251559,CDM,301,RC,84132,CPT,,,,Inpatient,,,58.35,58.35,Wellcare,Wellcare,58.35,,,,,,,case rate,58.35,58.35,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PREALBUMIN (FASTING)          ,38251560,CDM,301,RC,84134,CPT,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Meritain Health PPO CPD,Meritain Health PPO CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Aetna/Commercial Product,Aetna/Commercial Product,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Meritain Health CPD,Meritain Health CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Starmark CPD,Starmark CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Aetna Medicare,Aetna Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Ambetter ,Ambetter ,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Access,Anthem Blue Access,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Access Choice,Anthem Blue Access Choice,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Preferred,Anthem Blue Preferred,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Pathway,Anthem Pathway,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Alliance,Anthem Alliance,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Anthem Medicare,Anthem Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Cigna,Cigna,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Cigna PPO,Cigna PPO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Cigna Medicare Advantage,Cigna Medicare Advantage,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Essence,Essence,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Healthlink HMO,Healthlink HMO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Healthlink PPO,Healthlink PPO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,HomeState Health Plan,HomeState Health Plan,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Humana Gold,Humana Gold,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Medicaid MO,Medicaid MO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Medica,Medica,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Tricare,Tricare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,UHC All Payer,UHC All Payer,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,UHC Exchange,UHC Exchange,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,UHC Medicaid,UHC Medicaid,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,UMR CPD,UMR CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,UHC Medicare,UHC Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ANTIGEN     ,38251561,CDM,301,RC,84153,CPT,,,,Inpatient,,,167.35,167.35,Wellcare,Wellcare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Meritain Health PPO CPD,Meritain Health PPO CPD,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Aetna/Commercial Product,Aetna/Commercial Product,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Meritain Health CPD,Meritain Health CPD,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Starmark CPD,Starmark CPD,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Aetna Medicare,Aetna Medicare,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Ambetter ,Ambetter ,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Blue Access,Anthem Blue Access,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Blue Access Choice,Anthem Blue Access Choice,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Blue Preferred,Anthem Blue Preferred,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Pathway,Anthem Pathway,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Alliance,Anthem Alliance,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Anthem Medicare,Anthem Medicare,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Cigna,Cigna,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Cigna PPO,Cigna PPO,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Cigna Medicare Advantage,Cigna Medicare Advantage,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Essence,Essence,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Healthlink HMO,Healthlink HMO,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Healthlink PPO,Healthlink PPO,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,HomeState Health Plan,HomeState Health Plan,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Humana Gold,Humana Gold,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Medicaid MO,Medicaid MO,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Medica,Medica,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Tricare,Tricare,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,UHC All Payer,UHC All Payer,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,UHC Exchange,UHC Exchange,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,UHC Medicaid,UHC Medicaid,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,UMR CPD,UMR CPD,2.12,,,,,,,per diem,2.12,2.12,"Per diem rate, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,UHC Medicare,UHC Medicare,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
PROTEIN SERUM                 ,38251562,CDM,301,RC,84155,CPT,,,,Inpatient,,,2.12,2.12,Wellcare,Wellcare,2.12,,,,,,,case rate,2.12,2.12,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Meritain Health PPO CPD,Meritain Health PPO CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Aetna/Commercial Product,Aetna/Commercial Product,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Meritain Health CPD,Meritain Health CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Starmark CPD,Starmark CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Aetna Medicare,Aetna Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Ambetter ,Ambetter ,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Access,Anthem Blue Access,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Access Choice,Anthem Blue Access Choice,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Preferred,Anthem Blue Preferred,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Pathway,Anthem Pathway,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Alliance,Anthem Alliance,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Anthem Medicare,Anthem Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Cigna,Cigna,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Cigna PPO,Cigna PPO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Cigna Medicare Advantage,Cigna Medicare Advantage,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Essence,Essence,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Healthlink HMO,Healthlink HMO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Healthlink PPO,Healthlink PPO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,HomeState Health Plan,HomeState Health Plan,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Humana Gold,Humana Gold,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Medicaid MO,Medicaid MO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Medica,Medica,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Tricare,Tricare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,UHC All Payer,UHC All Payer,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,UHC Exchange,UHC Exchange,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,UHC Medicaid,UHC Medicaid,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,UMR CPD,UMR CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,UHC Medicare,UHC Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE RANDOM TOTAL PROTEI     ,38251563,CDM,301,RC,84156,CPT,,,,Inpatient,,,151.98,151.98,Wellcare,Wellcare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health PPO CPD,Meritain Health PPO CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Aetna/Commercial Product,Aetna/Commercial Product,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health CPD,Meritain Health CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Starmark CPD,Starmark CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Aetna Medicare,Aetna Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Ambetter ,Ambetter ,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access,Anthem Blue Access,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access Choice,Anthem Blue Access Choice,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Preferred,Anthem Blue Preferred,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Pathway,Anthem Pathway,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Alliance,Anthem Alliance,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Anthem Medicare,Anthem Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Cigna,Cigna,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Cigna PPO,Cigna PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Cigna Medicare Advantage,Cigna Medicare Advantage,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Essence,Essence,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Healthlink HMO,Healthlink HMO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Healthlink PPO,Healthlink PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,HomeState Health Plan,HomeState Health Plan,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Humana Gold,Humana Gold,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Medicaid MO,Medicaid MO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Medica,Medica,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Tricare,Tricare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,UHC All Payer,UHC All Payer,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,UHC Exchange,UHC Exchange,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicaid,UHC Medicaid,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,UMR CPD,UMR CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicare,UHC Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
PROTEIN ELECTROPH FRAC/QT     ,38251564,CDM,301,RC,84165,CPT,,,,Inpatient,,,239.76,239.76,Wellcare,Wellcare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health PPO CPD,Meritain Health PPO CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna/Commercial Product,Aetna/Commercial Product,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Meritain Health CPD,Meritain Health CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Starmark CPD,Starmark CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Aetna Medicare,Aetna Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Ambetter ,Ambetter ,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access,Anthem Blue Access,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Access Choice,Anthem Blue Access Choice,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Blue Preferred,Anthem Blue Preferred,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Pathway,Anthem Pathway,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Alliance,Anthem Alliance,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Anthem Medicare,Anthem Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna,Cigna,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna PPO,Cigna PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Cigna Medicare Advantage,Cigna Medicare Advantage,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Essence,Essence,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthlink HMO,Healthlink HMO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Healthlink PPO,Healthlink PPO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,HomeState Health Plan,HomeState Health Plan,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Humana Gold,Humana Gold,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Medicaid MO,Medicaid MO,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Medica,Medica,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Tricare,Tricare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC All Payer,UHC All Payer,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Exchange,UHC Exchange,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicaid,UHC Medicaid,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UMR CPD,UMR CPD,224.91,,,,,,,per diem,224.91,224.91,"Per diem rate, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,UHC Medicare,UHC Medicare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
VITAMIN B1 WHOLE BLOOD        ,38251565,CDM,301,RC,84425,CPT,,,,Inpatient,,,224.91,224.91,Wellcare,Wellcare,224.91,,,,,,,case rate,224.91,224.91,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Meritain Health PPO CPD,Meritain Health PPO CPD,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Aetna/Commercial Product,Aetna/Commercial Product,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Meritain Health CPD,Meritain Health CPD,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Starmark CPD,Starmark CPD,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Aetna Medicare,Aetna Medicare,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Ambetter ,Ambetter ,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Blue Access,Anthem Blue Access,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Blue Access Choice,Anthem Blue Access Choice,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Blue Preferred,Anthem Blue Preferred,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Pathway,Anthem Pathway,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Alliance,Anthem Alliance,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Anthem Medicare,Anthem Medicare,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Cigna,Cigna,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Cigna PPO,Cigna PPO,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Cigna Medicare Advantage,Cigna Medicare Advantage,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Essence,Essence,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Healthlink HMO,Healthlink HMO,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Healthlink PPO,Healthlink PPO,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,HomeState Health Plan,HomeState Health Plan,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Humana Gold,Humana Gold,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Medicaid MO,Medicaid MO,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Medica,Medica,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Tricare,Tricare,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,UHC All Payer,UHC All Payer,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,UHC Exchange,UHC Exchange,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,UHC Medicaid,UHC Medicaid,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,UMR CPD,UMR CPD,47.54,,,,,,,per diem,47.54,47.54,"Per diem rate, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,UHC Medicare,UHC Medicare,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
T4                            ,38251566,CDM,301,RC,84436,CPT,,,,Inpatient,,,47.54,47.54,Wellcare,Wellcare,47.54,,,,,,,case rate,47.54,47.54,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Meritain Health PPO CPD,Meritain Health PPO CPD,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Aetna/Commercial Product,Aetna/Commercial Product,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Meritain Health CPD,Meritain Health CPD,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Starmark CPD,Starmark CPD,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Aetna Medicare,Aetna Medicare,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Ambetter ,Ambetter ,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Blue Access,Anthem Blue Access,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Blue Access Choice,Anthem Blue Access Choice,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Blue Preferred,Anthem Blue Preferred,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Pathway,Anthem Pathway,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Alliance,Anthem Alliance,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Anthem Medicare,Anthem Medicare,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Cigna,Cigna,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Cigna PPO,Cigna PPO,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Cigna Medicare Advantage,Cigna Medicare Advantage,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Essence,Essence,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Healthlink HMO,Healthlink HMO,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Healthlink PPO,Healthlink PPO,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,HomeState Health Plan,HomeState Health Plan,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Humana Gold,Humana Gold,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Medicaid MO,Medicaid MO,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Medica,Medica,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Tricare,Tricare,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,UHC All Payer,UHC All Payer,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,UHC Exchange,UHC Exchange,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,UHC Medicaid,UHC Medicaid,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,UMR CPD,UMR CPD,176.13,,,,,,,per diem,176.13,176.13,"Per diem rate, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,UHC Medicare,UHC Medicare,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
THYROXINE FREE (FREE T4)      ,38251567,CDM,301,RC,84439,CPT,,,,Inpatient,,,176.13,176.13,Wellcare,Wellcare,176.13,,,,,,,case rate,176.13,176.13,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Meritain Health PPO CPD,Meritain Health PPO CPD,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Aetna/Commercial Product,Aetna/Commercial Product,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Meritain Health CPD,Meritain Health CPD,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Starmark CPD,Starmark CPD,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Aetna Medicare,Aetna Medicare,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Ambetter ,Ambetter ,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Blue Access,Anthem Blue Access,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Blue Access Choice,Anthem Blue Access Choice,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Blue Preferred,Anthem Blue Preferred,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Pathway,Anthem Pathway,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Alliance,Anthem Alliance,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Anthem Medicare,Anthem Medicare,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Cigna,Cigna,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Cigna PPO,Cigna PPO,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Cigna Medicare Advantage,Cigna Medicare Advantage,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Essence,Essence,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Healthlink HMO,Healthlink HMO,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Healthlink PPO,Healthlink PPO,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,HomeState Health Plan,HomeState Health Plan,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Humana Gold,Humana Gold,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Medicaid MO,Medicaid MO,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Medica,Medica,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Tricare,Tricare,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,UHC All Payer,UHC All Payer,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,UHC Exchange,UHC Exchange,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,UHC Medicaid,UHC Medicaid,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,UMR CPD,UMR CPD,209.09,,,,,,,per diem,209.09,209.09,"Per diem rate, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,UHC Medicare,UHC Medicare,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
TSH                           ,38251568,CDM,301,RC,84443,CPT,,,,Inpatient,,,209.09,209.09,Wellcare,Wellcare,209.09,,,,,,,case rate,209.09,209.09,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Meritain Health PPO CPD,Meritain Health PPO CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Aetna/Commercial Product,Aetna/Commercial Product,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Meritain Health CPD,Meritain Health CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Starmark CPD,Starmark CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Aetna Medicare,Aetna Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Ambetter ,Ambetter ,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Access,Anthem Blue Access,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Access Choice,Anthem Blue Access Choice,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Preferred,Anthem Blue Preferred,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Pathway,Anthem Pathway,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Alliance,Anthem Alliance,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Anthem Medicare,Anthem Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Cigna,Cigna,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Cigna PPO,Cigna PPO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Cigna Medicare Advantage,Cigna Medicare Advantage,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Essence,Essence,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Healthlink HMO,Healthlink HMO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Healthlink PPO,Healthlink PPO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,HomeState Health Plan,HomeState Health Plan,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Humana Gold,Humana Gold,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Medicaid MO,Medicaid MO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Medica,Medica,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Tricare,Tricare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,UHC All Payer,UHC All Payer,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,UHC Exchange,UHC Exchange,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,UHC Medicaid,UHC Medicaid,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,UMR CPD,UMR CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,UHC Medicare,UHC Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
AST                           ,38251569,CDM,301,RC,84450,CPT,,,,Inpatient,,,86.73,86.73,Wellcare,Wellcare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Meritain Health PPO CPD,Meritain Health PPO CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Aetna/Commercial Product,Aetna/Commercial Product,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Meritain Health CPD,Meritain Health CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Starmark CPD,Starmark CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Aetna Medicare,Aetna Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Ambetter ,Ambetter ,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Access,Anthem Blue Access,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Access Choice,Anthem Blue Access Choice,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Blue Preferred,Anthem Blue Preferred,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Pathway,Anthem Pathway,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Alliance,Anthem Alliance,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Anthem Medicare,Anthem Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Cigna,Cigna,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Cigna PPO,Cigna PPO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Cigna Medicare Advantage,Cigna Medicare Advantage,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Essence,Essence,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Healthlink HMO,Healthlink HMO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Healthlink PPO,Healthlink PPO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,HomeState Health Plan,HomeState Health Plan,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Humana Gold,Humana Gold,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Medicaid MO,Medicaid MO,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Medica,Medica,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Tricare,Tricare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,UHC All Payer,UHC All Payer,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,UHC Exchange,UHC Exchange,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,UHC Medicaid,UHC Medicaid,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,UMR CPD,UMR CPD,86.73,,,,,,,per diem,86.73,86.73,"Per diem rate, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,UHC Medicare,UHC Medicare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
ALT                           ,38251570,CDM,301,RC,84460,CPT,,,,Inpatient,,,86.73,86.73,Wellcare,Wellcare,86.73,,,,,,,case rate,86.73,86.73,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health PPO CPD,Meritain Health PPO CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Aetna/Commercial Product,Aetna/Commercial Product,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Meritain Health CPD,Meritain Health CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Starmark CPD,Starmark CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Aetna Medicare,Aetna Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Ambetter ,Ambetter ,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access,Anthem Blue Access,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Access Choice,Anthem Blue Access Choice,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Blue Preferred,Anthem Blue Preferred,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Pathway,Anthem Pathway,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Alliance,Anthem Alliance,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Anthem Medicare,Anthem Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Cigna,Cigna,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Cigna PPO,Cigna PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Cigna Medicare Advantage,Cigna Medicare Advantage,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Essence,Essence,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Healthlink HMO,Healthlink HMO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Healthlink PPO,Healthlink PPO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,HomeState Health Plan,HomeState Health Plan,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Humana Gold,Humana Gold,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Medicaid MO,Medicaid MO,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Medica,Medica,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Tricare,Tricare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,UHC All Payer,UHC All Payer,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,UHC Exchange,UHC Exchange,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicaid,UHC Medicaid,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,UMR CPD,UMR CPD,194.14,,,,,,,per diem,194.14,194.14,"Per diem rate, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,UHC Medicare,UHC Medicare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
TROPONIN-I                    ,38251571,CDM,301,RC,84484,CPT,,,,Inpatient,,,194.14,194.14,Wellcare,Wellcare,194.14,,,,,,,case rate,194.14,194.14,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health PPO CPD,Meritain Health PPO CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Aetna/Commercial Product,Aetna/Commercial Product,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Meritain Health CPD,Meritain Health CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Starmark CPD,Starmark CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Aetna Medicare,Aetna Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Ambetter ,Ambetter ,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access,Anthem Blue Access,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Access Choice,Anthem Blue Access Choice,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Blue Preferred,Anthem Blue Preferred,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Pathway,Anthem Pathway,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Alliance,Anthem Alliance,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Anthem Medicare,Anthem Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Cigna,Cigna,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Cigna PPO,Cigna PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Cigna Medicare Advantage,Cigna Medicare Advantage,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Essence,Essence,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Healthlink HMO,Healthlink HMO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Healthlink PPO,Healthlink PPO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,HomeState Health Plan,HomeState Health Plan,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Humana Gold,Humana Gold,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Medicaid MO,Medicaid MO,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Medica,Medica,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Tricare,Tricare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,UHC All Payer,UHC All Payer,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,UHC Exchange,UHC Exchange,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicaid,UHC Medicaid,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,UMR CPD,UMR CPD,105.03,,,,,,,per diem,105.03,105.03,"Per diem rate, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,UHC Medicare,UHC Medicare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
URIC ACID SERUM               ,38251572,CDM,301,RC,84550,CPT,,,,Inpatient,,,105.03,105.03,Wellcare,Wellcare,105.03,,,,,,,case rate,105.03,105.03,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C REACTIVE PROTEIN            ,38251573,CDM,302,RC,86140,CPT,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Meritain Health PPO CPD,Meritain Health PPO CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Aetna/Commercial Product,Aetna/Commercial Product,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Meritain Health CPD,Meritain Health CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Starmark CPD,Starmark CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Aetna Medicare,Aetna Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Ambetter ,Ambetter ,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Access,Anthem Blue Access,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Access Choice,Anthem Blue Access Choice,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Blue Preferred,Anthem Blue Preferred,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Pathway,Anthem Pathway,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Alliance,Anthem Alliance,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Anthem Medicare,Anthem Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Cigna,Cigna,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Cigna PPO,Cigna PPO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Cigna Medicare Advantage,Cigna Medicare Advantage,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Essence,Essence,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Healthlink HMO,Healthlink HMO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Healthlink PPO,Healthlink PPO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,HomeState Health Plan,HomeState Health Plan,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Humana Gold,Humana Gold,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Medicaid MO,Medicaid MO,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Medica,Medica,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Tricare,Tricare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,UHC All Payer,UHC All Payer,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,UHC Exchange,UHC Exchange,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,UHC Medicaid,UHC Medicaid,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,UMR CPD,UMR CPD,167.35,,,,,,,per diem,167.35,167.35,"Per diem rate, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,UHC Medicare,UHC Medicare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
CRP HIGH SENSITIVITY RISK     ,38251574,CDM,302,RC,86141,CPT,,,,Inpatient,,,167.35,167.35,Wellcare,Wellcare,167.35,,,,,,,case rate,167.35,167.35,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health PPO CPD,Meritain Health PPO CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna/Commercial Product,Aetna/Commercial Product,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Meritain Health CPD,Meritain Health CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Starmark CPD,Starmark CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Aetna Medicare,Aetna Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Ambetter ,Ambetter ,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access,Anthem Blue Access,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Access Choice,Anthem Blue Access Choice,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Blue Preferred,Anthem Blue Preferred,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Pathway,Anthem Pathway,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Alliance,Anthem Alliance,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Anthem Medicare,Anthem Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna,Cigna,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna PPO,Cigna PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Cigna Medicare Advantage,Cigna Medicare Advantage,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Essence,Essence,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink HMO,Healthlink HMO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Healthlink PPO,Healthlink PPO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,HomeState Health Plan,HomeState Health Plan,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Humana Gold,Humana Gold,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medicaid MO,Medicaid MO,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Medica,Medica,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Tricare,Tricare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC All Payer,UHC All Payer,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Exchange,UHC Exchange,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicaid,UHC Medicaid,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UMR CPD,UMR CPD,48.8,,,,,,,per diem,48.8,48.8,"Per diem rate, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,UHC Medicare,UHC Medicare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HCT                           ,38251575,CDM,305,RC,85014,CPT,,,,Inpatient,,,48.8,48.8,Wellcare,Wellcare,48.8,,,,,,,case rate,48.8,48.8,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Meritain Health PPO CPD,Meritain Health PPO CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna/Commercial Product,Aetna/Commercial Product,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Meritain Health CPD,Meritain Health CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Starmark CPD,Starmark CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Aetna Medicare,Aetna Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Ambetter ,Ambetter ,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Access,Anthem Blue Access,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Access Choice,Anthem Blue Access Choice,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Blue Preferred,Anthem Blue Preferred,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Pathway,Anthem Pathway,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Alliance,Anthem Alliance,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Anthem Medicare,Anthem Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna,Cigna,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna PPO,Cigna PPO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Cigna Medicare Advantage,Cigna Medicare Advantage,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Essence,Essence,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthlink HMO,Healthlink HMO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Healthlink PPO,Healthlink PPO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,HomeState Health Plan,HomeState Health Plan,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Humana Gold,Humana Gold,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Medicaid MO,Medicaid MO,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Medica,Medica,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Tricare,Tricare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC All Payer,UHC All Payer,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Exchange,UHC Exchange,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Medicaid,UHC Medicaid,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UMR CPD,UMR CPD,46.68,,,,,,,per diem,46.68,46.68,"Per diem rate, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,UHC Medicare,UHC Medicare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
HGB                           ,38251576,CDM,305,RC,85018,CPT,,,,Inpatient,,,46.68,46.68,Wellcare,Wellcare,46.68,,,,,,,case rate,46.68,46.68,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Meritain Health PPO CPD,Meritain Health PPO CPD,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Aetna/Commercial Product,Aetna/Commercial Product,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Meritain Health CPD,Meritain Health CPD,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Starmark CPD,Starmark CPD,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Aetna Medicare,Aetna Medicare,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Ambetter ,Ambetter ,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Blue Access,Anthem Blue Access,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Blue Access Choice,Anthem Blue Access Choice,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Blue Preferred,Anthem Blue Preferred,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Pathway,Anthem Pathway,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Alliance,Anthem Alliance,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Anthem Medicare,Anthem Medicare,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Cigna,Cigna,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Cigna PPO,Cigna PPO,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Cigna Medicare Advantage,Cigna Medicare Advantage,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Essence,Essence,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Healthlink HMO,Healthlink HMO,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Healthlink PPO,Healthlink PPO,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,HomeState Health Plan,HomeState Health Plan,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Humana Gold,Humana Gold,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Medicaid MO,Medicaid MO,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Medica,Medica,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Tricare,Tricare,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,UHC All Payer,UHC All Payer,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,UHC Exchange,UHC Exchange,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,UHC Medicaid,UHC Medicaid,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,UMR CPD,UMR CPD,161.03,,,,,,,per diem,161.03,161.03,"Per diem rate, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,UHC Medicare,UHC Medicare,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
CBC W/AUTO DIFF               ,38251577,CDM,305,RC,85025,CPT,,,,Inpatient,,,161.03,161.03,Wellcare,Wellcare,161.03,,,,,,,case rate,161.03,161.03,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Meritain Health PPO CPD,Meritain Health PPO CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Aetna/Commercial Product,Aetna/Commercial Product,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Meritain Health CPD,Meritain Health CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Starmark CPD,Starmark CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Aetna Medicare,Aetna Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Ambetter ,Ambetter ,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Access,Anthem Blue Access,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Access Choice,Anthem Blue Access Choice,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Preferred,Anthem Blue Preferred,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Pathway,Anthem Pathway,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Alliance,Anthem Alliance,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Anthem Medicare,Anthem Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Cigna,Cigna,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Cigna PPO,Cigna PPO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Cigna Medicare Advantage,Cigna Medicare Advantage,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Essence,Essence,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Healthlink HMO,Healthlink HMO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Healthlink PPO,Healthlink PPO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,HomeState Health Plan,HomeState Health Plan,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Humana Gold,Humana Gold,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Medicaid MO,Medicaid MO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Medica,Medica,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Tricare,Tricare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,UHC All Payer,UHC All Payer,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,UHC Exchange,UHC Exchange,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,UHC Medicaid,UHC Medicaid,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,UMR CPD,UMR CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,UHC Medicare,UHC Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
AUTOMATED CBC                 ,38251578,CDM,305,RC,85027,CPT,,,,Inpatient,,,124.13,124.13,Wellcare,Wellcare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Meritain Health PPO CPD,Meritain Health PPO CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Aetna/Commercial Product,Aetna/Commercial Product,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Meritain Health CPD,Meritain Health CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Starmark CPD,Starmark CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Aetna Medicare,Aetna Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Ambetter ,Ambetter ,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Access,Anthem Blue Access,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Access Choice,Anthem Blue Access Choice,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Blue Preferred,Anthem Blue Preferred,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Pathway,Anthem Pathway,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Alliance,Anthem Alliance,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Anthem Medicare,Anthem Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Cigna,Cigna,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Cigna PPO,Cigna PPO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Cigna Medicare Advantage,Cigna Medicare Advantage,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Essence,Essence,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Healthlink HMO,Healthlink HMO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Healthlink PPO,Healthlink PPO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,HomeState Health Plan,HomeState Health Plan,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Humana Gold,Humana Gold,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Medicaid MO,Medicaid MO,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Medica,Medica,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Tricare,Tricare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,UHC All Payer,UHC All Payer,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,UHC Exchange,UHC Exchange,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,UHC Medicaid,UHC Medicaid,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,UMR CPD,UMR CPD,73.2,,,,,,,per diem,73.2,73.2,"Per diem rate, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,UHC Medicare,UHC Medicare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
RETIC AUTO W/CELL PARAMS      ,38251579,CDM,305,RC,85046,CPT,,,,Inpatient,,,73.2,73.2,Wellcare,Wellcare,73.2,,,,,,,case rate,73.2,73.2,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health PPO CPD,Meritain Health PPO CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna/Commercial Product,Aetna/Commercial Product,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Meritain Health CPD,Meritain Health CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Starmark CPD,Starmark CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Aetna Medicare,Aetna Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Ambetter ,Ambetter ,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access,Anthem Blue Access,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Access Choice,Anthem Blue Access Choice,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Blue Preferred,Anthem Blue Preferred,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Pathway,Anthem Pathway,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Alliance,Anthem Alliance,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Anthem Medicare,Anthem Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna,Cigna,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna PPO,Cigna PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Cigna Medicare Advantage,Cigna Medicare Advantage,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Essence,Essence,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthlink HMO,Healthlink HMO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Healthlink PPO,Healthlink PPO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,HomeState Health Plan,HomeState Health Plan,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Humana Gold,Humana Gold,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Medicaid MO,Medicaid MO,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Medica,Medica,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Tricare,Tricare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC All Payer,UHC All Payer,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Exchange,UHC Exchange,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicaid,UHC Medicaid,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UMR CPD,UMR CPD,189.9,,,,,,,per diem,189.9,189.9,"Per diem rate, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,UHC Medicare,UHC Medicare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
D-DIMER ELISA                 ,38251580,CDM,305,RC,85379,CPT,,,,Inpatient,,,189.9,189.9,Wellcare,Wellcare,189.9,,,,,,,case rate,189.9,189.9,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health PPO CPD,Meritain Health PPO CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Aetna/Commercial Product,Aetna/Commercial Product,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Meritain Health CPD,Meritain Health CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Starmark CPD,Starmark CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Aetna Medicare,Aetna Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Ambetter ,Ambetter ,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access,Anthem Blue Access,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Access Choice,Anthem Blue Access Choice,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Blue Preferred,Anthem Blue Preferred,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Pathway,Anthem Pathway,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Alliance,Anthem Alliance,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Anthem Medicare,Anthem Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Cigna,Cigna,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Cigna PPO,Cigna PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Cigna Medicare Advantage,Cigna Medicare Advantage,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Essence,Essence,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Healthlink HMO,Healthlink HMO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Healthlink PPO,Healthlink PPO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,HomeState Health Plan,HomeState Health Plan,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Humana Gold,Humana Gold,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Medicaid MO,Medicaid MO,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Medica,Medica,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Tricare,Tricare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,UHC All Payer,UHC All Payer,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,UHC Exchange,UHC Exchange,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicaid,UHC Medicaid,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,UMR CPD,UMR CPD,77.25,,,,,,,per diem,77.25,77.25,"Per diem rate, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,UHC Medicare,UHC Medicare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
PROTHROMBIN TIME              ,38251581,CDM,305,RC,85610,CPT,,,,Inpatient,,,77.25,77.25,Wellcare,Wellcare,77.25,,,,,,,case rate,77.25,77.25,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health PPO CPD,Meritain Health PPO CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna/Commercial Product,Aetna/Commercial Product,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health CPD,Meritain Health CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Starmark CPD,Starmark CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Aetna Medicare,Aetna Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Ambetter ,Ambetter ,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access,Anthem Blue Access,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access Choice,Anthem Blue Access Choice,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Preferred,Anthem Blue Preferred,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Pathway,Anthem Pathway,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Alliance,Anthem Alliance,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Anthem Medicare,Anthem Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna,Cigna,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna PPO,Cigna PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Cigna Medicare Advantage,Cigna Medicare Advantage,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Essence,Essence,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthlink HMO,Healthlink HMO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Healthlink PPO,Healthlink PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,HomeState Health Plan,HomeState Health Plan,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Humana Gold,Humana Gold,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Medicaid MO,Medicaid MO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Medica,Medica,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Tricare,Tricare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC All Payer,UHC All Payer,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Exchange,UHC Exchange,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicaid,UHC Medicaid,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UMR CPD,UMR CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicare,UHC Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
SED RATE                      ,38251582,CDM,305,RC,85652,CPT,,,,Inpatient,,,70.02,70.02,Wellcare,Wellcare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Meritain Health PPO CPD,Meritain Health PPO CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna/Commercial Product,Aetna/Commercial Product,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Meritain Health CPD,Meritain Health CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Starmark CPD,Starmark CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Aetna Medicare,Aetna Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Ambetter ,Ambetter ,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Access,Anthem Blue Access,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Access Choice,Anthem Blue Access Choice,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Blue Preferred,Anthem Blue Preferred,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Pathway,Anthem Pathway,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Alliance,Anthem Alliance,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Anthem Medicare,Anthem Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna,Cigna,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna PPO,Cigna PPO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Cigna Medicare Advantage,Cigna Medicare Advantage,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Essence,Essence,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthlink HMO,Healthlink HMO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Healthlink PPO,Healthlink PPO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,HomeState Health Plan,HomeState Health Plan,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Humana Gold,Humana Gold,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Medicaid MO,Medicaid MO,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Medica,Medica,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Tricare,Tricare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC All Payer,UHC All Payer,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Exchange,UHC Exchange,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Medicaid,UHC Medicaid,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UMR CPD,UMR CPD,115.64,,,,,,,per diem,115.64,115.64,"Per diem rate, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,UHC Medicare,UHC Medicare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
APTT                          ,38251583,CDM,305,RC,85730,CPT,,,,Inpatient,,,115.64,115.64,Wellcare,Wellcare,115.64,,,,,,,case rate,115.64,115.64,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Meritain Health PPO CPD,Meritain Health PPO CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Aetna/Commercial Product,Aetna/Commercial Product,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Meritain Health CPD,Meritain Health CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Starmark CPD,Starmark CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Aetna Medicare,Aetna Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Ambetter ,Ambetter ,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Access,Anthem Blue Access,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Access Choice,Anthem Blue Access Choice,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Preferred,Anthem Blue Preferred,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Pathway,Anthem Pathway,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Alliance,Anthem Alliance,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Anthem Medicare,Anthem Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Cigna,Cigna,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Cigna PPO,Cigna PPO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Cigna Medicare Advantage,Cigna Medicare Advantage,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Essence,Essence,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Healthlink HMO,Healthlink HMO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Healthlink PPO,Healthlink PPO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,HomeState Health Plan,HomeState Health Plan,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Humana Gold,Humana Gold,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Medicaid MO,Medicaid MO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Medica,Medica,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Tricare,Tricare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,UHC All Payer,UHC All Payer,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,UHC Exchange,UHC Exchange,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,UHC Medicaid,UHC Medicaid,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,UMR CPD,UMR CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,UHC Medicare,UHC Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
BLOOD CULTURE                 ,38251584,CDM,306,RC,87040,CPT,,,,Inpatient,,,261.52,261.52,Wellcare,Wellcare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health PPO CPD,Meritain Health PPO CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna/Commercial Product,Aetna/Commercial Product,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Meritain Health CPD,Meritain Health CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Starmark CPD,Starmark CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Aetna Medicare,Aetna Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Ambetter ,Ambetter ,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access,Anthem Blue Access,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Access Choice,Anthem Blue Access Choice,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Blue Preferred,Anthem Blue Preferred,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Pathway,Anthem Pathway,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Alliance,Anthem Alliance,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Anthem Medicare,Anthem Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna,Cigna,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna PPO,Cigna PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Cigna Medicare Advantage,Cigna Medicare Advantage,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Essence,Essence,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthlink HMO,Healthlink HMO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Healthlink PPO,Healthlink PPO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,HomeState Health Plan,HomeState Health Plan,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Humana Gold,Humana Gold,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Medicaid MO,Medicaid MO,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Medica,Medica,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Tricare,Tricare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC All Payer,UHC All Payer,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Exchange,UHC Exchange,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicaid,UHC Medicaid,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UMR CPD,UMR CPD,186.72,,,,,,,per diem,186.72,186.72,"Per diem rate, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,UHC Medicare,UHC Medicare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
STOOL CULTURE                 ,38251585,CDM,306,RC,87045,CPT,,,,Inpatient,,,186.72,186.72,Wellcare,Wellcare,186.72,,,,,,,case rate,186.72,186.72,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"CAMPYLOBACTER, ADD BILL       ",38251586,CDM,306,RC,87046,CPT,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Meritain Health PPO CPD,Meritain Health PPO CPD,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Aetna/Commercial Product,Aetna/Commercial Product,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Meritain Health CPD,Meritain Health CPD,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Starmark CPD,Starmark CPD,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Aetna Medicare,Aetna Medicare,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Ambetter ,Ambetter ,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Blue Access,Anthem Blue Access,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Blue Access Choice,Anthem Blue Access Choice,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Blue Preferred,Anthem Blue Preferred,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Pathway,Anthem Pathway,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Alliance,Anthem Alliance,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Anthem Medicare,Anthem Medicare,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Cigna,Cigna,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Cigna PPO,Cigna PPO,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Cigna Medicare Advantage,Cigna Medicare Advantage,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Essence,Essence,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Healthlink HMO,Healthlink HMO,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Healthlink PPO,Healthlink PPO,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,HomeState Health Plan,HomeState Health Plan,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Humana Gold,Humana Gold,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Medicaid MO,Medicaid MO,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Medica,Medica,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Tricare,Tricare,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,UHC All Payer,UHC All Payer,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,UHC Exchange,UHC Exchange,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,UHC Medicaid,UHC Medicaid,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,UMR CPD,UMR CPD,217.22,,,,,,,per diem,217.22,217.22,"Per diem rate, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,UHC Medicare,UHC Medicare,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
"WOUND CULTURE,AEROBIC         ",38251587,CDM,306,RC,87070,CPT,,,,Inpatient,,,217.22,217.22,Wellcare,Wellcare,217.22,,,,,,,case rate,217.22,217.22,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
DEF ID CULTURE AEROBIC        ,38251588,CDM,306,RC,87077,CPT,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Meritain Health PPO CPD,Meritain Health PPO CPD,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Aetna/Commercial Product,Aetna/Commercial Product,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Meritain Health CPD,Meritain Health CPD,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Starmark CPD,Starmark CPD,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Aetna Medicare,Aetna Medicare,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Ambetter ,Ambetter ,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Blue Access,Anthem Blue Access,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Blue Access Choice,Anthem Blue Access Choice,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Blue Preferred,Anthem Blue Preferred,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Pathway,Anthem Pathway,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Alliance,Anthem Alliance,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Anthem Medicare,Anthem Medicare,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Cigna,Cigna,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Cigna PPO,Cigna PPO,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Cigna Medicare Advantage,Cigna Medicare Advantage,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Essence,Essence,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Healthlink HMO,Healthlink HMO,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Healthlink PPO,Healthlink PPO,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,HomeState Health Plan,HomeState Health Plan,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Humana Gold,Humana Gold,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Medicaid MO,Medicaid MO,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Medica,Medica,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Tricare,Tricare,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,UHC All Payer,UHC All Payer,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,UHC Exchange,UHC Exchange,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,UHC Medicaid,UHC Medicaid,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,UMR CPD,UMR CPD,190.96,,,,,,,per diem,190.96,190.96,"Per diem rate, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,UHC Medicare,UHC Medicare,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
URINE CULTURE                 ,38251589,CDM,306,RC,87086,CPT,,,,Inpatient,,,190.96,190.96,Wellcare,Wellcare,190.96,,,,,,,case rate,190.96,190.96,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health PPO CPD,Meritain Health PPO CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna/Commercial Product,Aetna/Commercial Product,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Meritain Health CPD,Meritain Health CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Starmark CPD,Starmark CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Aetna Medicare,Aetna Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Ambetter ,Ambetter ,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access,Anthem Blue Access,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Access Choice,Anthem Blue Access Choice,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Blue Preferred,Anthem Blue Preferred,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Pathway,Anthem Pathway,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Alliance,Anthem Alliance,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Anthem Medicare,Anthem Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna,Cigna,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna PPO,Cigna PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Cigna Medicare Advantage,Cigna Medicare Advantage,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Essence,Essence,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthlink HMO,Healthlink HMO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Healthlink PPO,Healthlink PPO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,HomeState Health Plan,HomeState Health Plan,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Humana Gold,Humana Gold,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Medicaid MO,Medicaid MO,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Medica,Medica,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Tricare,Tricare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC All Payer,UHC All Payer,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Exchange,UHC Exchange,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicaid,UHC Medicaid,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UMR CPD,UMR CPD,47.74,,,,,,,per diem,47.74,47.74,"Per diem rate, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,UHC Medicare,UHC Medicare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
CULTURE IMMUNOLOGIC-LATX      ,38251590,CDM,306,RC,87147,CPT,,,,Inpatient,,,47.74,47.74,Wellcare,Wellcare,47.74,,,,,,,case rate,47.74,47.74,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Meritain Health PPO CPD,Meritain Health PPO CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Aetna/Commercial Product,Aetna/Commercial Product,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Meritain Health CPD,Meritain Health CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Starmark CPD,Starmark CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Aetna Medicare,Aetna Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Ambetter ,Ambetter ,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Access,Anthem Blue Access,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Access Choice,Anthem Blue Access Choice,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Preferred,Anthem Blue Preferred,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Pathway,Anthem Pathway,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Alliance,Anthem Alliance,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Anthem Medicare,Anthem Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Cigna,Cigna,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Cigna PPO,Cigna PPO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Cigna Medicare Advantage,Cigna Medicare Advantage,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Essence,Essence,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Healthlink HMO,Healthlink HMO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Healthlink PPO,Healthlink PPO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,HomeState Health Plan,HomeState Health Plan,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Humana Gold,Humana Gold,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Medicaid MO,Medicaid MO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Medica,Medica,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Tricare,Tricare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,UHC All Payer,UHC All Payer,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,UHC Exchange,UHC Exchange,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,UHC Medicaid,UHC Medicaid,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,UMR CPD,UMR CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,UHC Medicare,UHC Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
MIC SENSITIVITY               ,38251591,CDM,306,RC,87186,CPT,,,,Inpatient,,,173.04,173.04,Wellcare,Wellcare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Meritain Health PPO CPD,Meritain Health PPO CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Aetna/Commercial Product,Aetna/Commercial Product,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Meritain Health CPD,Meritain Health CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Starmark CPD,Starmark CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Aetna Medicare,Aetna Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Ambetter ,Ambetter ,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Access,Anthem Blue Access,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Access Choice,Anthem Blue Access Choice,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Blue Preferred,Anthem Blue Preferred,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Pathway,Anthem Pathway,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Alliance,Anthem Alliance,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Anthem Medicare,Anthem Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Cigna,Cigna,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Cigna PPO,Cigna PPO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Cigna Medicare Advantage,Cigna Medicare Advantage,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Essence,Essence,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Healthlink HMO,Healthlink HMO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Healthlink PPO,Healthlink PPO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,HomeState Health Plan,HomeState Health Plan,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Humana Gold,Humana Gold,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Medicaid MO,Medicaid MO,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Medica,Medica,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Tricare,Tricare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,UHC All Payer,UHC All Payer,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,UHC Exchange,UHC Exchange,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,UHC Medicaid,UHC Medicaid,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,UMR CPD,UMR CPD,90.18,,,,,,,per diem,90.18,90.18,"Per diem rate, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,UHC Medicare,UHC Medicare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
GRAM STAIN SMEAR              ,38251592,CDM,306,RC,87205,CPT,,,,Inpatient,,,90.18,90.18,Wellcare,Wellcare,90.18,,,,,,,case rate,90.18,90.18,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Meritain Health PPO CPD,Meritain Health PPO CPD,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Aetna/Commercial Product,Aetna/Commercial Product,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Meritain Health CPD,Meritain Health CPD,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Starmark CPD,Starmark CPD,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Aetna Medicare,Aetna Medicare,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Ambetter ,Ambetter ,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Blue Access,Anthem Blue Access,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Blue Access Choice,Anthem Blue Access Choice,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Blue Preferred,Anthem Blue Preferred,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Pathway,Anthem Pathway,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Alliance,Anthem Alliance,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Anthem Medicare,Anthem Medicare,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Cigna,Cigna,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Cigna PPO,Cigna PPO,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Cigna Medicare Advantage,Cigna Medicare Advantage,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Essence,Essence,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Healthlink HMO,Healthlink HMO,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Healthlink PPO,Healthlink PPO,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,HomeState Health Plan,HomeState Health Plan,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Humana Gold,Humana Gold,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Medicaid MO,Medicaid MO,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Medica,Medica,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Tricare,Tricare,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,UHC All Payer,UHC All Payer,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,UHC Exchange,UHC Exchange,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,UHC Medicaid,UHC Medicaid,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,UMR CPD,UMR CPD,260.59,,,,,,,per diem,260.59,260.59,"Per diem rate, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,UHC Medicare,UHC Medicare,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
CLOSTRIDIUM DIFF TOXIN AM     ,38251593,CDM,306,RC,87493,CPT,,,,Inpatient,,,260.59,260.59,Wellcare,Wellcare,260.59,,,,,,,case rate,260.59,260.59,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Meritain Health PPO CPD,Meritain Health PPO CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Aetna/Commercial Product,Aetna/Commercial Product,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Meritain Health CPD,Meritain Health CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Starmark CPD,Starmark CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Aetna Medicare,Aetna Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Ambetter ,Ambetter ,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Blue Access,Anthem Blue Access,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Blue Access Choice,Anthem Blue Access Choice,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Blue Preferred,Anthem Blue Preferred,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Pathway,Anthem Pathway,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Alliance,Anthem Alliance,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Anthem Medicare,Anthem Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Cigna,Cigna,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Cigna PPO,Cigna PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Cigna Medicare Advantage,Cigna Medicare Advantage,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Essence,Essence,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Healthlink HMO,Healthlink HMO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Healthlink PPO,Healthlink PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,HomeState Health Plan,HomeState Health Plan,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Humana Gold,Humana Gold,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Medicaid MO,Medicaid MO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Medica,Medica,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Tricare,Tricare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,UHC All Payer,UHC All Payer,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,UHC Exchange,UHC Exchange,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,UHC Medicaid,UHC Medicaid,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,UMR CPD,UMR CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,UHC Medicare,UHC Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
URINALYSIS AND MICROSCOPI     ,38251594,CDM,307,RC,81001,CPT,,,,Inpatient,,,103,103,Wellcare,Wellcare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Meritain Health PPO CPD,Meritain Health PPO CPD,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Aetna/Commercial Product,Aetna/Commercial Product,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Meritain Health CPD,Meritain Health CPD,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Starmark CPD,Starmark CPD,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Aetna Medicare,Aetna Medicare,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Ambetter ,Ambetter ,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Blue Access,Anthem Blue Access,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Blue Access Choice,Anthem Blue Access Choice,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Blue Preferred,Anthem Blue Preferred,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Pathway,Anthem Pathway,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Alliance,Anthem Alliance,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Anthem Medicare,Anthem Medicare,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Cigna,Cigna,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Cigna PPO,Cigna PPO,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Cigna Medicare Advantage,Cigna Medicare Advantage,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Essence,Essence,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Healthlink HMO,Healthlink HMO,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Healthlink PPO,Healthlink PPO,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,HomeState Health Plan,HomeState Health Plan,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Humana Gold,Humana Gold,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Medicaid MO,Medicaid MO,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Medica,Medica,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Tricare,Tricare,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,UHC All Payer,UHC All Payer,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,UHC Exchange,UHC Exchange,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,UHC Medicaid,UHC Medicaid,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,UMR CPD,UMR CPD,106.3,,,,,,,per diem,106.3,106.3,"Per diem rate, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,UHC Medicare,UHC Medicare,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
TACROLIMUS (FK506)            ,38251595,CDM,300,RC,,,,,,Inpatient,,,106.3,106.3,Wellcare,Wellcare,106.3,,,,,,,case rate,106.3,106.3,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Meritain Health PPO CPD,Meritain Health PPO CPD,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Aetna/Commercial Product,Aetna/Commercial Product,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Meritain Health CPD,Meritain Health CPD,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Starmark CPD,Starmark CPD,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Aetna Medicare,Aetna Medicare,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Ambetter ,Ambetter ,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Blue Access,Anthem Blue Access,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Blue Access Choice,Anthem Blue Access Choice,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Blue Preferred,Anthem Blue Preferred,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Pathway,Anthem Pathway,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Alliance,Anthem Alliance,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Anthem Medicare,Anthem Medicare,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Cigna,Cigna,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Cigna PPO,Cigna PPO,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Cigna Medicare Advantage,Cigna Medicare Advantage,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Essence,Essence,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Healthlink HMO,Healthlink HMO,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Healthlink PPO,Healthlink PPO,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,HomeState Health Plan,HomeState Health Plan,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Humana Gold,Humana Gold,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Medicaid MO,Medicaid MO,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Medica,Medica,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Tricare,Tricare,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,UHC All Payer,UHC All Payer,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,UHC Exchange,UHC Exchange,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,UHC Medicaid,UHC Medicaid,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,UMR CPD,UMR CPD,295.99,,,,,,,per diem,295.99,295.99,"Per diem rate, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,UHC Medicare,UHC Medicare,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
"INFLUENZA A, PCR              ",38251597,CDM,306,RC,87502,CPT,,,,Inpatient,,,295.99,295.99,Wellcare,Wellcare,295.99,,,,,,,case rate,295.99,295.99,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Meritain Health PPO CPD,Meritain Health PPO CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Aetna/Commercial Product,Aetna/Commercial Product,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Meritain Health CPD,Meritain Health CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Starmark CPD,Starmark CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Aetna Medicare,Aetna Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Ambetter ,Ambetter ,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Blue Access,Anthem Blue Access,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Blue Access Choice,Anthem Blue Access Choice,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Blue Preferred,Anthem Blue Preferred,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Pathway,Anthem Pathway,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Alliance,Anthem Alliance,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Anthem Medicare,Anthem Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Cigna,Cigna,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Cigna PPO,Cigna PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Cigna Medicare Advantage,Cigna Medicare Advantage,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Essence,Essence,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Healthlink HMO,Healthlink HMO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Healthlink PPO,Healthlink PPO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,HomeState Health Plan,HomeState Health Plan,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Humana Gold,Humana Gold,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Medicaid MO,Medicaid MO,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Medica,Medica,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Tricare,Tricare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,UHC All Payer,UHC All Payer,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,UHC Exchange,UHC Exchange,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,UHC Medicaid,UHC Medicaid,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,UMR CPD,UMR CPD,53.56,,,,,,,per diem,53.56,53.56,"Per diem rate, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,UHC Medicare,UHC Medicare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
COAGULATION SCREEN            ,38251600,CDM,301,RC,85601,CPT,,,,Inpatient,,,53.56,53.56,Wellcare,Wellcare,53.56,,,,,,,case rate,53.56,53.56,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Meritain Health PPO CPD,Meritain Health PPO CPD,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Aetna/Commercial Product,Aetna/Commercial Product,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Meritain Health CPD,Meritain Health CPD,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Starmark CPD,Starmark CPD,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Aetna Medicare,Aetna Medicare,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Ambetter ,Ambetter ,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Blue Access,Anthem Blue Access,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Blue Access Choice,Anthem Blue Access Choice,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Blue Preferred,Anthem Blue Preferred,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Pathway,Anthem Pathway,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Alliance,Anthem Alliance,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Anthem Medicare,Anthem Medicare,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Cigna,Cigna,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Cigna PPO,Cigna PPO,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Cigna Medicare Advantage,Cigna Medicare Advantage,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Essence,Essence,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Healthlink HMO,Healthlink HMO,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Healthlink PPO,Healthlink PPO,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,HomeState Health Plan,HomeState Health Plan,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Humana Gold,Humana Gold,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Medicaid MO,Medicaid MO,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Medica,Medica,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Tricare,Tricare,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,UHC All Payer,UHC All Payer,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,UHC Exchange,UHC Exchange,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,UHC Medicaid,UHC Medicaid,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,UMR CPD,UMR CPD,771.25,,,,,,,per diem,771.25,771.25,"Per diem rate, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,UHC Medicare,UHC Medicare,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
LEUKO REDUCED RED CELLS       ,38251601,CDM,301,RC,,,,,,Inpatient,,,771.25,771.25,Wellcare,Wellcare,771.25,,,,,,,case rate,771.25,771.25,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Meritain Health PPO CPD,Meritain Health PPO CPD,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Aetna/Commercial Product,Aetna/Commercial Product,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Meritain Health CPD,Meritain Health CPD,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Starmark CPD,Starmark CPD,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Aetna Medicare,Aetna Medicare,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Ambetter ,Ambetter ,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Blue Access,Anthem Blue Access,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Blue Access Choice,Anthem Blue Access Choice,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Blue Preferred,Anthem Blue Preferred,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Pathway,Anthem Pathway,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Alliance,Anthem Alliance,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Anthem Medicare,Anthem Medicare,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Cigna,Cigna,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Cigna PPO,Cigna PPO,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Cigna Medicare Advantage,Cigna Medicare Advantage,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Essence,Essence,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Healthlink HMO,Healthlink HMO,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Healthlink PPO,Healthlink PPO,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,HomeState Health Plan,HomeState Health Plan,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Humana Gold,Humana Gold,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Medicaid MO,Medicaid MO,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Medica,Medica,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Tricare,Tricare,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,UHC All Payer,UHC All Payer,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,UHC Exchange,UHC Exchange,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,UHC Medicaid,UHC Medicaid,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,UMR CPD,UMR CPD,79.05,,,,,,,per diem,79.05,79.05,"Per diem rate, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,UHC Medicare,UHC Medicare,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
IMMUNIOFIXATION URINE         ,38251602,CDM,301,RC,,,,,,Inpatient,,,79.05,79.05,Wellcare,Wellcare,79.05,,,,,,,case rate,79.05,79.05,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Meritain Health PPO CPD,Meritain Health PPO CPD,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Aetna/Commercial Product,Aetna/Commercial Product,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Meritain Health CPD,Meritain Health CPD,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Starmark CPD,Starmark CPD,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Aetna Medicare,Aetna Medicare,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Ambetter ,Ambetter ,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Blue Access,Anthem Blue Access,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Blue Access Choice,Anthem Blue Access Choice,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Blue Preferred,Anthem Blue Preferred,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Pathway,Anthem Pathway,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Alliance,Anthem Alliance,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Anthem Medicare,Anthem Medicare,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Cigna,Cigna,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Cigna PPO,Cigna PPO,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Cigna Medicare Advantage,Cigna Medicare Advantage,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Essence,Essence,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Healthlink HMO,Healthlink HMO,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Healthlink PPO,Healthlink PPO,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,HomeState Health Plan,HomeState Health Plan,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Humana Gold,Humana Gold,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Medicaid MO,Medicaid MO,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Medica,Medica,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Tricare,Tricare,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,UHC All Payer,UHC All Payer,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,UHC Exchange,UHC Exchange,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,UHC Medicaid,UHC Medicaid,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,UMR CPD,UMR CPD,141.72,,,,,,,per diem,141.72,141.72,"Per diem rate, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,UHC Medicare,UHC Medicare,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
ELECTROLYTE URINE SPOT        ,38251603,CDM,301,RC,,,,,,Inpatient,,,141.72,141.72,Wellcare,Wellcare,141.72,,,,,,,case rate,141.72,141.72,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Meritain Health PPO CPD,Meritain Health PPO CPD,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Aetna/Commercial Product,Aetna/Commercial Product,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Meritain Health CPD,Meritain Health CPD,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Starmark CPD,Starmark CPD,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Aetna Medicare,Aetna Medicare,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Ambetter ,Ambetter ,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Blue Access,Anthem Blue Access,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Blue Access Choice,Anthem Blue Access Choice,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Blue Preferred,Anthem Blue Preferred,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Pathway,Anthem Pathway,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Alliance,Anthem Alliance,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Anthem Medicare,Anthem Medicare,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Cigna,Cigna,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Cigna PPO,Cigna PPO,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Cigna Medicare Advantage,Cigna Medicare Advantage,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Essence,Essence,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Healthlink HMO,Healthlink HMO,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Healthlink PPO,Healthlink PPO,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,HomeState Health Plan,HomeState Health Plan,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Humana Gold,Humana Gold,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Medicaid MO,Medicaid MO,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Medica,Medica,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Tricare,Tricare,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,UHC All Payer,UHC All Payer,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,UHC Exchange,UHC Exchange,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,UHC Medicaid,UHC Medicaid,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,UMR CPD,UMR CPD,17.16,,,,,,,per diem,17.16,17.16,"Per diem rate, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,UHC Medicare,UHC Medicare,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
GLUCOSE POCT                  ,38251604,CDM,301,RC,,,,,,Inpatient,,,17.16,17.16,Wellcare,Wellcare,17.16,,,,,,,case rate,17.16,17.16,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Meritain Health PPO CPD,Meritain Health PPO CPD,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Aetna/Commercial Product,Aetna/Commercial Product,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Meritain Health CPD,Meritain Health CPD,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Starmark CPD,Starmark CPD,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Aetna Medicare,Aetna Medicare,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Ambetter ,Ambetter ,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Blue Access,Anthem Blue Access,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Blue Access Choice,Anthem Blue Access Choice,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Blue Preferred,Anthem Blue Preferred,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Pathway,Anthem Pathway,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Alliance,Anthem Alliance,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Anthem Medicare,Anthem Medicare,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Cigna,Cigna,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Cigna PPO,Cigna PPO,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Cigna Medicare Advantage,Cigna Medicare Advantage,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Essence,Essence,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Healthlink HMO,Healthlink HMO,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Healthlink PPO,Healthlink PPO,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,HomeState Health Plan,HomeState Health Plan,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Humana Gold,Humana Gold,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Medicaid MO,Medicaid MO,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Medica,Medica,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Tricare,Tricare,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,UHC All Payer,UHC All Payer,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,UHC Exchange,UHC Exchange,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,UHC Medicaid,UHC Medicaid,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,UMR CPD,UMR CPD,25.71,,,,,,,per diem,25.71,25.71,"Per diem rate, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,UHC Medicare,UHC Medicare,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
LACTATE DEHYDROGENASE         ,38251605,CDM,301,RC,,,,,,Inpatient,,,25.71,25.71,Wellcare,Wellcare,25.71,,,,,,,case rate,25.71,25.71,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Meritain Health PPO CPD,Meritain Health PPO CPD,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Aetna/Commercial Product,Aetna/Commercial Product,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Meritain Health CPD,Meritain Health CPD,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Starmark CPD,Starmark CPD,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Aetna Medicare,Aetna Medicare,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Ambetter ,Ambetter ,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Blue Access,Anthem Blue Access,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Blue Access Choice,Anthem Blue Access Choice,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Blue Preferred,Anthem Blue Preferred,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Pathway,Anthem Pathway,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Alliance,Anthem Alliance,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Anthem Medicare,Anthem Medicare,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Cigna,Cigna,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Cigna PPO,Cigna PPO,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Cigna Medicare Advantage,Cigna Medicare Advantage,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Essence,Essence,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Healthlink HMO,Healthlink HMO,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Healthlink PPO,Healthlink PPO,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,HomeState Health Plan,HomeState Health Plan,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Humana Gold,Humana Gold,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Medicaid MO,Medicaid MO,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Medica,Medica,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Tricare,Tricare,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,UHC All Payer,UHC All Payer,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,UHC Exchange,UHC Exchange,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,UHC Medicaid,UHC Medicaid,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,UMR CPD,UMR CPD,68.48,,,,,,,per diem,68.48,68.48,"Per diem rate, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,UHC Medicare,UHC Medicare,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
TYPE SCREEN                   ,38251606,CDM,301,RC,,,,,,Inpatient,,,68.48,68.48,Wellcare,Wellcare,68.48,,,,,,,case rate,68.48,68.48,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Meritain Health PPO CPD,Meritain Health PPO CPD,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Aetna/Commercial Product,Aetna/Commercial Product,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Meritain Health CPD,Meritain Health CPD,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Starmark CPD,Starmark CPD,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Aetna Medicare,Aetna Medicare,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Ambetter ,Ambetter ,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Blue Access,Anthem Blue Access,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Blue Access Choice,Anthem Blue Access Choice,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Blue Preferred,Anthem Blue Preferred,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Pathway,Anthem Pathway,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Alliance,Anthem Alliance,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Anthem Medicare,Anthem Medicare,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Cigna,Cigna,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Cigna PPO,Cigna PPO,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Cigna Medicare Advantage,Cigna Medicare Advantage,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Essence,Essence,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Healthlink HMO,Healthlink HMO,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Healthlink PPO,Healthlink PPO,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,HomeState Health Plan,HomeState Health Plan,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Humana Gold,Humana Gold,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Medicaid MO,Medicaid MO,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Medica,Medica,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Tricare,Tricare,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,UHC All Payer,UHC All Payer,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,UHC Exchange,UHC Exchange,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,UHC Medicaid,UHC Medicaid,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,UMR CPD,UMR CPD,24.07,,,,,,,per diem,24.07,24.07,"Per diem rate, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,UHC Medicare,UHC Medicare,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
DAT POLYSPECIFIC              ,38251607,CDM,301,RC,,,,,,Inpatient,,,24.07,24.07,Wellcare,Wellcare,24.07,,,,,,,case rate,24.07,24.07,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Meritain Health PPO CPD,Meritain Health PPO CPD,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Aetna/Commercial Product,Aetna/Commercial Product,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Meritain Health CPD,Meritain Health CPD,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Starmark CPD,Starmark CPD,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Aetna Medicare,Aetna Medicare,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Ambetter ,Ambetter ,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Blue Access,Anthem Blue Access,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Blue Access Choice,Anthem Blue Access Choice,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Blue Preferred,Anthem Blue Preferred,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Pathway,Anthem Pathway,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Alliance,Anthem Alliance,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Anthem Medicare,Anthem Medicare,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Cigna,Cigna,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Cigna PPO,Cigna PPO,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Cigna Medicare Advantage,Cigna Medicare Advantage,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Essence,Essence,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Healthlink HMO,Healthlink HMO,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Healthlink PPO,Healthlink PPO,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,HomeState Health Plan,HomeState Health Plan,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Humana Gold,Humana Gold,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Medicaid MO,Medicaid MO,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Medica,Medica,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Tricare,Tricare,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,UHC All Payer,UHC All Payer,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,UHC Exchange,UHC Exchange,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,UHC Medicaid,UHC Medicaid,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,UMR CPD,UMR CPD,448.75,,,,,,,per diem,448.75,448.75,"Per diem rate, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,UHC Medicare,UHC Medicare,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
ANA TITER ENA PANEL           ,38251611,CDM,301,RC,,,,,,Inpatient,,,448.75,448.75,Wellcare,Wellcare,448.75,,,,,,,case rate,448.75,448.75,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Meritain Health PPO CPD,Meritain Health PPO CPD,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Aetna/Commercial Product,Aetna/Commercial Product,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Meritain Health CPD,Meritain Health CPD,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Starmark CPD,Starmark CPD,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Aetna Medicare,Aetna Medicare,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Ambetter ,Ambetter ,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Blue Access,Anthem Blue Access,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Blue Access Choice,Anthem Blue Access Choice,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Blue Preferred,Anthem Blue Preferred,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Pathway,Anthem Pathway,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Alliance,Anthem Alliance,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Anthem Medicare,Anthem Medicare,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Cigna,Cigna,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Cigna PPO,Cigna PPO,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Cigna Medicare Advantage,Cigna Medicare Advantage,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Essence,Essence,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Healthlink HMO,Healthlink HMO,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Healthlink PPO,Healthlink PPO,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,HomeState Health Plan,HomeState Health Plan,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Humana Gold,Humana Gold,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Medicaid MO,Medicaid MO,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Medica,Medica,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Tricare,Tricare,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,UHC All Payer,UHC All Payer,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,UHC Exchange,UHC Exchange,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,UHC Medicaid,UHC Medicaid,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,UMR CPD,UMR CPD,145.64,,,,,,,per diem,145.64,145.64,"Per diem rate, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,UHC Medicare,UHC Medicare,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
METANEPHRINES PLASMA          ,38251612,CDM,301,RC,,,,,,Inpatient,,,145.64,145.64,Wellcare,Wellcare,145.64,,,,,,,case rate,145.64,145.64,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Meritain Health PPO CPD,Meritain Health PPO CPD,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Aetna/Commercial Product,Aetna/Commercial Product,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Meritain Health CPD,Meritain Health CPD,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Starmark CPD,Starmark CPD,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Aetna Medicare,Aetna Medicare,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Ambetter ,Ambetter ,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Blue Access,Anthem Blue Access,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Blue Access Choice,Anthem Blue Access Choice,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Blue Preferred,Anthem Blue Preferred,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Pathway,Anthem Pathway,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Alliance,Anthem Alliance,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Anthem Medicare,Anthem Medicare,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Cigna,Cigna,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Cigna PPO,Cigna PPO,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Cigna Medicare Advantage,Cigna Medicare Advantage,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Essence,Essence,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Healthlink HMO,Healthlink HMO,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Healthlink PPO,Healthlink PPO,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,HomeState Health Plan,HomeState Health Plan,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Humana Gold,Humana Gold,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Medicaid MO,Medicaid MO,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Medica,Medica,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Tricare,Tricare,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,UHC All Payer,UHC All Payer,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,UHC Exchange,UHC Exchange,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,UHC Medicaid,UHC Medicaid,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,UMR CPD,UMR CPD,50.47,,,,,,,per diem,50.47,50.47,"Per diem rate, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,UHC Medicare,UHC Medicare,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
ANCA                          ,38251614,CDM,301,RC,,,,,,Inpatient,,,50.47,50.47,Wellcare,Wellcare,50.47,,,,,,,case rate,50.47,50.47,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Meritain Health PPO CPD,Meritain Health PPO CPD,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Aetna/Commercial Product,Aetna/Commercial Product,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Meritain Health CPD,Meritain Health CPD,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Starmark CPD,Starmark CPD,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Aetna Medicare,Aetna Medicare,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Ambetter ,Ambetter ,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Blue Access,Anthem Blue Access,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Blue Access Choice,Anthem Blue Access Choice,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Blue Preferred,Anthem Blue Preferred,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Pathway,Anthem Pathway,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Alliance,Anthem Alliance,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Anthem Medicare,Anthem Medicare,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Cigna,Cigna,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Cigna PPO,Cigna PPO,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Cigna Medicare Advantage,Cigna Medicare Advantage,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Essence,Essence,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Healthlink HMO,Healthlink HMO,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Healthlink PPO,Healthlink PPO,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,HomeState Health Plan,HomeState Health Plan,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Humana Gold,Humana Gold,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Medicaid MO,Medicaid MO,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Medica,Medica,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Tricare,Tricare,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,UHC All Payer,UHC All Payer,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,UHC Exchange,UHC Exchange,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,UHC Medicaid,UHC Medicaid,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,UMR CPD,UMR CPD,47.59,,,,,,,per diem,47.59,47.59,"Per diem rate, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,UHC Medicare,UHC Medicare,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
EOSINOPHIL TOTAL              ,38251615,CDM,302,RC,,,,,,Inpatient,,,47.59,47.59,Wellcare,Wellcare,47.59,,,,,,,case rate,47.59,47.59,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Meritain Health PPO CPD,Meritain Health PPO CPD,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Aetna/Commercial Product,Aetna/Commercial Product,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Meritain Health CPD,Meritain Health CPD,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Starmark CPD,Starmark CPD,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Aetna Medicare,Aetna Medicare,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Ambetter ,Ambetter ,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Blue Access,Anthem Blue Access,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Blue Access Choice,Anthem Blue Access Choice,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Blue Preferred,Anthem Blue Preferred,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Pathway,Anthem Pathway,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Alliance,Anthem Alliance,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Anthem Medicare,Anthem Medicare,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Cigna,Cigna,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Cigna PPO,Cigna PPO,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Cigna Medicare Advantage,Cigna Medicare Advantage,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Essence,Essence,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Healthlink HMO,Healthlink HMO,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Healthlink PPO,Healthlink PPO,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,HomeState Health Plan,HomeState Health Plan,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Humana Gold,Humana Gold,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Medicaid MO,Medicaid MO,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Medica,Medica,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Tricare,Tricare,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,UHC All Payer,UHC All Payer,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,UHC Exchange,UHC Exchange,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,UHC Medicaid,UHC Medicaid,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,UMR CPD,UMR CPD,46.77,,,,,,,per diem,46.77,46.77,"Per diem rate, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,UHC Medicare,UHC Medicare,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
PH BLOOD I-STAT               ,38251618,CDM,301,RC,,,,,,Inpatient,,,46.77,46.77,Wellcare,Wellcare,46.77,,,,,,,case rate,46.77,46.77,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Meritain Health PPO CPD,Meritain Health PPO CPD,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Aetna/Commercial Product,Aetna/Commercial Product,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Meritain Health CPD,Meritain Health CPD,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Starmark CPD,Starmark CPD,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Aetna Medicare,Aetna Medicare,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Ambetter ,Ambetter ,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Blue Access,Anthem Blue Access,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Blue Access Choice,Anthem Blue Access Choice,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Blue Preferred,Anthem Blue Preferred,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Pathway,Anthem Pathway,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Alliance,Anthem Alliance,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Anthem Medicare,Anthem Medicare,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Cigna,Cigna,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Cigna PPO,Cigna PPO,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Cigna Medicare Advantage,Cigna Medicare Advantage,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Essence,Essence,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Healthlink HMO,Healthlink HMO,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Healthlink PPO,Healthlink PPO,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,HomeState Health Plan,HomeState Health Plan,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Humana Gold,Humana Gold,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Medicaid MO,Medicaid MO,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Medica,Medica,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Tricare,Tricare,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,UHC All Payer,UHC All Payer,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,UHC Exchange,UHC Exchange,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,UHC Medicaid,UHC Medicaid,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,UMR CPD,UMR CPD,130.17,,,,,,,per diem,130.17,130.17,"Per diem rate, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,UHC Medicare,UHC Medicare,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
HAEMOPHILUS INFLUENZAE B      ,38251619,CDM,302,RC,86684,CPT,,,,Inpatient,,,130.17,130.17,Wellcare,Wellcare,130.17,,,,,,,case rate,130.17,130.17,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Meritain Health PPO CPD,Meritain Health PPO CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Aetna/Commercial Product,Aetna/Commercial Product,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Meritain Health CPD,Meritain Health CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Starmark CPD,Starmark CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Aetna Medicare,Aetna Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Ambetter ,Ambetter ,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Access,Anthem Blue Access,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Access Choice,Anthem Blue Access Choice,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Preferred,Anthem Blue Preferred,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Pathway,Anthem Pathway,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Alliance,Anthem Alliance,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Anthem Medicare,Anthem Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Cigna,Cigna,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Cigna PPO,Cigna PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Cigna Medicare Advantage,Cigna Medicare Advantage,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Essence,Essence,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Healthlink HMO,Healthlink HMO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Healthlink PPO,Healthlink PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,HomeState Health Plan,HomeState Health Plan,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Humana Gold,Humana Gold,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Medicaid MO,Medicaid MO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Medica,Medica,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Tricare,Tricare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,UHC All Payer,UHC All Payer,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,UHC Exchange,UHC Exchange,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,UHC Medicaid,UHC Medicaid,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,UMR CPD,UMR CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,UHC Medicare,UHC Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE B ANTIGEN DFA      ,38251620,CDM,306,RC,87275,CPT,,,,Inpatient,,,58.4,58.4,Wellcare,Wellcare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Meritain Health PPO CPD,Meritain Health PPO CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Aetna/Commercial Product,Aetna/Commercial Product,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Meritain Health CPD,Meritain Health CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Starmark CPD,Starmark CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Aetna Medicare,Aetna Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Ambetter ,Ambetter ,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Access,Anthem Blue Access,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Access Choice,Anthem Blue Access Choice,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Blue Preferred,Anthem Blue Preferred,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Pathway,Anthem Pathway,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Alliance,Anthem Alliance,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Anthem Medicare,Anthem Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Cigna,Cigna,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Cigna PPO,Cigna PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Cigna Medicare Advantage,Cigna Medicare Advantage,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Essence,Essence,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Healthlink HMO,Healthlink HMO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Healthlink PPO,Healthlink PPO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,HomeState Health Plan,HomeState Health Plan,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Humana Gold,Humana Gold,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Medicaid MO,Medicaid MO,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Medica,Medica,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Tricare,Tricare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,UHC All Payer,UHC All Payer,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,UHC Exchange,UHC Exchange,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,UHC Medicaid,UHC Medicaid,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,UMR CPD,UMR CPD,58.4,,,,,,,per diem,58.4,58.4,"Per diem rate, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,UHC Medicare,UHC Medicare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
INFLUENZAE A ANTIGEN DFA      ,38251621,CDM,306,RC,87276,CPT,,,,Inpatient,,,58.4,58.4,Wellcare,Wellcare,58.4,,,,,,,case rate,58.4,58.4,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Meritain Health PPO CPD,Meritain Health PPO CPD,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Aetna/Commercial Product,Aetna/Commercial Product,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Meritain Health CPD,Meritain Health CPD,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Starmark CPD,Starmark CPD,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Aetna Medicare,Aetna Medicare,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Ambetter ,Ambetter ,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Blue Access,Anthem Blue Access,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Blue Access Choice,Anthem Blue Access Choice,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Blue Preferred,Anthem Blue Preferred,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Pathway,Anthem Pathway,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Alliance,Anthem Alliance,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Anthem Medicare,Anthem Medicare,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Cigna,Cigna,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Cigna PPO,Cigna PPO,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Cigna Medicare Advantage,Cigna Medicare Advantage,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Essence,Essence,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Healthlink HMO,Healthlink HMO,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Healthlink PPO,Healthlink PPO,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,HomeState Health Plan,HomeState Health Plan,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Humana Gold,Humana Gold,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Medicaid MO,Medicaid MO,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Medica,Medica,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Tricare,Tricare,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,UHC All Payer,UHC All Payer,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,UHC Exchange,UHC Exchange,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,UHC Medicaid,UHC Medicaid,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,UMR CPD,UMR CPD,322.96,,,,,,,per diem,322.96,322.96,"Per diem rate, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,UHC Medicare,UHC Medicare,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
FETAL LUNG MATURITY ASSESS    ,38251623,CDM,301,RC,83661,CPT,,,,Inpatient,,,322.96,322.96,Wellcare,Wellcare,322.96,,,,,,,case rate,322.96,322.96,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Meritain Health PPO CPD,Meritain Health PPO CPD,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Aetna/Commercial Product,Aetna/Commercial Product,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Meritain Health CPD,Meritain Health CPD,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Starmark CPD,Starmark CPD,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Aetna Medicare,Aetna Medicare,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Ambetter ,Ambetter ,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Blue Access,Anthem Blue Access,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Blue Access Choice,Anthem Blue Access Choice,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Blue Preferred,Anthem Blue Preferred,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Pathway,Anthem Pathway,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Alliance,Anthem Alliance,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Anthem Medicare,Anthem Medicare,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Cigna,Cigna,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Cigna PPO,Cigna PPO,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Cigna Medicare Advantage,Cigna Medicare Advantage,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Essence,Essence,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Healthlink HMO,Healthlink HMO,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Healthlink PPO,Healthlink PPO,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,HomeState Health Plan,HomeState Health Plan,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Humana Gold,Humana Gold,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Medicaid MO,Medicaid MO,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Medica,Medica,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Tricare,Tricare,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,UHC All Payer,UHC All Payer,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,UHC Exchange,UHC Exchange,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,UHC Medicaid,UHC Medicaid,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,UMR CPD,UMR CPD,126.78,,,,,,,per diem,126.78,126.78,"Per diem rate, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,UHC Medicare,UHC Medicare,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
ACTHB                         ,38251624,CDM,301,RC,82024,CPT,,,,Inpatient,,,126.78,126.78,Wellcare,Wellcare,126.78,,,,,,,case rate,126.78,126.78,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Meritain Health PPO CPD,Meritain Health PPO CPD,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Aetna/Commercial Product,Aetna/Commercial Product,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Meritain Health CPD,Meritain Health CPD,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Starmark CPD,Starmark CPD,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Aetna Medicare,Aetna Medicare,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Ambetter ,Ambetter ,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Blue Access,Anthem Blue Access,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Blue Access Choice,Anthem Blue Access Choice,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Blue Preferred,Anthem Blue Preferred,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Pathway,Anthem Pathway,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Alliance,Anthem Alliance,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Anthem Medicare,Anthem Medicare,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Cigna,Cigna,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Cigna PPO,Cigna PPO,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Cigna Medicare Advantage,Cigna Medicare Advantage,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Essence,Essence,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Healthlink HMO,Healthlink HMO,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Healthlink PPO,Healthlink PPO,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,HomeState Health Plan,HomeState Health Plan,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Humana Gold,Humana Gold,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Medicaid MO,Medicaid MO,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Medica,Medica,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Tricare,Tricare,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,UHC All Payer,UHC All Payer,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,UHC Exchange,UHC Exchange,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,UHC Medicaid,UHC Medicaid,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,UMR CPD,UMR CPD,350.1,,,,,,,per diem,350.1,350.1,"Per diem rate, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,UHC Medicare,UHC Medicare,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
TB INTERERON GAMMA            ,38251625,CDM,305,RC,,,,,,Inpatient,,,350.1,350.1,Wellcare,Wellcare,350.1,,,,,,,case rate,350.1,350.1,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Meritain Health PPO CPD,Meritain Health PPO CPD,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Aetna/Commercial Product,Aetna/Commercial Product,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Meritain Health CPD,Meritain Health CPD,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Starmark CPD,Starmark CPD,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Aetna Medicare,Aetna Medicare,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Ambetter ,Ambetter ,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Blue Access,Anthem Blue Access,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Blue Access Choice,Anthem Blue Access Choice,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Blue Preferred,Anthem Blue Preferred,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Pathway,Anthem Pathway,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Alliance,Anthem Alliance,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Anthem Medicare,Anthem Medicare,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Cigna,Cigna,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Cigna PPO,Cigna PPO,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Cigna Medicare Advantage,Cigna Medicare Advantage,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Essence,Essence,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Healthlink HMO,Healthlink HMO,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Healthlink PPO,Healthlink PPO,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,HomeState Health Plan,HomeState Health Plan,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Humana Gold,Humana Gold,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Medicaid MO,Medicaid MO,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Medica,Medica,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Tricare,Tricare,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,UHC All Payer,UHC All Payer,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,UHC Exchange,UHC Exchange,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,UHC Medicaid,UHC Medicaid,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,UMR CPD,UMR CPD,343.73,,,,,,,per diem,343.73,343.73,"Per diem rate, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,UHC Medicare,UHC Medicare,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
GHB SERUM CONFIRMATION        ,38251626,CDM,301,RC,,,,,,Inpatient,,,343.73,343.73,Wellcare,Wellcare,343.73,,,,,,,case rate,343.73,343.73,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Meritain Health PPO CPD,Meritain Health PPO CPD,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Aetna/Commercial Product,Aetna/Commercial Product,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Meritain Health CPD,Meritain Health CPD,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Starmark CPD,Starmark CPD,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Aetna Medicare,Aetna Medicare,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Ambetter ,Ambetter ,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Blue Access,Anthem Blue Access,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Blue Access Choice,Anthem Blue Access Choice,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Blue Preferred,Anthem Blue Preferred,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Pathway,Anthem Pathway,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Alliance,Anthem Alliance,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Anthem Medicare,Anthem Medicare,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Cigna,Cigna,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Cigna PPO,Cigna PPO,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Cigna Medicare Advantage,Cigna Medicare Advantage,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Essence,Essence,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Healthlink HMO,Healthlink HMO,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Healthlink PPO,Healthlink PPO,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,HomeState Health Plan,HomeState Health Plan,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Humana Gold,Humana Gold,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Medicaid MO,Medicaid MO,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Medica,Medica,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Tricare,Tricare,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,UHC All Payer,UHC All Payer,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,UHC Exchange,UHC Exchange,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,UHC Medicaid,UHC Medicaid,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,UMR CPD,UMR CPD,142.16,,,,,,,per diem,142.16,142.16,"Per diem rate, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,UHC Medicare,UHC Medicare,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
UCF URINE DRUG ABUSE PANE     ,38251627,CDM,301,RC,,,,,,Inpatient,,,142.16,142.16,Wellcare,Wellcare,142.16,,,,,,,case rate,142.16,142.16,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Meritain Health PPO CPD,Meritain Health PPO CPD,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Aetna/Commercial Product,Aetna/Commercial Product,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Meritain Health CPD,Meritain Health CPD,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Starmark CPD,Starmark CPD,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Aetna Medicare,Aetna Medicare,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Ambetter ,Ambetter ,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Blue Access,Anthem Blue Access,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Blue Access Choice,Anthem Blue Access Choice,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Blue Preferred,Anthem Blue Preferred,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Pathway,Anthem Pathway,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Alliance,Anthem Alliance,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Anthem Medicare,Anthem Medicare,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Cigna,Cigna,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Cigna PPO,Cigna PPO,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Cigna Medicare Advantage,Cigna Medicare Advantage,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Essence,Essence,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Healthlink HMO,Healthlink HMO,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Healthlink PPO,Healthlink PPO,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,HomeState Health Plan,HomeState Health Plan,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Humana Gold,Humana Gold,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Medicaid MO,Medicaid MO,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Medica,Medica,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Tricare,Tricare,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,UHC All Payer,UHC All Payer,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,UHC Exchange,UHC Exchange,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,UHC Medicaid,UHC Medicaid,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,UMR CPD,UMR CPD,215.27,,,,,,,per diem,215.27,215.27,"Per diem rate, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,UHC Medicare,UHC Medicare,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"PLT ANTIBODY, DIRECT          ",38251628,CDM,300,RC,,,,,,Inpatient,,,215.27,215.27,Wellcare,Wellcare,215.27,,,,,,,case rate,215.27,215.27,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Meritain Health PPO CPD,Meritain Health PPO CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Aetna/Commercial Product,Aetna/Commercial Product,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Meritain Health CPD,Meritain Health CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Starmark CPD,Starmark CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Aetna Medicare,Aetna Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Ambetter ,Ambetter ,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Blue Access,Anthem Blue Access,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Blue Access Choice,Anthem Blue Access Choice,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Blue Preferred,Anthem Blue Preferred,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Pathway,Anthem Pathway,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Alliance,Anthem Alliance,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Anthem Medicare,Anthem Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Cigna,Cigna,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Cigna PPO,Cigna PPO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Cigna Medicare Advantage,Cigna Medicare Advantage,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Essence,Essence,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Healthlink HMO,Healthlink HMO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Healthlink PPO,Healthlink PPO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,HomeState Health Plan,HomeState Health Plan,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Humana Gold,Humana Gold,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Medicaid MO,Medicaid MO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Medica,Medica,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Tricare,Tricare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,UHC All Payer,UHC All Payer,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,UHC Exchange,UHC Exchange,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,UHC Medicaid,UHC Medicaid,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,UMR CPD,UMR CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,UHC Medicare,UHC Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
"FOLATE, RBC W/HCT             ",38251629,CDM,301,RC,,,,,,Inpatient,,,169.74,169.74,Wellcare,Wellcare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Meritain Health PPO CPD,Meritain Health PPO CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Aetna/Commercial Product,Aetna/Commercial Product,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Meritain Health CPD,Meritain Health CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Starmark CPD,Starmark CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Aetna Medicare,Aetna Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Ambetter ,Ambetter ,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Blue Access,Anthem Blue Access,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Blue Access Choice,Anthem Blue Access Choice,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Blue Preferred,Anthem Blue Preferred,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Pathway,Anthem Pathway,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Alliance,Anthem Alliance,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Anthem Medicare,Anthem Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Cigna,Cigna,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Cigna PPO,Cigna PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Cigna Medicare Advantage,Cigna Medicare Advantage,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Essence,Essence,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Healthlink HMO,Healthlink HMO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Healthlink PPO,Healthlink PPO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,HomeState Health Plan,HomeState Health Plan,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Humana Gold,Humana Gold,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Medicaid MO,Medicaid MO,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Medica,Medica,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Tricare,Tricare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,UHC All Payer,UHC All Payer,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,UHC Exchange,UHC Exchange,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,UHC Medicaid,UHC Medicaid,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,UMR CPD,UMR CPD,96.54,,,,,,,per diem,96.54,96.54,"Per diem rate, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,UHC Medicare,UHC Medicare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
IRON W/TIBC                   ,38251630,CDM,301,RC,,,,,,Inpatient,,,96.54,96.54,Wellcare,Wellcare,96.54,,,,,,,case rate,96.54,96.54,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Meritain Health PPO CPD,Meritain Health PPO CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Aetna/Commercial Product,Aetna/Commercial Product,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Meritain Health CPD,Meritain Health CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Starmark CPD,Starmark CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Aetna Medicare,Aetna Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Ambetter ,Ambetter ,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Blue Access,Anthem Blue Access,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Blue Access Choice,Anthem Blue Access Choice,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Blue Preferred,Anthem Blue Preferred,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Pathway,Anthem Pathway,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Alliance,Anthem Alliance,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Anthem Medicare,Anthem Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Cigna,Cigna,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Cigna PPO,Cigna PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Cigna Medicare Advantage,Cigna Medicare Advantage,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Essence,Essence,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Healthlink HMO,Healthlink HMO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Healthlink PPO,Healthlink PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,HomeState Health Plan,HomeState Health Plan,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Humana Gold,Humana Gold,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Medicaid MO,Medicaid MO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Medica,Medica,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Tricare,Tricare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,UHC All Payer,UHC All Payer,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,UHC Exchange,UHC Exchange,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,UHC Medicaid,UHC Medicaid,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,UMR CPD,UMR CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,UHC Medicare,UHC Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
CHG URINE PREGNANCY  TEST     ,38251638,CDM,301,RC,,,,,,Inpatient,,,118.82,118.82,Wellcare,Wellcare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Meritain Health PPO CPD,Meritain Health PPO CPD,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Aetna/Commercial Product,Aetna/Commercial Product,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Meritain Health CPD,Meritain Health CPD,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Starmark CPD,Starmark CPD,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Aetna Medicare,Aetna Medicare,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Ambetter ,Ambetter ,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Blue Access,Anthem Blue Access,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Blue Access Choice,Anthem Blue Access Choice,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Blue Preferred,Anthem Blue Preferred,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Pathway,Anthem Pathway,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Alliance,Anthem Alliance,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Anthem Medicare,Anthem Medicare,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Cigna,Cigna,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Cigna PPO,Cigna PPO,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Cigna Medicare Advantage,Cigna Medicare Advantage,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Essence,Essence,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Healthlink HMO,Healthlink HMO,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Healthlink PPO,Healthlink PPO,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,HomeState Health Plan,HomeState Health Plan,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Humana Gold,Humana Gold,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Medicaid MO,Medicaid MO,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Medica,Medica,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Tricare,Tricare,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,UHC All Payer,UHC All Payer,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,UHC Exchange,UHC Exchange,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,UHC Medicaid,UHC Medicaid,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,UMR CPD,UMR CPD,48.52,,,,,,,per diem,48.52,48.52,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,UHC Medicare,UHC Medicare,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD TEST            ,38251639,CDM,301,RC,,,,,,Inpatient,,,48.52,48.52,Wellcare,Wellcare,48.52,,,,,,,case rate,48.52,48.52,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Meritain Health PPO CPD,Meritain Health PPO CPD,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Aetna/Commercial Product,Aetna/Commercial Product,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Meritain Health CPD,Meritain Health CPD,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Starmark CPD,Starmark CPD,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Aetna Medicare,Aetna Medicare,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Ambetter ,Ambetter ,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Blue Access,Anthem Blue Access,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Blue Access Choice,Anthem Blue Access Choice,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Blue Preferred,Anthem Blue Preferred,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Pathway,Anthem Pathway,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Alliance,Anthem Alliance,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Anthem Medicare,Anthem Medicare,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Cigna,Cigna,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Cigna PPO,Cigna PPO,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Cigna Medicare Advantage,Cigna Medicare Advantage,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Essence,Essence,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Healthlink HMO,Healthlink HMO,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Healthlink PPO,Healthlink PPO,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,HomeState Health Plan,HomeState Health Plan,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Humana Gold,Humana Gold,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Medicaid MO,Medicaid MO,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Medica,Medica,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Tricare,Tricare,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,UHC All Payer,UHC All Payer,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,UHC Exchange,UHC Exchange,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,UHC Medicaid,UHC Medicaid,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,UMR CPD,UMR CPD,148.73,,,,,,,per diem,148.73,148.73,"Per diem rate, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,UHC Medicare,UHC Medicare,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG CRE CULTURE TYPING ID     ,38251643,CDM,306,RC,,,,,,Inpatient,,,148.73,148.73,Wellcare,Wellcare,148.73,,,,,,,case rate,148.73,148.73,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Meritain Health PPO CPD,Meritain Health PPO CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Aetna/Commercial Product,Aetna/Commercial Product,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Meritain Health CPD,Meritain Health CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Starmark CPD,Starmark CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Aetna Medicare,Aetna Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Ambetter ,Ambetter ,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Blue Access,Anthem Blue Access,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Blue Access Choice,Anthem Blue Access Choice,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Blue Preferred,Anthem Blue Preferred,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Pathway,Anthem Pathway,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Alliance,Anthem Alliance,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Anthem Medicare,Anthem Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Cigna,Cigna,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Cigna PPO,Cigna PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Cigna Medicare Advantage,Cigna Medicare Advantage,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Essence,Essence,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Healthlink HMO,Healthlink HMO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Healthlink PPO,Healthlink PPO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,HomeState Health Plan,HomeState Health Plan,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Humana Gold,Humana Gold,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Medicaid MO,Medicaid MO,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Medica,Medica,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Tricare,Tricare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,UHC All Payer,UHC All Payer,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,UHC Exchange,UHC Exchange,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,UHC Medicaid,UHC Medicaid,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,UMR CPD,UMR CPD,152.77,,,,,,,per diem,152.77,152.77,"Per diem rate, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,UHC Medicare,UHC Medicare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG STAPH AUREUS DNA AMP      ,38251644,CDM,306,RC,,,,,,Inpatient,,,152.77,152.77,Wellcare,Wellcare,152.77,,,,,,,case rate,152.77,152.77,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Meritain Health PPO CPD,Meritain Health PPO CPD,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Aetna/Commercial Product,Aetna/Commercial Product,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Meritain Health CPD,Meritain Health CPD,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Starmark CPD,Starmark CPD,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Aetna Medicare,Aetna Medicare,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Ambetter ,Ambetter ,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Blue Access,Anthem Blue Access,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Blue Access Choice,Anthem Blue Access Choice,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Blue Preferred,Anthem Blue Preferred,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Pathway,Anthem Pathway,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Alliance,Anthem Alliance,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Anthem Medicare,Anthem Medicare,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Cigna,Cigna,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Cigna PPO,Cigna PPO,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Cigna Medicare Advantage,Cigna Medicare Advantage,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Essence,Essence,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Healthlink HMO,Healthlink HMO,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Healthlink PPO,Healthlink PPO,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,HomeState Health Plan,HomeState Health Plan,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Humana Gold,Humana Gold,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Medicaid MO,Medicaid MO,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Medica,Medica,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Tricare,Tricare,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,UHC All Payer,UHC All Payer,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,UHC Exchange,UHC Exchange,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,UHC Medicaid,UHC Medicaid,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,UMR CPD,UMR CPD,532.57,,,,,,,per diem,532.57,532.57,"Per diem rate, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,UHC Medicare,UHC Medicare,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG EBV BY PCR QUANT          ,38251645,CDM,306,RC,,,,,,Inpatient,,,532.57,532.57,Wellcare,Wellcare,532.57,,,,,,,case rate,532.57,532.57,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
CHG RAPID STREP               ,38251646,CDM,306,RC,,,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Meritain Health PPO CPD,Meritain Health PPO CPD,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Aetna/Commercial Product,Aetna/Commercial Product,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Meritain Health CPD,Meritain Health CPD,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Starmark CPD,Starmark CPD,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Aetna Medicare,Aetna Medicare,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Ambetter ,Ambetter ,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Blue Access,Anthem Blue Access,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Blue Access Choice,Anthem Blue Access Choice,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Blue Preferred,Anthem Blue Preferred,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Pathway,Anthem Pathway,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Alliance,Anthem Alliance,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Anthem Medicare,Anthem Medicare,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Cigna,Cigna,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Cigna PPO,Cigna PPO,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Cigna Medicare Advantage,Cigna Medicare Advantage,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Essence,Essence,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Healthlink HMO,Healthlink HMO,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Healthlink PPO,Healthlink PPO,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,HomeState Health Plan,HomeState Health Plan,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Humana Gold,Humana Gold,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Medicaid MO,Medicaid MO,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Medica,Medica,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Tricare,Tricare,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,UHC All Payer,UHC All Payer,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,UHC Exchange,UHC Exchange,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,UHC Medicaid,UHC Medicaid,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,UMR CPD,UMR CPD,429.65,,,,,,,per diem,429.65,429.65,"Per diem rate, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,UHC Medicare,UHC Medicare,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
PROGRAM MULTI LEAD PAC        ,38251647,CDM,300,RC,93281,CPT,,,,Inpatient,,,429.65,429.65,Wellcare,Wellcare,429.65,,,,,,,case rate,429.65,429.65,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Meritain Health PPO CPD,Meritain Health PPO CPD,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Aetna/Commercial Product,Aetna/Commercial Product,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Meritain Health CPD,Meritain Health CPD,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Starmark CPD,Starmark CPD,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Aetna Medicare,Aetna Medicare,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Ambetter ,Ambetter ,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Blue Access,Anthem Blue Access,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Blue Access Choice,Anthem Blue Access Choice,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Blue Preferred,Anthem Blue Preferred,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Pathway,Anthem Pathway,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Alliance,Anthem Alliance,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Anthem Medicare,Anthem Medicare,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Cigna,Cigna,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Cigna PPO,Cigna PPO,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Cigna Medicare Advantage,Cigna Medicare Advantage,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Essence,Essence,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Healthlink HMO,Healthlink HMO,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Healthlink PPO,Healthlink PPO,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,HomeState Health Plan,HomeState Health Plan,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Humana Gold,Humana Gold,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Medicaid MO,Medicaid MO,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Medica,Medica,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Tricare,Tricare,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,UHC All Payer,UHC All Payer,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,UHC Exchange,UHC Exchange,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,UHC Medicaid,UHC Medicaid,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,UMR CPD,UMR CPD,50.18,,,,,,,per diem,50.18,50.18,"Per diem rate, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,UHC Medicare,UHC Medicare,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
GLUCOSE BLOOD BY MONITORING DE,38251648,CDM,301,RC,82962,CPT,,,,Inpatient,,,50.18,50.18,Wellcare,Wellcare,50.18,,,,,,,case rate,50.18,50.18,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Meritain Health PPO CPD,Meritain Health PPO CPD,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Aetna/Commercial Product,Aetna/Commercial Product,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Meritain Health CPD,Meritain Health CPD,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Starmark CPD,Starmark CPD,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Aetna Medicare,Aetna Medicare,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Ambetter ,Ambetter ,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Blue Access,Anthem Blue Access,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Blue Access Choice,Anthem Blue Access Choice,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Blue Preferred,Anthem Blue Preferred,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Pathway,Anthem Pathway,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Alliance,Anthem Alliance,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Anthem Medicare,Anthem Medicare,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Cigna,Cigna,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Cigna PPO,Cigna PPO,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Cigna Medicare Advantage,Cigna Medicare Advantage,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Essence,Essence,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Healthlink HMO,Healthlink HMO,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Healthlink PPO,Healthlink PPO,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,HomeState Health Plan,HomeState Health Plan,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Humana Gold,Humana Gold,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Medicaid MO,Medicaid MO,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Medica,Medica,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Tricare,Tricare,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,UHC All Payer,UHC All Payer,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,UHC Exchange,UHC Exchange,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,UHC Medicaid,UHC Medicaid,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,UMR CPD,UMR CPD,443.15,,,,,,,per diem,443.15,443.15,"Per diem rate, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,UHC Medicare,UHC Medicare,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
HC LAB HBV DNA QUAL PCR       ,38251651,CDM,306,RC,,,,,,Inpatient,,,443.15,443.15,Wellcare,Wellcare,443.15,,,,,,,case rate,443.15,443.15,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Meritain Health PPO CPD,Meritain Health PPO CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Aetna/Commercial Product,Aetna/Commercial Product,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Meritain Health CPD,Meritain Health CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Starmark CPD,Starmark CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Aetna Medicare,Aetna Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Ambetter ,Ambetter ,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Blue Access,Anthem Blue Access,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Blue Access Choice,Anthem Blue Access Choice,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Blue Preferred,Anthem Blue Preferred,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Pathway,Anthem Pathway,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Alliance,Anthem Alliance,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Anthem Medicare,Anthem Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Cigna,Cigna,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Cigna PPO,Cigna PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Cigna Medicare Advantage,Cigna Medicare Advantage,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Essence,Essence,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Healthlink HMO,Healthlink HMO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Healthlink PPO,Healthlink PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,HomeState Health Plan,HomeState Health Plan,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Humana Gold,Humana Gold,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Medicaid MO,Medicaid MO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Medica,Medica,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Tricare,Tricare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,UHC All Payer,UHC All Payer,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,UHC Exchange,UHC Exchange,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,UHC Medicaid,UHC Medicaid,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,UMR CPD,UMR CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,UHC Medicare,UHC Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG MYCOPHENOLIC ACID         ,38251652,CDM,301,RC,,,,,,Inpatient,,,154.89,154.89,Wellcare,Wellcare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Meritain Health PPO CPD,Meritain Health PPO CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Aetna/Commercial Product,Aetna/Commercial Product,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Meritain Health CPD,Meritain Health CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Starmark CPD,Starmark CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Aetna Medicare,Aetna Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Ambetter ,Ambetter ,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Blue Access,Anthem Blue Access,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Blue Access Choice,Anthem Blue Access Choice,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Blue Preferred,Anthem Blue Preferred,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Pathway,Anthem Pathway,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Alliance,Anthem Alliance,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Anthem Medicare,Anthem Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Cigna,Cigna,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Cigna PPO,Cigna PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Cigna Medicare Advantage,Cigna Medicare Advantage,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Essence,Essence,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Healthlink HMO,Healthlink HMO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Healthlink PPO,Healthlink PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,HomeState Health Plan,HomeState Health Plan,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Humana Gold,Humana Gold,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Medicaid MO,Medicaid MO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Medica,Medica,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Tricare,Tricare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,UHC All Payer,UHC All Payer,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,UHC Exchange,UHC Exchange,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,UHC Medicaid,UHC Medicaid,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,UMR CPD,UMR CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,UHC Medicare,UHC Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG PREGABALIN LYRICA         ,38251653,CDM,301,RC,,,,,,Inpatient,,,200.51,200.51,Wellcare,Wellcare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Meritain Health PPO CPD,Meritain Health PPO CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Aetna/Commercial Product,Aetna/Commercial Product,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Meritain Health CPD,Meritain Health CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Starmark CPD,Starmark CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Aetna Medicare,Aetna Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Ambetter ,Ambetter ,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Blue Access,Anthem Blue Access,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Blue Access Choice,Anthem Blue Access Choice,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Blue Preferred,Anthem Blue Preferred,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Pathway,Anthem Pathway,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Alliance,Anthem Alliance,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Anthem Medicare,Anthem Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Cigna,Cigna,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Cigna PPO,Cigna PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Cigna Medicare Advantage,Cigna Medicare Advantage,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Essence,Essence,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Healthlink HMO,Healthlink HMO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Healthlink PPO,Healthlink PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,HomeState Health Plan,HomeState Health Plan,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Humana Gold,Humana Gold,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Medicaid MO,Medicaid MO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Medica,Medica,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Tricare,Tricare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,UHC All Payer,UHC All Payer,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,UHC Exchange,UHC Exchange,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,UHC Medicaid,UHC Medicaid,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,UMR CPD,UMR CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,UHC Medicare,UHC Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
CHG RIBOFLAVIN VITAMIN B2     ,38251654,CDM,301,RC,,,,,,Inpatient,,,196.27,196.27,Wellcare,Wellcare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Meritain Health PPO CPD,Meritain Health PPO CPD,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Aetna/Commercial Product,Aetna/Commercial Product,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Meritain Health CPD,Meritain Health CPD,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Starmark CPD,Starmark CPD,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Aetna Medicare,Aetna Medicare,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Ambetter ,Ambetter ,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Blue Access,Anthem Blue Access,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Blue Access Choice,Anthem Blue Access Choice,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Blue Preferred,Anthem Blue Preferred,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Pathway,Anthem Pathway,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Alliance,Anthem Alliance,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Anthem Medicare,Anthem Medicare,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Cigna,Cigna,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Cigna PPO,Cigna PPO,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Cigna Medicare Advantage,Cigna Medicare Advantage,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Essence,Essence,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Healthlink HMO,Healthlink HMO,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Healthlink PPO,Healthlink PPO,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,HomeState Health Plan,HomeState Health Plan,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Humana Gold,Humana Gold,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Medicaid MO,Medicaid MO,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Medica,Medica,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Tricare,Tricare,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,UHC All Payer,UHC All Payer,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,UHC Exchange,UHC Exchange,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,UHC Medicaid,UHC Medicaid,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,UMR CPD,UMR CPD,77.45,,,,,,,per diem,77.45,77.45,"Per diem rate, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,UHC Medicare,UHC Medicare,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
HEMOGRAM/DIFF/PLT             ,38251655,CDM,305,RC,,,,,,Inpatient,,,77.45,77.45,Wellcare,Wellcare,77.45,,,,,,,case rate,77.45,77.45,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG *CANDIDA DNA DIR PROB     ,38251656,CDM,306,RC,,,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG GARDNER VAG DNA DIR P     ,38251657,CDM,306,RC,,,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Meritain Health PPO CPD,Meritain Health PPO CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Aetna/Commercial Product,Aetna/Commercial Product,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Meritain Health CPD,Meritain Health CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Starmark CPD,Starmark CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Aetna Medicare,Aetna Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Ambetter ,Ambetter ,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Blue Access,Anthem Blue Access,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Blue Access Choice,Anthem Blue Access Choice,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Blue Preferred,Anthem Blue Preferred,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Pathway,Anthem Pathway,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Alliance,Anthem Alliance,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Anthem Medicare,Anthem Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Cigna,Cigna,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Cigna PPO,Cigna PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Cigna Medicare Advantage,Cigna Medicare Advantage,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Essence,Essence,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Healthlink HMO,Healthlink HMO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Healthlink PPO,Healthlink PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,HomeState Health Plan,HomeState Health Plan,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Humana Gold,Humana Gold,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Medicaid MO,Medicaid MO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Medica,Medica,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Tricare,Tricare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,UHC All Payer,UHC All Payer,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,UHC Exchange,UHC Exchange,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,UHC Medicaid,UHC Medicaid,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,UMR CPD,UMR CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,UHC Medicare,UHC Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
CHG TRICHOMONAS VAG DIR P     ,38251658,CDM,306,RC,,,,,,Inpatient,,,92.3,92.3,Wellcare,Wellcare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Meritain Health PPO CPD,Meritain Health PPO CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Aetna/Commercial Product,Aetna/Commercial Product,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Meritain Health CPD,Meritain Health CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Starmark CPD,Starmark CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Aetna Medicare,Aetna Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Ambetter ,Ambetter ,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Access,Anthem Blue Access,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Access Choice,Anthem Blue Access Choice,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Preferred,Anthem Blue Preferred,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Pathway,Anthem Pathway,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Alliance,Anthem Alliance,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Anthem Medicare,Anthem Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Cigna,Cigna,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Cigna PPO,Cigna PPO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Cigna Medicare Advantage,Cigna Medicare Advantage,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Essence,Essence,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Healthlink HMO,Healthlink HMO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Healthlink PPO,Healthlink PPO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,HomeState Health Plan,HomeState Health Plan,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Humana Gold,Humana Gold,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Medicaid MO,Medicaid MO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Medica,Medica,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Tricare,Tricare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,UHC All Payer,UHC All Payer,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,UHC Exchange,UHC Exchange,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,UHC Medicaid,UHC Medicaid,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,UMR CPD,UMR CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,UHC Medicare,UHC Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
NEISSERIA GONORRHOEAE         ,38251659,CDM,306,RC,87591,CPT,,,,Inpatient,,,141.64,141.64,Wellcare,Wellcare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Meritain Health PPO CPD,Meritain Health PPO CPD,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Aetna/Commercial Product,Aetna/Commercial Product,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Meritain Health CPD,Meritain Health CPD,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Starmark CPD,Starmark CPD,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Aetna Medicare,Aetna Medicare,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Ambetter ,Ambetter ,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Blue Access,Anthem Blue Access,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Blue Access Choice,Anthem Blue Access Choice,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Blue Preferred,Anthem Blue Preferred,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Pathway,Anthem Pathway,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Alliance,Anthem Alliance,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Anthem Medicare,Anthem Medicare,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Cigna,Cigna,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Cigna PPO,Cigna PPO,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Cigna Medicare Advantage,Cigna Medicare Advantage,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Essence,Essence,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Healthlink HMO,Healthlink HMO,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Healthlink PPO,Healthlink PPO,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,HomeState Health Plan,HomeState Health Plan,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Humana Gold,Humana Gold,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Medicaid MO,Medicaid MO,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Medica,Medica,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Tricare,Tricare,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,UHC All Payer,UHC All Payer,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,UHC Exchange,UHC Exchange,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,UHC Medicaid,UHC Medicaid,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,UMR CPD,UMR CPD,65.35,,,,,,,per diem,65.35,65.35,"Per diem rate, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,UHC Medicare,UHC Medicare,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
URINALYSIS W/REFLX CULT       ,38251666,CDM,302,RC,,,,,,Inpatient,,,65.35,65.35,Wellcare,Wellcare,65.35,,,,,,,case rate,65.35,65.35,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Meritain Health PPO CPD,Meritain Health PPO CPD,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Aetna/Commercial Product,Aetna/Commercial Product,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Meritain Health CPD,Meritain Health CPD,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Starmark CPD,Starmark CPD,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Aetna Medicare,Aetna Medicare,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Ambetter ,Ambetter ,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Blue Access,Anthem Blue Access,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Blue Access Choice,Anthem Blue Access Choice,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Blue Preferred,Anthem Blue Preferred,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Pathway,Anthem Pathway,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Alliance,Anthem Alliance,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Anthem Medicare,Anthem Medicare,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Cigna,Cigna,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Cigna PPO,Cigna PPO,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Cigna Medicare Advantage,Cigna Medicare Advantage,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Essence,Essence,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Healthlink HMO,Healthlink HMO,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Healthlink PPO,Healthlink PPO,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,HomeState Health Plan,HomeState Health Plan,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Humana Gold,Humana Gold,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Medicaid MO,Medicaid MO,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Medica,Medica,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Tricare,Tricare,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,UHC All Payer,UHC All Payer,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,UHC Exchange,UHC Exchange,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,UHC Medicaid,UHC Medicaid,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,UMR CPD,UMR CPD,52.07,,,,,,,per diem,52.07,52.07,"Per diem rate, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,UHC Medicare,UHC Medicare,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
STAPH AUREUS DNA AMP PROBE    ,38251668,CDM,300,RC,87640,CPT,,,,Inpatient,,,52.07,52.07,Wellcare,Wellcare,52.07,,,,,,,case rate,52.07,52.07,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health PPO CPD,Meritain Health PPO CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Aetna/Commercial Product,Aetna/Commercial Product,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Meritain Health CPD,Meritain Health CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Starmark CPD,Starmark CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Aetna Medicare,Aetna Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Ambetter ,Ambetter ,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access,Anthem Blue Access,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Access Choice,Anthem Blue Access Choice,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Blue Preferred,Anthem Blue Preferred,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Pathway,Anthem Pathway,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Alliance,Anthem Alliance,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Anthem Medicare,Anthem Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Cigna,Cigna,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Cigna PPO,Cigna PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Cigna Medicare Advantage,Cigna Medicare Advantage,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Essence,Essence,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Healthlink HMO,Healthlink HMO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Healthlink PPO,Healthlink PPO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,HomeState Health Plan,HomeState Health Plan,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Humana Gold,Humana Gold,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Medicaid MO,Medicaid MO,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Medica,Medica,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Tricare,Tricare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,UHC All Payer,UHC All Payer,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,UHC Exchange,UHC Exchange,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicaid,UHC Medicaid,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,UMR CPD,UMR CPD,116.7,,,,,,,per diem,116.7,116.7,"Per diem rate, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,UHC Medicare,UHC Medicare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
CULTURE TYPE NUC ACID AMP PROB,38251669,CDM,306,RC,87150,CPT,,,,Inpatient,,,116.7,116.7,Wellcare,Wellcare,116.7,,,,,,,case rate,116.7,116.7,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Meritain Health PPO CPD,Meritain Health PPO CPD,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Aetna/Commercial Product,Aetna/Commercial Product,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Meritain Health CPD,Meritain Health CPD,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Starmark CPD,Starmark CPD,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Aetna Medicare,Aetna Medicare,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Ambetter ,Ambetter ,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Blue Access,Anthem Blue Access,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Blue Access Choice,Anthem Blue Access Choice,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Blue Preferred,Anthem Blue Preferred,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Pathway,Anthem Pathway,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Alliance,Anthem Alliance,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Anthem Medicare,Anthem Medicare,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Cigna,Cigna,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Cigna PPO,Cigna PPO,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Cigna Medicare Advantage,Cigna Medicare Advantage,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Essence,Essence,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Healthlink HMO,Healthlink HMO,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Healthlink PPO,Healthlink PPO,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,HomeState Health Plan,HomeState Health Plan,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Humana Gold,Humana Gold,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Medicaid MO,Medicaid MO,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Medica,Medica,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Tricare,Tricare,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,UHC All Payer,UHC All Payer,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,UHC Exchange,UHC Exchange,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,UHC Medicaid,UHC Medicaid,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,UMR CPD,UMR CPD,153.48,,,,,,,per diem,153.48,153.48,"Per diem rate, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,UHC Medicare,UHC Medicare,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
LYME BY PCR                   ,38251670,CDM,300,RC,87476,CPT,,,,Inpatient,,,153.48,153.48,Wellcare,Wellcare,153.48,,,,,,,case rate,153.48,153.48,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Meritain Health PPO CPD,Meritain Health PPO CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Aetna/Commercial Product,Aetna/Commercial Product,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Meritain Health CPD,Meritain Health CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Starmark CPD,Starmark CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Aetna Medicare,Aetna Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Ambetter ,Ambetter ,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Blue Access,Anthem Blue Access,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Blue Access Choice,Anthem Blue Access Choice,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Blue Preferred,Anthem Blue Preferred,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Pathway,Anthem Pathway,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Alliance,Anthem Alliance,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Anthem Medicare,Anthem Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Cigna,Cigna,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Cigna PPO,Cigna PPO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Cigna Medicare Advantage,Cigna Medicare Advantage,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Essence,Essence,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Healthlink HMO,Healthlink HMO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Healthlink PPO,Healthlink PPO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,HomeState Health Plan,HomeState Health Plan,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Humana Gold,Humana Gold,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Medicaid MO,Medicaid MO,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Medica,Medica,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Tricare,Tricare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,UHC All Payer,UHC All Payer,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,UHC Exchange,UHC Exchange,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,UHC Medicaid,UHC Medicaid,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,UMR CPD,UMR CPD,90.64,,,,,,,per diem,90.64,90.64,"Per diem rate, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,UHC Medicare,UHC Medicare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
SUGARS SINGLE QUAN EA SPE     ,38251671,CDM,300,RC,,,,,,Inpatient,,,90.64,90.64,Wellcare,Wellcare,90.64,,,,,,,case rate,90.64,90.64,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health PPO CPD,Meritain Health PPO CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Aetna/Commercial Product,Aetna/Commercial Product,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health CPD,Meritain Health CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Starmark CPD,Starmark CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Aetna Medicare,Aetna Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Ambetter ,Ambetter ,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access,Anthem Blue Access,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access Choice,Anthem Blue Access Choice,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Preferred,Anthem Blue Preferred,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Pathway,Anthem Pathway,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Alliance,Anthem Alliance,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Anthem Medicare,Anthem Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Cigna,Cigna,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Cigna PPO,Cigna PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Cigna Medicare Advantage,Cigna Medicare Advantage,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Essence,Essence,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Healthlink HMO,Healthlink HMO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Healthlink PPO,Healthlink PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,HomeState Health Plan,HomeState Health Plan,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Humana Gold,Humana Gold,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Medicaid MO,Medicaid MO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Medica,Medica,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Tricare,Tricare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,UHC All Payer,UHC All Payer,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,UHC Exchange,UHC Exchange,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicaid,UHC Medicaid,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,UMR CPD,UMR CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicare,UHC Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
VON WILLEBRAND FACTOR ACTIVITY,38251672,CDM,305,RC,85397,CPT,,,,Inpatient,,,74.26,74.26,Wellcare,Wellcare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Meritain Health PPO CPD,Meritain Health PPO CPD,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Aetna/Commercial Product,Aetna/Commercial Product,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Meritain Health CPD,Meritain Health CPD,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Starmark CPD,Starmark CPD,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Aetna Medicare,Aetna Medicare,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Ambetter ,Ambetter ,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Blue Access,Anthem Blue Access,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Blue Access Choice,Anthem Blue Access Choice,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Blue Preferred,Anthem Blue Preferred,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Pathway,Anthem Pathway,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Alliance,Anthem Alliance,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Anthem Medicare,Anthem Medicare,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Cigna,Cigna,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Cigna PPO,Cigna PPO,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Cigna Medicare Advantage,Cigna Medicare Advantage,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Essence,Essence,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Healthlink HMO,Healthlink HMO,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Healthlink PPO,Healthlink PPO,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,HomeState Health Plan,HomeState Health Plan,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Humana Gold,Humana Gold,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Medicaid MO,Medicaid MO,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Medica,Medica,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Tricare,Tricare,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,UHC All Payer,UHC All Payer,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,UHC Exchange,UHC Exchange,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,UHC Medicaid,UHC Medicaid,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,UMR CPD,UMR CPD,1106.47,,,,,,,per diem,1106.47,1106.47,"Per diem rate, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,UHC Medicare,UHC Medicare,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
RESP VIRUS 12-25 TARGETS      ,38251673,CDM,306,RC,87633,CPT,,,,Inpatient,,,1106.47,1106.47,Wellcare,Wellcare,1106.47,,,,,,,case rate,1106.47,1106.47,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health PPO CPD,Meritain Health PPO CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Aetna/Commercial Product,Aetna/Commercial Product,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Meritain Health CPD,Meritain Health CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Starmark CPD,Starmark CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Aetna Medicare,Aetna Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Ambetter ,Ambetter ,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access,Anthem Blue Access,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Access Choice,Anthem Blue Access Choice,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Blue Preferred,Anthem Blue Preferred,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Pathway,Anthem Pathway,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Alliance,Anthem Alliance,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Anthem Medicare,Anthem Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Cigna,Cigna,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Cigna PPO,Cigna PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Cigna Medicare Advantage,Cigna Medicare Advantage,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Essence,Essence,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Healthlink HMO,Healthlink HMO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Healthlink PPO,Healthlink PPO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,HomeState Health Plan,HomeState Health Plan,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Humana Gold,Humana Gold,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Medicaid MO,Medicaid MO,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Medica,Medica,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Tricare,Tricare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,UHC All Payer,UHC All Payer,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,UHC Exchange,UHC Exchange,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicaid,UHC Medicaid,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,UMR CPD,UMR CPD,239.76,,,,,,,per diem,239.76,239.76,"Per diem rate, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,UHC Medicare,UHC Medicare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
ZONISAMIDE/ZONRGRAN           ,38251674,CDM,301,RC,80203,CPT,,,,Inpatient,,,239.76,239.76,Wellcare,Wellcare,239.76,,,,,,,case rate,239.76,239.76,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Meritain Health PPO CPD,Meritain Health PPO CPD,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Aetna/Commercial Product,Aetna/Commercial Product,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Meritain Health CPD,Meritain Health CPD,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Starmark CPD,Starmark CPD,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Aetna Medicare,Aetna Medicare,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Ambetter ,Ambetter ,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Blue Access,Anthem Blue Access,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Blue Access Choice,Anthem Blue Access Choice,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Blue Preferred,Anthem Blue Preferred,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Pathway,Anthem Pathway,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Alliance,Anthem Alliance,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Anthem Medicare,Anthem Medicare,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Cigna,Cigna,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Cigna PPO,Cigna PPO,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Cigna Medicare Advantage,Cigna Medicare Advantage,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Essence,Essence,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Healthlink HMO,Healthlink HMO,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Healthlink PPO,Healthlink PPO,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,HomeState Health Plan,HomeState Health Plan,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Humana Gold,Humana Gold,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Medicaid MO,Medicaid MO,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Medica,Medica,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Tricare,Tricare,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,UHC All Payer,UHC All Payer,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,UHC Exchange,UHC Exchange,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,UHC Medicaid,UHC Medicaid,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,UMR CPD,UMR CPD,184.96,,,,,,,per diem,184.96,184.96,"Per diem rate, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,UHC Medicare,UHC Medicare,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS I AB BY LUMINEX     ,38251675,CDM,300,RC,86832,CPT,,,,Inpatient,,,184.96,184.96,Wellcare,Wellcare,184.96,,,,,,,case rate,184.96,184.96,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Meritain Health PPO CPD,Meritain Health PPO CPD,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Aetna/Commercial Product,Aetna/Commercial Product,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Meritain Health CPD,Meritain Health CPD,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Starmark CPD,Starmark CPD,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Aetna Medicare,Aetna Medicare,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Ambetter ,Ambetter ,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Blue Access,Anthem Blue Access,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Blue Access Choice,Anthem Blue Access Choice,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Blue Preferred,Anthem Blue Preferred,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Pathway,Anthem Pathway,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Alliance,Anthem Alliance,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Anthem Medicare,Anthem Medicare,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Cigna,Cigna,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Cigna PPO,Cigna PPO,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Cigna Medicare Advantage,Cigna Medicare Advantage,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Essence,Essence,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Healthlink HMO,Healthlink HMO,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Healthlink PPO,Healthlink PPO,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,HomeState Health Plan,HomeState Health Plan,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Humana Gold,Humana Gold,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Medicaid MO,Medicaid MO,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Medica,Medica,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Tricare,Tricare,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,UHC All Payer,UHC All Payer,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,UHC Exchange,UHC Exchange,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,UHC Medicaid,UHC Medicaid,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,UMR CPD,UMR CPD,168.15,,,,,,,per diem,168.15,168.15,"Per diem rate, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,UHC Medicare,UHC Medicare,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
HLA CLASS II AB BY LUMINEXT   ,38251676,CDM,300,RC,86833,CPT,,,,Inpatient,,,168.15,168.15,Wellcare,Wellcare,168.15,,,,,,,case rate,168.15,168.15,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Meritain Health PPO CPD,Meritain Health PPO CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Aetna/Commercial Product,Aetna/Commercial Product,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Meritain Health CPD,Meritain Health CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Starmark CPD,Starmark CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Aetna Medicare,Aetna Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Ambetter ,Ambetter ,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Access,Anthem Blue Access,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Access Choice,Anthem Blue Access Choice,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Blue Preferred,Anthem Blue Preferred,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Pathway,Anthem Pathway,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Alliance,Anthem Alliance,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Anthem Medicare,Anthem Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Cigna,Cigna,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Cigna PPO,Cigna PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Cigna Medicare Advantage,Cigna Medicare Advantage,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Essence,Essence,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Healthlink HMO,Healthlink HMO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Healthlink PPO,Healthlink PPO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,HomeState Health Plan,HomeState Health Plan,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Humana Gold,Humana Gold,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Medicaid MO,Medicaid MO,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Medica,Medica,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Tricare,Tricare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,UHC All Payer,UHC All Payer,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,UHC Exchange,UHC Exchange,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,UHC Medicaid,UHC Medicaid,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,UMR CPD,UMR CPD,187.01,,,,,,,per diem,187.01,187.01,"Per diem rate, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,UHC Medicare,UHC Medicare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
FLU/RSV BY PCR                ,38251678,CDM,300,RC,87631,CPT,,,,Inpatient,,,187.01,187.01,Wellcare,Wellcare,187.01,,,,,,,case rate,187.01,187.01,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Meritain Health PPO CPD,Meritain Health PPO CPD,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Aetna/Commercial Product,Aetna/Commercial Product,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Meritain Health CPD,Meritain Health CPD,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Starmark CPD,Starmark CPD,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Aetna Medicare,Aetna Medicare,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Ambetter ,Ambetter ,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Blue Access,Anthem Blue Access,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Blue Access Choice,Anthem Blue Access Choice,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Blue Preferred,Anthem Blue Preferred,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Pathway,Anthem Pathway,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Alliance,Anthem Alliance,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Anthem Medicare,Anthem Medicare,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Cigna,Cigna,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Cigna PPO,Cigna PPO,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Cigna Medicare Advantage,Cigna Medicare Advantage,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Essence,Essence,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Healthlink HMO,Healthlink HMO,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Healthlink PPO,Healthlink PPO,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,HomeState Health Plan,HomeState Health Plan,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Humana Gold,Humana Gold,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Medicaid MO,Medicaid MO,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Medica,Medica,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Tricare,Tricare,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,UHC All Payer,UHC All Payer,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,UHC Exchange,UHC Exchange,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,UHC Medicaid,UHC Medicaid,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,UMR CPD,UMR CPD,53.57,,,,,,,per diem,53.57,53.57,"Per diem rate, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,UHC Medicare,UHC Medicare,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA A AG RAPID          ,38251679,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.57,53.57,Wellcare,Wellcare,53.57,,,,,,,case rate,53.57,53.57,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Meritain Health PPO CPD,Meritain Health PPO CPD,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Aetna/Commercial Product,Aetna/Commercial Product,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Meritain Health CPD,Meritain Health CPD,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Starmark CPD,Starmark CPD,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Aetna Medicare,Aetna Medicare,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Ambetter ,Ambetter ,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Blue Access,Anthem Blue Access,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Blue Access Choice,Anthem Blue Access Choice,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Blue Preferred,Anthem Blue Preferred,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Pathway,Anthem Pathway,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Alliance,Anthem Alliance,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Anthem Medicare,Anthem Medicare,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Cigna,Cigna,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Cigna PPO,Cigna PPO,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Cigna Medicare Advantage,Cigna Medicare Advantage,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Essence,Essence,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Healthlink HMO,Healthlink HMO,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Healthlink PPO,Healthlink PPO,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,HomeState Health Plan,HomeState Health Plan,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Humana Gold,Humana Gold,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Medicaid MO,Medicaid MO,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Medica,Medica,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Tricare,Tricare,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,UHC All Payer,UHC All Payer,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,UHC Exchange,UHC Exchange,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,UHC Medicaid,UHC Medicaid,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,UMR CPD,UMR CPD,53.48,,,,,,,per diem,53.48,53.48,"Per diem rate, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,UHC Medicare,UHC Medicare,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
INFLUENZA B AG RAPID          ,38251680,CDM,306,RC,87084,CPT,,,,Inpatient,,,53.48,53.48,Wellcare,Wellcare,53.48,,,,,,,case rate,53.48,53.48,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health PPO CPD,Meritain Health PPO CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Aetna/Commercial Product,Aetna/Commercial Product,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health CPD,Meritain Health CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Starmark CPD,Starmark CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Aetna Medicare,Aetna Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Ambetter ,Ambetter ,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access,Anthem Blue Access,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access Choice,Anthem Blue Access Choice,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Preferred,Anthem Blue Preferred,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Pathway,Anthem Pathway,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Alliance,Anthem Alliance,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Anthem Medicare,Anthem Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Cigna,Cigna,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Cigna PPO,Cigna PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Cigna Medicare Advantage,Cigna Medicare Advantage,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Essence,Essence,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Healthlink HMO,Healthlink HMO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Healthlink PPO,Healthlink PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,HomeState Health Plan,HomeState Health Plan,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Humana Gold,Humana Gold,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Medicaid MO,Medicaid MO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Medica,Medica,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Tricare,Tricare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,UHC All Payer,UHC All Payer,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,UHC Exchange,UHC Exchange,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicaid,UHC Medicaid,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,UMR CPD,UMR CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicare,UHC Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CADMIUM                       ,38251681,CDM,301,RC,82300,CPT,,,,Inpatient,,,245.07,245.07,Wellcare,Wellcare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Meritain Health PPO CPD,Meritain Health PPO CPD,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Aetna/Commercial Product,Aetna/Commercial Product,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Meritain Health CPD,Meritain Health CPD,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Starmark CPD,Starmark CPD,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Aetna Medicare,Aetna Medicare,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Ambetter ,Ambetter ,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Blue Access,Anthem Blue Access,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Blue Access Choice,Anthem Blue Access Choice,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Blue Preferred,Anthem Blue Preferred,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Pathway,Anthem Pathway,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Alliance,Anthem Alliance,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Anthem Medicare,Anthem Medicare,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Cigna,Cigna,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Cigna PPO,Cigna PPO,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Cigna Medicare Advantage,Cigna Medicare Advantage,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Essence,Essence,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Healthlink HMO,Healthlink HMO,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Healthlink PPO,Healthlink PPO,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,HomeState Health Plan,HomeState Health Plan,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Humana Gold,Humana Gold,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Medicaid MO,Medicaid MO,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Medica,Medica,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Tricare,Tricare,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,UHC All Payer,UHC All Payer,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,UHC Exchange,UHC Exchange,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,UHC Medicaid,UHC Medicaid,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,UMR CPD,UMR CPD,220.51,,,,,,,per diem,220.51,220.51,"Per diem rate, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,UHC Medicare,UHC Medicare,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
ALKALOIDS NOS                 ,38251704,CDM,301,RC,80323,CPT,,,,Inpatient,,,220.51,220.51,Wellcare,Wellcare,220.51,,,,,,,case rate,220.51,220.51,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Meritain Health PPO CPD,Meritain Health PPO CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Aetna/Commercial Product,Aetna/Commercial Product,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Meritain Health CPD,Meritain Health CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Starmark CPD,Starmark CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Aetna Medicare,Aetna Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Ambetter ,Ambetter ,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Blue Access,Anthem Blue Access,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Blue Access Choice,Anthem Blue Access Choice,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Blue Preferred,Anthem Blue Preferred,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Pathway,Anthem Pathway,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Alliance,Anthem Alliance,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Anthem Medicare,Anthem Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Cigna,Cigna,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Cigna PPO,Cigna PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Cigna Medicare Advantage,Cigna Medicare Advantage,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Essence,Essence,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Healthlink HMO,Healthlink HMO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Healthlink PPO,Healthlink PPO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,HomeState Health Plan,HomeState Health Plan,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Humana Gold,Humana Gold,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Medicaid MO,Medicaid MO,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Medica,Medica,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Tricare,Tricare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,UHC All Payer,UHC All Payer,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,UHC Exchange,UHC Exchange,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,UHC Medicaid,UHC Medicaid,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,UMR CPD,UMR CPD,26.7,,,,,,,per diem,26.7,26.7,"Per diem rate, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,UHC Medicare,UHC Medicare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
MALDI MICROBIAL IDENTIFICATION,38251705,CDM,300,RC,87158,CPT,,,,Inpatient,,,26.7,26.7,Wellcare,Wellcare,26.7,,,,,,,case rate,26.7,26.7,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Meritain Health PPO CPD,Meritain Health PPO CPD,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Aetna/Commercial Product,Aetna/Commercial Product,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Meritain Health CPD,Meritain Health CPD,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Starmark CPD,Starmark CPD,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Aetna Medicare,Aetna Medicare,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Ambetter ,Ambetter ,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Blue Access,Anthem Blue Access,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Blue Access Choice,Anthem Blue Access Choice,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Blue Preferred,Anthem Blue Preferred,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Pathway,Anthem Pathway,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Alliance,Anthem Alliance,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Anthem Medicare,Anthem Medicare,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Cigna,Cigna,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Cigna PPO,Cigna PPO,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Cigna Medicare Advantage,Cigna Medicare Advantage,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Essence,Essence,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Healthlink HMO,Healthlink HMO,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Healthlink PPO,Healthlink PPO,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,HomeState Health Plan,HomeState Health Plan,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Humana Gold,Humana Gold,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Medicaid MO,Medicaid MO,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Medica,Medica,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Tricare,Tricare,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,UHC All Payer,UHC All Payer,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,UHC Exchange,UHC Exchange,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,UHC Medicaid,UHC Medicaid,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,UMR CPD,UMR CPD,31.24,,,,,,,per diem,31.24,31.24,"Per diem rate, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,UHC Medicare,UHC Medicare,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
INSULIN ANTIBODIES            ,38251706,CDM,302,RC,86337,CPT,,,,Inpatient,,,31.24,31.24,Wellcare,Wellcare,31.24,,,,,,,case rate,31.24,31.24,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Meritain Health PPO CPD,Meritain Health PPO CPD,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Aetna/Commercial Product,Aetna/Commercial Product,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Meritain Health CPD,Meritain Health CPD,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Starmark CPD,Starmark CPD,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Aetna Medicare,Aetna Medicare,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Ambetter ,Ambetter ,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Blue Access,Anthem Blue Access,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Blue Access Choice,Anthem Blue Access Choice,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Blue Preferred,Anthem Blue Preferred,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Pathway,Anthem Pathway,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Alliance,Anthem Alliance,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Anthem Medicare,Anthem Medicare,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Cigna,Cigna,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Cigna PPO,Cigna PPO,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Cigna Medicare Advantage,Cigna Medicare Advantage,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Essence,Essence,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Healthlink HMO,Healthlink HMO,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Healthlink PPO,Healthlink PPO,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,HomeState Health Plan,HomeState Health Plan,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Humana Gold,Humana Gold,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Medicaid MO,Medicaid MO,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Medica,Medica,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Tricare,Tricare,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,UHC All Payer,UHC All Payer,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,UHC Exchange,UHC Exchange,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,UHC Medicaid,UHC Medicaid,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,UMR CPD,UMR CPD,12.51,,,,,,,per diem,12.51,12.51,"Per diem rate, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,UHC Medicare,UHC Medicare,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
CRYOFIBRINOGEN                ,38251707,CDM,301,RC,82585,CPT,,,,Inpatient,,,12.51,12.51,Wellcare,Wellcare,12.51,,,,,,,case rate,12.51,12.51,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health PPO CPD,Meritain Health PPO CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Aetna/Commercial Product,Aetna/Commercial Product,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Meritain Health CPD,Meritain Health CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Starmark CPD,Starmark CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Aetna Medicare,Aetna Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Ambetter ,Ambetter ,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access,Anthem Blue Access,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Access Choice,Anthem Blue Access Choice,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Blue Preferred,Anthem Blue Preferred,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Pathway,Anthem Pathway,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Alliance,Anthem Alliance,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Anthem Medicare,Anthem Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Cigna,Cigna,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Cigna PPO,Cigna PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Cigna Medicare Advantage,Cigna Medicare Advantage,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Essence,Essence,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Healthlink HMO,Healthlink HMO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Healthlink PPO,Healthlink PPO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,HomeState Health Plan,HomeState Health Plan,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Humana Gold,Humana Gold,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Medicaid MO,Medicaid MO,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Medica,Medica,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Tricare,Tricare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,UHC All Payer,UHC All Payer,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,UHC Exchange,UHC Exchange,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicaid,UHC Medicaid,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,UMR CPD,UMR CPD,101.85,,,,,,,per diem,101.85,101.85,"Per diem rate, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,UHC Medicare,UHC Medicare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
TRICHOMONAS VAGINAL AG IA W OP,38251708,CDM,306,RC,87808,CPT,,,,Inpatient,,,101.85,101.85,Wellcare,Wellcare,101.85,,,,,,,case rate,101.85,101.85,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health PPO CPD,Meritain Health PPO CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Aetna/Commercial Product,Aetna/Commercial Product,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health CPD,Meritain Health CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Starmark CPD,Starmark CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Aetna Medicare,Aetna Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Ambetter ,Ambetter ,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access,Anthem Blue Access,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access Choice,Anthem Blue Access Choice,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Preferred,Anthem Blue Preferred,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Pathway,Anthem Pathway,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Alliance,Anthem Alliance,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Anthem Medicare,Anthem Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Cigna,Cigna,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Cigna PPO,Cigna PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Cigna Medicare Advantage,Cigna Medicare Advantage,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Essence,Essence,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Healthlink HMO,Healthlink HMO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Healthlink PPO,Healthlink PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,HomeState Health Plan,HomeState Health Plan,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Humana Gold,Humana Gold,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Medicaid MO,Medicaid MO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Medica,Medica,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Tricare,Tricare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,UHC All Payer,UHC All Payer,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,UHC Exchange,UHC Exchange,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicaid,UHC Medicaid,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,UMR CPD,UMR CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicare,UHC Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
ENTEROVIROUS AMPLIFIED PROBE  ,38251709,CDM,306,RC,87498,CPT,,,,Inpatient,,,153.83,153.83,Wellcare,Wellcare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Meritain Health PPO CPD,Meritain Health PPO CPD,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Aetna/Commercial Product,Aetna/Commercial Product,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Meritain Health CPD,Meritain Health CPD,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Starmark CPD,Starmark CPD,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Aetna Medicare,Aetna Medicare,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Ambetter ,Ambetter ,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Blue Access,Anthem Blue Access,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Blue Access Choice,Anthem Blue Access Choice,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Blue Preferred,Anthem Blue Preferred,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Pathway,Anthem Pathway,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Alliance,Anthem Alliance,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Anthem Medicare,Anthem Medicare,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Cigna,Cigna,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Cigna PPO,Cigna PPO,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Cigna Medicare Advantage,Cigna Medicare Advantage,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Essence,Essence,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Healthlink HMO,Healthlink HMO,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Healthlink PPO,Healthlink PPO,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,HomeState Health Plan,HomeState Health Plan,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Humana Gold,Humana Gold,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Medicaid MO,Medicaid MO,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Medica,Medica,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Tricare,Tricare,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,UHC All Payer,UHC All Payer,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,UHC Exchange,UHC Exchange,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,UHC Medicaid,UHC Medicaid,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,UMR CPD,UMR CPD,161.26,,,,,,,per diem,161.26,161.26,"Per diem rate, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,UHC Medicare,UHC Medicare,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
HIV-1 AG W HIV1 & 2 AB DIR OPT,38251710,CDM,306,RC,87806,CPT,,,,Inpatient,,,161.26,161.26,Wellcare,Wellcare,161.26,,,,,,,case rate,161.26,161.26,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Meritain Health PPO CPD,Meritain Health PPO CPD,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Aetna/Commercial Product,Aetna/Commercial Product,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Meritain Health CPD,Meritain Health CPD,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Starmark CPD,Starmark CPD,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Aetna Medicare,Aetna Medicare,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Ambetter ,Ambetter ,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Blue Access,Anthem Blue Access,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Blue Access Choice,Anthem Blue Access Choice,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Blue Preferred,Anthem Blue Preferred,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Pathway,Anthem Pathway,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Alliance,Anthem Alliance,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Anthem Medicare,Anthem Medicare,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Cigna,Cigna,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Cigna PPO,Cigna PPO,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Cigna Medicare Advantage,Cigna Medicare Advantage,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Essence,Essence,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Healthlink HMO,Healthlink HMO,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Healthlink PPO,Healthlink PPO,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,HomeState Health Plan,HomeState Health Plan,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Humana Gold,Humana Gold,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Medicaid MO,Medicaid MO,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Medica,Medica,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Tricare,Tricare,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,UHC All Payer,UHC All Payer,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,UHC Exchange,UHC Exchange,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,UHC Medicaid,UHC Medicaid,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,UMR CPD,UMR CPD,17.5,,,,,,,per diem,17.5,17.5,"Per diem rate, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,UHC Medicare,UHC Medicare,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
RAPID STREP                   ,38251712,CDM,306,RC,87880,CPT,,,,Inpatient,,,17.5,17.5,Wellcare,Wellcare,17.5,,,,,,,case rate,17.5,17.5,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Meritain Health PPO CPD,Meritain Health PPO CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Aetna/Commercial Product,Aetna/Commercial Product,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Meritain Health CPD,Meritain Health CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Starmark CPD,Starmark CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Aetna Medicare,Aetna Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Ambetter ,Ambetter ,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Access,Anthem Blue Access,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Access Choice,Anthem Blue Access Choice,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Blue Preferred,Anthem Blue Preferred,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Pathway,Anthem Pathway,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Alliance,Anthem Alliance,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Anthem Medicare,Anthem Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Cigna,Cigna,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Cigna PPO,Cigna PPO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Cigna Medicare Advantage,Cigna Medicare Advantage,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Essence,Essence,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Healthlink HMO,Healthlink HMO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Healthlink PPO,Healthlink PPO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,HomeState Health Plan,HomeState Health Plan,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Humana Gold,Humana Gold,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Medicaid MO,Medicaid MO,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Medica,Medica,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Tricare,Tricare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,UHC All Payer,UHC All Payer,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,UHC Exchange,UHC Exchange,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,UHC Medicaid,UHC Medicaid,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,UMR CPD,UMR CPD,458.06,,,,,,,per diem,458.06,458.06,"Per diem rate, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,UHC Medicare,UHC Medicare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
TOOL PATHOGEN PCR PANEL       ,38251713,CDM,300,RC,87505,CPT,,,,Inpatient,,,458.06,458.06,Wellcare,Wellcare,458.06,,,,,,,case rate,458.06,458.06,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Meritain Health PPO CPD,Meritain Health PPO CPD,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Aetna/Commercial Product,Aetna/Commercial Product,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Meritain Health CPD,Meritain Health CPD,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Starmark CPD,Starmark CPD,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Aetna Medicare,Aetna Medicare,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Ambetter ,Ambetter ,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Blue Access,Anthem Blue Access,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Blue Access Choice,Anthem Blue Access Choice,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Blue Preferred,Anthem Blue Preferred,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Pathway,Anthem Pathway,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Alliance,Anthem Alliance,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Anthem Medicare,Anthem Medicare,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Cigna,Cigna,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Cigna PPO,Cigna PPO,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Cigna Medicare Advantage,Cigna Medicare Advantage,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Essence,Essence,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Healthlink HMO,Healthlink HMO,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Healthlink PPO,Healthlink PPO,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,HomeState Health Plan,HomeState Health Plan,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Humana Gold,Humana Gold,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Medicaid MO,Medicaid MO,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Medica,Medica,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Tricare,Tricare,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,UHC All Payer,UHC All Payer,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,UHC Exchange,UHC Exchange,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,UHC Medicaid,UHC Medicaid,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,UMR CPD,UMR CPD,1582.16,,,,,,,per diem,1582.16,1582.16,"Per diem rate, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,UHC Medicare,UHC Medicare,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
STATIFY JVC ANTIBODY          ,38251714,CDM,300,RC,,,,,,Inpatient,,,1582.16,1582.16,Wellcare,Wellcare,1582.16,,,,,,,case rate,1582.16,1582.16,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Meritain Health PPO CPD,Meritain Health PPO CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Aetna/Commercial Product,Aetna/Commercial Product,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Meritain Health CPD,Meritain Health CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Starmark CPD,Starmark CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Aetna Medicare,Aetna Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Ambetter ,Ambetter ,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Blue Access,Anthem Blue Access,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Blue Access Choice,Anthem Blue Access Choice,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Blue Preferred,Anthem Blue Preferred,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Pathway,Anthem Pathway,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Alliance,Anthem Alliance,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Anthem Medicare,Anthem Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Cigna,Cigna,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Cigna PPO,Cigna PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Cigna Medicare Advantage,Cigna Medicare Advantage,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Essence,Essence,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Healthlink HMO,Healthlink HMO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Healthlink PPO,Healthlink PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,HomeState Health Plan,HomeState Health Plan,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Humana Gold,Humana Gold,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Medicaid MO,Medicaid MO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Medica,Medica,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Tricare,Tricare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,UHC All Payer,UHC All Payer,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,UHC Exchange,UHC Exchange,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,UHC Medicaid,UHC Medicaid,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,UMR CPD,UMR CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,UHC Medicare,UHC Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
LACOSAMIDE                    ,38251720,CDM,300,RC,80235,CPT,,,,Inpatient,,,273.98,273.98,Wellcare,Wellcare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Meritain Health PPO CPD,Meritain Health PPO CPD,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Aetna/Commercial Product,Aetna/Commercial Product,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Meritain Health CPD,Meritain Health CPD,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Starmark CPD,Starmark CPD,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Aetna Medicare,Aetna Medicare,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Ambetter ,Ambetter ,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Blue Access,Anthem Blue Access,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Blue Access Choice,Anthem Blue Access Choice,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Blue Preferred,Anthem Blue Preferred,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Pathway,Anthem Pathway,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Alliance,Anthem Alliance,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Anthem Medicare,Anthem Medicare,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Cigna,Cigna,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Cigna PPO,Cigna PPO,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Cigna Medicare Advantage,Cigna Medicare Advantage,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Essence,Essence,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Healthlink HMO,Healthlink HMO,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Healthlink PPO,Healthlink PPO,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,HomeState Health Plan,HomeState Health Plan,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Humana Gold,Humana Gold,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Medicaid MO,Medicaid MO,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Medica,Medica,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Tricare,Tricare,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,UHC All Payer,UHC All Payer,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,UHC Exchange,UHC Exchange,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,UHC Medicaid,UHC Medicaid,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,UMR CPD,UMR CPD,530.45,,,,,,,per diem,530.45,530.45,"Per diem rate, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,UHC Medicare,UHC Medicare,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
FLU RSV & COVID-19 RNA        ,38251722,CDM,306,RC,87637,CPT,0241U,HCPCS,,Inpatient,,,530.45,530.45,Wellcare,Wellcare,530.45,,,,,,,case rate,530.45,530.45,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Meritain Health PPO CPD,Meritain Health PPO CPD,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Aetna/Commercial Product,Aetna/Commercial Product,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Meritain Health CPD,Meritain Health CPD,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Starmark CPD,Starmark CPD,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Aetna Medicare,Aetna Medicare,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Ambetter ,Ambetter ,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Blue Access,Anthem Blue Access,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Blue Access Choice,Anthem Blue Access Choice,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Blue Preferred,Anthem Blue Preferred,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Pathway,Anthem Pathway,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Alliance,Anthem Alliance,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Anthem Medicare,Anthem Medicare,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Cigna,Cigna,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Cigna PPO,Cigna PPO,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Cigna Medicare Advantage,Cigna Medicare Advantage,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Essence,Essence,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Healthlink HMO,Healthlink HMO,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Healthlink PPO,Healthlink PPO,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,HomeState Health Plan,HomeState Health Plan,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Humana Gold,Humana Gold,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Medicaid MO,Medicaid MO,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Medica,Medica,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Tricare,Tricare,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,UHC All Payer,UHC All Payer,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,UHC Exchange,UHC Exchange,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,UHC Medicaid,UHC Medicaid,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,UMR CPD,UMR CPD,56.85,,,,,,,per diem,56.85,56.85,"Per diem rate, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,UHC Medicare,UHC Medicare,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESPIRATORY SYNC VIRUS RSV    ,38251723,CDM,306,RC,87634,CPT,,,,Inpatient,,,56.85,56.85,Wellcare,Wellcare,56.85,,,,,,,case rate,56.85,56.85,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Meritain Health PPO CPD,Meritain Health PPO CPD,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Aetna/Commercial Product,Aetna/Commercial Product,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Meritain Health CPD,Meritain Health CPD,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Starmark CPD,Starmark CPD,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Aetna Medicare,Aetna Medicare,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Ambetter ,Ambetter ,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Blue Access,Anthem Blue Access,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Blue Access Choice,Anthem Blue Access Choice,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Blue Preferred,Anthem Blue Preferred,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Pathway,Anthem Pathway,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Alliance,Anthem Alliance,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Anthem Medicare,Anthem Medicare,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Cigna,Cigna,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Cigna PPO,Cigna PPO,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Cigna Medicare Advantage,Cigna Medicare Advantage,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Essence,Essence,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Healthlink HMO,Healthlink HMO,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Healthlink PPO,Healthlink PPO,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,HomeState Health Plan,HomeState Health Plan,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Humana Gold,Humana Gold,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Medicaid MO,Medicaid MO,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Medica,Medica,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Tricare,Tricare,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,UHC All Payer,UHC All Payer,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,UHC Exchange,UHC Exchange,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,UHC Medicaid,UHC Medicaid,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,UMR CPD,UMR CPD,936.27,,,,,,,per diem,936.27,936.27,"Per diem rate, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,UHC Medicare,UHC Medicare,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
RESP PATH AMPL PROBE 22 BIOFIR,38251724,CDM,306,RC,0202U,CPT,0202U,HCPCS,,Inpatient,,,936.27,936.27,Wellcare,Wellcare,936.27,,,,,,,case rate,936.27,936.27,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Meritain Health PPO CPD,Meritain Health PPO CPD,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Aetna/Commercial Product,Aetna/Commercial Product,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Meritain Health CPD,Meritain Health CPD,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Starmark CPD,Starmark CPD,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Aetna Medicare,Aetna Medicare,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Ambetter ,Ambetter ,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Blue Access,Anthem Blue Access,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Blue Access Choice,Anthem Blue Access Choice,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Blue Preferred,Anthem Blue Preferred,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Pathway,Anthem Pathway,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Alliance,Anthem Alliance,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Anthem Medicare,Anthem Medicare,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Cigna,Cigna,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Cigna PPO,Cigna PPO,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Cigna Medicare Advantage,Cigna Medicare Advantage,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Essence,Essence,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Healthlink HMO,Healthlink HMO,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Healthlink PPO,Healthlink PPO,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,HomeState Health Plan,HomeState Health Plan,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Humana Gold,Humana Gold,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Medicaid MO,Medicaid MO,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Medica,Medica,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Tricare,Tricare,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,UHC All Payer,UHC All Payer,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,UHC Exchange,UHC Exchange,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,UHC Medicaid,UHC Medicaid,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,UMR CPD,UMR CPD,206,,,,,,,per diem,206,206,"Per diem rate, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,UHC Medicare,UHC Medicare,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
COVID19 PCR HI THR PUT        ,38251725,CDM,306,RC,U0005,CPT,U0005,HCPCS,,Inpatient,,,206,206,Wellcare,Wellcare,206,,,,,,,case rate,206,206,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Meritain Health PPO CPD,Meritain Health PPO CPD,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Aetna/Commercial Product,Aetna/Commercial Product,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Meritain Health CPD,Meritain Health CPD,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Starmark CPD,Starmark CPD,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Aetna Medicare,Aetna Medicare,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Ambetter ,Ambetter ,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Blue Access,Anthem Blue Access,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Blue Access Choice,Anthem Blue Access Choice,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Blue Preferred,Anthem Blue Preferred,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Pathway,Anthem Pathway,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Alliance,Anthem Alliance,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Anthem Medicare,Anthem Medicare,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Cigna,Cigna,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Cigna PPO,Cigna PPO,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Cigna Medicare Advantage,Cigna Medicare Advantage,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Essence,Essence,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Healthlink HMO,Healthlink HMO,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Healthlink PPO,Healthlink PPO,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,HomeState Health Plan,HomeState Health Plan,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Humana Gold,Humana Gold,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Medicaid MO,Medicaid MO,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Medica,Medica,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Tricare,Tricare,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,UHC All Payer,UHC All Payer,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,UHC Exchange,UHC Exchange,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,UHC Medicaid,UHC Medicaid,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,UMR CPD,UMR CPD,314.15,,,,,,,per diem,314.15,314.15,"Per diem rate, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,UHC Medicare,UHC Medicare,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
PROTEIN ISOTOPE MALDI-TOF MS  ,38251731,CDM,301,RC,0077U,CPT,0077U,HCPCS,,Inpatient,,,314.15,314.15,Wellcare,Wellcare,314.15,,,,,,,case rate,314.15,314.15,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Meritain Health PPO CPD,Meritain Health PPO CPD,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Aetna/Commercial Product,Aetna/Commercial Product,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Meritain Health CPD,Meritain Health CPD,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Starmark CPD,Starmark CPD,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Aetna Medicare,Aetna Medicare,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Ambetter ,Ambetter ,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Blue Access,Anthem Blue Access,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Blue Access Choice,Anthem Blue Access Choice,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Blue Preferred,Anthem Blue Preferred,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Pathway,Anthem Pathway,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Alliance,Anthem Alliance,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Anthem Medicare,Anthem Medicare,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Cigna,Cigna,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Cigna PPO,Cigna PPO,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Cigna Medicare Advantage,Cigna Medicare Advantage,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Essence,Essence,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Healthlink HMO,Healthlink HMO,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Healthlink PPO,Healthlink PPO,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,HomeState Health Plan,HomeState Health Plan,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Humana Gold,Humana Gold,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Medicaid MO,Medicaid MO,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Medica,Medica,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Tricare,Tricare,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,UHC All Payer,UHC All Payer,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,UHC Exchange,UHC Exchange,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,UHC Medicaid,UHC Medicaid,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,UMR CPD,UMR CPD,917.73,,,,,,,per diem,917.73,917.73,"Per diem rate, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,UHC Medicare,UHC Medicare,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
COVID-19 INF AGT DNA/RNA 22 QL,38251733,CDM,306,RC,0202U,CPT,,,,Inpatient,,,917.73,917.73,Wellcare,Wellcare,917.73,,,,,,,case rate,917.73,917.73,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Meritain Health PPO CPD,Meritain Health PPO CPD,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Aetna/Commercial Product,Aetna/Commercial Product,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Meritain Health CPD,Meritain Health CPD,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Starmark CPD,Starmark CPD,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Aetna Medicare,Aetna Medicare,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Ambetter ,Ambetter ,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Blue Access,Anthem Blue Access,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Blue Access Choice,Anthem Blue Access Choice,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Blue Preferred,Anthem Blue Preferred,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Pathway,Anthem Pathway,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Alliance,Anthem Alliance,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Anthem Medicare,Anthem Medicare,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Cigna,Cigna,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Cigna PPO,Cigna PPO,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Cigna Medicare Advantage,Cigna Medicare Advantage,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Essence,Essence,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Healthlink HMO,Healthlink HMO,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Healthlink PPO,Healthlink PPO,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,HomeState Health Plan,HomeState Health Plan,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Humana Gold,Humana Gold,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Medicaid MO,Medicaid MO,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Medica,Medica,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Tricare,Tricare,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,UHC All Payer,UHC All Payer,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,UHC Exchange,UHC Exchange,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,UHC Medicaid,UHC Medicaid,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,UMR CPD,UMR CPD,434.66,,,,,,,per diem,434.66,434.66,"Per diem rate, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,UHC Medicare,UHC Medicare,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
IMMUNOGLOBULIN LIGHT CHAINS FR,38251734,CDM,300,RC,83521,CPT,,,,Inpatient,,,434.66,434.66,Wellcare,Wellcare,434.66,,,,,,,case rate,434.66,434.66,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Meritain Health PPO CPD,Meritain Health PPO CPD,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Aetna/Commercial Product,Aetna/Commercial Product,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Meritain Health CPD,Meritain Health CPD,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Starmark CPD,Starmark CPD,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Aetna Medicare,Aetna Medicare,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Ambetter ,Ambetter ,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Blue Access,Anthem Blue Access,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Blue Access Choice,Anthem Blue Access Choice,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Blue Preferred,Anthem Blue Preferred,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Pathway,Anthem Pathway,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Alliance,Anthem Alliance,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Anthem Medicare,Anthem Medicare,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Cigna,Cigna,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Cigna PPO,Cigna PPO,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Cigna Medicare Advantage,Cigna Medicare Advantage,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Essence,Essence,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Healthlink HMO,Healthlink HMO,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Healthlink PPO,Healthlink PPO,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,HomeState Health Plan,HomeState Health Plan,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Humana Gold,Humana Gold,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Medicaid MO,Medicaid MO,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Medica,Medica,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Tricare,Tricare,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,UHC All Payer,UHC All Payer,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,UHC Exchange,UHC Exchange,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,UHC Medicaid,UHC Medicaid,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,UMR CPD,UMR CPD,182.21,,,,,,,per diem,182.21,182.21,"Per diem rate, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,UHC Medicare,UHC Medicare,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV- COMPUTERIZED DIAGNOST,38270001,CDM,300,RC,,,,,,Inpatient,,,182.21,182.21,Wellcare,Wellcare,182.21,,,,,,,case rate,182.21,182.21,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Meritain Health PPO CPD,Meritain Health PPO CPD,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Aetna/Commercial Product,Aetna/Commercial Product,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Meritain Health CPD,Meritain Health CPD,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Starmark CPD,Starmark CPD,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Aetna Medicare,Aetna Medicare,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Ambetter ,Ambetter ,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Blue Access,Anthem Blue Access,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Blue Access Choice,Anthem Blue Access Choice,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Blue Preferred,Anthem Blue Preferred,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Pathway,Anthem Pathway,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Alliance,Anthem Alliance,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Anthem Medicare,Anthem Medicare,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Cigna,Cigna,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Cigna PPO,Cigna PPO,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Cigna Medicare Advantage,Cigna Medicare Advantage,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Essence,Essence,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Healthlink HMO,Healthlink HMO,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Healthlink PPO,Healthlink PPO,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,HomeState Health Plan,HomeState Health Plan,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Humana Gold,Humana Gold,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Medicaid MO,Medicaid MO,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Medica,Medica,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Tricare,Tricare,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,UHC All Payer,UHC All Payer,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,UHC Exchange,UHC Exchange,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,UHC Medicaid,UHC Medicaid,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,UMR CPD,UMR CPD,1787.31,,,,,,,per diem,1787.31,1787.31,"Per diem rate, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,UHC Medicare,UHC Medicare,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ABDOMINAL PARACENTESIS,38270002,CDM,300,RC,,,,,,Inpatient,,,1787.31,1787.31,Wellcare,Wellcare,1787.31,,,,,,,case rate,1787.31,1787.31,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Meritain Health PPO CPD,Meritain Health PPO CPD,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Aetna/Commercial Product,Aetna/Commercial Product,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Meritain Health CPD,Meritain Health CPD,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Starmark CPD,Starmark CPD,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Aetna Medicare,Aetna Medicare,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Ambetter ,Ambetter ,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Blue Access,Anthem Blue Access,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Blue Access Choice,Anthem Blue Access Choice,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Blue Preferred,Anthem Blue Preferred,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Pathway,Anthem Pathway,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Alliance,Anthem Alliance,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Anthem Medicare,Anthem Medicare,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Cigna,Cigna,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Cigna PPO,Cigna PPO,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Cigna Medicare Advantage,Cigna Medicare Advantage,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Essence,Essence,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Healthlink HMO,Healthlink HMO,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Healthlink PPO,Healthlink PPO,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,HomeState Health Plan,HomeState Health Plan,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Humana Gold,Humana Gold,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Medicaid MO,Medicaid MO,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Medica,Medica,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Tricare,Tricare,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,UHC All Payer,UHC All Payer,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,UHC Exchange,UHC Exchange,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,UHC Medicaid,UHC Medicaid,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,UMR CPD,UMR CPD,753.59,,,,,,,per diem,753.59,753.59,"Per diem rate, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,UHC Medicare,UHC Medicare,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD HALO REPLACEMENT L,38270003,CDM,300,RC,,,,,,Inpatient,,,753.59,753.59,Wellcare,Wellcare,753.59,,,,,,,case rate,753.59,753.59,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Meritain Health PPO CPD,Meritain Health PPO CPD,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Aetna/Commercial Product,Aetna/Commercial Product,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Meritain Health CPD,Meritain Health CPD,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Starmark CPD,Starmark CPD,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Aetna Medicare,Aetna Medicare,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Ambetter ,Ambetter ,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Blue Access,Anthem Blue Access,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Blue Access Choice,Anthem Blue Access Choice,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Blue Preferred,Anthem Blue Preferred,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Pathway,Anthem Pathway,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Alliance,Anthem Alliance,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Anthem Medicare,Anthem Medicare,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Cigna,Cigna,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Cigna PPO,Cigna PPO,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Cigna Medicare Advantage,Cigna Medicare Advantage,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Essence,Essence,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Healthlink HMO,Healthlink HMO,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Healthlink PPO,Healthlink PPO,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,HomeState Health Plan,HomeState Health Plan,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Humana Gold,Humana Gold,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Medicaid MO,Medicaid MO,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Medica,Medica,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Tricare,Tricare,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,UHC All Payer,UHC All Payer,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,UHC Exchange,UHC Exchange,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,UHC Medicaid,UHC Medicaid,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,UMR CPD,UMR CPD,331.8,,,,,,,per diem,331.8,331.8,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,UHC Medicare,UHC Medicare,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE LMTD ANKLE M,38270004,CDM,300,RC,,,,,,Inpatient,,,331.8,331.8,Wellcare,Wellcare,331.8,,,,,,,case rate,331.8,331.8,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Meritain Health PPO CPD,Meritain Health PPO CPD,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Aetna/Commercial Product,Aetna/Commercial Product,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Meritain Health CPD,Meritain Health CPD,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Starmark CPD,Starmark CPD,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Aetna Medicare,Aetna Medicare,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Ambetter ,Ambetter ,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Blue Access,Anthem Blue Access,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Blue Access Choice,Anthem Blue Access Choice,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Blue Preferred,Anthem Blue Preferred,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Pathway,Anthem Pathway,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Alliance,Anthem Alliance,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Anthem Medicare,Anthem Medicare,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Cigna,Cigna,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Cigna PPO,Cigna PPO,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Cigna Medicare Advantage,Cigna Medicare Advantage,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Essence,Essence,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Healthlink HMO,Healthlink HMO,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Healthlink PPO,Healthlink PPO,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,HomeState Health Plan,HomeState Health Plan,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Humana Gold,Humana Gold,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Medicaid MO,Medicaid MO,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Medica,Medica,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Tricare,Tricare,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,UHC All Payer,UHC All Payer,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,UHC Exchange,UHC Exchange,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,UHC Medicaid,UHC Medicaid,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,UMR CPD,UMR CPD,172.09,,,,,,,per diem,172.09,172.09,"Per diem rate, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,UHC Medicare,UHC Medicare,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
RGNCONV-ADD TO LE PADDED LINER,38270005,CDM,300,RC,,,,,,Inpatient,,,172.09,172.09,Wellcare,Wellcare,172.09,,,,,,,case rate,172.09,172.09,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Meritain Health PPO CPD,Meritain Health PPO CPD,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Aetna/Commercial Product,Aetna/Commercial Product,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Meritain Health CPD,Meritain Health CPD,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Starmark CPD,Starmark CPD,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Aetna Medicare,Aetna Medicare,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Ambetter ,Ambetter ,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Blue Access,Anthem Blue Access,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Blue Access Choice,Anthem Blue Access Choice,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Blue Preferred,Anthem Blue Preferred,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Pathway,Anthem Pathway,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Alliance,Anthem Alliance,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Anthem Medicare,Anthem Medicare,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Cigna,Cigna,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Cigna PPO,Cigna PPO,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Cigna Medicare Advantage,Cigna Medicare Advantage,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Essence,Essence,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Healthlink HMO,Healthlink HMO,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Healthlink PPO,Healthlink PPO,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,HomeState Health Plan,HomeState Health Plan,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Humana Gold,Humana Gold,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Medicaid MO,Medicaid MO,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Medica,Medica,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Tricare,Tricare,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,UHC All Payer,UHC All Payer,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,UHC Exchange,UHC Exchange,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,UHC Medicaid,UHC Medicaid,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,UMR CPD,UMR CPD,331.86,,,,,,,per diem,331.86,331.86,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,UHC Medicare,UHC Medicare,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, DORSIFLEX A",38270006,CDM,300,RC,,,,,,Inpatient,,,331.86,331.86,Wellcare,Wellcare,331.86,,,,,,,case rate,331.86,331.86,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Meritain Health PPO CPD,Meritain Health PPO CPD,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Aetna/Commercial Product,Aetna/Commercial Product,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Meritain Health CPD,Meritain Health CPD,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Starmark CPD,Starmark CPD,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Aetna Medicare,Aetna Medicare,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Ambetter ,Ambetter ,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Blue Access,Anthem Blue Access,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Blue Access Choice,Anthem Blue Access Choice,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Blue Preferred,Anthem Blue Preferred,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Pathway,Anthem Pathway,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Alliance,Anthem Alliance,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Anthem Medicare,Anthem Medicare,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Cigna,Cigna,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Cigna PPO,Cigna PPO,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Cigna Medicare Advantage,Cigna Medicare Advantage,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Essence,Essence,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Healthlink HMO,Healthlink HMO,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Healthlink PPO,Healthlink PPO,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,HomeState Health Plan,HomeState Health Plan,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Humana Gold,Humana Gold,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Medicaid MO,Medicaid MO,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Medica,Medica,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Tricare,Tricare,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,UHC All Payer,UHC All Payer,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,UHC Exchange,UHC Exchange,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,UHC Medicaid,UHC Medicaid,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,UMR CPD,UMR CPD,509.52,,,,,,,per diem,509.52,509.52,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,UHC Medicare,UHC Medicare,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE, PRE TIBIAL ",38270007,CDM,300,RC,,,,,,Inpatient,,,509.52,509.52,Wellcare,Wellcare,509.52,,,,,,,case rate,509.52,509.52,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Meritain Health PPO CPD,Meritain Health PPO CPD,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Aetna/Commercial Product,Aetna/Commercial Product,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Meritain Health CPD,Meritain Health CPD,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Starmark CPD,Starmark CPD,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Aetna Medicare,Aetna Medicare,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Ambetter ,Ambetter ,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Blue Access,Anthem Blue Access,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Blue Access Choice,Anthem Blue Access Choice,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Blue Preferred,Anthem Blue Preferred,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Pathway,Anthem Pathway,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Alliance,Anthem Alliance,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Anthem Medicare,Anthem Medicare,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Cigna,Cigna,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Cigna PPO,Cigna PPO,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Cigna Medicare Advantage,Cigna Medicare Advantage,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Essence,Essence,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Healthlink HMO,Healthlink HMO,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Healthlink PPO,Healthlink PPO,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,HomeState Health Plan,HomeState Health Plan,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Humana Gold,Humana Gold,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Medicaid MO,Medicaid MO,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Medica,Medica,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Tricare,Tricare,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,UHC All Payer,UHC All Payer,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,UHC Exchange,UHC Exchange,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,UHC Medicaid,UHC Medicaid,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,UMR CPD,UMR CPD,127.1,,,,,,,per diem,127.1,127.1,"Per diem rate, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,UHC Medicare,UHC Medicare,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
"RGNCONV-ADD TO LE,VARUS/VALGUS",38270008,CDM,300,RC,,,,,,Inpatient,,,127.1,127.1,Wellcare,Wellcare,127.1,,,,,,,case rate,127.1,127.1,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Meritain Health PPO CPD,Meritain Health PPO CPD,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Aetna/Commercial Product,Aetna/Commercial Product,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Meritain Health CPD,Meritain Health CPD,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Starmark CPD,Starmark CPD,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Aetna Medicare,Aetna Medicare,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Ambetter ,Ambetter ,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Blue Access,Anthem Blue Access,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Blue Access Choice,Anthem Blue Access Choice,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Blue Preferred,Anthem Blue Preferred,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Pathway,Anthem Pathway,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Alliance,Anthem Alliance,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Anthem Medicare,Anthem Medicare,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Cigna,Cigna,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Cigna PPO,Cigna PPO,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Cigna Medicare Advantage,Cigna Medicare Advantage,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Essence,Essence,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Healthlink HMO,Healthlink HMO,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Healthlink PPO,Healthlink PPO,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,HomeState Health Plan,HomeState Health Plan,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Humana Gold,Humana Gold,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Medicaid MO,Medicaid MO,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Medica,Medica,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Tricare,Tricare,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,UHC All Payer,UHC All Payer,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,UHC Exchange,UHC Exchange,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,UHC Medicaid,UHC Medicaid,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,UMR CPD,UMR CPD,1535.3,,,,,,,per diem,1535.3,1535.3,"Per diem rate, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,UHC Medicare,UHC Medicare,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
RGNCONV-AFO PLASTIC W/ ANKLE J,38270009,CDM,300,RC,,,,,,Inpatient,,,1535.3,1535.3,Wellcare,Wellcare,1535.3,,,,,,,case rate,1535.3,1535.3,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Meritain Health PPO CPD,Meritain Health PPO CPD,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Aetna/Commercial Product,Aetna/Commercial Product,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Meritain Health CPD,Meritain Health CPD,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Starmark CPD,Starmark CPD,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Aetna Medicare,Aetna Medicare,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Ambetter ,Ambetter ,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Blue Access,Anthem Blue Access,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Blue Access Choice,Anthem Blue Access Choice,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Blue Preferred,Anthem Blue Preferred,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Pathway,Anthem Pathway,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Alliance,Anthem Alliance,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Anthem Medicare,Anthem Medicare,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Cigna,Cigna,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Cigna PPO,Cigna PPO,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Cigna Medicare Advantage,Cigna Medicare Advantage,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Essence,Essence,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Healthlink HMO,Healthlink HMO,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Healthlink PPO,Healthlink PPO,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,HomeState Health Plan,HomeState Health Plan,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Humana Gold,Humana Gold,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Medicaid MO,Medicaid MO,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Medica,Medica,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Tricare,Tricare,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,UHC All Payer,UHC All Payer,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,UHC Exchange,UHC Exchange,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,UHC Medicaid,UHC Medicaid,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,UMR CPD,UMR CPD,1743.38,,,,,,,per diem,1743.38,1743.38,"Per diem rate, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,UHC Medicare,UHC Medicare,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
"RGNCONV-AFO PLASTIC, FLOOR REA",38270010,CDM,300,RC,,,,,,Inpatient,,,1743.38,1743.38,Wellcare,Wellcare,1743.38,,,,,,,case rate,1743.38,1743.38,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Meritain Health PPO CPD,Meritain Health PPO CPD,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Aetna/Commercial Product,Aetna/Commercial Product,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Meritain Health CPD,Meritain Health CPD,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Starmark CPD,Starmark CPD,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Aetna Medicare,Aetna Medicare,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Ambetter ,Ambetter ,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Blue Access,Anthem Blue Access,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Blue Access Choice,Anthem Blue Access Choice,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Blue Preferred,Anthem Blue Preferred,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Pathway,Anthem Pathway,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Alliance,Anthem Alliance,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Anthem Medicare,Anthem Medicare,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Cigna,Cigna,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Cigna PPO,Cigna PPO,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Cigna Medicare Advantage,Cigna Medicare Advantage,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Essence,Essence,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Healthlink HMO,Healthlink HMO,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Healthlink PPO,Healthlink PPO,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,HomeState Health Plan,HomeState Health Plan,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Humana Gold,Humana Gold,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Medicaid MO,Medicaid MO,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Medica,Medica,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Tricare,Tricare,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,UHC All Payer,UHC All Payer,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,UHC Exchange,UHC Exchange,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,UHC Medicaid,UHC Medicaid,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,UMR CPD,UMR CPD,1243.98,,,,,,,per diem,1243.98,1243.98,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,UHC Medicare,UHC Medicare,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SOLID POSTERIOR AN,38270011,CDM,300,RC,,,,,,Inpatient,,,1243.98,1243.98,Wellcare,Wellcare,1243.98,,,,,,,case rate,1243.98,1243.98,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Meritain Health PPO CPD,Meritain Health PPO CPD,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Aetna/Commercial Product,Aetna/Commercial Product,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Meritain Health CPD,Meritain Health CPD,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Starmark CPD,Starmark CPD,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Aetna Medicare,Aetna Medicare,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Ambetter ,Ambetter ,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Blue Access,Anthem Blue Access,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Blue Access Choice,Anthem Blue Access Choice,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Blue Preferred,Anthem Blue Preferred,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Pathway,Anthem Pathway,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Alliance,Anthem Alliance,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Anthem Medicare,Anthem Medicare,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Cigna,Cigna,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Cigna PPO,Cigna PPO,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Cigna Medicare Advantage,Cigna Medicare Advantage,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Essence,Essence,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Healthlink HMO,Healthlink HMO,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Healthlink PPO,Healthlink PPO,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,HomeState Health Plan,HomeState Health Plan,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Humana Gold,Humana Gold,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Medicaid MO,Medicaid MO,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Medica,Medica,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Tricare,Tricare,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,UHC All Payer,UHC All Payer,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,UHC Exchange,UHC Exchange,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,UHC Medicaid,UHC Medicaid,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,UMR CPD,UMR CPD,1349.71,,,,,,,per diem,1349.71,1349.71,"Per diem rate, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,UHC Medicare,UHC Medicare,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO SPIRAL PLASTIC/OTH,38270012,CDM,300,RC,,,,,,Inpatient,,,1349.71,1349.71,Wellcare,Wellcare,1349.71,,,,,,,case rate,1349.71,1349.71,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Meritain Health PPO CPD,Meritain Health PPO CPD,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Aetna/Commercial Product,Aetna/Commercial Product,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Meritain Health CPD,Meritain Health CPD,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Starmark CPD,Starmark CPD,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Aetna Medicare,Aetna Medicare,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Ambetter ,Ambetter ,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Blue Access,Anthem Blue Access,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Blue Access Choice,Anthem Blue Access Choice,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Blue Preferred,Anthem Blue Preferred,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Pathway,Anthem Pathway,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Alliance,Anthem Alliance,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Anthem Medicare,Anthem Medicare,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Cigna,Cigna,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Cigna PPO,Cigna PPO,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Cigna Medicare Advantage,Cigna Medicare Advantage,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Essence,Essence,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Healthlink HMO,Healthlink HMO,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Healthlink PPO,Healthlink PPO,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,HomeState Health Plan,HomeState Health Plan,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Humana Gold,Humana Gold,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Medicaid MO,Medicaid MO,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Medica,Medica,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Tricare,Tricare,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,UHC All Payer,UHC All Payer,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,UHC Exchange,UHC Exchange,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,UHC Medicaid,UHC Medicaid,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,UMR CPD,UMR CPD,418.41,,,,,,,per diem,418.41,418.41,"Per diem rate, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,UHC Medicare,UHC Medicare,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-AFO/PRAFO STATIC      ,38270013,CDM,300,RC,,,,,,Inpatient,,,418.41,418.41,Wellcare,Wellcare,418.41,,,,,,,case rate,418.41,418.41,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Meritain Health PPO CPD,Meritain Health PPO CPD,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Aetna/Commercial Product,Aetna/Commercial Product,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Meritain Health CPD,Meritain Health CPD,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Starmark CPD,Starmark CPD,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Aetna Medicare,Aetna Medicare,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Ambetter ,Ambetter ,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Blue Access,Anthem Blue Access,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Blue Access Choice,Anthem Blue Access Choice,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Blue Preferred,Anthem Blue Preferred,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Pathway,Anthem Pathway,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Alliance,Anthem Alliance,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Anthem Medicare,Anthem Medicare,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Cigna,Cigna,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Cigna PPO,Cigna PPO,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Cigna Medicare Advantage,Cigna Medicare Advantage,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Essence,Essence,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Healthlink HMO,Healthlink HMO,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Healthlink PPO,Healthlink PPO,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,HomeState Health Plan,HomeState Health Plan,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Humana Gold,Humana Gold,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Medicaid MO,Medicaid MO,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Medica,Medica,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Tricare,Tricare,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,UHC All Payer,UHC All Payer,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,UHC Exchange,UHC Exchange,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,UHC Medicaid,UHC Medicaid,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,UMR CPD,UMR CPD,107.02,,,,,,,per diem,107.02,107.02,"Per diem rate, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,UHC Medicare,UHC Medicare,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
RGNCONV-ANGIO TRAY            ,38270014,CDM,300,RC,,,,,,Inpatient,,,107.02,107.02,Wellcare,Wellcare,107.02,,,,,,,case rate,107.02,107.02,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Meritain Health PPO CPD,Meritain Health PPO CPD,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Aetna/Commercial Product,Aetna/Commercial Product,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Meritain Health CPD,Meritain Health CPD,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Starmark CPD,Starmark CPD,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Aetna Medicare,Aetna Medicare,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Ambetter ,Ambetter ,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Blue Access,Anthem Blue Access,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Blue Access Choice,Anthem Blue Access Choice,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Blue Preferred,Anthem Blue Preferred,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Pathway,Anthem Pathway,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Alliance,Anthem Alliance,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Anthem Medicare,Anthem Medicare,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Cigna,Cigna,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Cigna PPO,Cigna PPO,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Cigna Medicare Advantage,Cigna Medicare Advantage,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Essence,Essence,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Healthlink HMO,Healthlink HMO,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Healthlink PPO,Healthlink PPO,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,HomeState Health Plan,HomeState Health Plan,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Humana Gold,Humana Gold,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Medicaid MO,Medicaid MO,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Medica,Medica,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Tricare,Tricare,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,UHC All Payer,UHC All Payer,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,UHC Exchange,UHC Exchange,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,UHC Medicaid,UHC Medicaid,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,UMR CPD,UMR CPD,64.7,,,,,,,per diem,64.7,64.7,"Per diem rate, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,UHC Medicare,UHC Medicare,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
"RGNCONV-ANKLE-FOOT ORTHOSIS, M",38270015,CDM,300,RC,,,,,,Inpatient,,,64.7,64.7,Wellcare,Wellcare,64.7,,,,,,,case rate,64.7,64.7,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Meritain Health PPO CPD,Meritain Health PPO CPD,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Aetna/Commercial Product,Aetna/Commercial Product,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Meritain Health CPD,Meritain Health CPD,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Starmark CPD,Starmark CPD,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Aetna Medicare,Aetna Medicare,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Ambetter ,Ambetter ,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Blue Access,Anthem Blue Access,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Blue Access Choice,Anthem Blue Access Choice,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Blue Preferred,Anthem Blue Preferred,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Pathway,Anthem Pathway,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Alliance,Anthem Alliance,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Anthem Medicare,Anthem Medicare,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Cigna,Cigna,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Cigna PPO,Cigna PPO,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Cigna Medicare Advantage,Cigna Medicare Advantage,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Essence,Essence,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Healthlink HMO,Healthlink HMO,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Healthlink PPO,Healthlink PPO,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,HomeState Health Plan,HomeState Health Plan,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Humana Gold,Humana Gold,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Medicaid MO,Medicaid MO,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Medica,Medica,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Tricare,Tricare,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,UHC All Payer,UHC All Payer,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,UHC Exchange,UHC Exchange,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,UHC Medicaid,UHC Medicaid,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,UMR CPD,UMR CPD,372.35,,,,,,,per diem,372.35,372.35,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,UHC Medicare,UHC Medicare,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT ARM  ,38270016,CDM,300,RC,,,,,,Inpatient,,,372.35,372.35,Wellcare,Wellcare,372.35,,,,,,,case rate,372.35,372.35,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Meritain Health PPO CPD,Meritain Health PPO CPD,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Aetna/Commercial Product,Aetna/Commercial Product,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Meritain Health CPD,Meritain Health CPD,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Starmark CPD,Starmark CPD,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Aetna Medicare,Aetna Medicare,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Ambetter ,Ambetter ,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Blue Access,Anthem Blue Access,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Blue Access Choice,Anthem Blue Access Choice,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Blue Preferred,Anthem Blue Preferred,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Pathway,Anthem Pathway,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Alliance,Anthem Alliance,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Anthem Medicare,Anthem Medicare,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Cigna,Cigna,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Cigna PPO,Cigna PPO,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Cigna Medicare Advantage,Cigna Medicare Advantage,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Essence,Essence,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Healthlink HMO,Healthlink HMO,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Healthlink PPO,Healthlink PPO,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,HomeState Health Plan,HomeState Health Plan,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Humana Gold,Humana Gold,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Medicaid MO,Medicaid MO,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Medica,Medica,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Tricare,Tricare,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,UHC All Payer,UHC All Payer,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,UHC Exchange,UHC Exchange,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,UHC Medicaid,UHC Medicaid,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,UMR CPD,UMR CPD,536.57,,,,,,,per diem,536.57,536.57,"Per diem rate, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,UHC Medicare,UHC Medicare,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-APPLY CAST SHORT LEG  ,38270017,CDM,300,RC,,,,,,Inpatient,,,536.57,536.57,Wellcare,Wellcare,536.57,,,,,,,case rate,536.57,536.57,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Meritain Health PPO CPD,Meritain Health PPO CPD,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Aetna/Commercial Product,Aetna/Commercial Product,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Meritain Health CPD,Meritain Health CPD,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Starmark CPD,Starmark CPD,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Aetna Medicare,Aetna Medicare,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Ambetter ,Ambetter ,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Blue Access,Anthem Blue Access,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Blue Access Choice,Anthem Blue Access Choice,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Blue Preferred,Anthem Blue Preferred,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Pathway,Anthem Pathway,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Alliance,Anthem Alliance,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Anthem Medicare,Anthem Medicare,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Cigna,Cigna,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Cigna PPO,Cigna PPO,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Cigna Medicare Advantage,Cigna Medicare Advantage,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Essence,Essence,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Healthlink HMO,Healthlink HMO,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Healthlink PPO,Healthlink PPO,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,HomeState Health Plan,HomeState Health Plan,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Humana Gold,Humana Gold,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Medicaid MO,Medicaid MO,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Medica,Medica,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Tricare,Tricare,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,UHC All Payer,UHC All Payer,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,UHC Exchange,UHC Exchange,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,UHC Medicaid,UHC Medicaid,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,UMR CPD,UMR CPD,28.28,,,,,,,per diem,28.28,28.28,"Per diem rate, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,UHC Medicare,UHC Medicare,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-AUTOMATED DIFF WBC COU,38270018,CDM,300,RC,,,,,,Inpatient,,,28.28,28.28,Wellcare,Wellcare,28.28,,,,,,,case rate,28.28,28.28,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Meritain Health PPO CPD,Meritain Health PPO CPD,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Aetna/Commercial Product,Aetna/Commercial Product,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Meritain Health CPD,Meritain Health CPD,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Starmark CPD,Starmark CPD,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Aetna Medicare,Aetna Medicare,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Ambetter ,Ambetter ,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Blue Access,Anthem Blue Access,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Blue Access Choice,Anthem Blue Access Choice,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Blue Preferred,Anthem Blue Preferred,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Pathway,Anthem Pathway,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Alliance,Anthem Alliance,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Anthem Medicare,Anthem Medicare,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Cigna,Cigna,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Cigna PPO,Cigna PPO,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Cigna Medicare Advantage,Cigna Medicare Advantage,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Essence,Essence,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Healthlink HMO,Healthlink HMO,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Healthlink PPO,Healthlink PPO,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,HomeState Health Plan,HomeState Health Plan,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Humana Gold,Humana Gold,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Medicaid MO,Medicaid MO,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Medica,Medica,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Tricare,Tricare,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,UHC All Payer,UHC All Payer,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,UHC Exchange,UHC Exchange,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,UHC Medicaid,UHC Medicaid,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,UMR CPD,UMR CPD,80.88,,,,,,,per diem,80.88,80.88,"Per diem rate, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,UHC Medicare,UHC Medicare,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BATH BENCH WITH BACK  ,38270019,CDM,300,RC,,,,,,Inpatient,,,80.88,80.88,Wellcare,Wellcare,80.88,,,,,,,case rate,80.88,80.88,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Meritain Health PPO CPD,Meritain Health PPO CPD,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Aetna/Commercial Product,Aetna/Commercial Product,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Meritain Health CPD,Meritain Health CPD,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Starmark CPD,Starmark CPD,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Aetna Medicare,Aetna Medicare,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Ambetter ,Ambetter ,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Blue Access,Anthem Blue Access,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Blue Access Choice,Anthem Blue Access Choice,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Blue Preferred,Anthem Blue Preferred,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Pathway,Anthem Pathway,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Alliance,Anthem Alliance,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Anthem Medicare,Anthem Medicare,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Cigna,Cigna,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Cigna PPO,Cigna PPO,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Cigna Medicare Advantage,Cigna Medicare Advantage,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Essence,Essence,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Healthlink HMO,Healthlink HMO,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Healthlink PPO,Healthlink PPO,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,HomeState Health Plan,HomeState Health Plan,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Humana Gold,Humana Gold,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Medicaid MO,Medicaid MO,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Medica,Medica,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Tricare,Tricare,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,UHC All Payer,UHC All Payer,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,UHC Exchange,UHC Exchange,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,UHC Medicaid,UHC Medicaid,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,UMR CPD,UMR CPD,424.09,,,,,,,per diem,424.09,424.09,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,UHC Medicare,UHC Medicare,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY FORCEPS        ,38270020,CDM,300,RC,,,,,,Inpatient,,,424.09,424.09,Wellcare,Wellcare,424.09,,,,,,,case rate,424.09,424.09,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Meritain Health PPO CPD,Meritain Health PPO CPD,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Aetna/Commercial Product,Aetna/Commercial Product,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Meritain Health CPD,Meritain Health CPD,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Starmark CPD,Starmark CPD,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Aetna Medicare,Aetna Medicare,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Ambetter ,Ambetter ,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Blue Access,Anthem Blue Access,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Blue Access Choice,Anthem Blue Access Choice,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Blue Preferred,Anthem Blue Preferred,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Pathway,Anthem Pathway,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Alliance,Anthem Alliance,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Anthem Medicare,Anthem Medicare,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Cigna,Cigna,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Cigna PPO,Cigna PPO,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Cigna Medicare Advantage,Cigna Medicare Advantage,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Essence,Essence,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Healthlink HMO,Healthlink HMO,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Healthlink PPO,Healthlink PPO,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,HomeState Health Plan,HomeState Health Plan,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Humana Gold,Humana Gold,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Medicaid MO,Medicaid MO,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Medica,Medica,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Tricare,Tricare,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,UHC All Payer,UHC All Payer,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,UHC Exchange,UHC Exchange,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,UHC Medicaid,UHC Medicaid,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,UMR CPD,UMR CPD,1477.94,,,,,,,per diem,1477.94,1477.94,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,UHC Medicare,UHC Medicare,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY MUSCLE PERCUTAN,38270021,CDM,300,RC,,,,,,Inpatient,,,1477.94,1477.94,Wellcare,Wellcare,1477.94,,,,,,,case rate,1477.94,1477.94,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Meritain Health PPO CPD,Meritain Health PPO CPD,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Aetna/Commercial Product,Aetna/Commercial Product,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Meritain Health CPD,Meritain Health CPD,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Starmark CPD,Starmark CPD,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Aetna Medicare,Aetna Medicare,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Ambetter ,Ambetter ,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Blue Access,Anthem Blue Access,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Blue Access Choice,Anthem Blue Access Choice,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Blue Preferred,Anthem Blue Preferred,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Pathway,Anthem Pathway,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Alliance,Anthem Alliance,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Anthem Medicare,Anthem Medicare,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Cigna,Cigna,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Cigna PPO,Cigna PPO,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Cigna Medicare Advantage,Cigna Medicare Advantage,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Essence,Essence,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Healthlink HMO,Healthlink HMO,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Healthlink PPO,Healthlink PPO,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,HomeState Health Plan,HomeState Health Plan,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Humana Gold,Humana Gold,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Medicaid MO,Medicaid MO,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Medica,Medica,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Tricare,Tricare,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,UHC All Payer,UHC All Payer,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,UHC Exchange,UHC Exchange,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,UHC Medicaid,UHC Medicaid,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,UMR CPD,UMR CPD,1050.53,,,,,,,per diem,1050.53,1050.53,"Per diem rate, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,UHC Medicare,UHC Medicare,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BIOPSY/EXCISE LYMPH NO,38270022,CDM,300,RC,,,,,,Inpatient,,,1050.53,1050.53,Wellcare,Wellcare,1050.53,,,,,,,case rate,1050.53,1050.53,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Meritain Health PPO CPD,Meritain Health PPO CPD,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Aetna/Commercial Product,Aetna/Commercial Product,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Meritain Health CPD,Meritain Health CPD,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Starmark CPD,Starmark CPD,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Aetna Medicare,Aetna Medicare,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Ambetter ,Ambetter ,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Blue Access,Anthem Blue Access,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Blue Access Choice,Anthem Blue Access Choice,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Blue Preferred,Anthem Blue Preferred,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Pathway,Anthem Pathway,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Alliance,Anthem Alliance,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Anthem Medicare,Anthem Medicare,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Cigna,Cigna,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Cigna PPO,Cigna PPO,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Cigna Medicare Advantage,Cigna Medicare Advantage,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Essence,Essence,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Healthlink HMO,Healthlink HMO,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Healthlink PPO,Healthlink PPO,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,HomeState Health Plan,HomeState Health Plan,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Humana Gold,Humana Gold,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Medicaid MO,Medicaid MO,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Medica,Medica,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Tricare,Tricare,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,UHC All Payer,UHC All Payer,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,UHC Exchange,UHC Exchange,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,UHC Medicaid,UHC Medicaid,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,UMR CPD,UMR CPD,187.36,,,,,,,per diem,187.36,187.36,"Per diem rate, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,UHC Medicare,UHC Medicare,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
RGNCONV-BK VIRUS QUANTITATIVE ,38270023,CDM,300,RC,,,,,,Inpatient,,,187.36,187.36,Wellcare,Wellcare,187.36,,,,,,,case rate,187.36,187.36,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Meritain Health PPO CPD,Meritain Health PPO CPD,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Aetna/Commercial Product,Aetna/Commercial Product,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Meritain Health CPD,Meritain Health CPD,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Starmark CPD,Starmark CPD,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Aetna Medicare,Aetna Medicare,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Ambetter ,Ambetter ,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Blue Access,Anthem Blue Access,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Blue Access Choice,Anthem Blue Access Choice,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Blue Preferred,Anthem Blue Preferred,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Pathway,Anthem Pathway,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Alliance,Anthem Alliance,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Anthem Medicare,Anthem Medicare,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Cigna,Cigna,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Cigna PPO,Cigna PPO,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Cigna Medicare Advantage,Cigna Medicare Advantage,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Essence,Essence,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Healthlink HMO,Healthlink HMO,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Healthlink PPO,Healthlink PPO,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,HomeState Health Plan,HomeState Health Plan,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Humana Gold,Humana Gold,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Medicaid MO,Medicaid MO,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Medica,Medica,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Tricare,Tricare,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,UHC All Payer,UHC All Payer,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,UHC Exchange,UHC Exchange,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,UHC Medicaid,UHC Medicaid,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,UMR CPD,UMR CPD,42.21,,,,,,,per diem,42.21,42.21,"Per diem rate, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,UHC Medicare,UHC Medicare,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
"RGNCONV-BODY SOCK, PROTECTIVE,",38270024,CDM,300,RC,,,,,,Inpatient,,,42.21,42.21,Wellcare,Wellcare,42.21,,,,,,,case rate,42.21,42.21,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Meritain Health PPO CPD,Meritain Health PPO CPD,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Aetna/Commercial Product,Aetna/Commercial Product,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Meritain Health CPD,Meritain Health CPD,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Starmark CPD,Starmark CPD,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Aetna Medicare,Aetna Medicare,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Ambetter ,Ambetter ,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Blue Access,Anthem Blue Access,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Blue Access Choice,Anthem Blue Access Choice,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Blue Preferred,Anthem Blue Preferred,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Pathway,Anthem Pathway,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Alliance,Anthem Alliance,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Anthem Medicare,Anthem Medicare,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Cigna,Cigna,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Cigna PPO,Cigna PPO,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Cigna Medicare Advantage,Cigna Medicare Advantage,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Essence,Essence,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Healthlink HMO,Healthlink HMO,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Healthlink PPO,Healthlink PPO,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,HomeState Health Plan,HomeState Health Plan,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Humana Gold,Humana Gold,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Medicaid MO,Medicaid MO,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Medica,Medica,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Tricare,Tricare,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,UHC All Payer,UHC All Payer,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,UHC Exchange,UHC Exchange,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,UHC Medicaid,UHC Medicaid,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,UMR CPD,UMR CPD,76.37,,,,,,,per diem,76.37,76.37,"Per diem rate, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,UHC Medicare,UHC Medicare,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CANE QUAD LARGE BASE  ,38270025,CDM,300,RC,,,,,,Inpatient,,,76.37,76.37,Wellcare,Wellcare,76.37,,,,,,,case rate,76.37,76.37,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Meritain Health PPO CPD,Meritain Health PPO CPD,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Aetna/Commercial Product,Aetna/Commercial Product,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Meritain Health CPD,Meritain Health CPD,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Starmark CPD,Starmark CPD,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Aetna Medicare,Aetna Medicare,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Ambetter ,Ambetter ,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Blue Access,Anthem Blue Access,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Blue Access Choice,Anthem Blue Access Choice,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Blue Preferred,Anthem Blue Preferred,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Pathway,Anthem Pathway,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Alliance,Anthem Alliance,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Anthem Medicare,Anthem Medicare,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Cigna,Cigna,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Cigna PPO,Cigna PPO,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Cigna Medicare Advantage,Cigna Medicare Advantage,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Essence,Essence,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Healthlink HMO,Healthlink HMO,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Healthlink PPO,Healthlink PPO,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,HomeState Health Plan,HomeState Health Plan,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Humana Gold,Humana Gold,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Medicaid MO,Medicaid MO,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Medica,Medica,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Tricare,Tricare,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,UHC All Payer,UHC All Payer,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,UHC Exchange,UHC Exchange,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,UHC Medicaid,UHC Medicaid,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,UMR CPD,UMR CPD,49.49,,,,,,,per diem,49.49,49.49,"Per diem rate, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,UHC Medicare,UHC Medicare,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
RGNCONV-CATH                  ,38270026,CDM,300,RC,,,,,,Inpatient,,,49.49,49.49,Wellcare,Wellcare,49.49,,,,,,,case rate,49.49,49.49,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Meritain Health PPO CPD,Meritain Health PPO CPD,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Aetna/Commercial Product,Aetna/Commercial Product,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Meritain Health CPD,Meritain Health CPD,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Starmark CPD,Starmark CPD,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Aetna Medicare,Aetna Medicare,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Ambetter ,Ambetter ,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Blue Access,Anthem Blue Access,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Blue Access Choice,Anthem Blue Access Choice,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Blue Preferred,Anthem Blue Preferred,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Pathway,Anthem Pathway,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Alliance,Anthem Alliance,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Anthem Medicare,Anthem Medicare,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Cigna,Cigna,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Cigna PPO,Cigna PPO,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Cigna Medicare Advantage,Cigna Medicare Advantage,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Essence,Essence,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Healthlink HMO,Healthlink HMO,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Healthlink PPO,Healthlink PPO,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,HomeState Health Plan,HomeState Health Plan,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Humana Gold,Humana Gold,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Medicaid MO,Medicaid MO,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Medica,Medica,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Tricare,Tricare,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,UHC All Payer,UHC All Payer,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,UHC Exchange,UHC Exchange,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,UHC Medicaid,UHC Medicaid,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,UMR CPD,UMR CPD,122.65,,,,,,,per diem,122.65,122.65,"Per diem rate, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,UHC Medicare,UHC Medicare,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
"RGNCONV-CATH, GLIDE           ",38270027,CDM,300,RC,,,,,,Inpatient,,,122.65,122.65,Wellcare,Wellcare,122.65,,,,,,,case rate,122.65,122.65,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Meritain Health PPO CPD,Meritain Health PPO CPD,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Aetna/Commercial Product,Aetna/Commercial Product,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Meritain Health CPD,Meritain Health CPD,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Starmark CPD,Starmark CPD,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Aetna Medicare,Aetna Medicare,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Ambetter ,Ambetter ,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Blue Access,Anthem Blue Access,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Blue Access Choice,Anthem Blue Access Choice,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Blue Preferred,Anthem Blue Preferred,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Pathway,Anthem Pathway,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Alliance,Anthem Alliance,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Anthem Medicare,Anthem Medicare,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Cigna,Cigna,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Cigna PPO,Cigna PPO,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Cigna Medicare Advantage,Cigna Medicare Advantage,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Essence,Essence,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Healthlink HMO,Healthlink HMO,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Healthlink PPO,Healthlink PPO,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,HomeState Health Plan,HomeState Health Plan,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Humana Gold,Humana Gold,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Medicaid MO,Medicaid MO,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Medica,Medica,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Tricare,Tricare,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,UHC All Payer,UHC All Payer,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,UHC Exchange,UHC Exchange,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,UHC Medicaid,UHC Medicaid,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,UMR CPD,UMR CPD,167.64,,,,,,,per diem,167.64,167.64,"Per diem rate, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,UHC Medicare,UHC Medicare,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
RGNCONV-CATHETER RIGHT HEART  ,38270028,CDM,300,RC,,,,,,Inpatient,,,167.64,167.64,Wellcare,Wellcare,167.64,,,,,,,case rate,167.64,167.64,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Meritain Health PPO CPD,Meritain Health PPO CPD,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Aetna/Commercial Product,Aetna/Commercial Product,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Meritain Health CPD,Meritain Health CPD,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Starmark CPD,Starmark CPD,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Aetna Medicare,Aetna Medicare,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Ambetter ,Ambetter ,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Blue Access,Anthem Blue Access,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Blue Access Choice,Anthem Blue Access Choice,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Blue Preferred,Anthem Blue Preferred,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Pathway,Anthem Pathway,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Alliance,Anthem Alliance,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Anthem Medicare,Anthem Medicare,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Cigna,Cigna,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Cigna PPO,Cigna PPO,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Cigna Medicare Advantage,Cigna Medicare Advantage,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Essence,Essence,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Healthlink HMO,Healthlink HMO,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Healthlink PPO,Healthlink PPO,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,HomeState Health Plan,HomeState Health Plan,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Humana Gold,Humana Gold,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Medicaid MO,Medicaid MO,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Medica,Medica,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Tricare,Tricare,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,UHC All Payer,UHC All Payer,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,UHC Exchange,UHC Exchange,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,UHC Medicaid,UHC Medicaid,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,UMR CPD,UMR CPD,137.22,,,,,,,per diem,137.22,137.22,"Per diem rate, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,UHC Medicare,UHC Medicare,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
"RGNCONV-CERVICAL COLLAR, MIAMI",38270029,CDM,300,RC,,,,,,Inpatient,,,137.22,137.22,Wellcare,Wellcare,137.22,,,,,,,case rate,137.22,137.22,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Meritain Health PPO CPD,Meritain Health PPO CPD,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Aetna/Commercial Product,Aetna/Commercial Product,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Meritain Health CPD,Meritain Health CPD,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Starmark CPD,Starmark CPD,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Aetna Medicare,Aetna Medicare,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Ambetter ,Ambetter ,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Blue Access,Anthem Blue Access,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Blue Access Choice,Anthem Blue Access Choice,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Blue Preferred,Anthem Blue Preferred,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Pathway,Anthem Pathway,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Alliance,Anthem Alliance,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Anthem Medicare,Anthem Medicare,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Cigna,Cigna,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Cigna PPO,Cigna PPO,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Cigna Medicare Advantage,Cigna Medicare Advantage,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Essence,Essence,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Healthlink HMO,Healthlink HMO,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Healthlink PPO,Healthlink PPO,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,HomeState Health Plan,HomeState Health Plan,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Humana Gold,Humana Gold,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Medicaid MO,Medicaid MO,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Medica,Medica,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Tricare,Tricare,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,UHC All Payer,UHC All Payer,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,UHC Exchange,UHC Exchange,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,UHC Medicaid,UHC Medicaid,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,UMR CPD,UMR CPD,2297.89,,,,,,,per diem,2297.89,2297.89,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,UHC Medicare,UHC Medicare,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE GASTROSTOMY TUB,38270030,CDM,300,RC,,,,,,Inpatient,,,2297.89,2297.89,Wellcare,Wellcare,2297.89,,,,,,,case rate,2297.89,2297.89,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Meritain Health PPO CPD,Meritain Health PPO CPD,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Aetna/Commercial Product,Aetna/Commercial Product,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Meritain Health CPD,Meritain Health CPD,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Starmark CPD,Starmark CPD,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Aetna Medicare,Aetna Medicare,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Ambetter ,Ambetter ,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Blue Access,Anthem Blue Access,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Blue Access Choice,Anthem Blue Access Choice,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Blue Preferred,Anthem Blue Preferred,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Pathway,Anthem Pathway,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Alliance,Anthem Alliance,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Anthem Medicare,Anthem Medicare,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Cigna,Cigna,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Cigna PPO,Cigna PPO,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Cigna Medicare Advantage,Cigna Medicare Advantage,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Essence,Essence,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Healthlink HMO,Healthlink HMO,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Healthlink PPO,Healthlink PPO,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,HomeState Health Plan,HomeState Health Plan,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Humana Gold,Humana Gold,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Medicaid MO,Medicaid MO,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Medica,Medica,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Tricare,Tricare,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,UHC All Payer,UHC All Payer,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,UHC Exchange,UHC Exchange,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,UHC Medicaid,UHC Medicaid,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,UMR CPD,UMR CPD,2297.94,,,,,,,per diem,2297.94,2297.94,"Per diem rate, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,UHC Medicare,UHC Medicare,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHANGE G-J TUBE W/ FLU,38270031,CDM,300,RC,,,,,,Inpatient,,,2297.94,2297.94,Wellcare,Wellcare,2297.94,,,,,,,case rate,2297.94,2297.94,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Meritain Health PPO CPD,Meritain Health PPO CPD,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Aetna/Commercial Product,Aetna/Commercial Product,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Meritain Health CPD,Meritain Health CPD,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Starmark CPD,Starmark CPD,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Aetna Medicare,Aetna Medicare,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Ambetter ,Ambetter ,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Blue Access,Anthem Blue Access,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Blue Access Choice,Anthem Blue Access Choice,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Blue Preferred,Anthem Blue Preferred,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Pathway,Anthem Pathway,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Alliance,Anthem Alliance,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Anthem Medicare,Anthem Medicare,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Cigna,Cigna,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Cigna PPO,Cigna PPO,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Cigna Medicare Advantage,Cigna Medicare Advantage,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Essence,Essence,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Healthlink HMO,Healthlink HMO,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Healthlink PPO,Healthlink PPO,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,HomeState Health Plan,HomeState Health Plan,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Humana Gold,Humana Gold,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Medicaid MO,Medicaid MO,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Medica,Medica,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Tricare,Tricare,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,UHC All Payer,UHC All Payer,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,UHC Exchange,UHC Exchange,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,UHC Medicaid,UHC Medicaid,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,UMR CPD,UMR CPD,355.42,,,,,,,per diem,355.42,355.42,"Per diem rate, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,UHC Medicare,UHC Medicare,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CHEMO INJ SQ/IM NON-HO,38270032,CDM,300,RC,,,,,,Inpatient,,,355.42,355.42,Wellcare,Wellcare,355.42,,,,,,,case rate,355.42,355.42,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Meritain Health PPO CPD,Meritain Health PPO CPD,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Aetna/Commercial Product,Aetna/Commercial Product,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Meritain Health CPD,Meritain Health CPD,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Starmark CPD,Starmark CPD,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Aetna Medicare,Aetna Medicare,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Ambetter ,Ambetter ,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Blue Access,Anthem Blue Access,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Blue Access Choice,Anthem Blue Access Choice,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Blue Preferred,Anthem Blue Preferred,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Pathway,Anthem Pathway,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Alliance,Anthem Alliance,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Anthem Medicare,Anthem Medicare,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Cigna,Cigna,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Cigna PPO,Cigna PPO,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Cigna Medicare Advantage,Cigna Medicare Advantage,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Essence,Essence,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Healthlink HMO,Healthlink HMO,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Healthlink PPO,Healthlink PPO,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,HomeState Health Plan,HomeState Health Plan,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Humana Gold,Humana Gold,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Medicaid MO,Medicaid MO,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Medica,Medica,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Tricare,Tricare,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,UHC All Payer,UHC All Payer,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,UHC Exchange,UHC Exchange,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,UHC Medicaid,UHC Medicaid,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,UMR CPD,UMR CPD,143.97,,,,,,,per diem,143.97,143.97,"Per diem rate, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,UHC Medicare,UHC Medicare,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CORE NEEDLE           ,38270033,CDM,300,RC,,,,,,Inpatient,,,143.97,143.97,Wellcare,Wellcare,143.97,,,,,,,case rate,143.97,143.97,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Meritain Health PPO CPD,Meritain Health PPO CPD,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Aetna/Commercial Product,Aetna/Commercial Product,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Meritain Health CPD,Meritain Health CPD,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Starmark CPD,Starmark CPD,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Aetna Medicare,Aetna Medicare,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Ambetter ,Ambetter ,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Blue Access,Anthem Blue Access,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Blue Access Choice,Anthem Blue Access Choice,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Blue Preferred,Anthem Blue Preferred,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Pathway,Anthem Pathway,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Alliance,Anthem Alliance,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Anthem Medicare,Anthem Medicare,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Cigna,Cigna,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Cigna PPO,Cigna PPO,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Cigna Medicare Advantage,Cigna Medicare Advantage,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Essence,Essence,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Healthlink HMO,Healthlink HMO,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Healthlink PPO,Healthlink PPO,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,HomeState Health Plan,HomeState Health Plan,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Humana Gold,Humana Gold,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Medicaid MO,Medicaid MO,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Medica,Medica,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Tricare,Tricare,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,UHC All Payer,UHC All Payer,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,UHC Exchange,UHC Exchange,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,UHC Medicaid,UHC Medicaid,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,UMR CPD,UMR CPD,140.65,,,,,,,per diem,140.65,140.65,"Per diem rate, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,UHC Medicare,UHC Medicare,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-CTO REPLACEMENT PAD   ,38270034,CDM,300,RC,,,,,,Inpatient,,,140.65,140.65,Wellcare,Wellcare,140.65,,,,,,,case rate,140.65,140.65,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Meritain Health PPO CPD,Meritain Health PPO CPD,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Aetna/Commercial Product,Aetna/Commercial Product,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Meritain Health CPD,Meritain Health CPD,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Starmark CPD,Starmark CPD,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Aetna Medicare,Aetna Medicare,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Ambetter ,Ambetter ,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Blue Access,Anthem Blue Access,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Blue Access Choice,Anthem Blue Access Choice,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Blue Preferred,Anthem Blue Preferred,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Pathway,Anthem Pathway,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Alliance,Anthem Alliance,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Anthem Medicare,Anthem Medicare,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Cigna,Cigna,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Cigna PPO,Cigna PPO,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Cigna Medicare Advantage,Cigna Medicare Advantage,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Essence,Essence,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Healthlink HMO,Healthlink HMO,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Healthlink PPO,Healthlink PPO,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,HomeState Health Plan,HomeState Health Plan,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Humana Gold,Humana Gold,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Medicaid MO,Medicaid MO,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Medica,Medica,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Tricare,Tricare,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,UHC All Payer,UHC All Payer,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,UHC Exchange,UHC Exchange,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,UHC Medicaid,UHC Medicaid,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,UMR CPD,UMR CPD,15.1,,,,,,,per diem,15.1,15.1,"Per diem rate, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,UHC Medicare,UHC Medicare,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-DILATOR               ,38270035,CDM,300,RC,,,,,,Inpatient,,,15.1,15.1,Wellcare,Wellcare,15.1,,,,,,,case rate,15.1,15.1,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Meritain Health PPO CPD,Meritain Health PPO CPD,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Aetna/Commercial Product,Aetna/Commercial Product,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Meritain Health CPD,Meritain Health CPD,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Starmark CPD,Starmark CPD,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Aetna Medicare,Aetna Medicare,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Ambetter ,Ambetter ,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Blue Access,Anthem Blue Access,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Blue Access Choice,Anthem Blue Access Choice,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Blue Preferred,Anthem Blue Preferred,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Pathway,Anthem Pathway,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Alliance,Anthem Alliance,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Anthem Medicare,Anthem Medicare,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Cigna,Cigna,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Cigna PPO,Cigna PPO,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Cigna Medicare Advantage,Cigna Medicare Advantage,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Essence,Essence,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Healthlink HMO,Healthlink HMO,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Healthlink PPO,Healthlink PPO,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,HomeState Health Plan,HomeState Health Plan,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Humana Gold,Humana Gold,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Medicaid MO,Medicaid MO,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Medica,Medica,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Tricare,Tricare,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,UHC All Payer,UHC All Payer,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,UHC Exchange,UHC Exchange,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,UHC Medicaid,UHC Medicaid,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,UMR CPD,UMR CPD,1886.22,,,,,,,per diem,1886.22,1886.22,"Per diem rate, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,UHC Medicare,UHC Medicare,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ED LEVEL 4 VISIT      ,38270036,CDM,300,RC,,,,,,Inpatient,,,1886.22,1886.22,Wellcare,Wellcare,1886.22,,,,,,,case rate,1886.22,1886.22,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Meritain Health PPO CPD,Meritain Health PPO CPD,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Aetna/Commercial Product,Aetna/Commercial Product,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Meritain Health CPD,Meritain Health CPD,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Starmark CPD,Starmark CPD,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Aetna Medicare,Aetna Medicare,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Ambetter ,Ambetter ,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Blue Access,Anthem Blue Access,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Blue Access Choice,Anthem Blue Access Choice,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Blue Preferred,Anthem Blue Preferred,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Pathway,Anthem Pathway,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Alliance,Anthem Alliance,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Anthem Medicare,Anthem Medicare,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Cigna,Cigna,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Cigna PPO,Cigna PPO,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Cigna Medicare Advantage,Cigna Medicare Advantage,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Essence,Essence,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Healthlink HMO,Healthlink HMO,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Healthlink PPO,Healthlink PPO,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,HomeState Health Plan,HomeState Health Plan,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Humana Gold,Humana Gold,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Medicaid MO,Medicaid MO,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Medica,Medica,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Tricare,Tricare,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,UHC All Payer,UHC All Payer,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,UHC Exchange,UHC Exchange,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,UHC Medicaid,UHC Medicaid,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,UMR CPD,UMR CPD,4571.03,,,,,,,per diem,4571.03,4571.03,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,UHC Medicare,UHC Medicare,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOMYOCARDIAL BIOPSY ,38270037,CDM,300,RC,,,,,,Inpatient,,,4571.03,4571.03,Wellcare,Wellcare,4571.03,,,,,,,case rate,4571.03,4571.03,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Meritain Health PPO CPD,Meritain Health PPO CPD,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Aetna/Commercial Product,Aetna/Commercial Product,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Meritain Health CPD,Meritain Health CPD,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Starmark CPD,Starmark CPD,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Aetna Medicare,Aetna Medicare,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Ambetter ,Ambetter ,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Blue Access,Anthem Blue Access,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Blue Access Choice,Anthem Blue Access Choice,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Blue Preferred,Anthem Blue Preferred,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Pathway,Anthem Pathway,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Alliance,Anthem Alliance,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Anthem Medicare,Anthem Medicare,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Cigna,Cigna,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Cigna PPO,Cigna PPO,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Cigna Medicare Advantage,Cigna Medicare Advantage,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Essence,Essence,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Healthlink HMO,Healthlink HMO,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Healthlink PPO,Healthlink PPO,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,HomeState Health Plan,HomeState Health Plan,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Humana Gold,Humana Gold,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Medicaid MO,Medicaid MO,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Medica,Medica,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Tricare,Tricare,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,UHC All Payer,UHC All Payer,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,UHC Exchange,UHC Exchange,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,UHC Medicaid,UHC Medicaid,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,UMR CPD,UMR CPD,456.65,,,,,,,per diem,456.65,456.65,"Per diem rate, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,UHC Medicare,UHC Medicare,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-ENDOSCOPY NASAL DIAGNO,38270038,CDM,300,RC,,,,,,Inpatient,,,456.65,456.65,Wellcare,Wellcare,456.65,,,,,,,case rate,456.65,456.65,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Meritain Health PPO CPD,Meritain Health PPO CPD,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Aetna/Commercial Product,Aetna/Commercial Product,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Meritain Health CPD,Meritain Health CPD,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Starmark CPD,Starmark CPD,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Aetna Medicare,Aetna Medicare,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Ambetter ,Ambetter ,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Blue Access,Anthem Blue Access,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Blue Access Choice,Anthem Blue Access Choice,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Blue Preferred,Anthem Blue Preferred,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Pathway,Anthem Pathway,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Alliance,Anthem Alliance,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Anthem Medicare,Anthem Medicare,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Cigna,Cigna,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Cigna PPO,Cigna PPO,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Cigna Medicare Advantage,Cigna Medicare Advantage,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Essence,Essence,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Healthlink HMO,Healthlink HMO,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Healthlink PPO,Healthlink PPO,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,HomeState Health Plan,HomeState Health Plan,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Humana Gold,Humana Gold,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Medicaid MO,Medicaid MO,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Medica,Medica,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Tricare,Tricare,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,UHC All Payer,UHC All Payer,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,UHC Exchange,UHC Exchange,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,UHC Medicaid,UHC Medicaid,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,UMR CPD,UMR CPD,71.45,,,,,,,per diem,71.45,71.45,"Per diem rate, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,UHC Medicare,UHC Medicare,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
RGNCONV-EVEROLIMUS            ,38270039,CDM,300,RC,,,,,,Inpatient,,,71.45,71.45,Wellcare,Wellcare,71.45,,,,,,,case rate,71.45,71.45,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Meritain Health PPO CPD,Meritain Health PPO CPD,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Aetna/Commercial Product,Aetna/Commercial Product,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Meritain Health CPD,Meritain Health CPD,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Starmark CPD,Starmark CPD,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Aetna Medicare,Aetna Medicare,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Ambetter ,Ambetter ,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Blue Access,Anthem Blue Access,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Blue Access Choice,Anthem Blue Access Choice,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Blue Preferred,Anthem Blue Preferred,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Pathway,Anthem Pathway,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Alliance,Anthem Alliance,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Anthem Medicare,Anthem Medicare,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Cigna,Cigna,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Cigna PPO,Cigna PPO,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Cigna Medicare Advantage,Cigna Medicare Advantage,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Essence,Essence,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Healthlink HMO,Healthlink HMO,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Healthlink PPO,Healthlink PPO,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,HomeState Health Plan,HomeState Health Plan,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Humana Gold,Humana Gold,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Medicaid MO,Medicaid MO,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Medica,Medica,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Tricare,Tricare,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,UHC All Payer,UHC All Payer,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,UHC Exchange,UHC Exchange,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,UHC Medicaid,UHC Medicaid,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,UMR CPD,UMR CPD,3289.97,,,,,,,per diem,3289.97,3289.97,"Per diem rate, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,UHC Medicare,UHC Medicare,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
"RGNCONV-FILTER, VENATECH      ",38270040,CDM,300,RC,,,,,,Inpatient,,,3289.97,3289.97,Wellcare,Wellcare,3289.97,,,,,,,case rate,3289.97,3289.97,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Meritain Health PPO CPD,Meritain Health PPO CPD,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Aetna/Commercial Product,Aetna/Commercial Product,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Meritain Health CPD,Meritain Health CPD,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Starmark CPD,Starmark CPD,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Aetna Medicare,Aetna Medicare,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Ambetter ,Ambetter ,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Blue Access,Anthem Blue Access,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Blue Access Choice,Anthem Blue Access Choice,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Blue Preferred,Anthem Blue Preferred,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Pathway,Anthem Pathway,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Alliance,Anthem Alliance,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Anthem Medicare,Anthem Medicare,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Cigna,Cigna,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Cigna PPO,Cigna PPO,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Cigna Medicare Advantage,Cigna Medicare Advantage,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Essence,Essence,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Healthlink HMO,Healthlink HMO,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Healthlink PPO,Healthlink PPO,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,HomeState Health Plan,HomeState Health Plan,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Humana Gold,Humana Gold,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Medicaid MO,Medicaid MO,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Medica,Medica,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Tricare,Tricare,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,UHC All Payer,UHC All Payer,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,UHC Exchange,UHC Exchange,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,UHC Medicaid,UHC Medicaid,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,UMR CPD,UMR CPD,560.99,,,,,,,per diem,560.99,560.99,"Per diem rate, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,UHC Medicare,UHC Medicare,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLU/RSV BY PCR        ,38270041,CDM,300,RC,,,,,,Inpatient,,,560.99,560.99,Wellcare,Wellcare,560.99,,,,,,,case rate,560.99,560.99,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Meritain Health PPO CPD,Meritain Health PPO CPD,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Aetna/Commercial Product,Aetna/Commercial Product,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Meritain Health CPD,Meritain Health CPD,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Starmark CPD,Starmark CPD,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Aetna Medicare,Aetna Medicare,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Ambetter ,Ambetter ,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Blue Access,Anthem Blue Access,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Blue Access Choice,Anthem Blue Access Choice,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Blue Preferred,Anthem Blue Preferred,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Pathway,Anthem Pathway,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Alliance,Anthem Alliance,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Anthem Medicare,Anthem Medicare,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Cigna,Cigna,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Cigna PPO,Cigna PPO,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Cigna Medicare Advantage,Cigna Medicare Advantage,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Essence,Essence,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Healthlink HMO,Healthlink HMO,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Healthlink PPO,Healthlink PPO,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,HomeState Health Plan,HomeState Health Plan,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Humana Gold,Humana Gold,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Medicaid MO,Medicaid MO,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Medica,Medica,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Tricare,Tricare,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,UHC All Payer,UHC All Payer,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,UHC Exchange,UHC Exchange,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,UHC Medicaid,UHC Medicaid,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,UMR CPD,UMR CPD,22.81,,,,,,,per diem,22.81,22.81,"Per diem rate, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,UHC Medicare,UHC Medicare,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUID DUMP SYSTEM     ,38270042,CDM,300,RC,,,,,,Inpatient,,,22.81,22.81,Wellcare,Wellcare,22.81,,,,,,,case rate,22.81,22.81,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Meritain Health PPO CPD,Meritain Health PPO CPD,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Aetna/Commercial Product,Aetna/Commercial Product,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Meritain Health CPD,Meritain Health CPD,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Starmark CPD,Starmark CPD,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Aetna Medicare,Aetna Medicare,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Ambetter ,Ambetter ,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Blue Access,Anthem Blue Access,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Blue Access Choice,Anthem Blue Access Choice,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Blue Preferred,Anthem Blue Preferred,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Pathway,Anthem Pathway,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Alliance,Anthem Alliance,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Anthem Medicare,Anthem Medicare,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Cigna,Cigna,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Cigna PPO,Cigna PPO,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Cigna Medicare Advantage,Cigna Medicare Advantage,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Essence,Essence,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Healthlink HMO,Healthlink HMO,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Healthlink PPO,Healthlink PPO,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,HomeState Health Plan,HomeState Health Plan,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Humana Gold,Humana Gold,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Medicaid MO,Medicaid MO,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Medica,Medica,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Tricare,Tricare,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,UHC All Payer,UHC All Payer,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,UHC Exchange,UHC Exchange,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,UHC Medicaid,UHC Medicaid,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,UMR CPD,UMR CPD,647.86,,,,,,,per diem,647.86,647.86,"Per diem rate, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,UHC Medicare,UHC Medicare,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FLUORSCN ANGIO* ICG/FL,38270043,CDM,300,RC,,,,,,Inpatient,,,647.86,647.86,Wellcare,Wellcare,647.86,,,,,,,case rate,647.86,647.86,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Meritain Health PPO CPD,Meritain Health PPO CPD,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Aetna/Commercial Product,Aetna/Commercial Product,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Meritain Health CPD,Meritain Health CPD,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Starmark CPD,Starmark CPD,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Aetna Medicare,Aetna Medicare,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Ambetter ,Ambetter ,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Blue Access,Anthem Blue Access,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Blue Access Choice,Anthem Blue Access Choice,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Blue Preferred,Anthem Blue Preferred,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Pathway,Anthem Pathway,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Alliance,Anthem Alliance,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Anthem Medicare,Anthem Medicare,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Cigna,Cigna,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Cigna PPO,Cigna PPO,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Cigna Medicare Advantage,Cigna Medicare Advantage,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Essence,Essence,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Healthlink HMO,Healthlink HMO,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Healthlink PPO,Healthlink PPO,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,HomeState Health Plan,HomeState Health Plan,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Humana Gold,Humana Gold,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Medicaid MO,Medicaid MO,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Medica,Medica,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Tricare,Tricare,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,UHC All Payer,UHC All Payer,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,UHC Exchange,UHC Exchange,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,UHC Medicaid,UHC Medicaid,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,UMR CPD,UMR CPD,178.89,,,,,,,per diem,178.89,178.89,"Per diem rate, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,UHC Medicare,UHC Medicare,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
RGNCONV-FUNDUS PHOTOS 1 - 2   ,38270044,CDM,300,RC,,,,,,Inpatient,,,178.89,178.89,Wellcare,Wellcare,178.89,,,,,,,case rate,178.89,178.89,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Meritain Health PPO CPD,Meritain Health PPO CPD,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Aetna/Commercial Product,Aetna/Commercial Product,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Meritain Health CPD,Meritain Health CPD,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Starmark CPD,Starmark CPD,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Aetna Medicare,Aetna Medicare,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Ambetter ,Ambetter ,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Blue Access,Anthem Blue Access,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Blue Access Choice,Anthem Blue Access Choice,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Blue Preferred,Anthem Blue Preferred,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Pathway,Anthem Pathway,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Alliance,Anthem Alliance,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Anthem Medicare,Anthem Medicare,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Cigna,Cigna,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Cigna PPO,Cigna PPO,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Cigna Medicare Advantage,Cigna Medicare Advantage,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Essence,Essence,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Healthlink HMO,Healthlink HMO,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Healthlink PPO,Healthlink PPO,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,HomeState Health Plan,HomeState Health Plan,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Humana Gold,Humana Gold,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Medicaid MO,Medicaid MO,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Medica,Medica,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Tricare,Tricare,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,UHC All Payer,UHC All Payer,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,UHC Exchange,UHC Exchange,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,UHC Medicaid,UHC Medicaid,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,UMR CPD,UMR CPD,24.42,,,,,,,per diem,24.42,24.42,"Per diem rate, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,UHC Medicare,UHC Medicare,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
"RGNCONV-GLUCOSE, POC          ",38270045,CDM,300,RC,,,,,,Inpatient,,,24.42,24.42,Wellcare,Wellcare,24.42,,,,,,,case rate,24.42,24.42,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Meritain Health PPO CPD,Meritain Health PPO CPD,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Aetna/Commercial Product,Aetna/Commercial Product,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Meritain Health CPD,Meritain Health CPD,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Starmark CPD,Starmark CPD,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Aetna Medicare,Aetna Medicare,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Ambetter ,Ambetter ,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Blue Access,Anthem Blue Access,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Blue Access Choice,Anthem Blue Access Choice,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Blue Preferred,Anthem Blue Preferred,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Pathway,Anthem Pathway,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Alliance,Anthem Alliance,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Anthem Medicare,Anthem Medicare,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Cigna,Cigna,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Cigna PPO,Cigna PPO,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Cigna Medicare Advantage,Cigna Medicare Advantage,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Essence,Essence,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Healthlink HMO,Healthlink HMO,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Healthlink PPO,Healthlink PPO,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,HomeState Health Plan,HomeState Health Plan,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Humana Gold,Humana Gold,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Medicaid MO,Medicaid MO,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Medica,Medica,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Tricare,Tricare,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,UHC All Payer,UHC All Payer,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,UHC Exchange,UHC Exchange,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,UHC Medicaid,UHC Medicaid,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,UMR CPD,UMR CPD,744.59,,,,,,,per diem,744.59,744.59,"Per diem rate, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,UHC Medicare,UHC Medicare,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
RGNCONV-HEMOGLIDE             ,38270046,CDM,300,RC,,,,,,Inpatient,,,744.59,744.59,Wellcare,Wellcare,744.59,,,,,,,case rate,744.59,744.59,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Meritain Health PPO CPD,Meritain Health PPO CPD,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Aetna/Commercial Product,Aetna/Commercial Product,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Meritain Health CPD,Meritain Health CPD,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Starmark CPD,Starmark CPD,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Aetna Medicare,Aetna Medicare,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Ambetter ,Ambetter ,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Blue Access,Anthem Blue Access,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Blue Access Choice,Anthem Blue Access Choice,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Blue Preferred,Anthem Blue Preferred,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Pathway,Anthem Pathway,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Alliance,Anthem Alliance,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Anthem Medicare,Anthem Medicare,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Cigna,Cigna,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Cigna PPO,Cigna PPO,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Cigna Medicare Advantage,Cigna Medicare Advantage,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Essence,Essence,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Healthlink HMO,Healthlink HMO,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Healthlink PPO,Healthlink PPO,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,HomeState Health Plan,HomeState Health Plan,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Humana Gold,Humana Gold,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Medicaid MO,Medicaid MO,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Medica,Medica,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Tricare,Tricare,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,UHC All Payer,UHC All Payer,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,UHC Exchange,UHC Exchange,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,UHC Medicaid,UHC Medicaid,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,UMR CPD,UMR CPD,214.88,,,,,,,per diem,214.88,214.88,"Per diem rate, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,UHC Medicare,UHC Medicare,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-HOVERMAT 34"" MATTRESS ",38270047,CDM,300,RC,,,,,,Inpatient,,,214.88,214.88,Wellcare,Wellcare,214.88,,,,,,,case rate,214.88,214.88,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Meritain Health PPO CPD,Meritain Health PPO CPD,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Aetna/Commercial Product,Aetna/Commercial Product,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Meritain Health CPD,Meritain Health CPD,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Starmark CPD,Starmark CPD,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Aetna Medicare,Aetna Medicare,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Ambetter ,Ambetter ,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Blue Access,Anthem Blue Access,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Blue Access Choice,Anthem Blue Access Choice,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Blue Preferred,Anthem Blue Preferred,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Pathway,Anthem Pathway,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Alliance,Anthem Alliance,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Anthem Medicare,Anthem Medicare,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Cigna,Cigna,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Cigna PPO,Cigna PPO,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Cigna Medicare Advantage,Cigna Medicare Advantage,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Essence,Essence,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Healthlink HMO,Healthlink HMO,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Healthlink PPO,Healthlink PPO,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,HomeState Health Plan,HomeState Health Plan,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Humana Gold,Humana Gold,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Medicaid MO,Medicaid MO,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Medica,Medica,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Tricare,Tricare,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,UHC All Payer,UHC All Payer,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,UHC Exchange,UHC Exchange,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,UHC Medicaid,UHC Medicaid,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,UMR CPD,UMR CPD,29.03,,,,,,,per diem,29.03,29.03,"Per diem rate, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,UHC Medicare,UHC Medicare,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
"RGNCONV-IMMOBILIZER, KNEE OTS ",38270048,CDM,300,RC,,,,,,Inpatient,,,29.03,29.03,Wellcare,Wellcare,29.03,,,,,,,case rate,29.03,29.03,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Meritain Health PPO CPD,Meritain Health PPO CPD,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Aetna/Commercial Product,Aetna/Commercial Product,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Meritain Health CPD,Meritain Health CPD,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Starmark CPD,Starmark CPD,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Aetna Medicare,Aetna Medicare,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Ambetter ,Ambetter ,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Blue Access,Anthem Blue Access,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Blue Access Choice,Anthem Blue Access Choice,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Blue Preferred,Anthem Blue Preferred,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Pathway,Anthem Pathway,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Alliance,Anthem Alliance,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Anthem Medicare,Anthem Medicare,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Cigna,Cigna,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Cigna PPO,Cigna PPO,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Cigna Medicare Advantage,Cigna Medicare Advantage,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Essence,Essence,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Healthlink HMO,Healthlink HMO,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Healthlink PPO,Healthlink PPO,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,HomeState Health Plan,HomeState Health Plan,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Humana Gold,Humana Gold,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Medicaid MO,Medicaid MO,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Medica,Medica,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Tricare,Tricare,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,UHC All Payer,UHC All Payer,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,UHC Exchange,UHC Exchange,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,UHC Medicaid,UHC Medicaid,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,UMR CPD,UMR CPD,334.11,,,,,,,per diem,334.11,334.11,"Per diem rate, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,UHC Medicare,UHC Medicare,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-IMMUNOCYTOCHEM STAIN E,38270049,CDM,300,RC,,,,,,Inpatient,,,334.11,334.11,Wellcare,Wellcare,334.11,,,,,,,case rate,334.11,334.11,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Meritain Health PPO CPD,Meritain Health PPO CPD,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Aetna/Commercial Product,Aetna/Commercial Product,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Meritain Health CPD,Meritain Health CPD,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Starmark CPD,Starmark CPD,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Aetna Medicare,Aetna Medicare,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Ambetter ,Ambetter ,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Blue Access,Anthem Blue Access,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Blue Access Choice,Anthem Blue Access Choice,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Blue Preferred,Anthem Blue Preferred,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Pathway,Anthem Pathway,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Alliance,Anthem Alliance,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Anthem Medicare,Anthem Medicare,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Cigna,Cigna,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Cigna PPO,Cigna PPO,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Cigna Medicare Advantage,Cigna Medicare Advantage,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Essence,Essence,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Healthlink HMO,Healthlink HMO,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Healthlink PPO,Healthlink PPO,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,HomeState Health Plan,HomeState Health Plan,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Humana Gold,Humana Gold,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Medicaid MO,Medicaid MO,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Medica,Medica,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Tricare,Tricare,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,UHC All Payer,UHC All Payer,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,UHC Exchange,UHC Exchange,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,UHC Medicaid,UHC Medicaid,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,UMR CPD,UMR CPD,4709.43,,,,,,,per diem,4709.43,4709.43,"Per diem rate, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,UHC Medicare,UHC Medicare,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INSERT TUNNELED CENTRA,38270050,CDM,300,RC,,,,,,Inpatient,,,4709.43,4709.43,Wellcare,Wellcare,4709.43,,,,,,,case rate,4709.43,4709.43,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Meritain Health PPO CPD,Meritain Health PPO CPD,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Aetna/Commercial Product,Aetna/Commercial Product,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Meritain Health CPD,Meritain Health CPD,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Starmark CPD,Starmark CPD,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Aetna Medicare,Aetna Medicare,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Ambetter ,Ambetter ,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Blue Access,Anthem Blue Access,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Blue Access Choice,Anthem Blue Access Choice,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Blue Preferred,Anthem Blue Preferred,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Pathway,Anthem Pathway,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Alliance,Anthem Alliance,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Anthem Medicare,Anthem Medicare,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Cigna,Cigna,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Cigna PPO,Cigna PPO,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Cigna Medicare Advantage,Cigna Medicare Advantage,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Essence,Essence,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Healthlink HMO,Healthlink HMO,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Healthlink PPO,Healthlink PPO,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,HomeState Health Plan,HomeState Health Plan,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Humana Gold,Humana Gold,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Medicaid MO,Medicaid MO,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Medica,Medica,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Tricare,Tricare,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,UHC All Payer,UHC All Payer,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,UHC Exchange,UHC Exchange,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,UHC Medicaid,UHC Medicaid,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,UMR CPD,UMR CPD,344.17,,,,,,,per diem,344.17,344.17,"Per diem rate, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,UHC Medicare,UHC Medicare,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-INTERROGATION VAD DEVI,38270051,CDM,300,RC,,,,,,Inpatient,,,344.17,344.17,Wellcare,Wellcare,344.17,,,,,,,case rate,344.17,344.17,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Meritain Health PPO CPD,Meritain Health PPO CPD,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Aetna/Commercial Product,Aetna/Commercial Product,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Meritain Health CPD,Meritain Health CPD,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Starmark CPD,Starmark CPD,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Aetna Medicare,Aetna Medicare,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Ambetter ,Ambetter ,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Blue Access,Anthem Blue Access,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Blue Access Choice,Anthem Blue Access Choice,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Blue Preferred,Anthem Blue Preferred,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Pathway,Anthem Pathway,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Alliance,Anthem Alliance,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Anthem Medicare,Anthem Medicare,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Cigna,Cigna,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Cigna PPO,Cigna PPO,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Cigna Medicare Advantage,Cigna Medicare Advantage,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Essence,Essence,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Healthlink HMO,Healthlink HMO,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Healthlink PPO,Healthlink PPO,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,HomeState Health Plan,HomeState Health Plan,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Humana Gold,Humana Gold,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Medicaid MO,Medicaid MO,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Medica,Medica,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Tricare,Tricare,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,UHC All Payer,UHC All Payer,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,UHC Exchange,UHC Exchange,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,UHC Medicaid,UHC Medicaid,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,UMR CPD,UMR CPD,152.97,,,,,,,per diem,152.97,152.97,"Per diem rate, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,UHC Medicare,UHC Medicare,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV INFUSION TPD EACH A,38270052,CDM,300,RC,,,,,,Inpatient,,,152.97,152.97,Wellcare,Wellcare,152.97,,,,,,,case rate,152.97,152.97,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Meritain Health PPO CPD,Meritain Health PPO CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna/Commercial Product,Aetna/Commercial Product,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Meritain Health CPD,Meritain Health CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Starmark CPD,Starmark CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna Medicare,Aetna Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Ambetter ,Ambetter ,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Access,Anthem Blue Access,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Access Choice,Anthem Blue Access Choice,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Preferred,Anthem Blue Preferred,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Pathway,Anthem Pathway,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Alliance,Anthem Alliance,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Medicare,Anthem Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna,Cigna,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna PPO,Cigna PPO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna Medicare Advantage,Cigna Medicare Advantage,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Essence,Essence,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthlink HMO,Healthlink HMO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthlink PPO,Healthlink PPO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,HomeState Health Plan,HomeState Health Plan,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Humana Gold,Humana Gold,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Medicaid MO,Medicaid MO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Medica,Medica,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Tricare,Tricare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC All Payer,UHC All Payer,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Exchange,UHC Exchange,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Medicaid,UHC Medicaid,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UMR CPD,UMR CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Medicare,UHC Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270053,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Wellcare,Wellcare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Meritain Health PPO CPD,Meritain Health PPO CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna/Commercial Product,Aetna/Commercial Product,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Meritain Health CPD,Meritain Health CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Starmark CPD,Starmark CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Aetna Medicare,Aetna Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Ambetter ,Ambetter ,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Access,Anthem Blue Access,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Access Choice,Anthem Blue Access Choice,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Blue Preferred,Anthem Blue Preferred,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Pathway,Anthem Pathway,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Alliance,Anthem Alliance,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Anthem Medicare,Anthem Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna,Cigna,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna PPO,Cigna PPO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Cigna Medicare Advantage,Cigna Medicare Advantage,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Essence,Essence,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthlink HMO,Healthlink HMO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Healthlink PPO,Healthlink PPO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,HomeState Health Plan,HomeState Health Plan,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Humana Gold,Humana Gold,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Medicaid MO,Medicaid MO,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Medica,Medica,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Tricare,Tricare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC All Payer,UHC All Payer,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Exchange,UHC Exchange,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Medicaid,UHC Medicaid,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UMR CPD,UMR CPD,59.77,,,,,,,per diem,59.77,59.77,"Per diem rate, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,UHC Medicare,UHC Medicare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-IV SOLUTION PER BAG   ,38270054,CDM,300,RC,,,,,,Inpatient,,,59.77,59.77,Wellcare,Wellcare,59.77,,,,,,,case rate,59.77,59.77,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Meritain Health PPO CPD,Meritain Health PPO CPD,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Aetna/Commercial Product,Aetna/Commercial Product,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Meritain Health CPD,Meritain Health CPD,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Starmark CPD,Starmark CPD,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Aetna Medicare,Aetna Medicare,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Ambetter ,Ambetter ,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Blue Access,Anthem Blue Access,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Blue Access Choice,Anthem Blue Access Choice,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Blue Preferred,Anthem Blue Preferred,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Pathway,Anthem Pathway,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Alliance,Anthem Alliance,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Anthem Medicare,Anthem Medicare,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Cigna,Cigna,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Cigna PPO,Cigna PPO,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Cigna Medicare Advantage,Cigna Medicare Advantage,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Essence,Essence,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Healthlink HMO,Healthlink HMO,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Healthlink PPO,Healthlink PPO,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,HomeState Health Plan,HomeState Health Plan,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Humana Gold,Humana Gold,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Medicaid MO,Medicaid MO,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Medica,Medica,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Tricare,Tricare,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,UHC All Payer,UHC All Payer,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,UHC Exchange,UHC Exchange,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,UHC Medicaid,UHC Medicaid,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,UMR CPD,UMR CPD,666.39,,,,,,,per diem,666.39,666.39,"Per diem rate, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,UHC Medicare,UHC Medicare,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO ADJUST JNT RIGID PR,38270055,CDM,300,RC,,,,,,Inpatient,,,666.39,666.39,Wellcare,Wellcare,666.39,,,,,,,case rate,666.39,666.39,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Meritain Health PPO CPD,Meritain Health PPO CPD,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Aetna/Commercial Product,Aetna/Commercial Product,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Meritain Health CPD,Meritain Health CPD,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Starmark CPD,Starmark CPD,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Aetna Medicare,Aetna Medicare,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Ambetter ,Ambetter ,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Blue Access,Anthem Blue Access,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Blue Access Choice,Anthem Blue Access Choice,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Blue Preferred,Anthem Blue Preferred,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Pathway,Anthem Pathway,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Alliance,Anthem Alliance,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Anthem Medicare,Anthem Medicare,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Cigna,Cigna,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Cigna PPO,Cigna PPO,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Cigna Medicare Advantage,Cigna Medicare Advantage,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Essence,Essence,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Healthlink HMO,Healthlink HMO,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Healthlink PPO,Healthlink PPO,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,HomeState Health Plan,HomeState Health Plan,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Humana Gold,Humana Gold,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Medicaid MO,Medicaid MO,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Medica,Medica,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Tricare,Tricare,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,UHC All Payer,UHC All Payer,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,UHC Exchange,UHC Exchange,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,UHC Medicaid,UHC Medicaid,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,UMR CPD,UMR CPD,1831.11,,,,,,,per diem,1831.11,1831.11,"Per diem rate, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,UHC Medicare,UHC Medicare,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DBL UPRT JNT MLDED ,38270056,CDM,300,RC,,,,,,Inpatient,,,1831.11,1831.11,Wellcare,Wellcare,1831.11,,,,,,,case rate,1831.11,1831.11,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Meritain Health PPO CPD,Meritain Health PPO CPD,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Aetna/Commercial Product,Aetna/Commercial Product,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Meritain Health CPD,Meritain Health CPD,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Starmark CPD,Starmark CPD,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Aetna Medicare,Aetna Medicare,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Ambetter ,Ambetter ,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Blue Access,Anthem Blue Access,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Blue Access Choice,Anthem Blue Access Choice,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Blue Preferred,Anthem Blue Preferred,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Pathway,Anthem Pathway,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Alliance,Anthem Alliance,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Anthem Medicare,Anthem Medicare,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Cigna,Cigna,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Cigna PPO,Cigna PPO,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Cigna Medicare Advantage,Cigna Medicare Advantage,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Essence,Essence,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Healthlink HMO,Healthlink HMO,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Healthlink PPO,Healthlink PPO,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,HomeState Health Plan,HomeState Health Plan,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Humana Gold,Humana Gold,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Medicaid MO,Medicaid MO,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Medica,Medica,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Tricare,Tricare,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,UHC All Payer,UHC All Payer,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,UHC Exchange,UHC Exchange,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,UHC Medicaid,UHC Medicaid,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,UMR CPD,UMR CPD,3261.8,,,,,,,per diem,3261.8,3261.8,"Per diem rate, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,UHC Medicare,UHC Medicare,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO DOUBLE UPRIGHT JOIN,38270057,CDM,300,RC,,,,,,Inpatient,,,3261.8,3261.8,Wellcare,Wellcare,3261.8,,,,,,,case rate,3261.8,3261.8,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Meritain Health PPO CPD,Meritain Health PPO CPD,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Aetna/Commercial Product,Aetna/Commercial Product,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Meritain Health CPD,Meritain Health CPD,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Starmark CPD,Starmark CPD,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Aetna Medicare,Aetna Medicare,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Ambetter ,Ambetter ,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Blue Access,Anthem Blue Access,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Blue Access Choice,Anthem Blue Access Choice,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Blue Preferred,Anthem Blue Preferred,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Pathway,Anthem Pathway,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Alliance,Anthem Alliance,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Anthem Medicare,Anthem Medicare,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Cigna,Cigna,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Cigna PPO,Cigna PPO,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Cigna Medicare Advantage,Cigna Medicare Advantage,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Essence,Essence,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Healthlink HMO,Healthlink HMO,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Healthlink PPO,Healthlink PPO,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,HomeState Health Plan,HomeState Health Plan,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Humana Gold,Humana Gold,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Medicaid MO,Medicaid MO,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Medica,Medica,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Tricare,Tricare,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,UHC All Payer,UHC All Payer,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,UHC Exchange,UHC Exchange,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,UHC Medicaid,UHC Medicaid,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,UMR CPD,UMR CPD,267.16,,,,,,,per diem,267.16,267.16,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,UHC Medicare,UHC Medicare,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ JOINTS  ,38270058,CDM,300,RC,,,,,,Inpatient,,,267.16,267.16,Wellcare,Wellcare,267.16,,,,,,,case rate,267.16,267.16,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Meritain Health PPO CPD,Meritain Health PPO CPD,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Aetna/Commercial Product,Aetna/Commercial Product,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Meritain Health CPD,Meritain Health CPD,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Starmark CPD,Starmark CPD,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Aetna Medicare,Aetna Medicare,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Ambetter ,Ambetter ,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Blue Access,Anthem Blue Access,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Blue Access Choice,Anthem Blue Access Choice,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Blue Preferred,Anthem Blue Preferred,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Pathway,Anthem Pathway,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Alliance,Anthem Alliance,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Anthem Medicare,Anthem Medicare,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Cigna,Cigna,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Cigna PPO,Cigna PPO,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Cigna Medicare Advantage,Cigna Medicare Advantage,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Essence,Essence,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Healthlink HMO,Healthlink HMO,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Healthlink PPO,Healthlink PPO,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,HomeState Health Plan,HomeState Health Plan,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Humana Gold,Humana Gold,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Medicaid MO,Medicaid MO,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Medica,Medica,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Tricare,Tricare,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,UHC All Payer,UHC All Payer,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,UHC Exchange,UHC Exchange,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,UHC Medicaid,UHC Medicaid,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,UMR CPD,UMR CPD,253.12,,,,,,,per diem,253.12,253.12,"Per diem rate, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,UHC Medicare,UHC Medicare,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-KO ELASTIC W/ PADS & J,38270059,CDM,300,RC,,,,,,Inpatient,,,253.12,253.12,Wellcare,Wellcare,253.12,,,,,,,case rate,253.12,253.12,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Meritain Health PPO CPD,Meritain Health PPO CPD,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Aetna/Commercial Product,Aetna/Commercial Product,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Meritain Health CPD,Meritain Health CPD,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Starmark CPD,Starmark CPD,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Aetna Medicare,Aetna Medicare,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Ambetter ,Ambetter ,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Blue Access,Anthem Blue Access,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Blue Access Choice,Anthem Blue Access Choice,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Blue Preferred,Anthem Blue Preferred,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Pathway,Anthem Pathway,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Alliance,Anthem Alliance,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Anthem Medicare,Anthem Medicare,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Cigna,Cigna,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Cigna PPO,Cigna PPO,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Cigna Medicare Advantage,Cigna Medicare Advantage,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Essence,Essence,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Healthlink HMO,Healthlink HMO,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Healthlink PPO,Healthlink PPO,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,HomeState Health Plan,HomeState Health Plan,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Humana Gold,Humana Gold,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Medicaid MO,Medicaid MO,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Medica,Medica,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Tricare,Tricare,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,UHC All Payer,UHC All Payer,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,UHC Exchange,UHC Exchange,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,UHC Medicaid,UHC Medicaid,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,UMR CPD,UMR CPD,381.35,,,,,,,per diem,381.35,381.35,"Per diem rate, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,UHC Medicare,UHC Medicare,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LARYNGOSCOY FLEXIBLE F,38270060,CDM,300,RC,,,,,,Inpatient,,,381.35,381.35,Wellcare,Wellcare,381.35,,,,,,,case rate,381.35,381.35,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Meritain Health PPO CPD,Meritain Health PPO CPD,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Aetna/Commercial Product,Aetna/Commercial Product,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Meritain Health CPD,Meritain Health CPD,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Starmark CPD,Starmark CPD,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Aetna Medicare,Aetna Medicare,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Ambetter ,Ambetter ,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Blue Access,Anthem Blue Access,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Blue Access Choice,Anthem Blue Access Choice,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Blue Preferred,Anthem Blue Preferred,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Pathway,Anthem Pathway,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Alliance,Anthem Alliance,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Anthem Medicare,Anthem Medicare,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Cigna,Cigna,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Cigna PPO,Cigna PPO,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Cigna Medicare Advantage,Cigna Medicare Advantage,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Essence,Essence,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Healthlink HMO,Healthlink HMO,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Healthlink PPO,Healthlink PPO,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,HomeState Health Plan,HomeState Health Plan,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Humana Gold,Humana Gold,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Medicaid MO,Medicaid MO,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Medica,Medica,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Tricare,Tricare,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,UHC All Payer,UHC All Payer,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,UHC Exchange,UHC Exchange,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,UHC Medicaid,UHC Medicaid,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,UMR CPD,UMR CPD,1414.95,,,,,,,per diem,1414.95,1414.95,"Per diem rate, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,UHC Medicare,UHC Medicare,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
RGNCONV-LUNG VENTILATION/PERFU,38270061,CDM,300,RC,,,,,,Inpatient,,,1414.95,1414.95,Wellcare,Wellcare,1414.95,,,,,,,case rate,1414.95,1414.95,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Meritain Health PPO CPD,Meritain Health PPO CPD,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Aetna/Commercial Product,Aetna/Commercial Product,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Meritain Health CPD,Meritain Health CPD,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Starmark CPD,Starmark CPD,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Aetna Medicare,Aetna Medicare,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Ambetter ,Ambetter ,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Blue Access,Anthem Blue Access,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Blue Access Choice,Anthem Blue Access Choice,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Blue Preferred,Anthem Blue Preferred,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Pathway,Anthem Pathway,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Alliance,Anthem Alliance,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Anthem Medicare,Anthem Medicare,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Cigna,Cigna,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Cigna PPO,Cigna PPO,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Cigna Medicare Advantage,Cigna Medicare Advantage,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Essence,Essence,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Healthlink HMO,Healthlink HMO,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Healthlink PPO,Healthlink PPO,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,HomeState Health Plan,HomeState Health Plan,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Humana Gold,Humana Gold,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Medicaid MO,Medicaid MO,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Medica,Medica,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Tricare,Tricare,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,UHC All Payer,UHC All Payer,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,UHC Exchange,UHC Exchange,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,UHC Medicaid,UHC Medicaid,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,UMR CPD,UMR CPD,25.81,,,,,,,per diem,25.81,25.81,"Per diem rate, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,UHC Medicare,UHC Medicare,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
"RGNCONV-LVAD DRESSING KIT, DAI",38270062,CDM,300,RC,,,,,,Inpatient,,,25.81,25.81,Wellcare,Wellcare,25.81,,,,,,,case rate,25.81,25.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Meritain Health PPO CPD,Meritain Health PPO CPD,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Aetna/Commercial Product,Aetna/Commercial Product,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Meritain Health CPD,Meritain Health CPD,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Starmark CPD,Starmark CPD,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Aetna Medicare,Aetna Medicare,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Ambetter ,Ambetter ,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Blue Access,Anthem Blue Access,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Blue Access Choice,Anthem Blue Access Choice,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Blue Preferred,Anthem Blue Preferred,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Pathway,Anthem Pathway,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Alliance,Anthem Alliance,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Anthem Medicare,Anthem Medicare,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Cigna,Cigna,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Cigna PPO,Cigna PPO,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Cigna Medicare Advantage,Cigna Medicare Advantage,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Essence,Essence,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Healthlink HMO,Healthlink HMO,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Healthlink PPO,Healthlink PPO,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,HomeState Health Plan,HomeState Health Plan,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Humana Gold,Humana Gold,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Medicaid MO,Medicaid MO,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Medica,Medica,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Tricare,Tricare,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,UHC All Payer,UHC All Payer,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,UHC Exchange,UHC Exchange,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,UHC Medicaid,UHC Medicaid,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,UMR CPD,UMR CPD,61.81,,,,,,,per diem,61.81,61.81,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,UHC Medicare,UHC Medicare,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE INTRODUC,38270063,CDM,300,RC,,,,,,Inpatient,,,61.81,61.81,Wellcare,Wellcare,61.81,,,,,,,case rate,61.81,61.81,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Meritain Health PPO CPD,Meritain Health PPO CPD,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Aetna/Commercial Product,Aetna/Commercial Product,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Meritain Health CPD,Meritain Health CPD,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Starmark CPD,Starmark CPD,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Aetna Medicare,Aetna Medicare,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Ambetter ,Ambetter ,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Blue Access,Anthem Blue Access,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Blue Access Choice,Anthem Blue Access Choice,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Blue Preferred,Anthem Blue Preferred,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Pathway,Anthem Pathway,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Alliance,Anthem Alliance,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Anthem Medicare,Anthem Medicare,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Cigna,Cigna,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Cigna PPO,Cigna PPO,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Cigna Medicare Advantage,Cigna Medicare Advantage,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Essence,Essence,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Healthlink HMO,Healthlink HMO,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Healthlink PPO,Healthlink PPO,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,HomeState Health Plan,HomeState Health Plan,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Humana Gold,Humana Gold,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Medicaid MO,Medicaid MO,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Medica,Medica,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Tricare,Tricare,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,UHC All Payer,UHC All Payer,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,UHC Exchange,UHC Exchange,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,UHC Medicaid,UHC Medicaid,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,UMR CPD,UMR CPD,106.05,,,,,,,per diem,106.05,106.05,"Per diem rate, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,UHC Medicare,UHC Medicare,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
RGNCONV-MICROPUNCTURE SET     ,38270064,CDM,300,RC,,,,,,Inpatient,,,106.05,106.05,Wellcare,Wellcare,106.05,,,,,,,case rate,106.05,106.05,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Meritain Health PPO CPD,Meritain Health PPO CPD,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Aetna/Commercial Product,Aetna/Commercial Product,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Meritain Health CPD,Meritain Health CPD,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Starmark CPD,Starmark CPD,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Aetna Medicare,Aetna Medicare,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Ambetter ,Ambetter ,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Blue Access,Anthem Blue Access,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Blue Access Choice,Anthem Blue Access Choice,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Blue Preferred,Anthem Blue Preferred,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Pathway,Anthem Pathway,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Alliance,Anthem Alliance,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Anthem Medicare,Anthem Medicare,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Cigna,Cigna,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Cigna PPO,Cigna PPO,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Cigna Medicare Advantage,Cigna Medicare Advantage,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Essence,Essence,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Healthlink HMO,Healthlink HMO,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Healthlink PPO,Healthlink PPO,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,HomeState Health Plan,HomeState Health Plan,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Humana Gold,Humana Gold,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Medicaid MO,Medicaid MO,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Medica,Medica,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Tricare,Tricare,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,UHC All Payer,UHC All Payer,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,UHC Exchange,UHC Exchange,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,UHC Medicaid,UHC Medicaid,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,UMR CPD,UMR CPD,274.44,,,,,,,per diem,274.44,274.44,"Per diem rate, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,UHC Medicare,UHC Medicare,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
"RGNCONV-MINIMAL SEDATION, 1ST ",38270065,CDM,300,RC,,,,,,Inpatient,,,274.44,274.44,Wellcare,Wellcare,274.44,,,,,,,case rate,274.44,274.44,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Meritain Health PPO CPD,Meritain Health PPO CPD,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Aetna/Commercial Product,Aetna/Commercial Product,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Meritain Health CPD,Meritain Health CPD,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Starmark CPD,Starmark CPD,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Aetna Medicare,Aetna Medicare,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Ambetter ,Ambetter ,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Blue Access,Anthem Blue Access,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Blue Access Choice,Anthem Blue Access Choice,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Blue Preferred,Anthem Blue Preferred,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Pathway,Anthem Pathway,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Alliance,Anthem Alliance,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Anthem Medicare,Anthem Medicare,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Cigna,Cigna,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Cigna PPO,Cigna PPO,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Cigna Medicare Advantage,Cigna Medicare Advantage,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Essence,Essence,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Healthlink HMO,Healthlink HMO,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Healthlink PPO,Healthlink PPO,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,HomeState Health Plan,HomeState Health Plan,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Humana Gold,Humana Gold,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Medicaid MO,Medicaid MO,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Medica,Medica,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Tricare,Tricare,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,UHC All Payer,UHC All Payer,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,UHC Exchange,UHC Exchange,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,UHC Medicaid,UHC Medicaid,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,UMR CPD,UMR CPD,163.36,,,,,,,per diem,163.36,163.36,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,UHC Medicare,UHC Medicare,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5 ,38270066,CDM,300,RC,,,,,,Inpatient,,,163.36,163.36,Wellcare,Wellcare,163.36,,,,,,,case rate,163.36,163.36,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Meritain Health PPO CPD,Meritain Health PPO CPD,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Aetna/Commercial Product,Aetna/Commercial Product,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Meritain Health CPD,Meritain Health CPD,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Starmark CPD,Starmark CPD,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Aetna Medicare,Aetna Medicare,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Ambetter ,Ambetter ,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Blue Access,Anthem Blue Access,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Blue Access Choice,Anthem Blue Access Choice,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Blue Preferred,Anthem Blue Preferred,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Pathway,Anthem Pathway,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Alliance,Anthem Alliance,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Anthem Medicare,Anthem Medicare,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Cigna,Cigna,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Cigna PPO,Cigna PPO,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Cigna Medicare Advantage,Cigna Medicare Advantage,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Essence,Essence,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Healthlink HMO,Healthlink HMO,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Healthlink PPO,Healthlink PPO,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,HomeState Health Plan,HomeState Health Plan,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Humana Gold,Humana Gold,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Medicaid MO,Medicaid MO,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Medica,Medica,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Tricare,Tricare,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,UHC All Payer,UHC All Payer,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,UHC Exchange,UHC Exchange,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,UHC Medicaid,UHC Medicaid,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,UMR CPD,UMR CPD,312.69,,,,,,,per diem,312.69,312.69,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,UHC Medicare,UHC Medicare,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION >=5Y,38270067,CDM,300,RC,,,,,,Inpatient,,,312.69,312.69,Wellcare,Wellcare,312.69,,,,,,,case rate,312.69,312.69,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Meritain Health PPO CPD,Meritain Health PPO CPD,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Aetna/Commercial Product,Aetna/Commercial Product,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Meritain Health CPD,Meritain Health CPD,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Starmark CPD,Starmark CPD,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Aetna Medicare,Aetna Medicare,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Ambetter ,Ambetter ,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Blue Access,Anthem Blue Access,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Blue Access Choice,Anthem Blue Access Choice,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Blue Preferred,Anthem Blue Preferred,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Pathway,Anthem Pathway,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Alliance,Anthem Alliance,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Anthem Medicare,Anthem Medicare,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Cigna,Cigna,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Cigna PPO,Cigna PPO,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Cigna Medicare Advantage,Cigna Medicare Advantage,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Essence,Essence,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Healthlink HMO,Healthlink HMO,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Healthlink PPO,Healthlink PPO,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,HomeState Health Plan,HomeState Health Plan,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Humana Gold,Humana Gold,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Medicaid MO,Medicaid MO,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Medica,Medica,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Tricare,Tricare,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,UHC All Payer,UHC All Payer,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,UHC Exchange,UHC Exchange,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,UHC Medicaid,UHC Medicaid,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,UMR CPD,UMR CPD,130.47,,,,,,,per diem,130.47,130.47,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,UHC Medicare,UHC Medicare,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270068,CDM,300,RC,,,,,,Inpatient,,,130.47,130.47,Wellcare,Wellcare,130.47,,,,,,,case rate,130.47,130.47,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Meritain Health PPO CPD,Meritain Health PPO CPD,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Aetna/Commercial Product,Aetna/Commercial Product,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Meritain Health CPD,Meritain Health CPD,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Starmark CPD,Starmark CPD,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Aetna Medicare,Aetna Medicare,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Ambetter ,Ambetter ,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Blue Access,Anthem Blue Access,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Blue Access Choice,Anthem Blue Access Choice,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Blue Preferred,Anthem Blue Preferred,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Pathway,Anthem Pathway,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Alliance,Anthem Alliance,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Anthem Medicare,Anthem Medicare,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Cigna,Cigna,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Cigna PPO,Cigna PPO,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Cigna Medicare Advantage,Cigna Medicare Advantage,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Essence,Essence,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Healthlink HMO,Healthlink HMO,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Healthlink PPO,Healthlink PPO,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,HomeState Health Plan,HomeState Health Plan,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Humana Gold,Humana Gold,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Medicaid MO,Medicaid MO,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Medica,Medica,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Tricare,Tricare,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,UHC All Payer,UHC All Payer,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,UHC Exchange,UHC Exchange,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,UHC Medicaid,UHC Medicaid,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,UMR CPD,UMR CPD,146.86,,,,,,,per diem,146.86,146.86,"Per diem rate, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,UHC Medicare,UHC Medicare,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MODERATE SEDATION EACH,38270069,CDM,300,RC,,,,,,Inpatient,,,146.86,146.86,Wellcare,Wellcare,146.86,,,,,,,case rate,146.86,146.86,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Meritain Health PPO CPD,Meritain Health PPO CPD,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Aetna/Commercial Product,Aetna/Commercial Product,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Meritain Health CPD,Meritain Health CPD,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Starmark CPD,Starmark CPD,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Aetna Medicare,Aetna Medicare,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Ambetter ,Ambetter ,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Blue Access,Anthem Blue Access,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Blue Access Choice,Anthem Blue Access Choice,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Blue Preferred,Anthem Blue Preferred,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Pathway,Anthem Pathway,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Alliance,Anthem Alliance,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Anthem Medicare,Anthem Medicare,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Cigna,Cigna,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Cigna PPO,Cigna PPO,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Cigna Medicare Advantage,Cigna Medicare Advantage,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Essence,Essence,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Healthlink HMO,Healthlink HMO,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Healthlink PPO,Healthlink PPO,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,HomeState Health Plan,HomeState Health Plan,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Humana Gold,Humana Gold,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Medicaid MO,Medicaid MO,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Medica,Medica,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Tricare,Tricare,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,UHC All Payer,UHC All Payer,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,UHC Exchange,UHC Exchange,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,UHC Medicaid,UHC Medicaid,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,UMR CPD,UMR CPD,153.5,,,,,,,per diem,153.5,153.5,"Per diem rate, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,UHC Medicare,UHC Medicare,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
RGNCONV-MSSA BY PCR           ,38270070,CDM,300,RC,,,,,,Inpatient,,,153.5,153.5,Wellcare,Wellcare,153.5,,,,,,,case rate,153.5,153.5,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Meritain Health PPO CPD,Meritain Health PPO CPD,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Aetna/Commercial Product,Aetna/Commercial Product,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Meritain Health CPD,Meritain Health CPD,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Starmark CPD,Starmark CPD,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Aetna Medicare,Aetna Medicare,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Ambetter ,Ambetter ,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Blue Access,Anthem Blue Access,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Blue Access Choice,Anthem Blue Access Choice,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Blue Preferred,Anthem Blue Preferred,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Pathway,Anthem Pathway,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Alliance,Anthem Alliance,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Anthem Medicare,Anthem Medicare,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Cigna,Cigna,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Cigna PPO,Cigna PPO,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Cigna Medicare Advantage,Cigna Medicare Advantage,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Essence,Essence,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Healthlink HMO,Healthlink HMO,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Healthlink PPO,Healthlink PPO,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,HomeState Health Plan,HomeState Health Plan,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Humana Gold,Humana Gold,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Medicaid MO,Medicaid MO,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Medica,Medica,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Tricare,Tricare,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,UHC All Payer,UHC All Payer,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,UHC Exchange,UHC Exchange,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,UHC Medicaid,UHC Medicaid,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,UMR CPD,UMR CPD,7.82,,,,,,,per diem,7.82,7.82,"Per diem rate, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,UHC Medicare,UHC Medicare,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-NEEDLE, SPINAL        ",38270071,CDM,300,RC,,,,,,Inpatient,,,7.82,7.82,Wellcare,Wellcare,7.82,,,,,,,case rate,7.82,7.82,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Meritain Health PPO CPD,Meritain Health PPO CPD,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Aetna/Commercial Product,Aetna/Commercial Product,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Meritain Health CPD,Meritain Health CPD,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Starmark CPD,Starmark CPD,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Aetna Medicare,Aetna Medicare,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Ambetter ,Ambetter ,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Blue Access,Anthem Blue Access,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Blue Access Choice,Anthem Blue Access Choice,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Blue Preferred,Anthem Blue Preferred,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Pathway,Anthem Pathway,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Alliance,Anthem Alliance,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Anthem Medicare,Anthem Medicare,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Cigna,Cigna,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Cigna PPO,Cigna PPO,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Cigna Medicare Advantage,Cigna Medicare Advantage,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Essence,Essence,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Healthlink HMO,Healthlink HMO,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Healthlink PPO,Healthlink PPO,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,HomeState Health Plan,HomeState Health Plan,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Humana Gold,Humana Gold,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Medicaid MO,Medicaid MO,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Medica,Medica,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Tricare,Tricare,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,UHC All Payer,UHC All Payer,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,UHC Exchange,UHC Exchange,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,UHC Medicaid,UHC Medicaid,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,UMR CPD,UMR CPD,324.14,,,,,,,per diem,324.14,324.14,"Per diem rate, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,UHC Medicare,UHC Medicare,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
"RGNCONV-OPTHALMIC US, DIAGNOST",38270072,CDM,300,RC,,,,,,Inpatient,,,324.14,324.14,Wellcare,Wellcare,324.14,,,,,,,case rate,324.14,324.14,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health PPO CPD,Meritain Health PPO CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Aetna/Commercial Product,Aetna/Commercial Product,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Meritain Health CPD,Meritain Health CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Starmark CPD,Starmark CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Aetna Medicare,Aetna Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Ambetter ,Ambetter ,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access,Anthem Blue Access,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Access Choice,Anthem Blue Access Choice,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Blue Preferred,Anthem Blue Preferred,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Pathway,Anthem Pathway,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Alliance,Anthem Alliance,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Anthem Medicare,Anthem Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Cigna,Cigna,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Cigna PPO,Cigna PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Cigna Medicare Advantage,Cigna Medicare Advantage,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Essence,Essence,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink HMO,Healthlink HMO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Healthlink PPO,Healthlink PPO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,HomeState Health Plan,HomeState Health Plan,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Humana Gold,Humana Gold,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Medicaid MO,Medicaid MO,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Medica,Medica,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Tricare,Tricare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,UHC All Payer,UHC All Payer,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,UHC Exchange,UHC Exchange,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicaid,UHC Medicaid,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,UMR CPD,UMR CPD,40.17,,,,,,,per diem,40.17,40.17,"Per diem rate, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,UHC Medicare,UHC Medicare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-OR PROBE COVERS       ,38270073,CDM,300,RC,,,,,,Inpatient,,,40.17,40.17,Wellcare,Wellcare,40.17,,,,,,,case rate,40.17,40.17,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Meritain Health PPO CPD,Meritain Health PPO CPD,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Aetna/Commercial Product,Aetna/Commercial Product,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Meritain Health CPD,Meritain Health CPD,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Starmark CPD,Starmark CPD,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Aetna Medicare,Aetna Medicare,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Ambetter ,Ambetter ,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Blue Access,Anthem Blue Access,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Blue Access Choice,Anthem Blue Access Choice,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Blue Preferred,Anthem Blue Preferred,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Pathway,Anthem Pathway,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Alliance,Anthem Alliance,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Anthem Medicare,Anthem Medicare,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Cigna,Cigna,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Cigna PPO,Cigna PPO,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Cigna Medicare Advantage,Cigna Medicare Advantage,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Essence,Essence,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Healthlink HMO,Healthlink HMO,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Healthlink PPO,Healthlink PPO,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,HomeState Health Plan,HomeState Health Plan,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Humana Gold,Humana Gold,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Medicaid MO,Medicaid MO,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Medica,Medica,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Tricare,Tricare,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,UHC All Payer,UHC All Payer,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,UHC Exchange,UHC Exchange,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,UHC Medicaid,UHC Medicaid,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,UMR CPD,UMR CPD,79.27,,,,,,,per diem,79.27,79.27,"Per diem rate, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,UHC Medicare,UHC Medicare,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-PARACENTESIS/THORA NEE,38270074,CDM,300,RC,,,,,,Inpatient,,,79.27,79.27,Wellcare,Wellcare,79.27,,,,,,,case rate,79.27,79.27,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Meritain Health PPO CPD,Meritain Health PPO CPD,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Aetna/Commercial Product,Aetna/Commercial Product,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Meritain Health CPD,Meritain Health CPD,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Starmark CPD,Starmark CPD,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Aetna Medicare,Aetna Medicare,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Ambetter ,Ambetter ,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Blue Access,Anthem Blue Access,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Blue Access Choice,Anthem Blue Access Choice,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Blue Preferred,Anthem Blue Preferred,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Pathway,Anthem Pathway,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Alliance,Anthem Alliance,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Anthem Medicare,Anthem Medicare,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Cigna,Cigna,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Cigna PPO,Cigna PPO,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Cigna Medicare Advantage,Cigna Medicare Advantage,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Essence,Essence,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Healthlink HMO,Healthlink HMO,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Healthlink PPO,Healthlink PPO,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,HomeState Health Plan,HomeState Health Plan,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Humana Gold,Humana Gold,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Medicaid MO,Medicaid MO,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Medica,Medica,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Tricare,Tricare,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,UHC All Payer,UHC All Payer,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,UHC Exchange,UHC Exchange,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,UHC Medicaid,UHC Medicaid,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,UMR CPD,UMR CPD,256.45,,,,,,,per diem,256.45,256.45,"Per diem rate, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,UHC Medicare,UHC Medicare,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-POWER PIC DOUBLE      ,38270075,CDM,300,RC,,,,,,Inpatient,,,256.45,256.45,Wellcare,Wellcare,256.45,,,,,,,case rate,256.45,256.45,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Meritain Health PPO CPD,Meritain Health PPO CPD,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Aetna/Commercial Product,Aetna/Commercial Product,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Meritain Health CPD,Meritain Health CPD,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Starmark CPD,Starmark CPD,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Aetna Medicare,Aetna Medicare,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Ambetter ,Ambetter ,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Blue Access,Anthem Blue Access,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Blue Access Choice,Anthem Blue Access Choice,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Blue Preferred,Anthem Blue Preferred,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Pathway,Anthem Pathway,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Alliance,Anthem Alliance,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Anthem Medicare,Anthem Medicare,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Cigna,Cigna,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Cigna PPO,Cigna PPO,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Cigna Medicare Advantage,Cigna Medicare Advantage,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Essence,Essence,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Healthlink HMO,Healthlink HMO,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Healthlink PPO,Healthlink PPO,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,HomeState Health Plan,HomeState Health Plan,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Humana Gold,Humana Gold,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Medicaid MO,Medicaid MO,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Medica,Medica,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Tricare,Tricare,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,UHC All Payer,UHC All Payer,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,UHC Exchange,UHC Exchange,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,UHC Medicaid,UHC Medicaid,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,UMR CPD,UMR CPD,3071.77,,,,,,,per diem,3071.77,3071.77,"Per diem rate, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,UHC Medicare,UHC Medicare,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PR TTE W OR WO FOL WCO,38270076,CDM,300,RC,,,,,,Inpatient,,,3071.77,3071.77,Wellcare,Wellcare,3071.77,,,,,,,case rate,3071.77,3071.77,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Meritain Health PPO CPD,Meritain Health PPO CPD,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Aetna/Commercial Product,Aetna/Commercial Product,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Meritain Health CPD,Meritain Health CPD,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Starmark CPD,Starmark CPD,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Aetna Medicare,Aetna Medicare,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Ambetter ,Ambetter ,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Blue Access,Anthem Blue Access,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Blue Access Choice,Anthem Blue Access Choice,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Blue Preferred,Anthem Blue Preferred,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Pathway,Anthem Pathway,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Alliance,Anthem Alliance,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Anthem Medicare,Anthem Medicare,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Cigna,Cigna,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Cigna PPO,Cigna PPO,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Cigna Medicare Advantage,Cigna Medicare Advantage,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Essence,Essence,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Healthlink HMO,Healthlink HMO,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Healthlink PPO,Healthlink PPO,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,HomeState Health Plan,HomeState Health Plan,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Humana Gold,Humana Gold,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Medicaid MO,Medicaid MO,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Medica,Medica,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Tricare,Tricare,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,UHC All Payer,UHC All Payer,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,UHC Exchange,UHC Exchange,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,UHC Medicaid,UHC Medicaid,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,UMR CPD,UMR CPD,1754.63,,,,,,,per diem,1754.63,1754.63,"Per diem rate, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,UHC Medicare,UHC Medicare,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PREFABRICATED CARBON F,38270077,CDM,300,RC,,,,,,Inpatient,,,1754.63,1754.63,Wellcare,Wellcare,1754.63,,,,,,,case rate,1754.63,1754.63,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Meritain Health PPO CPD,Meritain Health PPO CPD,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Aetna/Commercial Product,Aetna/Commercial Product,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Meritain Health CPD,Meritain Health CPD,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Starmark CPD,Starmark CPD,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Aetna Medicare,Aetna Medicare,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Ambetter ,Ambetter ,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Blue Access,Anthem Blue Access,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Blue Access Choice,Anthem Blue Access Choice,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Blue Preferred,Anthem Blue Preferred,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Pathway,Anthem Pathway,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Alliance,Anthem Alliance,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Anthem Medicare,Anthem Medicare,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Cigna,Cigna,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Cigna PPO,Cigna PPO,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Cigna Medicare Advantage,Cigna Medicare Advantage,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Essence,Essence,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Healthlink HMO,Healthlink HMO,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Healthlink PPO,Healthlink PPO,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,HomeState Health Plan,HomeState Health Plan,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Humana Gold,Humana Gold,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Medicaid MO,Medicaid MO,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Medica,Medica,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Tricare,Tricare,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,UHC All Payer,UHC All Payer,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,UHC Exchange,UHC Exchange,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,UHC Medicaid,UHC Medicaid,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,UMR CPD,UMR CPD,425.16,,,,,,,per diem,425.16,425.16,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,UHC Medicare,UHC Medicare,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY IV INFUSION TP,38270078,CDM,300,RC,,,,,,Inpatient,,,425.16,425.16,Wellcare,Wellcare,425.16,,,,,,,case rate,425.16,425.16,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Meritain Health PPO CPD,Meritain Health PPO CPD,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Aetna/Commercial Product,Aetna/Commercial Product,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Meritain Health CPD,Meritain Health CPD,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Starmark CPD,Starmark CPD,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Aetna Medicare,Aetna Medicare,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Ambetter ,Ambetter ,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Blue Access,Anthem Blue Access,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Blue Access Choice,Anthem Blue Access Choice,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Blue Preferred,Anthem Blue Preferred,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Pathway,Anthem Pathway,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Alliance,Anthem Alliance,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Anthem Medicare,Anthem Medicare,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Cigna,Cigna,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Cigna PPO,Cigna PPO,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Cigna Medicare Advantage,Cigna Medicare Advantage,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Essence,Essence,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Healthlink HMO,Healthlink HMO,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Healthlink PPO,Healthlink PPO,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,HomeState Health Plan,HomeState Health Plan,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Humana Gold,Humana Gold,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Medicaid MO,Medicaid MO,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Medica,Medica,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Tricare,Tricare,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,UHC All Payer,UHC All Payer,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,UHC Exchange,UHC Exchange,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,UHC Medicaid,UHC Medicaid,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,UMR CPD,UMR CPD,164.21,,,,,,,per diem,164.21,164.21,"Per diem rate, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,UHC Medicare,UHC Medicare,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PRIMARY TPD INJ IV PUS,38270079,CDM,300,RC,,,,,,Inpatient,,,164.21,164.21,Wellcare,Wellcare,164.21,,,,,,,case rate,164.21,164.21,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Meritain Health PPO CPD,Meritain Health PPO CPD,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Aetna/Commercial Product,Aetna/Commercial Product,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Meritain Health CPD,Meritain Health CPD,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Starmark CPD,Starmark CPD,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Aetna Medicare,Aetna Medicare,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Ambetter ,Ambetter ,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Blue Access,Anthem Blue Access,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Blue Access Choice,Anthem Blue Access Choice,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Blue Preferred,Anthem Blue Preferred,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Pathway,Anthem Pathway,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Alliance,Anthem Alliance,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Anthem Medicare,Anthem Medicare,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Cigna,Cigna,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Cigna PPO,Cigna PPO,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Cigna Medicare Advantage,Cigna Medicare Advantage,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Essence,Essence,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Healthlink HMO,Healthlink HMO,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Healthlink PPO,Healthlink PPO,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,HomeState Health Plan,HomeState Health Plan,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Humana Gold,Humana Gold,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Medicaid MO,Medicaid MO,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Medica,Medica,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Tricare,Tricare,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,UHC All Payer,UHC All Payer,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,UHC Exchange,UHC Exchange,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,UHC Medicaid,UHC Medicaid,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,UMR CPD,UMR CPD,384.66,,,,,,,per diem,384.66,384.66,"Per diem rate, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,UHC Medicare,UHC Medicare,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-PUNCT ASP ABSCESS/HEMA,38270080,CDM,300,RC,,,,,,Inpatient,,,384.66,384.66,Wellcare,Wellcare,384.66,,,,,,,case rate,384.66,384.66,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Meritain Health PPO CPD,Meritain Health PPO CPD,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Aetna/Commercial Product,Aetna/Commercial Product,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Meritain Health CPD,Meritain Health CPD,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Starmark CPD,Starmark CPD,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Aetna Medicare,Aetna Medicare,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Ambetter ,Ambetter ,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Blue Access,Anthem Blue Access,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Blue Access Choice,Anthem Blue Access Choice,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Blue Preferred,Anthem Blue Preferred,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Pathway,Anthem Pathway,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Alliance,Anthem Alliance,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Anthem Medicare,Anthem Medicare,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Cigna,Cigna,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Cigna PPO,Cigna PPO,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Cigna Medicare Advantage,Cigna Medicare Advantage,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Essence,Essence,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Healthlink HMO,Healthlink HMO,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Healthlink PPO,Healthlink PPO,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,HomeState Health Plan,HomeState Health Plan,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Humana Gold,Humana Gold,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Medicaid MO,Medicaid MO,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Medica,Medica,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Tricare,Tricare,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,UHC All Payer,UHC All Payer,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,UHC Exchange,UHC Exchange,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,UHC Medicaid,UHC Medicaid,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,UMR CPD,UMR CPD,10.46,,,,,,,per diem,10.46,10.46,"Per diem rate, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,UHC Medicare,UHC Medicare,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-RECOVERY LEVEL 2 PER M,38270081,CDM,300,RC,,,,,,Inpatient,,,10.46,10.46,Wellcare,Wellcare,10.46,,,,,,,case rate,10.46,10.46,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Meritain Health PPO CPD,Meritain Health PPO CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna/Commercial Product,Aetna/Commercial Product,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Meritain Health CPD,Meritain Health CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Starmark CPD,Starmark CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna Medicare,Aetna Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Ambetter ,Ambetter ,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Access,Anthem Blue Access,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Access Choice,Anthem Blue Access Choice,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Preferred,Anthem Blue Preferred,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Pathway,Anthem Pathway,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Alliance,Anthem Alliance,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Medicare,Anthem Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna,Cigna,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna PPO,Cigna PPO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna Medicare Advantage,Cigna Medicare Advantage,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Essence,Essence,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthlink HMO,Healthlink HMO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthlink PPO,Healthlink PPO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,HomeState Health Plan,HomeState Health Plan,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Humana Gold,Humana Gold,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Medicaid MO,Medicaid MO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Medica,Medica,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Tricare,Tricare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC All Payer,UHC All Payer,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Exchange,UHC Exchange,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Medicaid,UHC Medicaid,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UMR CPD,UMR CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Medicare,UHC Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REM OF DEVITALIZED TIS,38270082,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Wellcare,Wellcare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Meritain Health PPO CPD,Meritain Health PPO CPD,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Aetna/Commercial Product,Aetna/Commercial Product,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Meritain Health CPD,Meritain Health CPD,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Starmark CPD,Starmark CPD,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Aetna Medicare,Aetna Medicare,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Ambetter ,Ambetter ,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Blue Access,Anthem Blue Access,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Blue Access Choice,Anthem Blue Access Choice,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Blue Preferred,Anthem Blue Preferred,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Pathway,Anthem Pathway,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Alliance,Anthem Alliance,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Anthem Medicare,Anthem Medicare,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Cigna,Cigna,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Cigna PPO,Cigna PPO,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Cigna Medicare Advantage,Cigna Medicare Advantage,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Essence,Essence,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Healthlink HMO,Healthlink HMO,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Healthlink PPO,Healthlink PPO,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,HomeState Health Plan,HomeState Health Plan,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Humana Gold,Humana Gold,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Medicaid MO,Medicaid MO,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Medica,Medica,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Tricare,Tricare,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,UHC All Payer,UHC All Payer,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,UHC Exchange,UHC Exchange,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,UHC Medicaid,UHC Medicaid,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,UMR CPD,UMR CPD,40.76,,,,,,,per diem,40.76,40.76,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,UHC Medicare,UHC Medicare,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT PAD ASPEN ,38270083,CDM,300,RC,,,,,,Inpatient,,,40.76,40.76,Wellcare,Wellcare,40.76,,,,,,,case rate,40.76,40.76,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Meritain Health PPO CPD,Meritain Health PPO CPD,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Aetna/Commercial Product,Aetna/Commercial Product,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Meritain Health CPD,Meritain Health CPD,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Starmark CPD,Starmark CPD,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Aetna Medicare,Aetna Medicare,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Ambetter ,Ambetter ,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Blue Access,Anthem Blue Access,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Blue Access Choice,Anthem Blue Access Choice,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Blue Preferred,Anthem Blue Preferred,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Pathway,Anthem Pathway,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Alliance,Anthem Alliance,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Anthem Medicare,Anthem Medicare,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Cigna,Cigna,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Cigna PPO,Cigna PPO,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Cigna Medicare Advantage,Cigna Medicare Advantage,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Essence,Essence,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Healthlink HMO,Healthlink HMO,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Healthlink PPO,Healthlink PPO,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,HomeState Health Plan,HomeState Health Plan,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Humana Gold,Humana Gold,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Medicaid MO,Medicaid MO,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Medica,Medica,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Tricare,Tricare,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,UHC All Payer,UHC All Payer,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,UHC Exchange,UHC Exchange,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,UHC Medicaid,UHC Medicaid,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,UMR CPD,UMR CPD,68.45,,,,,,,per diem,68.45,68.45,"Per diem rate, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,UHC Medicare,UHC Medicare,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-REPLACEMENT STRAP AFO ,38270084,CDM,300,RC,,,,,,Inpatient,,,68.45,68.45,Wellcare,Wellcare,68.45,,,,,,,case rate,68.45,68.45,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Meritain Health PPO CPD,Meritain Health PPO CPD,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Aetna/Commercial Product,Aetna/Commercial Product,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Meritain Health CPD,Meritain Health CPD,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Starmark CPD,Starmark CPD,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Aetna Medicare,Aetna Medicare,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Ambetter ,Ambetter ,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Blue Access,Anthem Blue Access,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Blue Access Choice,Anthem Blue Access Choice,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Blue Preferred,Anthem Blue Preferred,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Pathway,Anthem Pathway,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Alliance,Anthem Alliance,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Anthem Medicare,Anthem Medicare,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Cigna,Cigna,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Cigna PPO,Cigna PPO,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Cigna Medicare Advantage,Cigna Medicare Advantage,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Essence,Essence,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Healthlink HMO,Healthlink HMO,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Healthlink PPO,Healthlink PPO,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,HomeState Health Plan,HomeState Health Plan,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Humana Gold,Humana Gold,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Medicaid MO,Medicaid MO,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Medica,Medica,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Tricare,Tricare,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,UHC All Payer,UHC All Payer,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,UHC Exchange,UHC Exchange,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,UHC Medicaid,UHC Medicaid,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,UMR CPD,UMR CPD,8620.16,,,,,,,per diem,8620.16,8620.16,"Per diem rate, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,UHC Medicare,UHC Medicare,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-RIGHT HEART CATHETERIZ,38270085,CDM,300,RC,,,,,,Inpatient,,,8620.16,8620.16,Wellcare,Wellcare,8620.16,,,,,,,case rate,8620.16,8620.16,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Meritain Health PPO CPD,Meritain Health PPO CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Aetna/Commercial Product,Aetna/Commercial Product,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Meritain Health CPD,Meritain Health CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Starmark CPD,Starmark CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Aetna Medicare,Aetna Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Ambetter ,Ambetter ,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Blue Access,Anthem Blue Access,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Blue Access Choice,Anthem Blue Access Choice,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Blue Preferred,Anthem Blue Preferred,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Pathway,Anthem Pathway,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Alliance,Anthem Alliance,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Anthem Medicare,Anthem Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Cigna,Cigna,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Cigna PPO,Cigna PPO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Cigna Medicare Advantage,Cigna Medicare Advantage,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Essence,Essence,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Healthlink HMO,Healthlink HMO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Healthlink PPO,Healthlink PPO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,HomeState Health Plan,HomeState Health Plan,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Humana Gold,Humana Gold,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Medicaid MO,Medicaid MO,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Medica,Medica,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Tricare,Tricare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,UHC All Payer,UHC All Payer,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,UHC Exchange,UHC Exchange,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,UHC Medicaid,UHC Medicaid,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,UMR CPD,UMR CPD,129.4,,,,,,,per diem,129.4,129.4,"Per diem rate, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,UHC Medicare,UHC Medicare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SEQUENTIAL INJ IV PUSH,38270086,CDM,300,RC,,,,,,Inpatient,,,129.4,129.4,Wellcare,Wellcare,129.4,,,,,,,case rate,129.4,129.4,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Meritain Health PPO CPD,Meritain Health PPO CPD,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Aetna/Commercial Product,Aetna/Commercial Product,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Meritain Health CPD,Meritain Health CPD,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Starmark CPD,Starmark CPD,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Aetna Medicare,Aetna Medicare,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Ambetter ,Ambetter ,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Blue Access,Anthem Blue Access,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Blue Access Choice,Anthem Blue Access Choice,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Blue Preferred,Anthem Blue Preferred,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Pathway,Anthem Pathway,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Alliance,Anthem Alliance,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Anthem Medicare,Anthem Medicare,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Cigna,Cigna,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Cigna PPO,Cigna PPO,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Cigna Medicare Advantage,Cigna Medicare Advantage,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Essence,Essence,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Healthlink HMO,Healthlink HMO,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Healthlink PPO,Healthlink PPO,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,HomeState Health Plan,HomeState Health Plan,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Humana Gold,Humana Gold,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Medicaid MO,Medicaid MO,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Medica,Medica,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Tricare,Tricare,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,UHC All Payer,UHC All Payer,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,UHC Exchange,UHC Exchange,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,UHC Medicaid,UHC Medicaid,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,UMR CPD,UMR CPD,23.13,,,,,,,per diem,23.13,23.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,UHC Medicare,UHC Medicare,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHEATH STANDARD SHORT ,38270087,CDM,300,RC,,,,,,Inpatient,,,23.13,23.13,Wellcare,Wellcare,23.13,,,,,,,case rate,23.13,23.13,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Meritain Health PPO CPD,Meritain Health PPO CPD,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Aetna/Commercial Product,Aetna/Commercial Product,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Meritain Health CPD,Meritain Health CPD,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Starmark CPD,Starmark CPD,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Aetna Medicare,Aetna Medicare,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Ambetter ,Ambetter ,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Blue Access,Anthem Blue Access,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Blue Access Choice,Anthem Blue Access Choice,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Blue Preferred,Anthem Blue Preferred,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Pathway,Anthem Pathway,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Alliance,Anthem Alliance,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Anthem Medicare,Anthem Medicare,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Cigna,Cigna,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Cigna PPO,Cigna PPO,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Cigna Medicare Advantage,Cigna Medicare Advantage,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Essence,Essence,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Healthlink HMO,Healthlink HMO,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Healthlink PPO,Healthlink PPO,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,HomeState Health Plan,HomeState Health Plan,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Humana Gold,Humana Gold,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Medicaid MO,Medicaid MO,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Medica,Medica,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Tricare,Tricare,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,UHC All Payer,UHC All Payer,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,UHC Exchange,UHC Exchange,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,UHC Medicaid,UHC Medicaid,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,UMR CPD,UMR CPD,112.37,,,,,,,per diem,112.37,112.37,"Per diem rate, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,UHC Medicare,UHC Medicare,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
"RGNCONV-SHEATH, PEELAWAY 30 CM",38270088,CDM,300,RC,,,,,,Inpatient,,,112.37,112.37,Wellcare,Wellcare,112.37,,,,,,,case rate,112.37,112.37,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Meritain Health PPO CPD,Meritain Health PPO CPD,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Aetna/Commercial Product,Aetna/Commercial Product,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Meritain Health CPD,Meritain Health CPD,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Starmark CPD,Starmark CPD,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Aetna Medicare,Aetna Medicare,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Ambetter ,Ambetter ,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Blue Access,Anthem Blue Access,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Blue Access Choice,Anthem Blue Access Choice,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Blue Preferred,Anthem Blue Preferred,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Pathway,Anthem Pathway,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Alliance,Anthem Alliance,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Anthem Medicare,Anthem Medicare,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Cigna,Cigna,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Cigna PPO,Cigna PPO,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Cigna Medicare Advantage,Cigna Medicare Advantage,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Essence,Essence,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Healthlink HMO,Healthlink HMO,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Healthlink PPO,Healthlink PPO,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,HomeState Health Plan,HomeState Health Plan,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Humana Gold,Humana Gold,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Medicaid MO,Medicaid MO,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Medica,Medica,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Tricare,Tricare,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,UHC All Payer,UHC All Payer,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,UHC Exchange,UHC Exchange,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,UHC Medicaid,UHC Medicaid,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,UMR CPD,UMR CPD,128.33,,,,,,,per diem,128.33,128.33,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,UHC Medicare,UHC Medicare,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE LIFT INTERNAL TAP,38270089,CDM,300,RC,,,,,,Inpatient,,,128.33,128.33,Wellcare,Wellcare,128.33,,,,,,,case rate,128.33,128.33,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Meritain Health PPO CPD,Meritain Health PPO CPD,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Aetna/Commercial Product,Aetna/Commercial Product,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Meritain Health CPD,Meritain Health CPD,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Starmark CPD,Starmark CPD,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Aetna Medicare,Aetna Medicare,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Ambetter ,Ambetter ,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Blue Access,Anthem Blue Access,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Blue Access Choice,Anthem Blue Access Choice,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Blue Preferred,Anthem Blue Preferred,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Pathway,Anthem Pathway,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Alliance,Anthem Alliance,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Anthem Medicare,Anthem Medicare,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Cigna,Cigna,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Cigna PPO,Cigna PPO,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Cigna Medicare Advantage,Cigna Medicare Advantage,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Essence,Essence,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Healthlink HMO,Healthlink HMO,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Healthlink PPO,Healthlink PPO,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,HomeState Health Plan,HomeState Health Plan,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Humana Gold,Humana Gold,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Medicaid MO,Medicaid MO,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Medica,Medica,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Tricare,Tricare,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,UHC All Payer,UHC All Payer,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,UHC Exchange,UHC Exchange,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,UHC Medicaid,UHC Medicaid,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,UMR CPD,UMR CPD,65.13,,,,,,,per diem,65.13,65.13,"Per diem rate, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,UHC Medicare,UHC Medicare,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SHOE/BOOT SURGICL POST,38270090,CDM,300,RC,,,,,,Inpatient,,,65.13,65.13,Wellcare,Wellcare,65.13,,,,,,,case rate,65.13,65.13,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Meritain Health PPO CPD,Meritain Health PPO CPD,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Aetna/Commercial Product,Aetna/Commercial Product,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Meritain Health CPD,Meritain Health CPD,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Starmark CPD,Starmark CPD,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Aetna Medicare,Aetna Medicare,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Ambetter ,Ambetter ,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Blue Access,Anthem Blue Access,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Blue Access Choice,Anthem Blue Access Choice,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Blue Preferred,Anthem Blue Preferred,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Pathway,Anthem Pathway,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Alliance,Anthem Alliance,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Anthem Medicare,Anthem Medicare,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Cigna,Cigna,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Cigna PPO,Cigna PPO,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Cigna Medicare Advantage,Cigna Medicare Advantage,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Essence,Essence,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Healthlink HMO,Healthlink HMO,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Healthlink PPO,Healthlink PPO,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,HomeState Health Plan,HomeState Health Plan,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Humana Gold,Humana Gold,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Medicaid MO,Medicaid MO,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Medica,Medica,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Tricare,Tricare,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,UHC All Payer,UHC All Payer,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,UHC Exchange,UHC Exchange,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,UHC Medicaid,UHC Medicaid,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,UMR CPD,UMR CPD,65.88,,,,,,,per diem,65.88,65.88,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,UHC Medicare,UHC Medicare,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN .9PCT NACL INJ 50,38270091,CDM,300,RC,,,,,,Inpatient,,,65.88,65.88,Wellcare,Wellcare,65.88,,,,,,,case rate,65.88,65.88,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Meritain Health PPO CPD,Meritain Health PPO CPD,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Aetna/Commercial Product,Aetna/Commercial Product,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Meritain Health CPD,Meritain Health CPD,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Starmark CPD,Starmark CPD,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Aetna Medicare,Aetna Medicare,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Ambetter ,Ambetter ,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Blue Access,Anthem Blue Access,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Blue Access Choice,Anthem Blue Access Choice,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Blue Preferred,Anthem Blue Preferred,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Pathway,Anthem Pathway,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Alliance,Anthem Alliance,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Anthem Medicare,Anthem Medicare,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Cigna,Cigna,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Cigna PPO,Cigna PPO,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Cigna Medicare Advantage,Cigna Medicare Advantage,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Essence,Essence,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Healthlink HMO,Healthlink HMO,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Healthlink PPO,Healthlink PPO,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,HomeState Health Plan,HomeState Health Plan,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Humana Gold,Humana Gold,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Medicaid MO,Medicaid MO,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Medica,Medica,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Tricare,Tricare,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,UHC All Payer,UHC All Payer,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,UHC Exchange,UHC Exchange,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,UHC Medicaid,UHC Medicaid,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,UMR CPD,UMR CPD,66.41,,,,,,,per diem,66.41,66.41,"Per diem rate, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,UHC Medicare,UHC Medicare,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SOLN 5PCT DEXT .45PCT ,38270092,CDM,300,RC,,,,,,Inpatient,,,66.41,66.41,Wellcare,Wellcare,66.41,,,,,,,case rate,66.41,66.41,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Meritain Health PPO CPD,Meritain Health PPO CPD,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Aetna/Commercial Product,Aetna/Commercial Product,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Meritain Health CPD,Meritain Health CPD,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Starmark CPD,Starmark CPD,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Aetna Medicare,Aetna Medicare,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Ambetter ,Ambetter ,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Blue Access,Anthem Blue Access,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Blue Access Choice,Anthem Blue Access Choice,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Blue Preferred,Anthem Blue Preferred,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Pathway,Anthem Pathway,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Alliance,Anthem Alliance,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Anthem Medicare,Anthem Medicare,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Cigna,Cigna,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Cigna PPO,Cigna PPO,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Cigna Medicare Advantage,Cigna Medicare Advantage,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Essence,Essence,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Healthlink HMO,Healthlink HMO,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Healthlink PPO,Healthlink PPO,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,HomeState Health Plan,HomeState Health Plan,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Humana Gold,Humana Gold,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Medicaid MO,Medicaid MO,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Medica,Medica,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Tricare,Tricare,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,UHC All Payer,UHC All Payer,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,UHC Exchange,UHC Exchange,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,UHC Medicaid,UHC Medicaid,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,UMR CPD,UMR CPD,98.33,,,,,,,per diem,98.33,98.33,"Per diem rate, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,UHC Medicare,UHC Medicare,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
RGNCONV-SPLINT WRIST FRACTURE ,38270093,CDM,300,RC,,,,,,Inpatient,,,98.33,98.33,Wellcare,Wellcare,98.33,,,,,,,case rate,98.33,98.33,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Meritain Health PPO CPD,Meritain Health PPO CPD,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Aetna/Commercial Product,Aetna/Commercial Product,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Meritain Health CPD,Meritain Health CPD,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Starmark CPD,Starmark CPD,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Aetna Medicare,Aetna Medicare,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Ambetter ,Ambetter ,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Blue Access,Anthem Blue Access,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Blue Access Choice,Anthem Blue Access Choice,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Blue Preferred,Anthem Blue Preferred,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Pathway,Anthem Pathway,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Alliance,Anthem Alliance,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Anthem Medicare,Anthem Medicare,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Cigna,Cigna,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Cigna PPO,Cigna PPO,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Cigna Medicare Advantage,Cigna Medicare Advantage,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Essence,Essence,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Healthlink HMO,Healthlink HMO,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Healthlink PPO,Healthlink PPO,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,HomeState Health Plan,HomeState Health Plan,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Humana Gold,Humana Gold,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Medicaid MO,Medicaid MO,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Medica,Medica,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Tricare,Tricare,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,UHC All Payer,UHC All Payer,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,UHC Exchange,UHC Exchange,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,UHC Medicaid,UHC Medicaid,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,UMR CPD,UMR CPD,52.49,,,,,,,per diem,52.49,52.49,"Per diem rate, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,UHC Medicare,UHC Medicare,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
"RGNCONV-STREP A SCREEN, RAPID ",38270094,CDM,300,RC,,,,,,Inpatient,,,52.49,52.49,Wellcare,Wellcare,52.49,,,,,,,case rate,52.49,52.49,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Meritain Health PPO CPD,Meritain Health PPO CPD,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Aetna/Commercial Product,Aetna/Commercial Product,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Meritain Health CPD,Meritain Health CPD,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Starmark CPD,Starmark CPD,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Aetna Medicare,Aetna Medicare,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Ambetter ,Ambetter ,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Blue Access,Anthem Blue Access,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Blue Access Choice,Anthem Blue Access Choice,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Blue Preferred,Anthem Blue Preferred,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Pathway,Anthem Pathway,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Alliance,Anthem Alliance,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Anthem Medicare,Anthem Medicare,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Cigna,Cigna,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Cigna PPO,Cigna PPO,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Cigna Medicare Advantage,Cigna Medicare Advantage,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Essence,Essence,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Healthlink HMO,Healthlink HMO,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Healthlink PPO,Healthlink PPO,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,HomeState Health Plan,HomeState Health Plan,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Humana Gold,Humana Gold,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Medicaid MO,Medicaid MO,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Medica,Medica,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Tricare,Tricare,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,UHC All Payer,UHC All Payer,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,UHC Exchange,UHC Exchange,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,UHC Medicaid,UHC Medicaid,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,UMR CPD,UMR CPD,326.79,,,,,,,per diem,326.79,326.79,"Per diem rate, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,UHC Medicare,UHC Medicare,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-SWALLOW MOTION FLORO E,38270095,CDM,300,RC,,,,,,Inpatient,,,326.79,326.79,Wellcare,Wellcare,326.79,,,,,,,case rate,326.79,326.79,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Meritain Health PPO CPD,Meritain Health PPO CPD,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Aetna/Commercial Product,Aetna/Commercial Product,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Meritain Health CPD,Meritain Health CPD,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Starmark CPD,Starmark CPD,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Aetna Medicare,Aetna Medicare,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Ambetter ,Ambetter ,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Blue Access,Anthem Blue Access,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Blue Access Choice,Anthem Blue Access Choice,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Blue Preferred,Anthem Blue Preferred,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Pathway,Anthem Pathway,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Alliance,Anthem Alliance,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Anthem Medicare,Anthem Medicare,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Cigna,Cigna,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Cigna PPO,Cigna PPO,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Cigna Medicare Advantage,Cigna Medicare Advantage,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Essence,Essence,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Healthlink HMO,Healthlink HMO,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Healthlink PPO,Healthlink PPO,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,HomeState Health Plan,HomeState Health Plan,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Humana Gold,Humana Gold,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Medicaid MO,Medicaid MO,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Medica,Medica,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Tricare,Tricare,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,UHC All Payer,UHC All Payer,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,UHC Exchange,UHC Exchange,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,UHC Medicaid,UHC Medicaid,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,UMR CPD,UMR CPD,89.23,,,,,,,per diem,89.23,89.23,"Per diem rate, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,UHC Medicare,UHC Medicare,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TPD INJECTION SUBCU/IN,38270096,CDM,300,RC,,,,,,Inpatient,,,89.23,89.23,Wellcare,Wellcare,89.23,,,,,,,case rate,89.23,89.23,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Meritain Health PPO CPD,Meritain Health PPO CPD,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Aetna/Commercial Product,Aetna/Commercial Product,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Meritain Health CPD,Meritain Health CPD,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Starmark CPD,Starmark CPD,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Aetna Medicare,Aetna Medicare,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Ambetter ,Ambetter ,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Blue Access,Anthem Blue Access,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Blue Access Choice,Anthem Blue Access Choice,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Blue Preferred,Anthem Blue Preferred,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Pathway,Anthem Pathway,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Alliance,Anthem Alliance,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Anthem Medicare,Anthem Medicare,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Cigna,Cigna,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Cigna PPO,Cigna PPO,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Cigna Medicare Advantage,Cigna Medicare Advantage,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Essence,Essence,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Healthlink HMO,Healthlink HMO,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Healthlink PPO,Healthlink PPO,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,HomeState Health Plan,HomeState Health Plan,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Humana Gold,Humana Gold,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Medicaid MO,Medicaid MO,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Medica,Medica,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Tricare,Tricare,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,UHC All Payer,UHC All Payer,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,UHC Exchange,UHC Exchange,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,UHC Medicaid,UHC Medicaid,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,UMR CPD,UMR CPD,179.96,,,,,,,per diem,179.96,179.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,UHC Medicare,UHC Medicare,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRANSFER BATH BENCH ST,38270097,CDM,300,RC,,,,,,Inpatient,,,179.96,179.96,Wellcare,Wellcare,179.96,,,,,,,case rate,179.96,179.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Meritain Health PPO CPD,Meritain Health PPO CPD,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Aetna/Commercial Product,Aetna/Commercial Product,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Meritain Health CPD,Meritain Health CPD,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Starmark CPD,Starmark CPD,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Aetna Medicare,Aetna Medicare,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Ambetter ,Ambetter ,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Blue Access,Anthem Blue Access,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Blue Access Choice,Anthem Blue Access Choice,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Blue Preferred,Anthem Blue Preferred,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Pathway,Anthem Pathway,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Alliance,Anthem Alliance,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Anthem Medicare,Anthem Medicare,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Cigna,Cigna,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Cigna PPO,Cigna PPO,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Cigna Medicare Advantage,Cigna Medicare Advantage,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Essence,Essence,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Healthlink HMO,Healthlink HMO,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Healthlink PPO,Healthlink PPO,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,HomeState Health Plan,HomeState Health Plan,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Humana Gold,Humana Gold,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Medicaid MO,Medicaid MO,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Medica,Medica,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Tricare,Tricare,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,UHC All Payer,UHC All Payer,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,UHC Exchange,UHC Exchange,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,UHC Medicaid,UHC Medicaid,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,UMR CPD,UMR CPD,1328.05,,,,,,,per diem,1328.05,1328.05,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,UHC Medicare,UHC Medicare,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT AID BLK         ,38270098,CDM,300,RC,,,,,,Inpatient,,,1328.05,1328.05,Wellcare,Wellcare,1328.05,,,,,,,case rate,1328.05,1328.05,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Meritain Health PPO CPD,Meritain Health PPO CPD,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Aetna/Commercial Product,Aetna/Commercial Product,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Meritain Health CPD,Meritain Health CPD,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Starmark CPD,Starmark CPD,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Aetna Medicare,Aetna Medicare,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Ambetter ,Ambetter ,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Blue Access,Anthem Blue Access,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Blue Access Choice,Anthem Blue Access Choice,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Blue Preferred,Anthem Blue Preferred,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Pathway,Anthem Pathway,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Alliance,Anthem Alliance,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Anthem Medicare,Anthem Medicare,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Cigna,Cigna,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Cigna PPO,Cigna PPO,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Cigna Medicare Advantage,Cigna Medicare Advantage,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Essence,Essence,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Healthlink HMO,Healthlink HMO,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Healthlink PPO,Healthlink PPO,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,HomeState Health Plan,HomeState Health Plan,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Humana Gold,Humana Gold,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Medicaid MO,Medicaid MO,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Medica,Medica,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Tricare,Tricare,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,UHC All Payer,UHC All Payer,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,UHC Exchange,UHC Exchange,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,UHC Medicaid,UHC Medicaid,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,UMR CPD,UMR CPD,1010.84,,,,,,,per diem,1010.84,1010.84,"Per diem rate, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,UHC Medicare,UHC Medicare,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
RGNCONV-TRTMT SIM-COM         ,38270099,CDM,300,RC,,,,,,Inpatient,,,1010.84,1010.84,Wellcare,Wellcare,1010.84,,,,,,,case rate,1010.84,1010.84,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Meritain Health PPO CPD,Meritain Health PPO CPD,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Aetna/Commercial Product,Aetna/Commercial Product,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Meritain Health CPD,Meritain Health CPD,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Starmark CPD,Starmark CPD,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Aetna Medicare,Aetna Medicare,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Ambetter ,Ambetter ,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Blue Access,Anthem Blue Access,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Blue Access Choice,Anthem Blue Access Choice,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Blue Preferred,Anthem Blue Preferred,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Pathway,Anthem Pathway,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Alliance,Anthem Alliance,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Anthem Medicare,Anthem Medicare,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Cigna,Cigna,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Cigna PPO,Cigna PPO,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Cigna Medicare Advantage,Cigna Medicare Advantage,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Essence,Essence,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Healthlink HMO,Healthlink HMO,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Healthlink PPO,Healthlink PPO,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,HomeState Health Plan,HomeState Health Plan,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Humana Gold,Humana Gold,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Medicaid MO,Medicaid MO,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Medica,Medica,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Tricare,Tricare,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,UHC All Payer,UHC All Payer,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,UHC Exchange,UHC Exchange,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,UHC Medicaid,UHC Medicaid,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,UMR CPD,UMR CPD,95.34,,,,,,,per diem,95.34,95.34,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,UHC Medicare,UHC Medicare,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, G               ",38270100,CDM,300,RC,,,,,,Inpatient,,,95.34,95.34,Wellcare,Wellcare,95.34,,,,,,,case rate,95.34,95.34,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Meritain Health PPO CPD,Meritain Health PPO CPD,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Aetna/Commercial Product,Aetna/Commercial Product,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Meritain Health CPD,Meritain Health CPD,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Starmark CPD,Starmark CPD,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Aetna Medicare,Aetna Medicare,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Ambetter ,Ambetter ,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Blue Access,Anthem Blue Access,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Blue Access Choice,Anthem Blue Access Choice,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Blue Preferred,Anthem Blue Preferred,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Pathway,Anthem Pathway,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Alliance,Anthem Alliance,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Anthem Medicare,Anthem Medicare,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Cigna,Cigna,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Cigna PPO,Cigna PPO,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Cigna Medicare Advantage,Cigna Medicare Advantage,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Essence,Essence,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Healthlink HMO,Healthlink HMO,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Healthlink PPO,Healthlink PPO,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,HomeState Health Plan,HomeState Health Plan,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Humana Gold,Humana Gold,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Medicaid MO,Medicaid MO,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Medica,Medica,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Tricare,Tricare,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,UHC All Payer,UHC All Payer,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,UHC Exchange,UHC Exchange,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,UHC Medicaid,UHC Medicaid,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,UMR CPD,UMR CPD,570.25,,,,,,,per diem,570.25,570.25,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,UHC Medicare,UHC Medicare,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, GJ              ",38270101,CDM,300,RC,,,,,,Inpatient,,,570.25,570.25,Wellcare,Wellcare,570.25,,,,,,,case rate,570.25,570.25,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Meritain Health PPO CPD,Meritain Health PPO CPD,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Aetna/Commercial Product,Aetna/Commercial Product,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Meritain Health CPD,Meritain Health CPD,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Starmark CPD,Starmark CPD,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Aetna Medicare,Aetna Medicare,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Ambetter ,Ambetter ,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Blue Access,Anthem Blue Access,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Blue Access Choice,Anthem Blue Access Choice,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Blue Preferred,Anthem Blue Preferred,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Pathway,Anthem Pathway,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Alliance,Anthem Alliance,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Anthem Medicare,Anthem Medicare,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Cigna,Cigna,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Cigna PPO,Cigna PPO,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Cigna Medicare Advantage,Cigna Medicare Advantage,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Essence,Essence,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Healthlink HMO,Healthlink HMO,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Healthlink PPO,Healthlink PPO,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,HomeState Health Plan,HomeState Health Plan,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Humana Gold,Humana Gold,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Medicaid MO,Medicaid MO,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Medica,Medica,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Tricare,Tricare,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,UHC All Payer,UHC All Payer,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,UHC Exchange,UHC Exchange,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,UHC Medicaid,UHC Medicaid,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,UMR CPD,UMR CPD,393.67,,,,,,,per diem,393.67,393.67,"Per diem rate, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,UHC Medicare,UHC Medicare,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
"RGNCONV-TUBE, J               ",38270102,CDM,300,RC,,,,,,Inpatient,,,393.67,393.67,Wellcare,Wellcare,393.67,,,,,,,case rate,393.67,393.67,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Meritain Health PPO CPD,Meritain Health PPO CPD,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Aetna/Commercial Product,Aetna/Commercial Product,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Meritain Health CPD,Meritain Health CPD,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Starmark CPD,Starmark CPD,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Aetna Medicare,Aetna Medicare,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Ambetter ,Ambetter ,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Blue Access,Anthem Blue Access,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Blue Access Choice,Anthem Blue Access Choice,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Blue Preferred,Anthem Blue Preferred,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Pathway,Anthem Pathway,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Alliance,Anthem Alliance,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Anthem Medicare,Anthem Medicare,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Cigna,Cigna,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Cigna PPO,Cigna PPO,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Cigna Medicare Advantage,Cigna Medicare Advantage,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Essence,Essence,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Healthlink HMO,Healthlink HMO,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Healthlink PPO,Healthlink PPO,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,HomeState Health Plan,HomeState Health Plan,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Humana Gold,Humana Gold,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Medicaid MO,Medicaid MO,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Medica,Medica,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Tricare,Tricare,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,UHC All Payer,UHC All Payer,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,UHC Exchange,UHC Exchange,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,UHC Medicaid,UHC Medicaid,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,UMR CPD,UMR CPD,433.4,,,,,,,per diem,433.4,433.4,"Per diem rate, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,UHC Medicare,UHC Medicare,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-ULTRASOUND-TX KIDNEY  ,38270103,CDM,300,RC,,,,,,Inpatient,,,433.4,433.4,Wellcare,Wellcare,433.4,,,,,,,case rate,433.4,433.4,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Meritain Health PPO CPD,Meritain Health PPO CPD,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Aetna/Commercial Product,Aetna/Commercial Product,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Meritain Health CPD,Meritain Health CPD,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Starmark CPD,Starmark CPD,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Aetna Medicare,Aetna Medicare,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Ambetter ,Ambetter ,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Blue Access,Anthem Blue Access,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Blue Access Choice,Anthem Blue Access Choice,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Blue Preferred,Anthem Blue Preferred,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Pathway,Anthem Pathway,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Alliance,Anthem Alliance,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Anthem Medicare,Anthem Medicare,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Cigna,Cigna,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Cigna PPO,Cigna PPO,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Cigna Medicare Advantage,Cigna Medicare Advantage,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Essence,Essence,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Healthlink HMO,Healthlink HMO,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Healthlink PPO,Healthlink PPO,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,HomeState Health Plan,HomeState Health Plan,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Humana Gold,Humana Gold,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Medicaid MO,Medicaid MO,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Medica,Medica,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Tricare,Tricare,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,UHC All Payer,UHC All Payer,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,UHC Exchange,UHC Exchange,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,UHC Medicaid,UHC Medicaid,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,UMR CPD,UMR CPD,807.58,,,,,,,per diem,807.58,807.58,"Per diem rate, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,UHC Medicare,UHC Medicare,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-URETHROCYSTOGRAPHY RET,38270104,CDM,300,RC,,,,,,Inpatient,,,807.58,807.58,Wellcare,Wellcare,807.58,,,,,,,case rate,807.58,807.58,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Meritain Health PPO CPD,Meritain Health PPO CPD,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Aetna/Commercial Product,Aetna/Commercial Product,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Meritain Health CPD,Meritain Health CPD,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Starmark CPD,Starmark CPD,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Aetna Medicare,Aetna Medicare,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Ambetter ,Ambetter ,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Blue Access,Anthem Blue Access,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Blue Access Choice,Anthem Blue Access Choice,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Blue Preferred,Anthem Blue Preferred,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Pathway,Anthem Pathway,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Alliance,Anthem Alliance,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Anthem Medicare,Anthem Medicare,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Cigna,Cigna,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Cigna PPO,Cigna PPO,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Cigna Medicare Advantage,Cigna Medicare Advantage,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Essence,Essence,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Healthlink HMO,Healthlink HMO,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Healthlink PPO,Healthlink PPO,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,HomeState Health Plan,HomeState Health Plan,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Humana Gold,Humana Gold,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Medicaid MO,Medicaid MO,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Medica,Medica,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Tricare,Tricare,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,UHC All Payer,UHC All Payer,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,UHC Exchange,UHC Exchange,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,UHC Medicaid,UHC Medicaid,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,UMR CPD,UMR CPD,17.78,,,,,,,per diem,17.78,17.78,"Per diem rate, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,UHC Medicare,UHC Medicare,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VAD DRIVELINE SECUREME,38270105,CDM,300,RC,,,,,,Inpatient,,,17.78,17.78,Wellcare,Wellcare,17.78,,,,,,,case rate,17.78,17.78,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Meritain Health PPO CPD,Meritain Health PPO CPD,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Aetna/Commercial Product,Aetna/Commercial Product,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Meritain Health CPD,Meritain Health CPD,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Starmark CPD,Starmark CPD,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Aetna Medicare,Aetna Medicare,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Ambetter ,Ambetter ,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Blue Access,Anthem Blue Access,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Blue Access Choice,Anthem Blue Access Choice,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Blue Preferred,Anthem Blue Preferred,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Pathway,Anthem Pathway,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Alliance,Anthem Alliance,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Anthem Medicare,Anthem Medicare,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Cigna,Cigna,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Cigna PPO,Cigna PPO,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Cigna Medicare Advantage,Cigna Medicare Advantage,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Essence,Essence,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Healthlink HMO,Healthlink HMO,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Healthlink PPO,Healthlink PPO,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,HomeState Health Plan,HomeState Health Plan,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Humana Gold,Humana Gold,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Medicaid MO,Medicaid MO,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Medica,Medica,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Tricare,Tricare,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,UHC All Payer,UHC All Payer,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,UHC Exchange,UHC Exchange,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,UHC Medicaid,UHC Medicaid,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,UMR CPD,UMR CPD,454.41,,,,,,,per diem,454.41,454.41,"Per diem rate, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,UHC Medicare,UHC Medicare,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-VNS PROGRAMMING 1ST HO,38270106,CDM,300,RC,,,,,,Inpatient,,,454.41,454.41,Wellcare,Wellcare,454.41,,,,,,,case rate,454.41,454.41,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Meritain Health PPO CPD,Meritain Health PPO CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna/Commercial Product,Aetna/Commercial Product,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Meritain Health CPD,Meritain Health CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Starmark CPD,Starmark CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Aetna Medicare,Aetna Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Ambetter ,Ambetter ,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Access,Anthem Blue Access,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Access Choice,Anthem Blue Access Choice,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Blue Preferred,Anthem Blue Preferred,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Pathway,Anthem Pathway,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Alliance,Anthem Alliance,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Anthem Medicare,Anthem Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna,Cigna,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna PPO,Cigna PPO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Cigna Medicare Advantage,Cigna Medicare Advantage,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Essence,Essence,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthlink HMO,Healthlink HMO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Healthlink PPO,Healthlink PPO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,HomeState Health Plan,HomeState Health Plan,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Humana Gold,Humana Gold,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Medicaid MO,Medicaid MO,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Medica,Medica,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Tricare,Tricare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC All Payer,UHC All Payer,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Exchange,UHC Exchange,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Medicaid,UHC Medicaid,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UMR CPD,UMR CPD,320.61,,,,,,,per diem,320.61,320.61,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,UHC Medicare,UHC Medicare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER 4 WHEELD W/BASK,38270107,CDM,300,RC,,,,,,Inpatient,,,320.61,320.61,Wellcare,Wellcare,320.61,,,,,,,case rate,320.61,320.61,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Meritain Health PPO CPD,Meritain Health PPO CPD,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Aetna/Commercial Product,Aetna/Commercial Product,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Meritain Health CPD,Meritain Health CPD,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Starmark CPD,Starmark CPD,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Aetna Medicare,Aetna Medicare,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Ambetter ,Ambetter ,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Blue Access,Anthem Blue Access,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Blue Access Choice,Anthem Blue Access Choice,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Blue Preferred,Anthem Blue Preferred,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Pathway,Anthem Pathway,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Alliance,Anthem Alliance,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Anthem Medicare,Anthem Medicare,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Cigna,Cigna,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Cigna PPO,Cigna PPO,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Cigna Medicare Advantage,Cigna Medicare Advantage,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Essence,Essence,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Healthlink HMO,Healthlink HMO,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Healthlink PPO,Healthlink PPO,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,HomeState Health Plan,HomeState Health Plan,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Humana Gold,Humana Gold,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Medicaid MO,Medicaid MO,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Medica,Medica,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Tricare,Tricare,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,UHC All Payer,UHC All Payer,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,UHC Exchange,UHC Exchange,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,UHC Medicaid,UHC Medicaid,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,UMR CPD,UMR CPD,174.39,,,,,,,per diem,174.39,174.39,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,UHC Medicare,UHC Medicare,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER JUNIOR W/WHLS P,38270108,CDM,300,RC,,,,,,Inpatient,,,174.39,174.39,Wellcare,Wellcare,174.39,,,,,,,case rate,174.39,174.39,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Meritain Health PPO CPD,Meritain Health PPO CPD,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Aetna/Commercial Product,Aetna/Commercial Product,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Meritain Health CPD,Meritain Health CPD,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Starmark CPD,Starmark CPD,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Aetna Medicare,Aetna Medicare,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Ambetter ,Ambetter ,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Blue Access,Anthem Blue Access,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Blue Access Choice,Anthem Blue Access Choice,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Blue Preferred,Anthem Blue Preferred,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Pathway,Anthem Pathway,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Alliance,Anthem Alliance,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Anthem Medicare,Anthem Medicare,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Cigna,Cigna,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Cigna PPO,Cigna PPO,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Cigna Medicare Advantage,Cigna Medicare Advantage,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Essence,Essence,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Healthlink HMO,Healthlink HMO,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Healthlink PPO,Healthlink PPO,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,HomeState Health Plan,HomeState Health Plan,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Humana Gold,Humana Gold,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Medicaid MO,Medicaid MO,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Medica,Medica,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Tricare,Tricare,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,UHC All Payer,UHC All Payer,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,UHC Exchange,UHC Exchange,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,UHC Medicaid,UHC Medicaid,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,UMR CPD,UMR CPD,58.38,,,,,,,per diem,58.38,58.38,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,UHC Medicare,UHC Medicare,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER SEAT ATTACHMENT,38270109,CDM,300,RC,,,,,,Inpatient,,,58.38,58.38,Wellcare,Wellcare,58.38,,,,,,,case rate,58.38,58.38,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Meritain Health PPO CPD,Meritain Health PPO CPD,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Aetna/Commercial Product,Aetna/Commercial Product,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Meritain Health CPD,Meritain Health CPD,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Starmark CPD,Starmark CPD,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Aetna Medicare,Aetna Medicare,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Ambetter ,Ambetter ,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Blue Access,Anthem Blue Access,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Blue Access Choice,Anthem Blue Access Choice,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Blue Preferred,Anthem Blue Preferred,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Pathway,Anthem Pathway,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Alliance,Anthem Alliance,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Anthem Medicare,Anthem Medicare,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Cigna,Cigna,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Cigna PPO,Cigna PPO,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Cigna Medicare Advantage,Cigna Medicare Advantage,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Essence,Essence,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Healthlink HMO,Healthlink HMO,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Healthlink PPO,Healthlink PPO,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,HomeState Health Plan,HomeState Health Plan,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Humana Gold,Humana Gold,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Medicaid MO,Medicaid MO,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Medica,Medica,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Tricare,Tricare,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,UHC All Payer,UHC All Payer,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,UHC Exchange,UHC Exchange,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,UHC Medicaid,UHC Medicaid,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,UMR CPD,UMR CPD,216.82,,,,,,,per diem,216.82,216.82,"Per diem rate, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,UHC Medicare,UHC Medicare,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKER STD W/WHLS PURC,38270110,CDM,300,RC,,,,,,Inpatient,,,216.82,216.82,Wellcare,Wellcare,216.82,,,,,,,case rate,216.82,216.82,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Meritain Health PPO CPD,Meritain Health PPO CPD,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Aetna/Commercial Product,Aetna/Commercial Product,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Meritain Health CPD,Meritain Health CPD,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Starmark CPD,Starmark CPD,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Aetna Medicare,Aetna Medicare,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Ambetter ,Ambetter ,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Blue Access,Anthem Blue Access,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Blue Access Choice,Anthem Blue Access Choice,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Blue Preferred,Anthem Blue Preferred,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Pathway,Anthem Pathway,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Alliance,Anthem Alliance,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Anthem Medicare,Anthem Medicare,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Cigna,Cigna,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Cigna PPO,Cigna PPO,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Cigna Medicare Advantage,Cigna Medicare Advantage,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Essence,Essence,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Healthlink HMO,Healthlink HMO,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Healthlink PPO,Healthlink PPO,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,HomeState Health Plan,HomeState Health Plan,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Humana Gold,Humana Gold,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Medicaid MO,Medicaid MO,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Medica,Medica,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Tricare,Tricare,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,UHC All Payer,UHC All Payer,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,UHC Exchange,UHC Exchange,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,UHC Medicaid,UHC Medicaid,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,UMR CPD,UMR CPD,236.2,,,,,,,per diem,236.2,236.2,"Per diem rate, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,UHC Medicare,UHC Medicare,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WALKING BOOT PNEUMATIC,38270111,CDM,300,RC,,,,,,Inpatient,,,236.2,236.2,Wellcare,Wellcare,236.2,,,,,,,case rate,236.2,236.2,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Meritain Health PPO CPD,Meritain Health PPO CPD,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Aetna/Commercial Product,Aetna/Commercial Product,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Meritain Health CPD,Meritain Health CPD,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Starmark CPD,Starmark CPD,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Aetna Medicare,Aetna Medicare,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Ambetter ,Ambetter ,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Blue Access,Anthem Blue Access,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Blue Access Choice,Anthem Blue Access Choice,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Blue Preferred,Anthem Blue Preferred,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Pathway,Anthem Pathway,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Alliance,Anthem Alliance,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Anthem Medicare,Anthem Medicare,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Cigna,Cigna,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Cigna PPO,Cigna PPO,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Cigna Medicare Advantage,Cigna Medicare Advantage,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Essence,Essence,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Healthlink HMO,Healthlink HMO,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Healthlink PPO,Healthlink PPO,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,HomeState Health Plan,HomeState Health Plan,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Humana Gold,Humana Gold,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Medicaid MO,Medicaid MO,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Medica,Medica,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Tricare,Tricare,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,UHC All Payer,UHC All Payer,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,UHC Exchange,UHC Exchange,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,UHC Medicaid,UHC Medicaid,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,UMR CPD,UMR CPD,11.68,,,,,,,per diem,11.68,11.68,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,UHC Medicare,UHC Medicare,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR ANTI-TIP DEV RN,38270112,CDM,300,RC,,,,,,Inpatient,,,11.68,11.68,Wellcare,Wellcare,11.68,,,,,,,case rate,11.68,11.68,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Meritain Health PPO CPD,Meritain Health PPO CPD,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Aetna/Commercial Product,Aetna/Commercial Product,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Meritain Health CPD,Meritain Health CPD,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Starmark CPD,Starmark CPD,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Aetna Medicare,Aetna Medicare,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Ambetter ,Ambetter ,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Blue Access,Anthem Blue Access,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Blue Access Choice,Anthem Blue Access Choice,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Blue Preferred,Anthem Blue Preferred,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Pathway,Anthem Pathway,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Alliance,Anthem Alliance,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Anthem Medicare,Anthem Medicare,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Cigna,Cigna,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Cigna PPO,Cigna PPO,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Cigna Medicare Advantage,Cigna Medicare Advantage,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Essence,Essence,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Healthlink HMO,Healthlink HMO,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Healthlink PPO,Healthlink PPO,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,HomeState Health Plan,HomeState Health Plan,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Humana Gold,Humana Gold,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Medicaid MO,Medicaid MO,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Medica,Medica,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Tricare,Tricare,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,UHC All Payer,UHC All Payer,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,UHC Exchange,UHC Exchange,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,UHC Medicaid,UHC Medicaid,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,UMR CPD,UMR CPD,94.7,,,,,,,per diem,94.7,94.7,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,UHC Medicare,UHC Medicare,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR CUSHION LOW PRE,38270113,CDM,300,RC,,,,,,Inpatient,,,94.7,94.7,Wellcare,Wellcare,94.7,,,,,,,case rate,94.7,94.7,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health PPO CPD,Meritain Health PPO CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Aetna/Commercial Product,Aetna/Commercial Product,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Meritain Health CPD,Meritain Health CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Starmark CPD,Starmark CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Aetna Medicare,Aetna Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Ambetter ,Ambetter ,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access,Anthem Blue Access,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Access Choice,Anthem Blue Access Choice,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Blue Preferred,Anthem Blue Preferred,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Pathway,Anthem Pathway,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Alliance,Anthem Alliance,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Anthem Medicare,Anthem Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Cigna,Cigna,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Cigna PPO,Cigna PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Cigna Medicare Advantage,Cigna Medicare Advantage,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Essence,Essence,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink HMO,Healthlink HMO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Healthlink PPO,Healthlink PPO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,HomeState Health Plan,HomeState Health Plan,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Humana Gold,Humana Gold,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Medicaid MO,Medicaid MO,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Medica,Medica,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Tricare,Tricare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,UHC All Payer,UHC All Payer,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,UHC Exchange,UHC Exchange,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicaid,UHC Medicaid,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,UMR CPD,UMR CPD,31.5,,,,,,,per diem,31.5,31.5,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,UHC Medicare,UHC Medicare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR LEGREST ELV CTM,38270114,CDM,300,RC,,,,,,Inpatient,,,31.5,31.5,Wellcare,Wellcare,31.5,,,,,,,case rate,31.5,31.5,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Meritain Health PPO CPD,Meritain Health PPO CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Aetna/Commercial Product,Aetna/Commercial Product,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Meritain Health CPD,Meritain Health CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Starmark CPD,Starmark CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Aetna Medicare,Aetna Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Ambetter ,Ambetter ,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Access,Anthem Blue Access,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Access Choice,Anthem Blue Access Choice,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Blue Preferred,Anthem Blue Preferred,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Pathway,Anthem Pathway,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Alliance,Anthem Alliance,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Anthem Medicare,Anthem Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Cigna,Cigna,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Cigna PPO,Cigna PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Cigna Medicare Advantage,Cigna Medicare Advantage,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Essence,Essence,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Healthlink HMO,Healthlink HMO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Healthlink PPO,Healthlink PPO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,HomeState Health Plan,HomeState Health Plan,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Humana Gold,Humana Gold,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Medicaid MO,Medicaid MO,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Medica,Medica,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Tricare,Tricare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,UHC All Payer,UHC All Payer,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,UHC Exchange,UHC Exchange,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,UHC Medicaid,UHC Medicaid,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,UMR CPD,UMR CPD,133.9,,,,,,,per diem,133.9,133.9,"Per diem rate, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,UHC Medicare,UHC Medicare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
RGNCONV-WHLCHR STANDARD RENT/M,38270115,CDM,300,RC,,,,,,Inpatient,,,133.9,133.9,Wellcare,Wellcare,133.9,,,,,,,case rate,133.9,133.9,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Meritain Health PPO CPD,Meritain Health PPO CPD,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Aetna/Commercial Product,Aetna/Commercial Product,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Meritain Health CPD,Meritain Health CPD,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Starmark CPD,Starmark CPD,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Aetna Medicare,Aetna Medicare,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Ambetter ,Ambetter ,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Blue Access,Anthem Blue Access,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Blue Access Choice,Anthem Blue Access Choice,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Blue Preferred,Anthem Blue Preferred,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Pathway,Anthem Pathway,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Alliance,Anthem Alliance,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Anthem Medicare,Anthem Medicare,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Cigna,Cigna,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Cigna PPO,Cigna PPO,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Cigna Medicare Advantage,Cigna Medicare Advantage,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Essence,Essence,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Healthlink HMO,Healthlink HMO,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Healthlink PPO,Healthlink PPO,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,HomeState Health Plan,HomeState Health Plan,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Humana Gold,Humana Gold,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Medicaid MO,Medicaid MO,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Medica,Medica,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Tricare,Tricare,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,UHC All Payer,UHC All Payer,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,UHC Exchange,UHC Exchange,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,UHC Medicaid,UHC Medicaid,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,UMR CPD,UMR CPD,173.22,,,,,,,per diem,173.22,173.22,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,UHC Medicare,UHC Medicare,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, 018             ",38270116,CDM,300,RC,,,,,,Inpatient,,,173.22,173.22,Wellcare,Wellcare,173.22,,,,,,,case rate,173.22,173.22,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Meritain Health PPO CPD,Meritain Health PPO CPD,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Aetna/Commercial Product,Aetna/Commercial Product,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Meritain Health CPD,Meritain Health CPD,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Starmark CPD,Starmark CPD,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Aetna Medicare,Aetna Medicare,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Ambetter ,Ambetter ,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Blue Access,Anthem Blue Access,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Blue Access Choice,Anthem Blue Access Choice,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Blue Preferred,Anthem Blue Preferred,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Pathway,Anthem Pathway,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Alliance,Anthem Alliance,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Anthem Medicare,Anthem Medicare,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Cigna,Cigna,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Cigna PPO,Cigna PPO,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Cigna Medicare Advantage,Cigna Medicare Advantage,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Essence,Essence,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Healthlink HMO,Healthlink HMO,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Healthlink PPO,Healthlink PPO,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,HomeState Health Plan,HomeState Health Plan,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Humana Gold,Humana Gold,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Medicaid MO,Medicaid MO,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Medica,Medica,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Tricare,Tricare,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,UHC All Payer,UHC All Payer,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,UHC Exchange,UHC Exchange,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,UHC Medicaid,UHC Medicaid,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,UMR CPD,UMR CPD,70.27,,,,,,,per diem,70.27,70.27,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,UHC Medicare,UHC Medicare,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, AMPLATZ         ",38270117,CDM,300,RC,,,,,,Inpatient,,,70.27,70.27,Wellcare,Wellcare,70.27,,,,,,,case rate,70.27,70.27,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Meritain Health PPO CPD,Meritain Health PPO CPD,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Aetna/Commercial Product,Aetna/Commercial Product,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Meritain Health CPD,Meritain Health CPD,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Starmark CPD,Starmark CPD,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Aetna Medicare,Aetna Medicare,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Ambetter ,Ambetter ,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Blue Access,Anthem Blue Access,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Blue Access Choice,Anthem Blue Access Choice,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Blue Preferred,Anthem Blue Preferred,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Pathway,Anthem Pathway,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Alliance,Anthem Alliance,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Anthem Medicare,Anthem Medicare,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Cigna,Cigna,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Cigna PPO,Cigna PPO,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Cigna Medicare Advantage,Cigna Medicare Advantage,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Essence,Essence,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Healthlink HMO,Healthlink HMO,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Healthlink PPO,Healthlink PPO,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,HomeState Health Plan,HomeState Health Plan,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Humana Gold,Humana Gold,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Medicaid MO,Medicaid MO,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Medica,Medica,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Tricare,Tricare,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,UHC All Payer,UHC All Payer,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,UHC Exchange,UHC Exchange,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,UHC Medicaid,UHC Medicaid,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,UMR CPD,UMR CPD,22.39,,,,,,,per diem,22.39,22.39,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,UHC Medicare,UHC Medicare,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, DIAGNOSTIC      ",38270118,CDM,300,RC,,,,,,Inpatient,,,22.39,22.39,Wellcare,Wellcare,22.39,,,,,,,case rate,22.39,22.39,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Meritain Health PPO CPD,Meritain Health PPO CPD,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Aetna/Commercial Product,Aetna/Commercial Product,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Meritain Health CPD,Meritain Health CPD,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Starmark CPD,Starmark CPD,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Aetna Medicare,Aetna Medicare,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Ambetter ,Ambetter ,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Blue Access,Anthem Blue Access,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Blue Access Choice,Anthem Blue Access Choice,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Blue Preferred,Anthem Blue Preferred,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Pathway,Anthem Pathway,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Alliance,Anthem Alliance,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Anthem Medicare,Anthem Medicare,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Cigna,Cigna,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Cigna PPO,Cigna PPO,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Cigna Medicare Advantage,Cigna Medicare Advantage,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Essence,Essence,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Healthlink HMO,Healthlink HMO,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Healthlink PPO,Healthlink PPO,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,HomeState Health Plan,HomeState Health Plan,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Humana Gold,Humana Gold,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Medicaid MO,Medicaid MO,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Medica,Medica,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Tricare,Tricare,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,UHC All Payer,UHC All Payer,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,UHC Exchange,UHC Exchange,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,UHC Medicaid,UHC Medicaid,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,UMR CPD,UMR CPD,455.58,,,,,,,per diem,455.58,455.58,"Per diem rate, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,UHC Medicare,UHC Medicare,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
"RGNCONV-WIRE, GLIDE           ",38270119,CDM,300,RC,,,,,,Inpatient,,,455.58,455.58,Wellcare,Wellcare,455.58,,,,,,,case rate,455.58,455.58,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Meritain Health PPO CPD,Meritain Health PPO CPD,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Aetna/Commercial Product,Aetna/Commercial Product,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Meritain Health CPD,Meritain Health CPD,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Starmark CPD,Starmark CPD,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Aetna Medicare,Aetna Medicare,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Ambetter ,Ambetter ,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Blue Access,Anthem Blue Access,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Blue Access Choice,Anthem Blue Access Choice,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Blue Preferred,Anthem Blue Preferred,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Pathway,Anthem Pathway,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Alliance,Anthem Alliance,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Anthem Medicare,Anthem Medicare,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Cigna,Cigna,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Cigna PPO,Cigna PPO,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Cigna Medicare Advantage,Cigna Medicare Advantage,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Essence,Essence,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Healthlink HMO,Healthlink HMO,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Healthlink PPO,Healthlink PPO,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,HomeState Health Plan,HomeState Health Plan,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Humana Gold,Humana Gold,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Medicaid MO,Medicaid MO,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Medica,Medica,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Tricare,Tricare,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,UHC All Payer,UHC All Payer,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,UHC Exchange,UHC Exchange,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,UHC Medicaid,UHC Medicaid,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,UMR CPD,UMR CPD,433.91,,,,,,,per diem,433.91,433.91,"Per diem rate, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,UHC Medicare,UHC Medicare,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-Laboratory            ,38270120,CDM,300,RC,,,,,,Inpatient,,,433.91,433.91,Wellcare,Wellcare,433.91,,,,,,,case rate,433.91,433.91,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Meritain Health PPO CPD,Meritain Health PPO CPD,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Aetna/Commercial Product,Aetna/Commercial Product,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Meritain Health CPD,Meritain Health CPD,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Starmark CPD,Starmark CPD,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Aetna Medicare,Aetna Medicare,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Ambetter ,Ambetter ,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Blue Access,Anthem Blue Access,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Blue Access Choice,Anthem Blue Access Choice,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Blue Preferred,Anthem Blue Preferred,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Pathway,Anthem Pathway,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Alliance,Anthem Alliance,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Anthem Medicare,Anthem Medicare,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Cigna,Cigna,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Cigna PPO,Cigna PPO,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Cigna Medicare Advantage,Cigna Medicare Advantage,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Essence,Essence,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Healthlink HMO,Healthlink HMO,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Healthlink PPO,Healthlink PPO,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,HomeState Health Plan,HomeState Health Plan,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Humana Gold,Humana Gold,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Medicaid MO,Medicaid MO,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Medica,Medica,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Tricare,Tricare,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,UHC All Payer,UHC All Payer,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,UHC Exchange,UHC Exchange,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,UHC Medicaid,UHC Medicaid,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,UMR CPD,UMR CPD,29.67,,,,,,,per diem,29.67,29.67,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,UHC Medicare,UHC Medicare,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL   ,38270121,CDM,300,RC,,,,,,Inpatient,,,29.67,29.67,Wellcare,Wellcare,29.67,,,,,,,case rate,29.67,29.67,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Meritain Health PPO CPD,Meritain Health PPO CPD,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Aetna/Commercial Product,Aetna/Commercial Product,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Meritain Health CPD,Meritain Health CPD,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Starmark CPD,Starmark CPD,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Aetna Medicare,Aetna Medicare,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Ambetter ,Ambetter ,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Blue Access,Anthem Blue Access,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Blue Access Choice,Anthem Blue Access Choice,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Blue Preferred,Anthem Blue Preferred,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Pathway,Anthem Pathway,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Alliance,Anthem Alliance,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Anthem Medicare,Anthem Medicare,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Cigna,Cigna,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Cigna PPO,Cigna PPO,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Cigna Medicare Advantage,Cigna Medicare Advantage,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Essence,Essence,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Healthlink HMO,Healthlink HMO,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Healthlink PPO,Healthlink PPO,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,HomeState Health Plan,HomeState Health Plan,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Humana Gold,Humana Gold,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Medicaid MO,Medicaid MO,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Medica,Medica,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Tricare,Tricare,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,UHC All Payer,UHC All Payer,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,UHC Exchange,UHC Exchange,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,UHC Medicaid,UHC Medicaid,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,UMR CPD,UMR CPD,31.17,,,,,,,per diem,31.17,31.17,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,UHC Medicare,UHC Medicare,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE 2 PCT GEL 20,38270122,CDM,300,RC,,,,,,Inpatient,,,31.17,31.17,Wellcare,Wellcare,31.17,,,,,,,case rate,31.17,31.17,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Meritain Health PPO CPD,Meritain Health PPO CPD,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Aetna/Commercial Product,Aetna/Commercial Product,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Meritain Health CPD,Meritain Health CPD,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Starmark CPD,Starmark CPD,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Aetna Medicare,Aetna Medicare,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Ambetter ,Ambetter ,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Blue Access,Anthem Blue Access,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Blue Access Choice,Anthem Blue Access Choice,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Blue Preferred,Anthem Blue Preferred,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Pathway,Anthem Pathway,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Alliance,Anthem Alliance,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Anthem Medicare,Anthem Medicare,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Cigna,Cigna,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Cigna PPO,Cigna PPO,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Cigna Medicare Advantage,Cigna Medicare Advantage,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Essence,Essence,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Healthlink HMO,Healthlink HMO,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Healthlink PPO,Healthlink PPO,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,HomeState Health Plan,HomeState Health Plan,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Humana Gold,Humana Gold,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Medicaid MO,Medicaid MO,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Medica,Medica,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Tricare,Tricare,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,UHC All Payer,UHC All Payer,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,UHC Exchange,UHC Exchange,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,UHC Medicaid,UHC Medicaid,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,UMR CPD,UMR CPD,54.2,,,,,,,per diem,54.2,54.2,"Per diem rate, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,UHC Medicare,UHC Medicare,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-LIDOCAINE PF 1PCT SOLN,38270123,CDM,300,RC,,,,,,Inpatient,,,54.2,54.2,Wellcare,Wellcare,54.2,,,,,,,case rate,54.2,54.2,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Meritain Health PPO CPD,Meritain Health PPO CPD,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Aetna/Commercial Product,Aetna/Commercial Product,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Meritain Health CPD,Meritain Health CPD,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Starmark CPD,Starmark CPD,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Aetna Medicare,Aetna Medicare,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Ambetter ,Ambetter ,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Blue Access,Anthem Blue Access,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Blue Access Choice,Anthem Blue Access Choice,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Blue Preferred,Anthem Blue Preferred,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Pathway,Anthem Pathway,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Alliance,Anthem Alliance,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Anthem Medicare,Anthem Medicare,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Cigna,Cigna,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Cigna PPO,Cigna PPO,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Cigna Medicare Advantage,Cigna Medicare Advantage,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Essence,Essence,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Healthlink HMO,Healthlink HMO,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Healthlink PPO,Healthlink PPO,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,HomeState Health Plan,HomeState Health Plan,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Humana Gold,Humana Gold,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Medicaid MO,Medicaid MO,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Medica,Medica,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Tricare,Tricare,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,UHC All Payer,UHC All Payer,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,UHC Exchange,UHC Exchange,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,UHC Medicaid,UHC Medicaid,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,UMR CPD,UMR CPD,12.96,,,,,,,per diem,12.96,12.96,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,UHC Medicare,UHC Medicare,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270124,CDM,300,RC,,,,,,Inpatient,,,12.96,12.96,Wellcare,Wellcare,12.96,,,,,,,case rate,12.96,12.96,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Meritain Health PPO CPD,Meritain Health PPO CPD,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Aetna/Commercial Product,Aetna/Commercial Product,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Meritain Health CPD,Meritain Health CPD,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Starmark CPD,Starmark CPD,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Aetna Medicare,Aetna Medicare,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Ambetter ,Ambetter ,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Blue Access,Anthem Blue Access,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Blue Access Choice,Anthem Blue Access Choice,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Blue Preferred,Anthem Blue Preferred,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Pathway,Anthem Pathway,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Alliance,Anthem Alliance,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Anthem Medicare,Anthem Medicare,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Cigna,Cigna,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Cigna PPO,Cigna PPO,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Cigna Medicare Advantage,Cigna Medicare Advantage,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Essence,Essence,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Healthlink HMO,Healthlink HMO,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Healthlink PPO,Healthlink PPO,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,HomeState Health Plan,HomeState Health Plan,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Humana Gold,Humana Gold,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Medicaid MO,Medicaid MO,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Medica,Medica,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Tricare,Tricare,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,UHC All Payer,UHC All Payer,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,UHC Exchange,UHC Exchange,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,UHC Medicaid,UHC Medicaid,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,UMR CPD,UMR CPD,21.42,,,,,,,per diem,21.42,21.42,"Per diem rate, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,UHC Medicare,UHC Medicare,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-OXYCODONE 5 MG TABS   ,38270125,CDM,300,RC,,,,,,Inpatient,,,21.42,21.42,Wellcare,Wellcare,21.42,,,,,,,case rate,21.42,21.42,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Meritain Health PPO CPD,Meritain Health PPO CPD,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Aetna/Commercial Product,Aetna/Commercial Product,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Meritain Health CPD,Meritain Health CPD,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Starmark CPD,Starmark CPD,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Aetna Medicare,Aetna Medicare,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Ambetter ,Ambetter ,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Blue Access,Anthem Blue Access,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Blue Access Choice,Anthem Blue Access Choice,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Blue Preferred,Anthem Blue Preferred,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Pathway,Anthem Pathway,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Alliance,Anthem Alliance,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Anthem Medicare,Anthem Medicare,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Cigna,Cigna,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Cigna PPO,Cigna PPO,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Cigna Medicare Advantage,Cigna Medicare Advantage,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Essence,Essence,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Healthlink HMO,Healthlink HMO,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Healthlink PPO,Healthlink PPO,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,HomeState Health Plan,HomeState Health Plan,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Humana Gold,Humana Gold,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Medicaid MO,Medicaid MO,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Medica,Medica,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Tricare,Tricare,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,UHC All Payer,UHC All Payer,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,UHC Exchange,UHC Exchange,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,UHC Medicaid,UHC Medicaid,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,UMR CPD,UMR CPD,62.77,,,,,,,per diem,62.77,62.77,"Per diem rate, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,UHC Medicare,UHC Medicare,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SILVER SULFADIAZINE 1 ,38270126,CDM,300,RC,,,,,,Inpatient,,,62.77,62.77,Wellcare,Wellcare,62.77,,,,,,,case rate,62.77,62.77,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Meritain Health PPO CPD,Meritain Health PPO CPD,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Aetna/Commercial Product,Aetna/Commercial Product,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Meritain Health CPD,Meritain Health CPD,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Starmark CPD,Starmark CPD,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Aetna Medicare,Aetna Medicare,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Ambetter ,Ambetter ,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Blue Access,Anthem Blue Access,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Blue Access Choice,Anthem Blue Access Choice,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Blue Preferred,Anthem Blue Preferred,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Pathway,Anthem Pathway,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Alliance,Anthem Alliance,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Anthem Medicare,Anthem Medicare,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Cigna,Cigna,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Cigna PPO,Cigna PPO,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Cigna Medicare Advantage,Cigna Medicare Advantage,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Essence,Essence,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Healthlink HMO,Healthlink HMO,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Healthlink PPO,Healthlink PPO,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,HomeState Health Plan,HomeState Health Plan,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Humana Gold,Humana Gold,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Medicaid MO,Medicaid MO,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Medica,Medica,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Tricare,Tricare,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,UHC All Payer,UHC All Payer,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,UHC Exchange,UHC Exchange,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,UHC Medicaid,UHC Medicaid,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,UMR CPD,UMR CPD,73.38,,,,,,,per diem,73.38,73.38,"Per diem rate, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,UHC Medicare,UHC Medicare,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-SODIUM BICARBONATE 8.4,38270127,CDM,300,RC,,,,,,Inpatient,,,73.38,73.38,Wellcare,Wellcare,73.38,,,,,,,case rate,73.38,73.38,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Meritain Health PPO CPD,Meritain Health PPO CPD,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Aetna/Commercial Product,Aetna/Commercial Product,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Meritain Health CPD,Meritain Health CPD,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Starmark CPD,Starmark CPD,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Aetna Medicare,Aetna Medicare,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Ambetter ,Ambetter ,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Blue Access,Anthem Blue Access,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Blue Access Choice,Anthem Blue Access Choice,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Blue Preferred,Anthem Blue Preferred,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Pathway,Anthem Pathway,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Alliance,Anthem Alliance,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Anthem Medicare,Anthem Medicare,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Cigna,Cigna,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Cigna PPO,Cigna PPO,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Cigna Medicare Advantage,Cigna Medicare Advantage,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Essence,Essence,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Healthlink HMO,Healthlink HMO,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Healthlink PPO,Healthlink PPO,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,HomeState Health Plan,HomeState Health Plan,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Humana Gold,Humana Gold,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Medicaid MO,Medicaid MO,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Medica,Medica,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Tricare,Tricare,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,UHC All Payer,UHC All Payer,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,UHC Exchange,UHC Exchange,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,UHC Medicaid,UHC Medicaid,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,UMR CPD,UMR CPD,1816.55,,,,,,,per diem,1816.55,1816.55,"Per diem rate, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,UHC Medicare,UHC Medicare,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TECHNETIUM PENTETATE K,38270128,CDM,300,RC,,,,,,Inpatient,,,1816.55,1816.55,Wellcare,Wellcare,1816.55,,,,,,,case rate,1816.55,1816.55,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Meritain Health PPO CPD,Meritain Health PPO CPD,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Aetna/Commercial Product,Aetna/Commercial Product,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Meritain Health CPD,Meritain Health CPD,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Starmark CPD,Starmark CPD,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Aetna Medicare,Aetna Medicare,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Ambetter ,Ambetter ,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Blue Access,Anthem Blue Access,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Blue Access Choice,Anthem Blue Access Choice,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Blue Preferred,Anthem Blue Preferred,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Pathway,Anthem Pathway,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Alliance,Anthem Alliance,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Anthem Medicare,Anthem Medicare,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Cigna,Cigna,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Cigna PPO,Cigna PPO,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Cigna Medicare Advantage,Cigna Medicare Advantage,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Essence,Essence,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Healthlink HMO,Healthlink HMO,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Healthlink PPO,Healthlink PPO,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,HomeState Health Plan,HomeState Health Plan,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Humana Gold,Humana Gold,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Medicaid MO,Medicaid MO,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Medica,Medica,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Tricare,Tricare,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,UHC All Payer,UHC All Payer,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,UHC Exchange,UHC Exchange,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,UHC Medicaid,UHC Medicaid,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,UMR CPD,UMR CPD,9.96,,,,,,,per diem,9.96,9.96,"Per diem rate, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,UHC Medicare,UHC Medicare,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
RGNCONV-TRAMADOL 50 MG TABS   ,38270129,CDM,300,RC,,,,,,Inpatient,,,9.96,9.96,Wellcare,Wellcare,9.96,,,,,,,case rate,9.96,9.96,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Meritain Health PPO CPD,Meritain Health PPO CPD,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Aetna/Commercial Product,Aetna/Commercial Product,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Meritain Health CPD,Meritain Health CPD,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Starmark CPD,Starmark CPD,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Aetna Medicare,Aetna Medicare,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Ambetter ,Ambetter ,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Blue Access,Anthem Blue Access,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Blue Access Choice,Anthem Blue Access Choice,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Blue Preferred,Anthem Blue Preferred,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Pathway,Anthem Pathway,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Alliance,Anthem Alliance,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Anthem Medicare,Anthem Medicare,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Cigna,Cigna,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Cigna PPO,Cigna PPO,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Cigna Medicare Advantage,Cigna Medicare Advantage,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Essence,Essence,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Healthlink HMO,Healthlink HMO,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Healthlink PPO,Healthlink PPO,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,HomeState Health Plan,HomeState Health Plan,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Humana Gold,Humana Gold,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Medicaid MO,Medicaid MO,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Medica,Medica,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Tricare,Tricare,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,UHC All Payer,UHC All Payer,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,UHC Exchange,UHC Exchange,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,UHC Medicaid,UHC Medicaid,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,UMR CPD,UMR CPD,393.59,,,,,,,per diem,393.59,393.59,"Per diem rate, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,UHC Medicare,UHC Medicare,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
HEMOCRHOMATOSIS HFE GENE ANAL ,38270130,CDM,301,RC,81256,CPT,,,,Inpatient,,,393.59,393.59,Wellcare,Wellcare,393.59,,,,,,,case rate,393.59,393.59,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Meritain Health PPO CPD,Meritain Health PPO CPD,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Aetna/Commercial Product,Aetna/Commercial Product,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Meritain Health CPD,Meritain Health CPD,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Starmark CPD,Starmark CPD,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Aetna Medicare,Aetna Medicare,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Ambetter ,Ambetter ,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Blue Access,Anthem Blue Access,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Blue Access Choice,Anthem Blue Access Choice,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Blue Preferred,Anthem Blue Preferred,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Pathway,Anthem Pathway,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Alliance,Anthem Alliance,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Anthem Medicare,Anthem Medicare,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Cigna,Cigna,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Cigna PPO,Cigna PPO,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Cigna Medicare Advantage,Cigna Medicare Advantage,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Essence,Essence,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Healthlink HMO,Healthlink HMO,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Healthlink PPO,Healthlink PPO,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,HomeState Health Plan,HomeState Health Plan,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Humana Gold,Humana Gold,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Medicaid MO,Medicaid MO,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Medica,Medica,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Tricare,Tricare,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,UHC All Payer,UHC All Payer,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,UHC Exchange,UHC Exchange,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,UHC Medicaid,UHC Medicaid,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,UMR CPD,UMR CPD,37.39,,,,,,,per diem,37.39,37.39,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,UHC Medicare,UHC Medicare,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38270131,CDM,306,RC,87075,CPT,,,,Inpatient,,,37.39,37.39,Wellcare,Wellcare,37.39,,,,,,,case rate,37.39,37.39,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Meritain Health PPO CPD,Meritain Health PPO CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Aetna/Commercial Product,Aetna/Commercial Product,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Meritain Health CPD,Meritain Health CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Starmark CPD,Starmark CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Aetna Medicare,Aetna Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Ambetter ,Ambetter ,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Access,Anthem Blue Access,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Access Choice,Anthem Blue Access Choice,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Preferred,Anthem Blue Preferred,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Pathway,Anthem Pathway,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Alliance,Anthem Alliance,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Anthem Medicare,Anthem Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Cigna,Cigna,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Cigna PPO,Cigna PPO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Cigna Medicare Advantage,Cigna Medicare Advantage,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Essence,Essence,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Healthlink HMO,Healthlink HMO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Healthlink PPO,Healthlink PPO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,HomeState Health Plan,HomeState Health Plan,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Humana Gold,Humana Gold,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Medicaid MO,Medicaid MO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Medica,Medica,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Tricare,Tricare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,UHC All Payer,UHC All Payer,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,UHC Exchange,UHC Exchange,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,UHC Medicaid,UHC Medicaid,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,UMR CPD,UMR CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,UHC Medicare,UHC Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B SURFACE AG              ,38270132,CDM,306,RC,87340,CPT,,,,Inpatient,,,100.43,100.43,Wellcare,Wellcare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Meritain Health PPO CPD,Meritain Health PPO CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Aetna/Commercial Product,Aetna/Commercial Product,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Meritain Health CPD,Meritain Health CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Starmark CPD,Starmark CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Aetna Medicare,Aetna Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Ambetter ,Ambetter ,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Access,Anthem Blue Access,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Access Choice,Anthem Blue Access Choice,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Blue Preferred,Anthem Blue Preferred,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Pathway,Anthem Pathway,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Alliance,Anthem Alliance,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Anthem Medicare,Anthem Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Cigna,Cigna,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Cigna PPO,Cigna PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Cigna Medicare Advantage,Cigna Medicare Advantage,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Essence,Essence,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Healthlink HMO,Healthlink HMO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Healthlink PPO,Healthlink PPO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,HomeState Health Plan,HomeState Health Plan,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Humana Gold,Humana Gold,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Medicaid MO,Medicaid MO,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Medica,Medica,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Tricare,Tricare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,UHC All Payer,UHC All Payer,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,UHC Exchange,UHC Exchange,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,UHC Medicaid,UHC Medicaid,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,UMR CPD,UMR CPD,92.3,,,,,,,per diem,92.3,92.3,"Per diem rate, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,UHC Medicare,UHC Medicare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
"BLOOD CNT, MAN (RBC,WBC,PLT)EA",38280020,CDM,305,RC,85032,CPT,,,,Inpatient,,,92.3,92.3,Wellcare,Wellcare,92.3,,,,,,,case rate,92.3,92.3,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Meritain Health PPO CPD,Meritain Health PPO CPD,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Aetna/Commercial Product,Aetna/Commercial Product,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Meritain Health CPD,Meritain Health CPD,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Starmark CPD,Starmark CPD,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Aetna Medicare,Aetna Medicare,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Ambetter ,Ambetter ,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Blue Access,Anthem Blue Access,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Blue Access Choice,Anthem Blue Access Choice,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Blue Preferred,Anthem Blue Preferred,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Pathway,Anthem Pathway,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Alliance,Anthem Alliance,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Anthem Medicare,Anthem Medicare,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Cigna,Cigna,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Cigna PPO,Cigna PPO,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Cigna Medicare Advantage,Cigna Medicare Advantage,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Essence,Essence,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Healthlink HMO,Healthlink HMO,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Healthlink PPO,Healthlink PPO,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,HomeState Health Plan,HomeState Health Plan,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Humana Gold,Humana Gold,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Medicaid MO,Medicaid MO,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Medica,Medica,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Tricare,Tricare,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,UHC All Payer,UHC All Payer,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,UHC Exchange,UHC Exchange,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,UHC Medicaid,UHC Medicaid,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,UMR CPD,UMR CPD,263.33,,,,,,,per diem,263.33,263.33,"Per diem rate, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,UHC Medicare,UHC Medicare,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
THYROGLOBULIN LEVEL           ,38280030,CDM,301,RC,84432,CPT,,,,Inpatient,,,263.33,263.33,Wellcare,Wellcare,263.33,,,,,,,case rate,263.33,263.33,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Meritain Health PPO CPD,Meritain Health PPO CPD,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Aetna/Commercial Product,Aetna/Commercial Product,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Meritain Health CPD,Meritain Health CPD,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Starmark CPD,Starmark CPD,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Aetna Medicare,Aetna Medicare,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Ambetter ,Ambetter ,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Blue Access,Anthem Blue Access,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Blue Access Choice,Anthem Blue Access Choice,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Blue Preferred,Anthem Blue Preferred,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Pathway,Anthem Pathway,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Alliance,Anthem Alliance,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Anthem Medicare,Anthem Medicare,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Cigna,Cigna,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Cigna PPO,Cigna PPO,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Cigna Medicare Advantage,Cigna Medicare Advantage,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Essence,Essence,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Healthlink HMO,Healthlink HMO,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Healthlink PPO,Healthlink PPO,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,HomeState Health Plan,HomeState Health Plan,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Humana Gold,Humana Gold,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Medicaid MO,Medicaid MO,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Medica,Medica,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Tricare,Tricare,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,UHC All Payer,UHC All Payer,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,UHC Exchange,UHC Exchange,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,UHC Medicaid,UHC Medicaid,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,UMR CPD,UMR CPD,245.67,,,,,,,per diem,245.67,245.67,"Per diem rate, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,UHC Medicare,UHC Medicare,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
FRUCTOSAMINE-GLYCATED PROTEIN ,38280040,CDM,301,RC,82985,CPT,,,,Inpatient,,,245.67,245.67,Wellcare,Wellcare,245.67,,,,,,,case rate,245.67,245.67,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Meritain Health PPO CPD,Meritain Health PPO CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Aetna/Commercial Product,Aetna/Commercial Product,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Meritain Health CPD,Meritain Health CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Starmark CPD,Starmark CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Aetna Medicare,Aetna Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Ambetter ,Ambetter ,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Access,Anthem Blue Access,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Access Choice,Anthem Blue Access Choice,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Preferred,Anthem Blue Preferred,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Pathway,Anthem Pathway,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Alliance,Anthem Alliance,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Anthem Medicare,Anthem Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Cigna,Cigna,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Cigna PPO,Cigna PPO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Cigna Medicare Advantage,Cigna Medicare Advantage,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Essence,Essence,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Healthlink HMO,Healthlink HMO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Healthlink PPO,Healthlink PPO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,HomeState Health Plan,HomeState Health Plan,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Humana Gold,Humana Gold,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Medicaid MO,Medicaid MO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Medica,Medica,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Tricare,Tricare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,UHC All Payer,UHC All Payer,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,UHC Exchange,UHC Exchange,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,UHC Medicaid,UHC Medicaid,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,UMR CPD,UMR CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,UHC Medicare,UHC Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL IONIZED CA    ,38280047,CDM,301,RC,80047,CPT,,,,Inpatient,,,252.35,252.35,Wellcare,Wellcare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Meritain Health PPO CPD,Meritain Health PPO CPD,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Aetna/Commercial Product,Aetna/Commercial Product,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Meritain Health CPD,Meritain Health CPD,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Starmark CPD,Starmark CPD,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Aetna Medicare,Aetna Medicare,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Ambetter ,Ambetter ,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Blue Access,Anthem Blue Access,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Blue Access Choice,Anthem Blue Access Choice,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Blue Preferred,Anthem Blue Preferred,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Pathway,Anthem Pathway,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Alliance,Anthem Alliance,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Anthem Medicare,Anthem Medicare,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Cigna,Cigna,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Cigna PPO,Cigna PPO,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Cigna Medicare Advantage,Cigna Medicare Advantage,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Essence,Essence,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Healthlink HMO,Healthlink HMO,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Healthlink PPO,Healthlink PPO,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,HomeState Health Plan,HomeState Health Plan,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Humana Gold,Humana Gold,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Medicaid MO,Medicaid MO,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Medica,Medica,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Tricare,Tricare,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,UHC All Payer,UHC All Payer,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,UHC Exchange,UHC Exchange,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,UHC Medicaid,UHC Medicaid,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,UMR CPD,UMR CPD,207.94,,,,,,,per diem,207.94,207.94,"Per diem rate, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,UHC Medicare,UHC Medicare,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
METABOLIC PANEL TOTAL CA      ,38280048,CDM,301,RC,80048,CPT,,,,Inpatient,,,207.94,207.94,Wellcare,Wellcare,207.94,,,,,,,case rate,207.94,207.94,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Meritain Health PPO CPD,Meritain Health PPO CPD,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Aetna/Commercial Product,Aetna/Commercial Product,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Meritain Health CPD,Meritain Health CPD,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Starmark CPD,Starmark CPD,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Aetna Medicare,Aetna Medicare,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Ambetter ,Ambetter ,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Blue Access,Anthem Blue Access,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Blue Access Choice,Anthem Blue Access Choice,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Blue Preferred,Anthem Blue Preferred,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Pathway,Anthem Pathway,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Alliance,Anthem Alliance,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Anthem Medicare,Anthem Medicare,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Cigna,Cigna,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Cigna PPO,Cigna PPO,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Cigna Medicare Advantage,Cigna Medicare Advantage,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Essence,Essence,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Healthlink HMO,Healthlink HMO,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Healthlink PPO,Healthlink PPO,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,HomeState Health Plan,HomeState Health Plan,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Humana Gold,Humana Gold,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Medicaid MO,Medicaid MO,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Medica,Medica,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Tricare,Tricare,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,UHC All Payer,UHC All Payer,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,UHC Exchange,UHC Exchange,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,UHC Medicaid,UHC Medicaid,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,UMR CPD,UMR CPD,264.71,,,,,,,per diem,264.71,264.71,"Per diem rate, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,UHC Medicare,UHC Medicare,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
MET PANEL TTL CA CHEM 8+      ,38280049,CDM,301,RC,80048,CPT,,,QW,Inpatient,,,264.71,264.71,Wellcare,Wellcare,264.71,,,,,,,case rate,264.71,264.71,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Meritain Health PPO CPD,Meritain Health PPO CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Aetna/Commercial Product,Aetna/Commercial Product,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Meritain Health CPD,Meritain Health CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Starmark CPD,Starmark CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Aetna Medicare,Aetna Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Ambetter ,Ambetter ,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Access,Anthem Blue Access,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Access Choice,Anthem Blue Access Choice,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Preferred,Anthem Blue Preferred,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Pathway,Anthem Pathway,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Alliance,Anthem Alliance,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Anthem Medicare,Anthem Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Cigna,Cigna,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Cigna PPO,Cigna PPO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Cigna Medicare Advantage,Cigna Medicare Advantage,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Essence,Essence,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Healthlink HMO,Healthlink HMO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Healthlink PPO,Healthlink PPO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,HomeState Health Plan,HomeState Health Plan,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Humana Gold,Humana Gold,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Medicaid MO,Medicaid MO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Medica,Medica,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Tricare,Tricare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,UHC All Payer,UHC All Payer,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,UHC Exchange,UHC Exchange,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,UHC Medicaid,UHC Medicaid,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,UMR CPD,UMR CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,UHC Medicare,UHC Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
COMPREHEN METABOLIC PANEL     ,38280053,CDM,301,RC,80053,CPT,,,,Inpatient,,,264.16,264.16,Wellcare,Wellcare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Meritain Health PPO CPD,Meritain Health PPO CPD,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Aetna/Commercial Product,Aetna/Commercial Product,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Meritain Health CPD,Meritain Health CPD,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Starmark CPD,Starmark CPD,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Aetna Medicare,Aetna Medicare,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Ambetter ,Ambetter ,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Blue Access,Anthem Blue Access,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Blue Access Choice,Anthem Blue Access Choice,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Blue Preferred,Anthem Blue Preferred,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Pathway,Anthem Pathway,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Alliance,Anthem Alliance,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Anthem Medicare,Anthem Medicare,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Cigna,Cigna,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Cigna PPO,Cigna PPO,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Cigna Medicare Advantage,Cigna Medicare Advantage,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Essence,Essence,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Healthlink HMO,Healthlink HMO,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Healthlink PPO,Healthlink PPO,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,HomeState Health Plan,HomeState Health Plan,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Humana Gold,Humana Gold,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Medicaid MO,Medicaid MO,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Medica,Medica,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Tricare,Tricare,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,UHC All Payer,UHC All Payer,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,UHC Exchange,UHC Exchange,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,UHC Medicaid,UHC Medicaid,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,UMR CPD,UMR CPD,260.98,,,,,,,per diem,260.98,260.98,"Per diem rate, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,UHC Medicare,UHC Medicare,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
RENAL FUNCTION PANEL          ,38280069,CDM,301,RC,80069,CPT,,,,Inpatient,,,260.98,260.98,Wellcare,Wellcare,260.98,,,,,,,case rate,260.98,260.98,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Meritain Health PPO CPD,Meritain Health PPO CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Aetna/Commercial Product,Aetna/Commercial Product,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Meritain Health CPD,Meritain Health CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Starmark CPD,Starmark CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Aetna Medicare,Aetna Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Ambetter ,Ambetter ,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Blue Access,Anthem Blue Access,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Blue Access Choice,Anthem Blue Access Choice,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Blue Preferred,Anthem Blue Preferred,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Pathway,Anthem Pathway,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Alliance,Anthem Alliance,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Anthem Medicare,Anthem Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Cigna,Cigna,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Cigna PPO,Cigna PPO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Cigna Medicare Advantage,Cigna Medicare Advantage,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Essence,Essence,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Healthlink HMO,Healthlink HMO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Healthlink PPO,Healthlink PPO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,HomeState Health Plan,HomeState Health Plan,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Humana Gold,Humana Gold,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Medicaid MO,Medicaid MO,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Medica,Medica,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Tricare,Tricare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,UHC All Payer,UHC All Payer,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,UHC Exchange,UHC Exchange,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,UHC Medicaid,UHC Medicaid,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,UMR CPD,UMR CPD,519,,,,,,,per diem,519,519,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,UHC Medicare,UHC Medicare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VII           ,38286433,CDM,305,RC,85230,CPT,,,,Inpatient,,,519,519,Wellcare,Wellcare,519,,,,,,,case rate,519,519,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health PPO CPD,Meritain Health PPO CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna/Commercial Product,Aetna/Commercial Product,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Meritain Health CPD,Meritain Health CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Starmark CPD,Starmark CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Aetna Medicare,Aetna Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Ambetter ,Ambetter ,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access,Anthem Blue Access,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Access Choice,Anthem Blue Access Choice,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Blue Preferred,Anthem Blue Preferred,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Pathway,Anthem Pathway,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Alliance,Anthem Alliance,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Anthem Medicare,Anthem Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna,Cigna,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna PPO,Cigna PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Cigna Medicare Advantage,Cigna Medicare Advantage,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Essence,Essence,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink HMO,Healthlink HMO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Healthlink PPO,Healthlink PPO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,HomeState Health Plan,HomeState Health Plan,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Humana Gold,Humana Gold,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medicaid MO,Medicaid MO,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Medica,Medica,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Tricare,Tricare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC All Payer,UHC All Payer,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Exchange,UHC Exchange,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicaid,UHC Medicaid,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UMR CPD,UMR CPD,213.24,,,,,,,per diem,213.24,213.24,"Per diem rate, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,UHC Medicare,UHC Medicare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
TSH ULTRA SENSITIVE           ,38286434,CDM,300,RC,84443,CPT,,,,Inpatient,,,213.24,213.24,Wellcare,Wellcare,213.24,,,,,,,case rate,213.24,213.24,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Meritain Health PPO CPD,Meritain Health PPO CPD,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Aetna/Commercial Product,Aetna/Commercial Product,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Meritain Health CPD,Meritain Health CPD,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Starmark CPD,Starmark CPD,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Aetna Medicare,Aetna Medicare,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Ambetter ,Ambetter ,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Blue Access,Anthem Blue Access,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Blue Access Choice,Anthem Blue Access Choice,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Blue Preferred,Anthem Blue Preferred,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Pathway,Anthem Pathway,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Alliance,Anthem Alliance,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Anthem Medicare,Anthem Medicare,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Cigna,Cigna,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Cigna PPO,Cigna PPO,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Cigna Medicare Advantage,Cigna Medicare Advantage,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Essence,Essence,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Healthlink HMO,Healthlink HMO,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Healthlink PPO,Healthlink PPO,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,HomeState Health Plan,HomeState Health Plan,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Humana Gold,Humana Gold,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Medicaid MO,Medicaid MO,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Medica,Medica,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Tricare,Tricare,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,UHC All Payer,UHC All Payer,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,UHC Exchange,UHC Exchange,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,UHC Medicaid,UHC Medicaid,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,UMR CPD,UMR CPD,68.8,,,,,,,per diem,68.8,68.8,"Per diem rate, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,UHC Medicare,UHC Medicare,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
APOLIPOPROTEIN                ,38286437,CDM,301,RC,82172,CPT,,,,Inpatient,,,68.8,68.8,Wellcare,Wellcare,68.8,,,,,,,case rate,68.8,68.8,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Meritain Health PPO CPD,Meritain Health PPO CPD,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Aetna/Commercial Product,Aetna/Commercial Product,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Meritain Health CPD,Meritain Health CPD,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Starmark CPD,Starmark CPD,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Aetna Medicare,Aetna Medicare,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Ambetter ,Ambetter ,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Blue Access,Anthem Blue Access,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Blue Access Choice,Anthem Blue Access Choice,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Blue Preferred,Anthem Blue Preferred,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Pathway,Anthem Pathway,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Alliance,Anthem Alliance,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Anthem Medicare,Anthem Medicare,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Cigna,Cigna,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Cigna PPO,Cigna PPO,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Cigna Medicare Advantage,Cigna Medicare Advantage,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Essence,Essence,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Healthlink HMO,Healthlink HMO,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Healthlink PPO,Healthlink PPO,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,HomeState Health Plan,HomeState Health Plan,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Humana Gold,Humana Gold,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Medicaid MO,Medicaid MO,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Medica,Medica,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Tricare,Tricare,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,UHC All Payer,UHC All Payer,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,UHC Exchange,UHC Exchange,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,UHC Medicaid,UHC Medicaid,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,UMR CPD,UMR CPD,91.11,,,,,,,per diem,91.11,91.11,"Per diem rate, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,UHC Medicare,UHC Medicare,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
BLASTOMYCES AB                ,38286443,CDM,302,RC,86612,CPT,,,,Inpatient,,,91.11,91.11,Wellcare,Wellcare,91.11,,,,,,,case rate,91.11,91.11,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Meritain Health PPO CPD,Meritain Health PPO CPD,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Aetna/Commercial Product,Aetna/Commercial Product,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Meritain Health CPD,Meritain Health CPD,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Starmark CPD,Starmark CPD,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Aetna Medicare,Aetna Medicare,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Ambetter ,Ambetter ,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Blue Access,Anthem Blue Access,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Blue Access Choice,Anthem Blue Access Choice,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Blue Preferred,Anthem Blue Preferred,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Pathway,Anthem Pathway,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Alliance,Anthem Alliance,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Anthem Medicare,Anthem Medicare,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Cigna,Cigna,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Cigna PPO,Cigna PPO,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Cigna Medicare Advantage,Cigna Medicare Advantage,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Essence,Essence,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Healthlink HMO,Healthlink HMO,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Healthlink PPO,Healthlink PPO,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,HomeState Health Plan,HomeState Health Plan,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Humana Gold,Humana Gold,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Medicaid MO,Medicaid MO,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Medica,Medica,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Tricare,Tricare,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,UHC All Payer,UHC All Payer,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,UHC Exchange,UHC Exchange,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,UHC Medicaid,UHC Medicaid,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,UMR CPD,UMR CPD,233.81,,,,,,,per diem,233.81,233.81,"Per diem rate, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,UHC Medicare,UHC Medicare,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
HISTOPLASMA AB                ,38286449,CDM,302,RC,86698,CPT,,,,Inpatient,,,233.81,233.81,Wellcare,Wellcare,233.81,,,,,,,case rate,233.81,233.81,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Meritain Health PPO CPD,Meritain Health PPO CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Aetna/Commercial Product,Aetna/Commercial Product,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Meritain Health CPD,Meritain Health CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Starmark CPD,Starmark CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Aetna Medicare,Aetna Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Ambetter ,Ambetter ,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Blue Access,Anthem Blue Access,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Blue Access Choice,Anthem Blue Access Choice,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Blue Preferred,Anthem Blue Preferred,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Pathway,Anthem Pathway,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Alliance,Anthem Alliance,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Anthem Medicare,Anthem Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Cigna,Cigna,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Cigna PPO,Cigna PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Cigna Medicare Advantage,Cigna Medicare Advantage,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Essence,Essence,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Healthlink HMO,Healthlink HMO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Healthlink PPO,Healthlink PPO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,HomeState Health Plan,HomeState Health Plan,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Humana Gold,Humana Gold,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Medicaid MO,Medicaid MO,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Medica,Medica,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Tricare,Tricare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,UHC All Payer,UHC All Payer,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,UHC Exchange,UHC Exchange,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,UHC Medicaid,UHC Medicaid,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,UMR CPD,UMR CPD,79.85,,,,,,,per diem,79.85,79.85,"Per diem rate, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,UHC Medicare,UHC Medicare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
ANTI 1-A2 (ISLET CELL AB)     ,38286601,CDM,302,RC,86341,CPT,,,,Inpatient,,,79.85,79.85,Wellcare,Wellcare,79.85,,,,,,,case rate,79.85,79.85,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Meritain Health PPO CPD,Meritain Health PPO CPD,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Aetna/Commercial Product,Aetna/Commercial Product,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Meritain Health CPD,Meritain Health CPD,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Starmark CPD,Starmark CPD,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Aetna Medicare,Aetna Medicare,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Ambetter ,Ambetter ,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Blue Access,Anthem Blue Access,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Blue Access Choice,Anthem Blue Access Choice,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Blue Preferred,Anthem Blue Preferred,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Pathway,Anthem Pathway,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Alliance,Anthem Alliance,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Anthem Medicare,Anthem Medicare,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Cigna,Cigna,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Cigna PPO,Cigna PPO,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Cigna Medicare Advantage,Cigna Medicare Advantage,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Essence,Essence,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Healthlink HMO,Healthlink HMO,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Healthlink PPO,Healthlink PPO,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,HomeState Health Plan,HomeState Health Plan,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Humana Gold,Humana Gold,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Medicaid MO,Medicaid MO,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Medica,Medica,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Tricare,Tricare,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,UHC All Payer,UHC All Payer,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,UHC Exchange,UHC Exchange,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,UHC Medicaid,UHC Medicaid,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,UMR CPD,UMR CPD,67.66,,,,,,,per diem,67.66,67.66,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,UHC Medicare,UHC Medicare,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287000,CDM,300,RC,81240,CPT,,,,Inpatient,,,67.66,67.66,Wellcare,Wellcare,67.66,,,,,,,case rate,67.66,67.66,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Meritain Health PPO CPD,Meritain Health PPO CPD,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Aetna/Commercial Product,Aetna/Commercial Product,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Meritain Health CPD,Meritain Health CPD,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Starmark CPD,Starmark CPD,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Aetna Medicare,Aetna Medicare,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Ambetter ,Ambetter ,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Blue Access,Anthem Blue Access,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Blue Access Choice,Anthem Blue Access Choice,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Blue Preferred,Anthem Blue Preferred,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Pathway,Anthem Pathway,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Alliance,Anthem Alliance,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Anthem Medicare,Anthem Medicare,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Cigna,Cigna,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Cigna PPO,Cigna PPO,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Cigna Medicare Advantage,Cigna Medicare Advantage,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Essence,Essence,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Healthlink HMO,Healthlink HMO,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Healthlink PPO,Healthlink PPO,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,HomeState Health Plan,HomeState Health Plan,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Humana Gold,Humana Gold,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Medicaid MO,Medicaid MO,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Medica,Medica,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Tricare,Tricare,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,UHC All Payer,UHC All Payer,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,UHC Exchange,UHC Exchange,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,UHC Medicaid,UHC Medicaid,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,UMR CPD,UMR CPD,77.7,,,,,,,per diem,77.7,77.7,"Per diem rate, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,UHC Medicare,UHC Medicare,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
F5 LEIDEN GENE ANALYSIS       ,38287001,CDM,300,RC,81241,CPT,,,,Inpatient,,,77.7,77.7,Wellcare,Wellcare,77.7,,,,,,,case rate,77.7,77.7,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Meritain Health PPO CPD,Meritain Health PPO CPD,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Aetna/Commercial Product,Aetna/Commercial Product,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Meritain Health CPD,Meritain Health CPD,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Starmark CPD,Starmark CPD,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Aetna Medicare,Aetna Medicare,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Ambetter ,Ambetter ,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Blue Access,Anthem Blue Access,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Blue Access Choice,Anthem Blue Access Choice,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Blue Preferred,Anthem Blue Preferred,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Pathway,Anthem Pathway,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Alliance,Anthem Alliance,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Anthem Medicare,Anthem Medicare,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Cigna,Cigna,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Cigna PPO,Cigna PPO,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Cigna Medicare Advantage,Cigna Medicare Advantage,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Essence,Essence,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Healthlink HMO,Healthlink HMO,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Healthlink PPO,Healthlink PPO,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,HomeState Health Plan,HomeState Health Plan,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Humana Gold,Humana Gold,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Medicaid MO,Medicaid MO,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Medica,Medica,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Tricare,Tricare,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,UHC All Payer,UHC All Payer,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,UHC Exchange,UHC Exchange,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,UHC Medicaid,UHC Medicaid,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,UMR CPD,UMR CPD,230.05,,,,,,,per diem,230.05,230.05,"Per diem rate, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,UHC Medicare,UHC Medicare,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
BCR/ABL1 TRANSLOCATION MAJ BRK,38287002,CDM,310,RC,81206,CPT,,,,Inpatient,,,230.05,230.05,Wellcare,Wellcare,230.05,,,,,,,case rate,230.05,230.05,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Meritain Health PPO CPD,Meritain Health PPO CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Aetna/Commercial Product,Aetna/Commercial Product,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Meritain Health CPD,Meritain Health CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Starmark CPD,Starmark CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Aetna Medicare,Aetna Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Ambetter ,Ambetter ,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Access,Anthem Blue Access,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Access Choice,Anthem Blue Access Choice,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Blue Preferred,Anthem Blue Preferred,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Pathway,Anthem Pathway,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Alliance,Anthem Alliance,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Anthem Medicare,Anthem Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Cigna,Cigna,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Cigna PPO,Cigna PPO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Cigna Medicare Advantage,Cigna Medicare Advantage,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Essence,Essence,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Healthlink HMO,Healthlink HMO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Healthlink PPO,Healthlink PPO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,HomeState Health Plan,HomeState Health Plan,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Humana Gold,Humana Gold,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Medicaid MO,Medicaid MO,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Medica,Medica,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Tricare,Tricare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,UHC All Payer,UHC All Payer,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,UHC Exchange,UHC Exchange,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,UHC Medicaid,UHC Medicaid,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,UMR CPD,UMR CPD,336.19,,,,,,,per diem,336.19,336.19,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,UHC Medicare,UHC Medicare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 1-3 ,38288700,CDM,301,RC,80375,CPT,,,,Inpatient,,,336.19,336.19,Wellcare,Wellcare,336.19,,,,,,,case rate,336.19,336.19,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Meritain Health PPO CPD,Meritain Health PPO CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Aetna/Commercial Product,Aetna/Commercial Product,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Meritain Health CPD,Meritain Health CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Starmark CPD,Starmark CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Aetna Medicare,Aetna Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Ambetter ,Ambetter ,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Blue Access,Anthem Blue Access,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Blue Access Choice,Anthem Blue Access Choice,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Blue Preferred,Anthem Blue Preferred,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Pathway,Anthem Pathway,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Alliance,Anthem Alliance,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Anthem Medicare,Anthem Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Cigna,Cigna,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Cigna PPO,Cigna PPO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Cigna Medicare Advantage,Cigna Medicare Advantage,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Essence,Essence,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Healthlink HMO,Healthlink HMO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Healthlink PPO,Healthlink PPO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,HomeState Health Plan,HomeState Health Plan,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Humana Gold,Humana Gold,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Medicaid MO,Medicaid MO,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Medica,Medica,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Tricare,Tricare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,UHC All Payer,UHC All Payer,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,UHC Exchange,UHC Exchange,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,UHC Medicaid,UHC Medicaid,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,UMR CPD,UMR CPD,451.76,,,,,,,per diem,451.76,451.76,"Per diem rate, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,UHC Medicare,UHC Medicare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
DRUG DEFIN QUAL/QUANT NOS 7+  ,38288702,CDM,301,RC,80377,CPT,,,,Inpatient,,,451.76,451.76,Wellcare,Wellcare,451.76,,,,,,,case rate,451.76,451.76,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health PPO CPD,Meritain Health PPO CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna/Commercial Product,Aetna/Commercial Product,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health CPD,Meritain Health CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Starmark CPD,Starmark CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna Medicare,Aetna Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Ambetter ,Ambetter ,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access,Anthem Blue Access,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access Choice,Anthem Blue Access Choice,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Preferred,Anthem Blue Preferred,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Pathway,Anthem Pathway,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Alliance,Anthem Alliance,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Medicare,Anthem Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna,Cigna,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna PPO,Cigna PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna Medicare Advantage,Cigna Medicare Advantage,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Essence,Essence,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthlink HMO,Healthlink HMO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthlink PPO,Healthlink PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,HomeState Health Plan,HomeState Health Plan,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Humana Gold,Humana Gold,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Medicaid MO,Medicaid MO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Medica,Medica,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Tricare,Tricare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC All Payer,UHC All Payer,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Exchange,UHC Exchange,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicaid,UHC Medicaid,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UMR CPD,UMR CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicare,UHC Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA A AB                ,38293900,CDM,306,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Wellcare,Wellcare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health PPO CPD,Meritain Health PPO CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna/Commercial Product,Aetna/Commercial Product,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health CPD,Meritain Health CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Starmark CPD,Starmark CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Aetna Medicare,Aetna Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Ambetter ,Ambetter ,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access,Anthem Blue Access,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access Choice,Anthem Blue Access Choice,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Preferred,Anthem Blue Preferred,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Pathway,Anthem Pathway,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Alliance,Anthem Alliance,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Anthem Medicare,Anthem Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna,Cigna,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna PPO,Cigna PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Cigna Medicare Advantage,Cigna Medicare Advantage,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Essence,Essence,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthlink HMO,Healthlink HMO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Healthlink PPO,Healthlink PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,HomeState Health Plan,HomeState Health Plan,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Humana Gold,Humana Gold,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Medicaid MO,Medicaid MO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Medica,Medica,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Tricare,Tricare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC All Payer,UHC All Payer,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Exchange,UHC Exchange,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicaid,UHC Medicaid,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UMR CPD,UMR CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicare,UHC Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
INFLUENZA B AB                ,38293905,CDM,302,RC,86710,CPT,,,,Inpatient,,,146.4,146.4,Wellcare,Wellcare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Meritain Health PPO CPD,Meritain Health PPO CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Aetna/Commercial Product,Aetna/Commercial Product,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Meritain Health CPD,Meritain Health CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Starmark CPD,Starmark CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Aetna Medicare,Aetna Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Ambetter ,Ambetter ,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Access,Anthem Blue Access,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Access Choice,Anthem Blue Access Choice,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Preferred,Anthem Blue Preferred,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Pathway,Anthem Pathway,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Alliance,Anthem Alliance,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Anthem Medicare,Anthem Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Cigna,Cigna,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Cigna PPO,Cigna PPO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Cigna Medicare Advantage,Cigna Medicare Advantage,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Essence,Essence,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Healthlink HMO,Healthlink HMO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Healthlink PPO,Healthlink PPO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,HomeState Health Plan,HomeState Health Plan,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Humana Gold,Humana Gold,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Medicaid MO,Medicaid MO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Medica,Medica,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Tricare,Tricare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,UHC All Payer,UHC All Payer,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,UHC Exchange,UHC Exchange,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,UHC Medicaid,UHC Medicaid,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,UMR CPD,UMR CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,UHC Medicare,UHC Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38293920,CDM,302,RC,86705,CPT,,,,Inpatient,,,163.38,163.38,Wellcare,Wellcare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Meritain Health PPO CPD,Meritain Health PPO CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Aetna/Commercial Product,Aetna/Commercial Product,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Meritain Health CPD,Meritain Health CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Starmark CPD,Starmark CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Aetna Medicare,Aetna Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Ambetter ,Ambetter ,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Blue Access,Anthem Blue Access,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Blue Access Choice,Anthem Blue Access Choice,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Blue Preferred,Anthem Blue Preferred,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Pathway,Anthem Pathway,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Alliance,Anthem Alliance,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Anthem Medicare,Anthem Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Cigna,Cigna,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Cigna PPO,Cigna PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Cigna Medicare Advantage,Cigna Medicare Advantage,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Essence,Essence,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Healthlink HMO,Healthlink HMO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Healthlink PPO,Healthlink PPO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,HomeState Health Plan,HomeState Health Plan,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Humana Gold,Humana Gold,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Medicaid MO,Medicaid MO,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Medica,Medica,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Tricare,Tricare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,UHC All Payer,UHC All Payer,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,UHC Exchange,UHC Exchange,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,UHC Medicaid,UHC Medicaid,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,UMR CPD,UMR CPD,141.83,,,,,,,per diem,141.83,141.83,"Per diem rate, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,UHC Medicare,UHC Medicare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
PLATELET AGGREGATION EA AGENT ,38293921,CDM,305,RC,85576,CPT,,,,Inpatient,,,141.83,141.83,Wellcare,Wellcare,141.83,,,,,,,case rate,141.83,141.83,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Meritain Health PPO CPD,Meritain Health PPO CPD,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Aetna/Commercial Product,Aetna/Commercial Product,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Meritain Health CPD,Meritain Health CPD,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Starmark CPD,Starmark CPD,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Aetna Medicare,Aetna Medicare,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Ambetter ,Ambetter ,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Blue Access,Anthem Blue Access,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Blue Access Choice,Anthem Blue Access Choice,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Blue Preferred,Anthem Blue Preferred,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Pathway,Anthem Pathway,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Alliance,Anthem Alliance,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Anthem Medicare,Anthem Medicare,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Cigna,Cigna,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Cigna PPO,Cigna PPO,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Cigna Medicare Advantage,Cigna Medicare Advantage,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Essence,Essence,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Healthlink HMO,Healthlink HMO,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Healthlink PPO,Healthlink PPO,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,HomeState Health Plan,HomeState Health Plan,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Humana Gold,Humana Gold,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Medicaid MO,Medicaid MO,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Medica,Medica,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Tricare,Tricare,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,UHC All Payer,UHC All Payer,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,UHC Exchange,UHC Exchange,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,UHC Medicaid,UHC Medicaid,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,UMR CPD,UMR CPD,260.13,,,,,,,per diem,260.13,260.13,"Per diem rate, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,UHC Medicare,UHC Medicare,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
INTRINSIC FACTOR ANTIBODY     ,38293923,CDM,302,RC,86340,CPT,,,,Inpatient,,,260.13,260.13,Wellcare,Wellcare,260.13,,,,,,,case rate,260.13,260.13,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Meritain Health PPO CPD,Meritain Health PPO CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Aetna/Commercial Product,Aetna/Commercial Product,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Meritain Health CPD,Meritain Health CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Starmark CPD,Starmark CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Aetna Medicare,Aetna Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Ambetter ,Ambetter ,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Access,Anthem Blue Access,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Access Choice,Anthem Blue Access Choice,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Preferred,Anthem Blue Preferred,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Pathway,Anthem Pathway,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Alliance,Anthem Alliance,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Anthem Medicare,Anthem Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Cigna,Cigna,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Cigna PPO,Cigna PPO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Cigna Medicare Advantage,Cigna Medicare Advantage,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Essence,Essence,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Healthlink HMO,Healthlink HMO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Healthlink PPO,Healthlink PPO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,HomeState Health Plan,HomeState Health Plan,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Humana Gold,Humana Gold,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Medicaid MO,Medicaid MO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Medica,Medica,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Tricare,Tricare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,UHC All Payer,UHC All Payer,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,UHC Exchange,UHC Exchange,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,UHC Medicaid,UHC Medicaid,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,UMR CPD,UMR CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,UHC Medicare,UHC Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
DRUG SCREEN                   ,38293927,CDM,300,RC,80100,CPT,,,,Inpatient,,,72.1,72.1,Wellcare,Wellcare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Meritain Health PPO CPD,Meritain Health PPO CPD,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Aetna/Commercial Product,Aetna/Commercial Product,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Meritain Health CPD,Meritain Health CPD,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Starmark CPD,Starmark CPD,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Aetna Medicare,Aetna Medicare,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Ambetter ,Ambetter ,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Blue Access,Anthem Blue Access,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Blue Access Choice,Anthem Blue Access Choice,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Blue Preferred,Anthem Blue Preferred,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Pathway,Anthem Pathway,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Alliance,Anthem Alliance,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Anthem Medicare,Anthem Medicare,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Cigna,Cigna,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Cigna PPO,Cigna PPO,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Cigna Medicare Advantage,Cigna Medicare Advantage,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Essence,Essence,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Healthlink HMO,Healthlink HMO,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Healthlink PPO,Healthlink PPO,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,HomeState Health Plan,HomeState Health Plan,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Humana Gold,Humana Gold,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Medicaid MO,Medicaid MO,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Medica,Medica,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Tricare,Tricare,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,UHC All Payer,UHC All Payer,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,UHC Exchange,UHC Exchange,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,UHC Medicaid,UHC Medicaid,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,UMR CPD,UMR CPD,194.63,,,,,,,per diem,194.63,194.63,"Per diem rate, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,UHC Medicare,UHC Medicare,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
GABAPENTIN                    ,38293928,CDM,301,RC,80171,CPT,,,,Inpatient,,,194.63,194.63,Wellcare,Wellcare,194.63,,,,,,,case rate,194.63,194.63,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Meritain Health PPO CPD,Meritain Health PPO CPD,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Aetna/Commercial Product,Aetna/Commercial Product,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Meritain Health CPD,Meritain Health CPD,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Starmark CPD,Starmark CPD,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Aetna Medicare,Aetna Medicare,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Ambetter ,Ambetter ,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Blue Access,Anthem Blue Access,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Blue Access Choice,Anthem Blue Access Choice,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Blue Preferred,Anthem Blue Preferred,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Pathway,Anthem Pathway,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Alliance,Anthem Alliance,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Anthem Medicare,Anthem Medicare,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Cigna,Cigna,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Cigna PPO,Cigna PPO,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Cigna Medicare Advantage,Cigna Medicare Advantage,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Essence,Essence,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Healthlink HMO,Healthlink HMO,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Healthlink PPO,Healthlink PPO,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,HomeState Health Plan,HomeState Health Plan,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Humana Gold,Humana Gold,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Medicaid MO,Medicaid MO,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Medica,Medica,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Tricare,Tricare,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,UHC All Payer,UHC All Payer,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,UHC Exchange,UHC Exchange,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,UHC Medicaid,UHC Medicaid,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,UMR CPD,UMR CPD,47,,,,,,,per diem,47,47,"Per diem rate, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,UHC Medicare,UHC Medicare,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
HEPARIN LEVEL                 ,38293939,CDM,305,RC,85520,CPT,,,,Inpatient,,,47,47,Wellcare,Wellcare,47,,,,,,,case rate,47,47,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
C DIFFICILE TOXIN A/B         ,38293950,CDM,306,RC,87324,CPT,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health PPO CPD,Meritain Health PPO CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Aetna/Commercial Product,Aetna/Commercial Product,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Meritain Health CPD,Meritain Health CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Starmark CPD,Starmark CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Aetna Medicare,Aetna Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Ambetter ,Ambetter ,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access,Anthem Blue Access,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Access Choice,Anthem Blue Access Choice,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Blue Preferred,Anthem Blue Preferred,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Pathway,Anthem Pathway,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Alliance,Anthem Alliance,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Anthem Medicare,Anthem Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Cigna,Cigna,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Cigna PPO,Cigna PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Cigna Medicare Advantage,Cigna Medicare Advantage,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Essence,Essence,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Healthlink HMO,Healthlink HMO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Healthlink PPO,Healthlink PPO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,HomeState Health Plan,HomeState Health Plan,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Humana Gold,Humana Gold,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Medicaid MO,Medicaid MO,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Medica,Medica,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Tricare,Tricare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,UHC All Payer,UHC All Payer,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,UHC Exchange,UHC Exchange,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicaid,UHC Medicaid,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,UMR CPD,UMR CPD,98.76,,,,,,,per diem,98.76,98.76,"Per diem rate, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,UHC Medicare,UHC Medicare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
ESTRONE                       ,38293953,CDM,301,RC,82679,CPT,,,,Inpatient,,,98.76,98.76,Wellcare,Wellcare,98.76,,,,,,,case rate,98.76,98.76,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Meritain Health PPO CPD,Meritain Health PPO CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Aetna/Commercial Product,Aetna/Commercial Product,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Meritain Health CPD,Meritain Health CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Starmark CPD,Starmark CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Aetna Medicare,Aetna Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Ambetter ,Ambetter ,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Blue Access,Anthem Blue Access,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Blue Access Choice,Anthem Blue Access Choice,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Blue Preferred,Anthem Blue Preferred,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Pathway,Anthem Pathway,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Alliance,Anthem Alliance,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Anthem Medicare,Anthem Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Cigna,Cigna,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Cigna PPO,Cigna PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Cigna Medicare Advantage,Cigna Medicare Advantage,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Essence,Essence,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Healthlink HMO,Healthlink HMO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Healthlink PPO,Healthlink PPO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,HomeState Health Plan,HomeState Health Plan,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Humana Gold,Humana Gold,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Medicaid MO,Medicaid MO,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Medica,Medica,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Tricare,Tricare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,UHC All Payer,UHC All Payer,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,UHC Exchange,UHC Exchange,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,UHC Medicaid,UHC Medicaid,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,UMR CPD,UMR CPD,78.8,,,,,,,per diem,78.8,78.8,"Per diem rate, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,UHC Medicare,UHC Medicare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
COLLAGEN CROSS LINKS          ,38293960,CDM,301,RC,82523,CPT,,,,Inpatient,,,78.8,78.8,Wellcare,Wellcare,78.8,,,,,,,case rate,78.8,78.8,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Meritain Health PPO CPD,Meritain Health PPO CPD,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Aetna/Commercial Product,Aetna/Commercial Product,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Meritain Health CPD,Meritain Health CPD,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Starmark CPD,Starmark CPD,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Aetna Medicare,Aetna Medicare,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Ambetter ,Ambetter ,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Blue Access,Anthem Blue Access,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Blue Access Choice,Anthem Blue Access Choice,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Blue Preferred,Anthem Blue Preferred,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Pathway,Anthem Pathway,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Alliance,Anthem Alliance,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Anthem Medicare,Anthem Medicare,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Cigna,Cigna,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Cigna PPO,Cigna PPO,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Cigna Medicare Advantage,Cigna Medicare Advantage,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Essence,Essence,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Healthlink HMO,Healthlink HMO,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Healthlink PPO,Healthlink PPO,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,HomeState Health Plan,HomeState Health Plan,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Humana Gold,Humana Gold,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Medicaid MO,Medicaid MO,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Medica,Medica,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Tricare,Tricare,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,UHC All Payer,UHC All Payer,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,UHC Exchange,UHC Exchange,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,UHC Medicaid,UHC Medicaid,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,UMR CPD,UMR CPD,93.71,,,,,,,per diem,93.71,93.71,"Per diem rate, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,UHC Medicare,UHC Medicare,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
URINALYS QUAL/SEMIQNT XCPT IA ,38299301,CDM,301,RC,81005,CPT,,,,Inpatient,,,93.71,93.71,Wellcare,Wellcare,93.71,,,,,,,case rate,93.71,93.71,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Meritain Health PPO CPD,Meritain Health PPO CPD,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Aetna/Commercial Product,Aetna/Commercial Product,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Meritain Health CPD,Meritain Health CPD,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Starmark CPD,Starmark CPD,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Aetna Medicare,Aetna Medicare,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Ambetter ,Ambetter ,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Blue Access,Anthem Blue Access,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Blue Access Choice,Anthem Blue Access Choice,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Blue Preferred,Anthem Blue Preferred,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Pathway,Anthem Pathway,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Alliance,Anthem Alliance,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Anthem Medicare,Anthem Medicare,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Cigna,Cigna,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Cigna PPO,Cigna PPO,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Cigna Medicare Advantage,Cigna Medicare Advantage,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Essence,Essence,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Healthlink HMO,Healthlink HMO,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Healthlink PPO,Healthlink PPO,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,HomeState Health Plan,HomeState Health Plan,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Humana Gold,Humana Gold,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Medicaid MO,Medicaid MO,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Medica,Medica,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Tricare,Tricare,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,UHC All Payer,UHC All Payer,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,UHC Exchange,UHC Exchange,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,UHC Medicaid,UHC Medicaid,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,UMR CPD,UMR CPD,206.53,,,,,,,per diem,206.53,206.53,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,UHC Medicare,UHC Medicare,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38299305,CDM,301,RC,82805,CPT,,,,Inpatient,,,206.53,206.53,Wellcare,Wellcare,206.53,,,,,,,case rate,206.53,206.53,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Meritain Health PPO CPD,Meritain Health PPO CPD,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Aetna/Commercial Product,Aetna/Commercial Product,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Meritain Health CPD,Meritain Health CPD,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Starmark CPD,Starmark CPD,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Aetna Medicare,Aetna Medicare,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Ambetter ,Ambetter ,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Blue Access,Anthem Blue Access,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Blue Access Choice,Anthem Blue Access Choice,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Blue Preferred,Anthem Blue Preferred,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Pathway,Anthem Pathway,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Alliance,Anthem Alliance,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Anthem Medicare,Anthem Medicare,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Cigna,Cigna,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Cigna PPO,Cigna PPO,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Cigna Medicare Advantage,Cigna Medicare Advantage,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Essence,Essence,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Healthlink HMO,Healthlink HMO,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Healthlink PPO,Healthlink PPO,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,HomeState Health Plan,HomeState Health Plan,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Humana Gold,Humana Gold,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Medicaid MO,Medicaid MO,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Medica,Medica,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Tricare,Tricare,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,UHC All Payer,UHC All Payer,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,UHC Exchange,UHC Exchange,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,UHC Medicaid,UHC Medicaid,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,UMR CPD,UMR CPD,132.71,,,,,,,per diem,132.71,132.71,"Per diem rate, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,UHC Medicare,UHC Medicare,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
LACTOFERRIN FECAL QUAL        ,38299306,CDM,301,RC,83630,CPT,,,,Inpatient,,,132.71,132.71,Wellcare,Wellcare,132.71,,,,,,,case rate,132.71,132.71,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DEPAKOTE                      ,38299309,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Meritain Health PPO CPD,Meritain Health PPO CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Aetna/Commercial Product,Aetna/Commercial Product,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Meritain Health CPD,Meritain Health CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Starmark CPD,Starmark CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Aetna Medicare,Aetna Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Ambetter ,Ambetter ,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Access,Anthem Blue Access,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Access Choice,Anthem Blue Access Choice,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Blue Preferred,Anthem Blue Preferred,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Pathway,Anthem Pathway,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Alliance,Anthem Alliance,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Anthem Medicare,Anthem Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Cigna,Cigna,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Cigna PPO,Cigna PPO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Cigna Medicare Advantage,Cigna Medicare Advantage,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Essence,Essence,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Healthlink HMO,Healthlink HMO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Healthlink PPO,Healthlink PPO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,HomeState Health Plan,HomeState Health Plan,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Humana Gold,Humana Gold,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Medicaid MO,Medicaid MO,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Medica,Medica,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Tricare,Tricare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,UHC All Payer,UHC All Payer,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,UHC Exchange,UHC Exchange,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,UHC Medicaid,UHC Medicaid,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,UMR CPD,UMR CPD,252.35,,,,,,,per diem,252.35,252.35,"Per diem rate, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,UHC Medicare,UHC Medicare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
PSA                           ,38299311,CDM,301,RC,84152,CPT,,,,Inpatient,,,252.35,252.35,Wellcare,Wellcare,252.35,,,,,,,case rate,252.35,252.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Meritain Health PPO CPD,Meritain Health PPO CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Aetna/Commercial Product,Aetna/Commercial Product,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Meritain Health CPD,Meritain Health CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Starmark CPD,Starmark CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Aetna Medicare,Aetna Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Ambetter ,Ambetter ,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Access,Anthem Blue Access,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Access Choice,Anthem Blue Access Choice,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Blue Preferred,Anthem Blue Preferred,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Pathway,Anthem Pathway,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Alliance,Anthem Alliance,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Anthem Medicare,Anthem Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Cigna,Cigna,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Cigna PPO,Cigna PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Cigna Medicare Advantage,Cigna Medicare Advantage,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Essence,Essence,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Healthlink HMO,Healthlink HMO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Healthlink PPO,Healthlink PPO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,HomeState Health Plan,HomeState Health Plan,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Humana Gold,Humana Gold,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Medicaid MO,Medicaid MO,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Medica,Medica,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Tricare,Tricare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,UHC All Payer,UHC All Payer,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,UHC Exchange,UHC Exchange,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,UHC Medicaid,UHC Medicaid,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,UMR CPD,UMR CPD,90.35,,,,,,,per diem,90.35,90.35,"Per diem rate, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,UHC Medicare,UHC Medicare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
IMMUNOASSAY FOR TUMOR ANTIGEN ,38299312,CDM,302,RC,86316,CPT,,,,Inpatient,,,90.35,90.35,Wellcare,Wellcare,90.35,,,,,,,case rate,90.35,90.35,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Meritain Health PPO CPD,Meritain Health PPO CPD,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Aetna/Commercial Product,Aetna/Commercial Product,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Meritain Health CPD,Meritain Health CPD,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Starmark CPD,Starmark CPD,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Aetna Medicare,Aetna Medicare,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Ambetter ,Ambetter ,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Blue Access,Anthem Blue Access,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Blue Access Choice,Anthem Blue Access Choice,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Blue Preferred,Anthem Blue Preferred,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Pathway,Anthem Pathway,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Alliance,Anthem Alliance,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Anthem Medicare,Anthem Medicare,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Cigna,Cigna,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Cigna PPO,Cigna PPO,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Cigna Medicare Advantage,Cigna Medicare Advantage,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Essence,Essence,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Healthlink HMO,Healthlink HMO,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Healthlink PPO,Healthlink PPO,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,HomeState Health Plan,HomeState Health Plan,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Humana Gold,Humana Gold,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Medicaid MO,Medicaid MO,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Medica,Medica,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Tricare,Tricare,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,UHC All Payer,UHC All Payer,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,UHC Exchange,UHC Exchange,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,UHC Medicaid,UHC Medicaid,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,UMR CPD,UMR CPD,317.53,,,,,,,per diem,317.53,317.53,"Per diem rate, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,UHC Medicare,UHC Medicare,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
HERPES SIMPLEX NON-SPEC TYPE  ,38299313,CDM,302,RC,86694,CPT,,,,Inpatient,,,317.53,317.53,Wellcare,Wellcare,317.53,,,,,,,case rate,317.53,317.53,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Meritain Health PPO CPD,Meritain Health PPO CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Aetna/Commercial Product,Aetna/Commercial Product,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Meritain Health CPD,Meritain Health CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Starmark CPD,Starmark CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Aetna Medicare,Aetna Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Ambetter ,Ambetter ,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Blue Access,Anthem Blue Access,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Blue Access Choice,Anthem Blue Access Choice,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Blue Preferred,Anthem Blue Preferred,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Pathway,Anthem Pathway,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Alliance,Anthem Alliance,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Anthem Medicare,Anthem Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Cigna,Cigna,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Cigna PPO,Cigna PPO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Cigna Medicare Advantage,Cigna Medicare Advantage,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Essence,Essence,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Healthlink HMO,Healthlink HMO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Healthlink PPO,Healthlink PPO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,HomeState Health Plan,HomeState Health Plan,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Humana Gold,Humana Gold,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Medicaid MO,Medicaid MO,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Medica,Medica,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Tricare,Tricare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,UHC All Payer,UHC All Payer,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,UHC Exchange,UHC Exchange,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,UHC Medicaid,UHC Medicaid,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,UMR CPD,UMR CPD,183.86,,,,,,,per diem,183.86,183.86,"Per diem rate, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,UHC Medicare,UHC Medicare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
DTT SERUM TREATMENT           ,38299315,CDM,302,RC,86977,CPT,,,,Inpatient,,,183.86,183.86,Wellcare,Wellcare,183.86,,,,,,,case rate,183.86,183.86,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Meritain Health PPO CPD,Meritain Health PPO CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Aetna/Commercial Product,Aetna/Commercial Product,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Meritain Health CPD,Meritain Health CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Starmark CPD,Starmark CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Aetna Medicare,Aetna Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Ambetter ,Ambetter ,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Blue Access,Anthem Blue Access,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Blue Access Choice,Anthem Blue Access Choice,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Blue Preferred,Anthem Blue Preferred,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Pathway,Anthem Pathway,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Alliance,Anthem Alliance,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Anthem Medicare,Anthem Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Cigna,Cigna,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Cigna PPO,Cigna PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Cigna Medicare Advantage,Cigna Medicare Advantage,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Essence,Essence,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Healthlink HMO,Healthlink HMO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Healthlink PPO,Healthlink PPO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,HomeState Health Plan,HomeState Health Plan,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Humana Gold,Humana Gold,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Medicaid MO,Medicaid MO,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Medica,Medica,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Tricare,Tricare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,UHC All Payer,UHC All Payer,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,UHC Exchange,UHC Exchange,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,UHC Medicaid,UHC Medicaid,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,UMR CPD,UMR CPD,156.54,,,,,,,per diem,156.54,156.54,"Per diem rate, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,UHC Medicare,UHC Medicare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
B CELL TOTAL COUNT            ,38299316,CDM,302,RC,86355,CPT,,,,Inpatient,,,156.54,156.54,Wellcare,Wellcare,156.54,,,,,,,case rate,156.54,156.54,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Meritain Health PPO CPD,Meritain Health PPO CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Aetna/Commercial Product,Aetna/Commercial Product,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Meritain Health CPD,Meritain Health CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Starmark CPD,Starmark CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Aetna Medicare,Aetna Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Ambetter ,Ambetter ,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Blue Access,Anthem Blue Access,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Blue Access Choice,Anthem Blue Access Choice,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Blue Preferred,Anthem Blue Preferred,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Pathway,Anthem Pathway,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Alliance,Anthem Alliance,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Anthem Medicare,Anthem Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Cigna,Cigna,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Cigna PPO,Cigna PPO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Cigna Medicare Advantage,Cigna Medicare Advantage,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Essence,Essence,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Healthlink HMO,Healthlink HMO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Healthlink PPO,Healthlink PPO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,HomeState Health Plan,HomeState Health Plan,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Humana Gold,Humana Gold,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Medicaid MO,Medicaid MO,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Medica,Medica,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Tricare,Tricare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,UHC All Payer,UHC All Payer,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,UHC Exchange,UHC Exchange,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,UHC Medicaid,UHC Medicaid,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,UMR CPD,UMR CPD,260.55,,,,,,,per diem,260.55,260.55,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,UHC Medicare,UHC Medicare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38299317,CDM,302,RC,86970,CPT,,,,Inpatient,,,260.55,260.55,Wellcare,Wellcare,260.55,,,,,,,case rate,260.55,260.55,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health PPO CPD,Meritain Health PPO CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Aetna/Commercial Product,Aetna/Commercial Product,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Meritain Health CPD,Meritain Health CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Starmark CPD,Starmark CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Aetna Medicare,Aetna Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Ambetter ,Ambetter ,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access,Anthem Blue Access,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Access Choice,Anthem Blue Access Choice,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Blue Preferred,Anthem Blue Preferred,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Pathway,Anthem Pathway,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Alliance,Anthem Alliance,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Anthem Medicare,Anthem Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Cigna,Cigna,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Cigna PPO,Cigna PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Cigna Medicare Advantage,Cigna Medicare Advantage,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Essence,Essence,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Healthlink HMO,Healthlink HMO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Healthlink PPO,Healthlink PPO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,HomeState Health Plan,HomeState Health Plan,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Humana Gold,Humana Gold,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Medicaid MO,Medicaid MO,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Medica,Medica,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Tricare,Tricare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,UHC All Payer,UHC All Payer,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,UHC Exchange,UHC Exchange,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicaid,UHC Medicaid,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,UMR CPD,UMR CPD,181.41,,,,,,,per diem,181.41,181.41,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,UHC Medicare,UHC Medicare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38299318,CDM,302,RC,86359,CPT,,,,Inpatient,,,181.41,181.41,Wellcare,Wellcare,181.41,,,,,,,case rate,181.41,181.41,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Meritain Health PPO CPD,Meritain Health PPO CPD,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Aetna/Commercial Product,Aetna/Commercial Product,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Meritain Health CPD,Meritain Health CPD,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Starmark CPD,Starmark CPD,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Aetna Medicare,Aetna Medicare,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Ambetter ,Ambetter ,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Blue Access,Anthem Blue Access,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Blue Access Choice,Anthem Blue Access Choice,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Blue Preferred,Anthem Blue Preferred,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Pathway,Anthem Pathway,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Alliance,Anthem Alliance,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Anthem Medicare,Anthem Medicare,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Cigna,Cigna,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Cigna PPO,Cigna PPO,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Cigna Medicare Advantage,Cigna Medicare Advantage,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Essence,Essence,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Healthlink HMO,Healthlink HMO,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Healthlink PPO,Healthlink PPO,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,HomeState Health Plan,HomeState Health Plan,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Humana Gold,Humana Gold,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Medicaid MO,Medicaid MO,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Medica,Medica,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Tricare,Tricare,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,UHC All Payer,UHC All Payer,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,UHC Exchange,UHC Exchange,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,UHC Medicaid,UHC Medicaid,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,UMR CPD,UMR CPD,49.44,,,,,,,per diem,49.44,49.44,"Per diem rate, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,UHC Medicare,UHC Medicare,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
CBC WITHOUT PLATELETS         ,38299323,CDM,305,RC,G0307,CPT,G0307,HCPCS,,Inpatient,,,49.44,49.44,Wellcare,Wellcare,49.44,,,,,,,case rate,49.44,49.44,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Meritain Health PPO CPD,Meritain Health PPO CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Aetna/Commercial Product,Aetna/Commercial Product,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Meritain Health CPD,Meritain Health CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Starmark CPD,Starmark CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Aetna Medicare,Aetna Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Ambetter ,Ambetter ,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Access,Anthem Blue Access,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Access Choice,Anthem Blue Access Choice,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Preferred,Anthem Blue Preferred,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Pathway,Anthem Pathway,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Alliance,Anthem Alliance,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Anthem Medicare,Anthem Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Cigna,Cigna,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Cigna PPO,Cigna PPO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Cigna Medicare Advantage,Cigna Medicare Advantage,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Essence,Essence,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Healthlink HMO,Healthlink HMO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Healthlink PPO,Healthlink PPO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,HomeState Health Plan,HomeState Health Plan,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Humana Gold,Humana Gold,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Medicaid MO,Medicaid MO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Medica,Medica,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Tricare,Tricare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,UHC All Payer,UHC All Payer,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,UHC Exchange,UHC Exchange,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,UHC Medicaid,UHC Medicaid,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,UMR CPD,UMR CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,UHC Medicare,UHC Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38299324,CDM,306,RC,87641,CPT,,,,Inpatient,,,205.81,205.81,Wellcare,Wellcare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Meritain Health PPO CPD,Meritain Health PPO CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Aetna/Commercial Product,Aetna/Commercial Product,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Meritain Health CPD,Meritain Health CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Starmark CPD,Starmark CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Aetna Medicare,Aetna Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Ambetter ,Ambetter ,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Blue Access,Anthem Blue Access,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Blue Access Choice,Anthem Blue Access Choice,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Blue Preferred,Anthem Blue Preferred,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Pathway,Anthem Pathway,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Alliance,Anthem Alliance,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Anthem Medicare,Anthem Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Cigna,Cigna,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Cigna PPO,Cigna PPO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Cigna Medicare Advantage,Cigna Medicare Advantage,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Essence,Essence,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Healthlink HMO,Healthlink HMO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Healthlink PPO,Healthlink PPO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,HomeState Health Plan,HomeState Health Plan,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Humana Gold,Humana Gold,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Medicaid MO,Medicaid MO,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Medica,Medica,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Tricare,Tricare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,UHC All Payer,UHC All Payer,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,UHC Exchange,UHC Exchange,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,UHC Medicaid,UHC Medicaid,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,UMR CPD,UMR CPD,108.21,,,,,,,per diem,108.21,108.21,"Per diem rate, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,UHC Medicare,UHC Medicare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE TISSUE ADDL STUDIES   ,38299327,CDM,306,RC,87253,CPT,,,,Inpatient,,,108.21,108.21,Wellcare,Wellcare,108.21,,,,,,,case rate,108.21,108.21,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Meritain Health PPO CPD,Meritain Health PPO CPD,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Aetna/Commercial Product,Aetna/Commercial Product,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Meritain Health CPD,Meritain Health CPD,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Starmark CPD,Starmark CPD,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Aetna Medicare,Aetna Medicare,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Ambetter ,Ambetter ,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Blue Access,Anthem Blue Access,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Blue Access Choice,Anthem Blue Access Choice,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Blue Preferred,Anthem Blue Preferred,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Pathway,Anthem Pathway,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Alliance,Anthem Alliance,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Anthem Medicare,Anthem Medicare,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Cigna,Cigna,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Cigna PPO,Cigna PPO,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Cigna Medicare Advantage,Cigna Medicare Advantage,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Essence,Essence,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Healthlink HMO,Healthlink HMO,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Healthlink PPO,Healthlink PPO,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,HomeState Health Plan,HomeState Health Plan,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Humana Gold,Humana Gold,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Medicaid MO,Medicaid MO,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Medica,Medica,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Tricare,Tricare,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,UHC All Payer,UHC All Payer,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,UHC Exchange,UHC Exchange,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,UHC Medicaid,UHC Medicaid,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,UMR CPD,UMR CPD,294.3,,,,,,,per diem,294.3,294.3,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,UHC Medicare,UHC Medicare,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS SKIN           ,38299328,CDM,306,RC,87101,CPT,,,,Inpatient,,,294.3,294.3,Wellcare,Wellcare,294.3,,,,,,,case rate,294.3,294.3,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Meritain Health PPO CPD,Meritain Health PPO CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Aetna/Commercial Product,Aetna/Commercial Product,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Meritain Health CPD,Meritain Health CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Starmark CPD,Starmark CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Aetna Medicare,Aetna Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Ambetter ,Ambetter ,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Blue Access,Anthem Blue Access,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Blue Access Choice,Anthem Blue Access Choice,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Blue Preferred,Anthem Blue Preferred,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Pathway,Anthem Pathway,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Alliance,Anthem Alliance,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Anthem Medicare,Anthem Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Cigna,Cigna,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Cigna PPO,Cigna PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Cigna Medicare Advantage,Cigna Medicare Advantage,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Essence,Essence,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Healthlink HMO,Healthlink HMO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Healthlink PPO,Healthlink PPO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,HomeState Health Plan,HomeState Health Plan,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Humana Gold,Humana Gold,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Medicaid MO,Medicaid MO,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Medica,Medica,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Tricare,Tricare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,UHC All Payer,UHC All Payer,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,UHC Exchange,UHC Exchange,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,UHC Medicaid,UHC Medicaid,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,UMR CPD,UMR CPD,194.36,,,,,,,per diem,194.36,194.36,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,UHC Medicare,UHC Medicare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING             ,38299329,CDM,306,RC,87299,CPT,,,,Inpatient,,,194.36,194.36,Wellcare,Wellcare,194.36,,,,,,,case rate,194.36,194.36,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health PPO CPD,Meritain Health PPO CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Aetna/Commercial Product,Aetna/Commercial Product,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Meritain Health CPD,Meritain Health CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Starmark CPD,Starmark CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Aetna Medicare,Aetna Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Ambetter ,Ambetter ,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access,Anthem Blue Access,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Access Choice,Anthem Blue Access Choice,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Blue Preferred,Anthem Blue Preferred,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Pathway,Anthem Pathway,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Alliance,Anthem Alliance,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Anthem Medicare,Anthem Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Cigna,Cigna,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Cigna PPO,Cigna PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Cigna Medicare Advantage,Cigna Medicare Advantage,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Essence,Essence,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Healthlink HMO,Healthlink HMO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Healthlink PPO,Healthlink PPO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,HomeState Health Plan,HomeState Health Plan,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Humana Gold,Humana Gold,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Medicaid MO,Medicaid MO,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Medica,Medica,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Tricare,Tricare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,UHC All Payer,UHC All Payer,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,UHC Exchange,UHC Exchange,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicaid,UHC Medicaid,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,UMR CPD,UMR CPD,305.91,,,,,,,per diem,305.91,305.91,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,UHC Medicare,UHC Medicare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38299330,CDM,306,RC,87073,CPT,,,,Inpatient,,,305.91,305.91,Wellcare,Wellcare,305.91,,,,,,,case rate,305.91,305.91,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Meritain Health PPO CPD,Meritain Health PPO CPD,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Aetna/Commercial Product,Aetna/Commercial Product,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Meritain Health CPD,Meritain Health CPD,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Starmark CPD,Starmark CPD,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Aetna Medicare,Aetna Medicare,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Ambetter ,Ambetter ,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Blue Access,Anthem Blue Access,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Blue Access Choice,Anthem Blue Access Choice,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Blue Preferred,Anthem Blue Preferred,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Pathway,Anthem Pathway,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Alliance,Anthem Alliance,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Anthem Medicare,Anthem Medicare,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Cigna,Cigna,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Cigna PPO,Cigna PPO,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Cigna Medicare Advantage,Cigna Medicare Advantage,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Essence,Essence,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Healthlink HMO,Healthlink HMO,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Healthlink PPO,Healthlink PPO,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,HomeState Health Plan,HomeState Health Plan,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Humana Gold,Humana Gold,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Medicaid MO,Medicaid MO,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Medica,Medica,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Tricare,Tricare,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,UHC All Payer,UHC All Payer,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,UHC Exchange,UHC Exchange,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,UHC Medicaid,UHC Medicaid,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,UMR CPD,UMR CPD,121.16,,,,,,,per diem,121.16,121.16,"Per diem rate, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,UHC Medicare,UHC Medicare,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
SHIGA-LIKE TOXIN              ,38299331,CDM,306,RC,87427,CPT,,,,Inpatient,,,121.16,121.16,Wellcare,Wellcare,121.16,,,,,,,case rate,121.16,121.16,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Meritain Health PPO CPD,Meritain Health PPO CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Aetna/Commercial Product,Aetna/Commercial Product,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Meritain Health CPD,Meritain Health CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Starmark CPD,Starmark CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Aetna Medicare,Aetna Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Ambetter ,Ambetter ,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Access,Anthem Blue Access,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Access Choice,Anthem Blue Access Choice,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Blue Preferred,Anthem Blue Preferred,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Pathway,Anthem Pathway,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Alliance,Anthem Alliance,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Anthem Medicare,Anthem Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Cigna,Cigna,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Cigna PPO,Cigna PPO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Cigna Medicare Advantage,Cigna Medicare Advantage,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Essence,Essence,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Healthlink HMO,Healthlink HMO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Healthlink PPO,Healthlink PPO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,HomeState Health Plan,HomeState Health Plan,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Humana Gold,Humana Gold,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Medicaid MO,Medicaid MO,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Medica,Medica,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Tricare,Tricare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,UHC All Payer,UHC All Payer,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,UHC Exchange,UHC Exchange,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,UHC Medicaid,UHC Medicaid,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,UMR CPD,UMR CPD,100.43,,,,,,,per diem,100.43,100.43,"Per diem rate, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,UHC Medicare,UHC Medicare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
HEP B S AG EIA                ,38299332,CDM,306,RC,87515,CPT,,,,Inpatient,,,100.43,100.43,Wellcare,Wellcare,100.43,,,,,,,case rate,100.43,100.43,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Meritain Health PPO CPD,Meritain Health PPO CPD,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Aetna/Commercial Product,Aetna/Commercial Product,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Meritain Health CPD,Meritain Health CPD,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Starmark CPD,Starmark CPD,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Aetna Medicare,Aetna Medicare,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Ambetter ,Ambetter ,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Blue Access,Anthem Blue Access,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Blue Access Choice,Anthem Blue Access Choice,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Blue Preferred,Anthem Blue Preferred,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Pathway,Anthem Pathway,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Alliance,Anthem Alliance,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Anthem Medicare,Anthem Medicare,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Cigna,Cigna,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Cigna PPO,Cigna PPO,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Cigna Medicare Advantage,Cigna Medicare Advantage,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Essence,Essence,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Healthlink HMO,Healthlink HMO,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Healthlink PPO,Healthlink PPO,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,HomeState Health Plan,HomeState Health Plan,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Humana Gold,Humana Gold,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Medicaid MO,Medicaid MO,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Medica,Medica,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Tricare,Tricare,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,UHC All Payer,UHC All Payer,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,UHC Exchange,UHC Exchange,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,UHC Medicaid,UHC Medicaid,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,UMR CPD,UMR CPD,271.62,,,,,,,per diem,271.62,271.62,"Per diem rate, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,UHC Medicare,UHC Medicare,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
ANTIGEN RSV                   ,38299334,CDM,306,RC,87420,CPT,,,,Inpatient,,,271.62,271.62,Wellcare,Wellcare,271.62,,,,,,,case rate,271.62,271.62,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Meritain Health PPO CPD,Meritain Health PPO CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Aetna/Commercial Product,Aetna/Commercial Product,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Meritain Health CPD,Meritain Health CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Starmark CPD,Starmark CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Aetna Medicare,Aetna Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Ambetter ,Ambetter ,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Blue Access,Anthem Blue Access,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Blue Access Choice,Anthem Blue Access Choice,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Blue Preferred,Anthem Blue Preferred,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Pathway,Anthem Pathway,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Alliance,Anthem Alliance,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Anthem Medicare,Anthem Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Cigna,Cigna,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Cigna PPO,Cigna PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Cigna Medicare Advantage,Cigna Medicare Advantage,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Essence,Essence,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Healthlink HMO,Healthlink HMO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Healthlink PPO,Healthlink PPO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,HomeState Health Plan,HomeState Health Plan,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Humana Gold,Humana Gold,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Medicaid MO,Medicaid MO,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Medica,Medica,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Tricare,Tricare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,UHC All Payer,UHC All Payer,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,UHC Exchange,UHC Exchange,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,UHC Medicaid,UHC Medicaid,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,UMR CPD,UMR CPD,616.7,,,,,,,per diem,616.7,616.7,"Per diem rate, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,UHC Medicare,UHC Medicare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
WESTERN BLOT                  ,38299338,CDM,301,RC,84181,CPT,,,,Inpatient,,,616.7,616.7,Wellcare,Wellcare,616.7,,,,,,,case rate,616.7,616.7,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Meritain Health PPO CPD,Meritain Health PPO CPD,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Aetna/Commercial Product,Aetna/Commercial Product,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Meritain Health CPD,Meritain Health CPD,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Starmark CPD,Starmark CPD,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Aetna Medicare,Aetna Medicare,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Ambetter ,Ambetter ,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Blue Access,Anthem Blue Access,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Blue Access Choice,Anthem Blue Access Choice,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Blue Preferred,Anthem Blue Preferred,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Pathway,Anthem Pathway,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Alliance,Anthem Alliance,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Anthem Medicare,Anthem Medicare,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Cigna,Cigna,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Cigna PPO,Cigna PPO,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Cigna Medicare Advantage,Cigna Medicare Advantage,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Essence,Essence,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Healthlink HMO,Healthlink HMO,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Healthlink PPO,Healthlink PPO,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,HomeState Health Plan,HomeState Health Plan,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Humana Gold,Humana Gold,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Medicaid MO,Medicaid MO,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Medica,Medica,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Tricare,Tricare,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,UHC All Payer,UHC All Payer,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,UHC Exchange,UHC Exchange,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,UHC Medicaid,UHC Medicaid,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,UMR CPD,UMR CPD,74.86,,,,,,,per diem,74.86,74.86,"Per diem rate, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,UHC Medicare,UHC Medicare,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
ICTOTEST                      ,38299339,CDM,301,RC,81007,CPT,,,,Inpatient,,,74.86,74.86,Wellcare,Wellcare,74.86,,,,,,,case rate,74.86,74.86,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Meritain Health PPO CPD,Meritain Health PPO CPD,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Aetna/Commercial Product,Aetna/Commercial Product,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Meritain Health CPD,Meritain Health CPD,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Starmark CPD,Starmark CPD,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Aetna Medicare,Aetna Medicare,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Ambetter ,Ambetter ,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Blue Access,Anthem Blue Access,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Blue Access Choice,Anthem Blue Access Choice,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Blue Preferred,Anthem Blue Preferred,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Pathway,Anthem Pathway,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Alliance,Anthem Alliance,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Anthem Medicare,Anthem Medicare,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Cigna,Cigna,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Cigna PPO,Cigna PPO,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Cigna Medicare Advantage,Cigna Medicare Advantage,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Essence,Essence,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Healthlink HMO,Healthlink HMO,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Healthlink PPO,Healthlink PPO,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,HomeState Health Plan,HomeState Health Plan,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Humana Gold,Humana Gold,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Medicaid MO,Medicaid MO,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Medica,Medica,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Tricare,Tricare,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,UHC All Payer,UHC All Payer,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,UHC Exchange,UHC Exchange,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,UHC Medicaid,UHC Medicaid,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,UMR CPD,UMR CPD,658.29,,,,,,,per diem,658.29,658.29,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,UHC Medicare,UHC Medicare,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38299341,CDM,306,RC,87529,CPT,,,,Inpatient,,,658.29,658.29,Wellcare,Wellcare,658.29,,,,,,,case rate,658.29,658.29,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Meritain Health PPO CPD,Meritain Health PPO CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Aetna/Commercial Product,Aetna/Commercial Product,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Meritain Health CPD,Meritain Health CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Starmark CPD,Starmark CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Aetna Medicare,Aetna Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Ambetter ,Ambetter ,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Blue Access,Anthem Blue Access,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Blue Access Choice,Anthem Blue Access Choice,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Blue Preferred,Anthem Blue Preferred,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Pathway,Anthem Pathway,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Alliance,Anthem Alliance,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Anthem Medicare,Anthem Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Cigna,Cigna,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Cigna PPO,Cigna PPO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Cigna Medicare Advantage,Cigna Medicare Advantage,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Essence,Essence,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Healthlink HMO,Healthlink HMO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Healthlink PPO,Healthlink PPO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,HomeState Health Plan,HomeState Health Plan,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Humana Gold,Humana Gold,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Medicaid MO,Medicaid MO,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Medica,Medica,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Tricare,Tricare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,UHC All Payer,UHC All Payer,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,UHC Exchange,UHC Exchange,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,UHC Medicaid,UHC Medicaid,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,UMR CPD,UMR CPD,169.95,,,,,,,per diem,169.95,169.95,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,UHC Medicare,UHC Medicare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38299344,CDM,306,RC,87116,CPT,,,,Inpatient,,,169.95,169.95,Wellcare,Wellcare,169.95,,,,,,,case rate,169.95,169.95,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Meritain Health PPO CPD,Meritain Health PPO CPD,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Aetna/Commercial Product,Aetna/Commercial Product,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Meritain Health CPD,Meritain Health CPD,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Starmark CPD,Starmark CPD,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Aetna Medicare,Aetna Medicare,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Ambetter ,Ambetter ,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Blue Access,Anthem Blue Access,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Blue Access Choice,Anthem Blue Access Choice,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Blue Preferred,Anthem Blue Preferred,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Pathway,Anthem Pathway,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Alliance,Anthem Alliance,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Anthem Medicare,Anthem Medicare,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Cigna,Cigna,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Cigna PPO,Cigna PPO,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Cigna Medicare Advantage,Cigna Medicare Advantage,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Essence,Essence,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Healthlink HMO,Healthlink HMO,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Healthlink PPO,Healthlink PPO,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,HomeState Health Plan,HomeState Health Plan,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Humana Gold,Humana Gold,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Medicaid MO,Medicaid MO,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Medica,Medica,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Tricare,Tricare,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,UHC All Payer,UHC All Payer,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,UHC Exchange,UHC Exchange,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,UHC Medicaid,UHC Medicaid,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,UMR CPD,UMR CPD,22.59,,,,,,,per diem,22.59,22.59,"Per diem rate, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,UHC Medicare,UHC Medicare,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
HEMOCHRON ACT                 ,38299345,CDM,306,RC,85347,CPT,,,,Inpatient,,,22.59,22.59,Wellcare,Wellcare,22.59,,,,,,,case rate,22.59,22.59,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Meritain Health PPO CPD,Meritain Health PPO CPD,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Aetna/Commercial Product,Aetna/Commercial Product,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Meritain Health CPD,Meritain Health CPD,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Starmark CPD,Starmark CPD,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Aetna Medicare,Aetna Medicare,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Ambetter ,Ambetter ,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Blue Access,Anthem Blue Access,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Blue Access Choice,Anthem Blue Access Choice,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Blue Preferred,Anthem Blue Preferred,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Pathway,Anthem Pathway,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Alliance,Anthem Alliance,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Anthem Medicare,Anthem Medicare,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Cigna,Cigna,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Cigna PPO,Cigna PPO,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Cigna Medicare Advantage,Cigna Medicare Advantage,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Essence,Essence,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Healthlink HMO,Healthlink HMO,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Healthlink PPO,Healthlink PPO,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,HomeState Health Plan,HomeState Health Plan,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Humana Gold,Humana Gold,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Medicaid MO,Medicaid MO,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Medica,Medica,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Tricare,Tricare,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,UHC All Payer,UHC All Payer,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,UHC Exchange,UHC Exchange,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,UHC Medicaid,UHC Medicaid,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,UMR CPD,UMR CPD,253.56,,,,,,,per diem,253.56,253.56,"Per diem rate, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,UHC Medicare,UHC Medicare,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
C DIFFICILE AMP PROBE         ,38299350,CDM,306,RC,87493,CPT,,,,Inpatient,,,253.56,253.56,Wellcare,Wellcare,253.56,,,,,,,case rate,253.56,253.56,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
DILANTIN ASSAY                ,38299351,CDM,301,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Meritain Health PPO CPD,Meritain Health PPO CPD,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Aetna/Commercial Product,Aetna/Commercial Product,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Meritain Health CPD,Meritain Health CPD,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Starmark CPD,Starmark CPD,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Aetna Medicare,Aetna Medicare,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Ambetter ,Ambetter ,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Blue Access,Anthem Blue Access,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Blue Access Choice,Anthem Blue Access Choice,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Blue Preferred,Anthem Blue Preferred,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Pathway,Anthem Pathway,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Alliance,Anthem Alliance,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Anthem Medicare,Anthem Medicare,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Cigna,Cigna,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Cigna PPO,Cigna PPO,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Cigna Medicare Advantage,Cigna Medicare Advantage,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Essence,Essence,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Healthlink HMO,Healthlink HMO,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Healthlink PPO,Healthlink PPO,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,HomeState Health Plan,HomeState Health Plan,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Humana Gold,Humana Gold,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Medicaid MO,Medicaid MO,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Medica,Medica,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Tricare,Tricare,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,UHC All Payer,UHC All Payer,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,UHC Exchange,UHC Exchange,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,UHC Medicaid,UHC Medicaid,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,UMR CPD,UMR CPD,393.07,,,,,,,per diem,393.07,393.07,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,UHC Medicare,UHC Medicare,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38299352,CDM,301,RC,84597,CPT,,,,Inpatient,,,393.07,393.07,Wellcare,Wellcare,393.07,,,,,,,case rate,393.07,393.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Meritain Health PPO CPD,Meritain Health PPO CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Aetna/Commercial Product,Aetna/Commercial Product,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Meritain Health CPD,Meritain Health CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Starmark CPD,Starmark CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Aetna Medicare,Aetna Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Ambetter ,Ambetter ,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Blue Access,Anthem Blue Access,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Blue Access Choice,Anthem Blue Access Choice,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Blue Preferred,Anthem Blue Preferred,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Pathway,Anthem Pathway,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Alliance,Anthem Alliance,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Anthem Medicare,Anthem Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Cigna,Cigna,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Cigna PPO,Cigna PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Cigna Medicare Advantage,Cigna Medicare Advantage,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Essence,Essence,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Healthlink HMO,Healthlink HMO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Healthlink PPO,Healthlink PPO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,HomeState Health Plan,HomeState Health Plan,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Humana Gold,Humana Gold,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Medicaid MO,Medicaid MO,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Medica,Medica,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Tricare,Tricare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,UHC All Payer,UHC All Payer,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,UHC Exchange,UHC Exchange,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,UHC Medicaid,UHC Medicaid,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,UMR CPD,UMR CPD,43.07,,,,,,,per diem,43.07,43.07,"Per diem rate, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,UHC Medicare,UHC Medicare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
ANTIPHOSPHOLIPID AB           ,38299353,CDM,302,RC,86148,CPT,,,,Inpatient,,,43.07,43.07,Wellcare,Wellcare,43.07,,,,,,,case rate,43.07,43.07,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health PPO CPD,Meritain Health PPO CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Aetna/Commercial Product,Aetna/Commercial Product,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health CPD,Meritain Health CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Starmark CPD,Starmark CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Aetna Medicare,Aetna Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Ambetter ,Ambetter ,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access,Anthem Blue Access,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access Choice,Anthem Blue Access Choice,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Preferred,Anthem Blue Preferred,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Pathway,Anthem Pathway,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Alliance,Anthem Alliance,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Anthem Medicare,Anthem Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Cigna,Cigna,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Cigna PPO,Cigna PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Cigna Medicare Advantage,Cigna Medicare Advantage,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Essence,Essence,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Healthlink HMO,Healthlink HMO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Healthlink PPO,Healthlink PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,HomeState Health Plan,HomeState Health Plan,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Humana Gold,Humana Gold,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Medicaid MO,Medicaid MO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Medica,Medica,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Tricare,Tricare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,UHC All Payer,UHC All Payer,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,UHC Exchange,UHC Exchange,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicaid,UHC Medicaid,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,UMR CPD,UMR CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicare,UHC Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38299354,CDM,302,RC,86200,CPT,,,,Inpatient,,,180.35,180.35,Wellcare,Wellcare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Meritain Health PPO CPD,Meritain Health PPO CPD,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Aetna/Commercial Product,Aetna/Commercial Product,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Meritain Health CPD,Meritain Health CPD,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Starmark CPD,Starmark CPD,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Aetna Medicare,Aetna Medicare,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Ambetter ,Ambetter ,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Blue Access,Anthem Blue Access,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Blue Access Choice,Anthem Blue Access Choice,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Blue Preferred,Anthem Blue Preferred,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Pathway,Anthem Pathway,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Alliance,Anthem Alliance,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Anthem Medicare,Anthem Medicare,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Cigna,Cigna,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Cigna PPO,Cigna PPO,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Cigna Medicare Advantage,Cigna Medicare Advantage,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Essence,Essence,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Healthlink HMO,Healthlink HMO,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Healthlink PPO,Healthlink PPO,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,HomeState Health Plan,HomeState Health Plan,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Humana Gold,Humana Gold,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Medicaid MO,Medicaid MO,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Medica,Medica,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Tricare,Tricare,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,UHC All Payer,UHC All Payer,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,UHC Exchange,UHC Exchange,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,UHC Medicaid,UHC Medicaid,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,UMR CPD,UMR CPD,51.98,,,,,,,per diem,51.98,51.98,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,UHC Medicare,UHC Medicare,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38299356,CDM,301,RC,82272,CPT,,,,Inpatient,,,51.98,51.98,Wellcare,Wellcare,51.98,,,,,,,case rate,51.98,51.98,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Meritain Health PPO CPD,Meritain Health PPO CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Aetna/Commercial Product,Aetna/Commercial Product,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Meritain Health CPD,Meritain Health CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Starmark CPD,Starmark CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Aetna Medicare,Aetna Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Ambetter ,Ambetter ,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Blue Access,Anthem Blue Access,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Blue Access Choice,Anthem Blue Access Choice,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Blue Preferred,Anthem Blue Preferred,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Pathway,Anthem Pathway,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Alliance,Anthem Alliance,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Anthem Medicare,Anthem Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Cigna,Cigna,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Cigna PPO,Cigna PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Cigna Medicare Advantage,Cigna Medicare Advantage,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Essence,Essence,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Healthlink HMO,Healthlink HMO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Healthlink PPO,Healthlink PPO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,HomeState Health Plan,HomeState Health Plan,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Humana Gold,Humana Gold,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Medicaid MO,Medicaid MO,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Medica,Medica,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Tricare,Tricare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,UHC All Payer,UHC All Payer,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,UHC Exchange,UHC Exchange,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,UHC Medicaid,UHC Medicaid,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,UMR CPD,UMR CPD,51.48,,,,,,,per diem,51.48,51.48,"Per diem rate, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,UHC Medicare,UHC Medicare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
Q FEVER AB COXIELLA BURNETII  ,38299357,CDM,302,RC,86638,CPT,,,,Inpatient,,,51.48,51.48,Wellcare,Wellcare,51.48,,,,,,,case rate,51.48,51.48,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health PPO CPD,Meritain Health PPO CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna/Commercial Product,Aetna/Commercial Product,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Meritain Health CPD,Meritain Health CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Starmark CPD,Starmark CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Aetna Medicare,Aetna Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Ambetter ,Ambetter ,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access,Anthem Blue Access,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Access Choice,Anthem Blue Access Choice,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Blue Preferred,Anthem Blue Preferred,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Pathway,Anthem Pathway,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Alliance,Anthem Alliance,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Anthem Medicare,Anthem Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna,Cigna,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna PPO,Cigna PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Cigna Medicare Advantage,Cigna Medicare Advantage,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Essence,Essence,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink HMO,Healthlink HMO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Healthlink PPO,Healthlink PPO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,HomeState Health Plan,HomeState Health Plan,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Humana Gold,Humana Gold,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medicaid MO,Medicaid MO,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Medica,Medica,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Tricare,Tricare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC All Payer,UHC All Payer,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Exchange,UHC Exchange,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicaid,UHC Medicaid,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UMR CPD,UMR CPD,232.34,,,,,,,per diem,232.34,232.34,"Per diem rate, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,UHC Medicare,UHC Medicare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
QUANT OF DRUG NOT ELSE SPEC   ,38299980,CDM,300,RC,80299,CPT,,,,Inpatient,,,232.34,232.34,Wellcare,Wellcare,232.34,,,,,,,case rate,232.34,232.34,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Meritain Health PPO CPD,Meritain Health PPO CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Aetna/Commercial Product,Aetna/Commercial Product,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Meritain Health CPD,Meritain Health CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Starmark CPD,Starmark CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Aetna Medicare,Aetna Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Ambetter ,Ambetter ,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Access,Anthem Blue Access,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Access Choice,Anthem Blue Access Choice,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Blue Preferred,Anthem Blue Preferred,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Pathway,Anthem Pathway,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Alliance,Anthem Alliance,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Anthem Medicare,Anthem Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Cigna,Cigna,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Cigna PPO,Cigna PPO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Cigna Medicare Advantage,Cigna Medicare Advantage,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Essence,Essence,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Healthlink HMO,Healthlink HMO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Healthlink PPO,Healthlink PPO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,HomeState Health Plan,HomeState Health Plan,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Humana Gold,Humana Gold,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Medicaid MO,Medicaid MO,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Medica,Medica,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Tricare,Tricare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,UHC All Payer,UHC All Payer,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,UHC Exchange,UHC Exchange,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,UHC Medicaid,UHC Medicaid,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,UMR CPD,UMR CPD,115.36,,,,,,,per diem,115.36,115.36,"Per diem rate, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,UHC Medicare,UHC Medicare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
GLUTAMINE                     ,38299981,CDM,300,RC,82975,CPT,,,,Inpatient,,,115.36,115.36,Wellcare,Wellcare,115.36,,,,,,,case rate,115.36,115.36,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Meritain Health PPO CPD,Meritain Health PPO CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Aetna/Commercial Product,Aetna/Commercial Product,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Meritain Health CPD,Meritain Health CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Starmark CPD,Starmark CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Aetna Medicare,Aetna Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Ambetter ,Ambetter ,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Access,Anthem Blue Access,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Access Choice,Anthem Blue Access Choice,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Preferred,Anthem Blue Preferred,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Pathway,Anthem Pathway,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Alliance,Anthem Alliance,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Anthem Medicare,Anthem Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Cigna,Cigna,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Cigna PPO,Cigna PPO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Cigna Medicare Advantage,Cigna Medicare Advantage,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Essence,Essence,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Healthlink HMO,Healthlink HMO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Healthlink PPO,Healthlink PPO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,HomeState Health Plan,HomeState Health Plan,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Humana Gold,Humana Gold,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Medicaid MO,Medicaid MO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Medica,Medica,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Tricare,Tricare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,UHC All Payer,UHC All Payer,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,UHC Exchange,UHC Exchange,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,UHC Medicaid,UHC Medicaid,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,UMR CPD,UMR CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,UHC Medicare,UHC Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
CULTURE MYCOBACTERIAL DEFIN   ,38299982,CDM,300,RC,87118,CPT,,,,Inpatient,,,62.83,62.83,Wellcare,Wellcare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Meritain Health PPO CPD,Meritain Health PPO CPD,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Aetna/Commercial Product,Aetna/Commercial Product,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Meritain Health CPD,Meritain Health CPD,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Starmark CPD,Starmark CPD,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Aetna Medicare,Aetna Medicare,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Ambetter ,Ambetter ,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Blue Access,Anthem Blue Access,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Blue Access Choice,Anthem Blue Access Choice,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Blue Preferred,Anthem Blue Preferred,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Pathway,Anthem Pathway,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Alliance,Anthem Alliance,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Anthem Medicare,Anthem Medicare,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Cigna,Cigna,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Cigna PPO,Cigna PPO,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Cigna Medicare Advantage,Cigna Medicare Advantage,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Essence,Essence,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Healthlink HMO,Healthlink HMO,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Healthlink PPO,Healthlink PPO,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,HomeState Health Plan,HomeState Health Plan,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Humana Gold,Humana Gold,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Medicaid MO,Medicaid MO,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Medica,Medica,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Tricare,Tricare,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,UHC All Payer,UHC All Payer,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,UHC Exchange,UHC Exchange,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,UHC Medicaid,UHC Medicaid,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,UMR CPD,UMR CPD,164.8,,,,,,,per diem,164.8,164.8,"Per diem rate, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,UHC Medicare,UHC Medicare,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
SPUTUM CULTURE & SENSITIVITY  ,38299983,CDM,300,RC,87451,CPT,,,,Inpatient,,,164.8,164.8,Wellcare,Wellcare,164.8,,,,,,,case rate,164.8,164.8,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health PPO CPD,Meritain Health PPO CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Aetna/Commercial Product,Aetna/Commercial Product,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Meritain Health CPD,Meritain Health CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Starmark CPD,Starmark CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Aetna Medicare,Aetna Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Ambetter ,Ambetter ,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access,Anthem Blue Access,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Access Choice,Anthem Blue Access Choice,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Blue Preferred,Anthem Blue Preferred,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Pathway,Anthem Pathway,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Alliance,Anthem Alliance,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Anthem Medicare,Anthem Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Cigna,Cigna,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Cigna PPO,Cigna PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Cigna Medicare Advantage,Cigna Medicare Advantage,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Essence,Essence,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink HMO,Healthlink HMO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Healthlink PPO,Healthlink PPO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,HomeState Health Plan,HomeState Health Plan,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Humana Gold,Humana Gold,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Medicaid MO,Medicaid MO,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Medica,Medica,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Tricare,Tricare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,UHC All Payer,UHC All Payer,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,UHC Exchange,UHC Exchange,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicaid,UHC Medicaid,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,UMR CPD,UMR CPD,142.88,,,,,,,per diem,142.88,142.88,"Per diem rate, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,UHC Medicare,UHC Medicare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
LAB-UNLISTED TEST             ,38299999,CDM,300,RC,,,,,,Inpatient,,,142.88,142.88,Wellcare,Wellcare,142.88,,,,,,,case rate,142.88,142.88,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Meritain Health PPO CPD,Meritain Health PPO CPD,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Aetna/Commercial Product,Aetna/Commercial Product,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Meritain Health CPD,Meritain Health CPD,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Starmark CPD,Starmark CPD,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Aetna Medicare,Aetna Medicare,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Ambetter ,Ambetter ,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Blue Access,Anthem Blue Access,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Blue Access Choice,Anthem Blue Access Choice,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Blue Preferred,Anthem Blue Preferred,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Pathway,Anthem Pathway,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Alliance,Anthem Alliance,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Anthem Medicare,Anthem Medicare,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Cigna,Cigna,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Cigna PPO,Cigna PPO,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Cigna Medicare Advantage,Cigna Medicare Advantage,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Essence,Essence,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Healthlink HMO,Healthlink HMO,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Healthlink PPO,Healthlink PPO,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,HomeState Health Plan,HomeState Health Plan,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Humana Gold,Humana Gold,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Medicaid MO,Medicaid MO,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Medica,Medica,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Tricare,Tricare,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,UHC All Payer,UHC All Payer,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,UHC Exchange,UHC Exchange,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,UHC Medicaid,UHC Medicaid,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,UMR CPD,UMR CPD,318.27,,,,,,,per diem,318.27,318.27,"Per diem rate, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,UHC Medicare,UHC Medicare,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
PROCALCITONIN                 ,38300004,CDM,301,RC,84145,CPT,,,,Inpatient,,,318.27,318.27,Wellcare,Wellcare,318.27,,,,,,,case rate,318.27,318.27,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Meritain Health PPO CPD,Meritain Health PPO CPD,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Aetna/Commercial Product,Aetna/Commercial Product,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Meritain Health CPD,Meritain Health CPD,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Starmark CPD,Starmark CPD,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Aetna Medicare,Aetna Medicare,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Ambetter ,Ambetter ,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Blue Access,Anthem Blue Access,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Blue Access Choice,Anthem Blue Access Choice,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Blue Preferred,Anthem Blue Preferred,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Pathway,Anthem Pathway,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Alliance,Anthem Alliance,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Anthem Medicare,Anthem Medicare,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Cigna,Cigna,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Cigna PPO,Cigna PPO,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Cigna Medicare Advantage,Cigna Medicare Advantage,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Essence,Essence,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Healthlink HMO,Healthlink HMO,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Healthlink PPO,Healthlink PPO,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,HomeState Health Plan,HomeState Health Plan,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Humana Gold,Humana Gold,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Medicaid MO,Medicaid MO,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Medica,Medica,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Tricare,Tricare,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,UHC All Payer,UHC All Payer,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,UHC Exchange,UHC Exchange,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,UHC Medicaid,UHC Medicaid,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,UMR CPD,UMR CPD,196,,,,,,,per diem,196,196,"Per diem rate, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,UHC Medicare,UHC Medicare,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
"CULTURE, GROUP A STREP SCR    ",38300008,CDM,306,RC,87081,CPT,,,,Inpatient,,,196,196,Wellcare,Wellcare,196,,,,,,,case rate,196,196,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health PPO CPD,Meritain Health PPO CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Aetna/Commercial Product,Aetna/Commercial Product,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health CPD,Meritain Health CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Starmark CPD,Starmark CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Aetna Medicare,Aetna Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Ambetter ,Ambetter ,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access,Anthem Blue Access,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access Choice,Anthem Blue Access Choice,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Preferred,Anthem Blue Preferred,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Pathway,Anthem Pathway,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Alliance,Anthem Alliance,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Anthem Medicare,Anthem Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Cigna,Cigna,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Cigna PPO,Cigna PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Cigna Medicare Advantage,Cigna Medicare Advantage,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Essence,Essence,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Healthlink HMO,Healthlink HMO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Healthlink PPO,Healthlink PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,HomeState Health Plan,HomeState Health Plan,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Humana Gold,Humana Gold,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Medicaid MO,Medicaid MO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Medica,Medica,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Tricare,Tricare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,UHC All Payer,UHC All Payer,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,UHC Exchange,UHC Exchange,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicaid,UHC Medicaid,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,UMR CPD,UMR CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicare,UHC Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
GAMMAGLOBULIN IGM             ,38300016,CDM,301,RC,82784,CPT,,,,Inpatient,,,153.83,153.83,Wellcare,Wellcare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Meritain Health PPO CPD,Meritain Health PPO CPD,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Aetna/Commercial Product,Aetna/Commercial Product,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Meritain Health CPD,Meritain Health CPD,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Starmark CPD,Starmark CPD,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Aetna Medicare,Aetna Medicare,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Ambetter ,Ambetter ,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Blue Access,Anthem Blue Access,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Blue Access Choice,Anthem Blue Access Choice,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Blue Preferred,Anthem Blue Preferred,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Pathway,Anthem Pathway,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Alliance,Anthem Alliance,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Anthem Medicare,Anthem Medicare,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Cigna,Cigna,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Cigna PPO,Cigna PPO,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Cigna Medicare Advantage,Cigna Medicare Advantage,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Essence,Essence,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Healthlink HMO,Healthlink HMO,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Healthlink PPO,Healthlink PPO,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,HomeState Health Plan,HomeState Health Plan,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Humana Gold,Humana Gold,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Medicaid MO,Medicaid MO,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Medica,Medica,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Tricare,Tricare,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,UHC All Payer,UHC All Payer,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,UHC Exchange,UHC Exchange,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,UHC Medicaid,UHC Medicaid,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,UMR CPD,UMR CPD,237.64,,,,,,,per diem,237.64,237.64,"Per diem rate, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,UHC Medicare,UHC Medicare,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
PURKINJE CELL CYTOPLASMA      ,38300020,CDM,302,RC,86255,CPT,,,,Inpatient,,,237.64,237.64,Wellcare,Wellcare,237.64,,,,,,,case rate,237.64,237.64,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health PPO CPD,Meritain Health PPO CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Aetna/Commercial Product,Aetna/Commercial Product,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Meritain Health CPD,Meritain Health CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Starmark CPD,Starmark CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Aetna Medicare,Aetna Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Ambetter ,Ambetter ,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access,Anthem Blue Access,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Access Choice,Anthem Blue Access Choice,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Blue Preferred,Anthem Blue Preferred,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Pathway,Anthem Pathway,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Alliance,Anthem Alliance,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Anthem Medicare,Anthem Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Cigna,Cigna,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Cigna PPO,Cigna PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Cigna Medicare Advantage,Cigna Medicare Advantage,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Essence,Essence,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Healthlink HMO,Healthlink HMO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Healthlink PPO,Healthlink PPO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,HomeState Health Plan,HomeState Health Plan,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Humana Gold,Humana Gold,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Medicaid MO,Medicaid MO,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Medica,Medica,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Tricare,Tricare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,UHC All Payer,UHC All Payer,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,UHC Exchange,UHC Exchange,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicaid,UHC Medicaid,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,UMR CPD,UMR CPD,146.4,,,,,,,per diem,146.4,146.4,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,UHC Medicare,UHC Medicare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUALITATIVE        ",38300021,CDM,301,RC,84703,CPT,,,,Inpatient,,,146.4,146.4,Wellcare,Wellcare,146.4,,,,,,,case rate,146.4,146.4,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Meritain Health PPO CPD,Meritain Health PPO CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Aetna/Commercial Product,Aetna/Commercial Product,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Meritain Health CPD,Meritain Health CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Starmark CPD,Starmark CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Aetna Medicare,Aetna Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Ambetter ,Ambetter ,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Access,Anthem Blue Access,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Access Choice,Anthem Blue Access Choice,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Blue Preferred,Anthem Blue Preferred,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Pathway,Anthem Pathway,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Alliance,Anthem Alliance,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Anthem Medicare,Anthem Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Cigna,Cigna,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Cigna PPO,Cigna PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Cigna Medicare Advantage,Cigna Medicare Advantage,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Essence,Essence,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Healthlink HMO,Healthlink HMO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Healthlink PPO,Healthlink PPO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,HomeState Health Plan,HomeState Health Plan,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Humana Gold,Humana Gold,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Medicaid MO,Medicaid MO,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Medica,Medica,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Tricare,Tricare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,UHC All Payer,UHC All Payer,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,UHC Exchange,UHC Exchange,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,UHC Medicaid,UHC Medicaid,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,UMR CPD,UMR CPD,200.51,,,,,,,per diem,200.51,200.51,"Per diem rate, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,UHC Medicare,UHC Medicare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
"HCG SERUM, QUANTITATIVE       ",38300022,CDM,301,RC,84702,CPT,,,,Inpatient,,,200.51,200.51,Wellcare,Wellcare,200.51,,,,,,,case rate,200.51,200.51,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Meritain Health PPO CPD,Meritain Health PPO CPD,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Aetna/Commercial Product,Aetna/Commercial Product,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Meritain Health CPD,Meritain Health CPD,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Starmark CPD,Starmark CPD,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Aetna Medicare,Aetna Medicare,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Ambetter ,Ambetter ,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Blue Access,Anthem Blue Access,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Blue Access Choice,Anthem Blue Access Choice,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Blue Preferred,Anthem Blue Preferred,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Pathway,Anthem Pathway,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Alliance,Anthem Alliance,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Anthem Medicare,Anthem Medicare,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Cigna,Cigna,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Cigna PPO,Cigna PPO,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Cigna Medicare Advantage,Cigna Medicare Advantage,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Essence,Essence,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Healthlink HMO,Healthlink HMO,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Healthlink PPO,Healthlink PPO,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,HomeState Health Plan,HomeState Health Plan,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Humana Gold,Humana Gold,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Medicaid MO,Medicaid MO,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Medica,Medica,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Tricare,Tricare,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,UHC All Payer,UHC All Payer,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,UHC Exchange,UHC Exchange,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,UHC Medicaid,UHC Medicaid,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,UMR CPD,UMR CPD,360.97,,,,,,,per diem,360.97,360.97,"Per diem rate, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,UHC Medicare,UHC Medicare,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ANTIDIURETIC HORMONE          ,38300035,CDM,301,RC,84588,CPT,,,,Inpatient,,,360.97,360.97,Wellcare,Wellcare,360.97,,,,,,,case rate,360.97,360.97,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ALDOLASE                      ,38300070,CDM,301,RC,82085,CPT,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Meritain Health PPO CPD,Meritain Health PPO CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Aetna/Commercial Product,Aetna/Commercial Product,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Meritain Health CPD,Meritain Health CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Starmark CPD,Starmark CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Aetna Medicare,Aetna Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Ambetter ,Ambetter ,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Access,Anthem Blue Access,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Access Choice,Anthem Blue Access Choice,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Blue Preferred,Anthem Blue Preferred,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Pathway,Anthem Pathway,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Alliance,Anthem Alliance,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Anthem Medicare,Anthem Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Cigna,Cigna,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Cigna PPO,Cigna PPO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Cigna Medicare Advantage,Cigna Medicare Advantage,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Essence,Essence,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Healthlink HMO,Healthlink HMO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Healthlink PPO,Healthlink PPO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,HomeState Health Plan,HomeState Health Plan,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Humana Gold,Humana Gold,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Medicaid MO,Medicaid MO,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Medica,Medica,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Tricare,Tricare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,UHC All Payer,UHC All Payer,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,UHC Exchange,UHC Exchange,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,UHC Medicaid,UHC Medicaid,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,UMR CPD,UMR CPD,129.43,,,,,,,per diem,129.43,129.43,"Per diem rate, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,UHC Medicare,UHC Medicare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ACID FAST BACILLI SMEAR       ,38300073,CDM,306,RC,87206,CPT,,,,Inpatient,,,129.43,129.43,Wellcare,Wellcare,129.43,,,,,,,case rate,129.43,129.43,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Meritain Health PPO CPD,Meritain Health PPO CPD,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Aetna/Commercial Product,Aetna/Commercial Product,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Meritain Health CPD,Meritain Health CPD,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Starmark CPD,Starmark CPD,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Aetna Medicare,Aetna Medicare,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Ambetter ,Ambetter ,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Blue Access,Anthem Blue Access,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Blue Access Choice,Anthem Blue Access Choice,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Blue Preferred,Anthem Blue Preferred,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Pathway,Anthem Pathway,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Alliance,Anthem Alliance,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Anthem Medicare,Anthem Medicare,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Cigna,Cigna,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Cigna PPO,Cigna PPO,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Cigna Medicare Advantage,Cigna Medicare Advantage,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Essence,Essence,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Healthlink HMO,Healthlink HMO,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Healthlink PPO,Healthlink PPO,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,HomeState Health Plan,HomeState Health Plan,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Humana Gold,Humana Gold,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Medicaid MO,Medicaid MO,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Medica,Medica,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Tricare,Tricare,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,UHC All Payer,UHC All Payer,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,UHC Exchange,UHC Exchange,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,UHC Medicaid,UHC Medicaid,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,UMR CPD,UMR CPD,406.32,,,,,,,per diem,406.32,406.32,"Per diem rate, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,UHC Medicare,UHC Medicare,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALDOSTERONE SERUM             ,38300092,CDM,301,RC,82088,CPT,,,,Inpatient,,,406.32,406.32,Wellcare,Wellcare,406.32,,,,,,,case rate,406.32,406.32,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Meritain Health PPO CPD,Meritain Health PPO CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna/Commercial Product,Aetna/Commercial Product,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Meritain Health CPD,Meritain Health CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Starmark CPD,Starmark CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Aetna Medicare,Aetna Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Ambetter ,Ambetter ,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Access,Anthem Blue Access,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Access Choice,Anthem Blue Access Choice,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Blue Preferred,Anthem Blue Preferred,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Pathway,Anthem Pathway,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Alliance,Anthem Alliance,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Anthem Medicare,Anthem Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna,Cigna,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna PPO,Cigna PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Cigna Medicare Advantage,Cigna Medicare Advantage,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Essence,Essence,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthlink HMO,Healthlink HMO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Healthlink PPO,Healthlink PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,HomeState Health Plan,HomeState Health Plan,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Humana Gold,Humana Gold,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Medicaid MO,Medicaid MO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Medica,Medica,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Tricare,Tricare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC All Payer,UHC All Payer,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Exchange,UHC Exchange,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Medicaid,UHC Medicaid,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UMR CPD,UMR CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,UHC Medicare,UHC Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
ALPHA I ANTITRYPSIN LEVEL     ,38300093,CDM,301,RC,82103,CPT,,,,Inpatient,,,342.62,342.62,Wellcare,Wellcare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Meritain Health PPO CPD,Meritain Health PPO CPD,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Aetna/Commercial Product,Aetna/Commercial Product,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Meritain Health CPD,Meritain Health CPD,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Starmark CPD,Starmark CPD,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Aetna Medicare,Aetna Medicare,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Ambetter ,Ambetter ,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Blue Access,Anthem Blue Access,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Blue Access Choice,Anthem Blue Access Choice,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Blue Preferred,Anthem Blue Preferred,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Pathway,Anthem Pathway,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Alliance,Anthem Alliance,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Anthem Medicare,Anthem Medicare,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Cigna,Cigna,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Cigna PPO,Cigna PPO,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Cigna Medicare Advantage,Cigna Medicare Advantage,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Essence,Essence,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Healthlink HMO,Healthlink HMO,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Healthlink PPO,Healthlink PPO,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,HomeState Health Plan,HomeState Health Plan,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Humana Gold,Humana Gold,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Medicaid MO,Medicaid MO,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Medica,Medica,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Tricare,Tricare,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,UHC All Payer,UHC All Payer,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,UHC Exchange,UHC Exchange,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,UHC Medicaid,UHC Medicaid,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,UMR CPD,UMR CPD,92.57,,,,,,,per diem,92.57,92.57,"Per diem rate, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,UHC Medicare,UHC Medicare,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
"ALKALINE PHOSPHATASE, TOTAL   ",38300095,CDM,301,RC,84075,CPT,,,,Inpatient,,,92.57,92.57,Wellcare,Wellcare,92.57,,,,,,,case rate,92.57,92.57,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Meritain Health PPO CPD,Meritain Health PPO CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Aetna/Commercial Product,Aetna/Commercial Product,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Meritain Health CPD,Meritain Health CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Starmark CPD,Starmark CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Aetna Medicare,Aetna Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Ambetter ,Ambetter ,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Access,Anthem Blue Access,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Access Choice,Anthem Blue Access Choice,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Preferred,Anthem Blue Preferred,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Pathway,Anthem Pathway,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Alliance,Anthem Alliance,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Anthem Medicare,Anthem Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Cigna,Cigna,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Cigna PPO,Cigna PPO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Cigna Medicare Advantage,Cigna Medicare Advantage,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Essence,Essence,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Healthlink HMO,Healthlink HMO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Healthlink PPO,Healthlink PPO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,HomeState Health Plan,HomeState Health Plan,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Humana Gold,Humana Gold,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Medicaid MO,Medicaid MO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Medica,Medica,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Tricare,Tricare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,UHC All Payer,UHC All Payer,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,UHC Exchange,UHC Exchange,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,UHC Medicaid,UHC Medicaid,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,UMR CPD,UMR CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,UHC Medicare,UHC Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
BETA HYDROXYBUTYRATE          ,38300116,CDM,301,RC,82010,CPT,,,,Inpatient,,,98.66,98.66,Wellcare,Wellcare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Meritain Health PPO CPD,Meritain Health PPO CPD,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Aetna/Commercial Product,Aetna/Commercial Product,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Meritain Health CPD,Meritain Health CPD,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Starmark CPD,Starmark CPD,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Aetna Medicare,Aetna Medicare,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Ambetter ,Ambetter ,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Blue Access,Anthem Blue Access,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Blue Access Choice,Anthem Blue Access Choice,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Blue Preferred,Anthem Blue Preferred,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Pathway,Anthem Pathway,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Alliance,Anthem Alliance,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Anthem Medicare,Anthem Medicare,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Cigna,Cigna,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Cigna PPO,Cigna PPO,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Cigna Medicare Advantage,Cigna Medicare Advantage,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Essence,Essence,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Healthlink HMO,Healthlink HMO,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Healthlink PPO,Healthlink PPO,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,HomeState Health Plan,HomeState Health Plan,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Humana Gold,Humana Gold,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Medicaid MO,Medicaid MO,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Medica,Medica,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Tricare,Tricare,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,UHC All Payer,UHC All Payer,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,UHC Exchange,UHC Exchange,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,UHC Medicaid,UHC Medicaid,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,UMR CPD,UMR CPD,467.86,,,,,,,per diem,467.86,467.86,"Per diem rate, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,UHC Medicare,UHC Medicare,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
VON WILLEBRAND ANTIGEN        ,38300119,CDM,305,RC,85246,CPT,,,,Inpatient,,,467.86,467.86,Wellcare,Wellcare,467.86,,,,,,,case rate,467.86,467.86,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Meritain Health PPO CPD,Meritain Health PPO CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Aetna/Commercial Product,Aetna/Commercial Product,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Meritain Health CPD,Meritain Health CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Starmark CPD,Starmark CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Aetna Medicare,Aetna Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Ambetter ,Ambetter ,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Blue Access,Anthem Blue Access,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Blue Access Choice,Anthem Blue Access Choice,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Blue Preferred,Anthem Blue Preferred,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Pathway,Anthem Pathway,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Alliance,Anthem Alliance,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Anthem Medicare,Anthem Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Cigna,Cigna,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Cigna PPO,Cigna PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Cigna Medicare Advantage,Cigna Medicare Advantage,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Essence,Essence,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Healthlink HMO,Healthlink HMO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Healthlink PPO,Healthlink PPO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,HomeState Health Plan,HomeState Health Plan,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Humana Gold,Humana Gold,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Medicaid MO,Medicaid MO,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Medica,Medica,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Tricare,Tricare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,UHC All Payer,UHC All Payer,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,UHC Exchange,UHC Exchange,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,UHC Medicaid,UHC Medicaid,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,UMR CPD,UMR CPD,157.59,,,,,,,per diem,157.59,157.59,"Per diem rate, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,UHC Medicare,UHC Medicare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
ANA SCREEN                    ,38300140,CDM,302,RC,86038,CPT,,,,Inpatient,,,157.59,157.59,Wellcare,Wellcare,157.59,,,,,,,case rate,157.59,157.59,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Meritain Health PPO CPD,Meritain Health PPO CPD,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Aetna/Commercial Product,Aetna/Commercial Product,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Meritain Health CPD,Meritain Health CPD,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Starmark CPD,Starmark CPD,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Aetna Medicare,Aetna Medicare,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Ambetter ,Ambetter ,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Blue Access,Anthem Blue Access,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Blue Access Choice,Anthem Blue Access Choice,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Blue Preferred,Anthem Blue Preferred,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Pathway,Anthem Pathway,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Alliance,Anthem Alliance,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Anthem Medicare,Anthem Medicare,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Cigna,Cigna,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Cigna PPO,Cigna PPO,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Cigna Medicare Advantage,Cigna Medicare Advantage,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Essence,Essence,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Healthlink HMO,Healthlink HMO,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Healthlink PPO,Healthlink PPO,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,HomeState Health Plan,HomeState Health Plan,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Humana Gold,Humana Gold,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Medicaid MO,Medicaid MO,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Medica,Medica,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Tricare,Tricare,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,UHC All Payer,UHC All Payer,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,UHC Exchange,UHC Exchange,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,UHC Medicaid,UHC Medicaid,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,UMR CPD,UMR CPD,60.04,,,,,,,per diem,60.04,60.04,"Per diem rate, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,UHC Medicare,UHC Medicare,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
BK VIRUS PCR QNT              ,38300142,CDM,300,RC,87799,CPT,,,,Inpatient,,,60.04,60.04,Wellcare,Wellcare,60.04,,,,,,,case rate,60.04,60.04,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Meritain Health PPO CPD,Meritain Health PPO CPD,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Aetna/Commercial Product,Aetna/Commercial Product,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Meritain Health CPD,Meritain Health CPD,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Starmark CPD,Starmark CPD,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Aetna Medicare,Aetna Medicare,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Ambetter ,Ambetter ,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Blue Access,Anthem Blue Access,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Blue Access Choice,Anthem Blue Access Choice,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Blue Preferred,Anthem Blue Preferred,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Pathway,Anthem Pathway,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Alliance,Anthem Alliance,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Anthem Medicare,Anthem Medicare,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Cigna,Cigna,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Cigna PPO,Cigna PPO,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Cigna Medicare Advantage,Cigna Medicare Advantage,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Essence,Essence,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Healthlink HMO,Healthlink HMO,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Healthlink PPO,Healthlink PPO,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,HomeState Health Plan,HomeState Health Plan,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Humana Gold,Humana Gold,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Medicaid MO,Medicaid MO,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Medica,Medica,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Tricare,Tricare,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,UHC All Payer,UHC All Payer,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,UHC Exchange,UHC Exchange,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,UHC Medicaid,UHC Medicaid,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,UMR CPD,UMR CPD,25.19,,,,,,,per diem,25.19,25.19,"Per diem rate, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,UHC Medicare,UHC Medicare,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANA TITER                     ,38300150,CDM,302,RC,86039,CPT,,,,Inpatient,,,25.19,25.19,Wellcare,Wellcare,25.19,,,,,,,case rate,25.19,25.19,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Meritain Health PPO CPD,Meritain Health PPO CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Aetna/Commercial Product,Aetna/Commercial Product,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Meritain Health CPD,Meritain Health CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Starmark CPD,Starmark CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Aetna Medicare,Aetna Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Ambetter ,Ambetter ,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Access,Anthem Blue Access,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Access Choice,Anthem Blue Access Choice,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Preferred,Anthem Blue Preferred,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Pathway,Anthem Pathway,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Alliance,Anthem Alliance,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Anthem Medicare,Anthem Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Cigna,Cigna,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Cigna PPO,Cigna PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Cigna Medicare Advantage,Cigna Medicare Advantage,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Essence,Essence,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Healthlink HMO,Healthlink HMO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Healthlink PPO,Healthlink PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,HomeState Health Plan,HomeState Health Plan,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Humana Gold,Humana Gold,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Medicaid MO,Medicaid MO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Medica,Medica,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Tricare,Tricare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,UHC All Payer,UHC All Payer,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,UHC Exchange,UHC Exchange,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,UHC Medicaid,UHC Medicaid,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,UMR CPD,UMR CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,UHC Medicare,UHC Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
ANGIOTENSIN CONVERT ENZYME    ,38300157,CDM,301,RC,82164,CPT,,,,Inpatient,,,167.89,167.89,Wellcare,Wellcare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Meritain Health PPO CPD,Meritain Health PPO CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna/Commercial Product,Aetna/Commercial Product,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Meritain Health CPD,Meritain Health CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Starmark CPD,Starmark CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Aetna Medicare,Aetna Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Ambetter ,Ambetter ,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Access,Anthem Blue Access,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Access Choice,Anthem Blue Access Choice,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Blue Preferred,Anthem Blue Preferred,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Pathway,Anthem Pathway,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Alliance,Anthem Alliance,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Anthem Medicare,Anthem Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna,Cigna,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna PPO,Cigna PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Cigna Medicare Advantage,Cigna Medicare Advantage,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Essence,Essence,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthlink HMO,Healthlink HMO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Healthlink PPO,Healthlink PPO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,HomeState Health Plan,HomeState Health Plan,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Humana Gold,Humana Gold,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Medicaid MO,Medicaid MO,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Medica,Medica,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Tricare,Tricare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC All Payer,UHC All Payer,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Exchange,UHC Exchange,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Medicaid,UHC Medicaid,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,UMR CPD,UMR CPD,103,,,,,,,per diem,103,103,"Per diem rate, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,UHC Medicare,UHC Medicare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
COVID-19 CORONAVIRUS          ,38300161,CDM,300,RC,87635,CPT,U0003,HCPCS,,Inpatient,,,103,103,Wellcare,Wellcare,103,,,,,,,case rate,103,103,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Meritain Health PPO CPD,Meritain Health PPO CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Aetna/Commercial Product,Aetna/Commercial Product,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Meritain Health CPD,Meritain Health CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Starmark CPD,Starmark CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Aetna Medicare,Aetna Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Ambetter ,Ambetter ,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Blue Access,Anthem Blue Access,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Blue Access Choice,Anthem Blue Access Choice,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Blue Preferred,Anthem Blue Preferred,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Pathway,Anthem Pathway,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Alliance,Anthem Alliance,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Anthem Medicare,Anthem Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Cigna,Cigna,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Cigna PPO,Cigna PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Cigna Medicare Advantage,Cigna Medicare Advantage,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Essence,Essence,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Healthlink HMO,Healthlink HMO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Healthlink PPO,Healthlink PPO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,HomeState Health Plan,HomeState Health Plan,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Humana Gold,Humana Gold,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Medicaid MO,Medicaid MO,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Medica,Medica,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Tricare,Tricare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,UHC All Payer,UHC All Payer,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,UHC Exchange,UHC Exchange,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,UHC Medicaid,UHC Medicaid,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,UMR CPD,UMR CPD,123.6,,,,,,,per diem,123.6,123.6,"Per diem rate, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,UHC Medicare,UHC Medicare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
SARS-COV-2 NAA UNIT PERFORMED ,38300166,CDM,301,RC,87635,CPT,U0002,HCPCS,,Inpatient,,,123.6,123.6,Wellcare,Wellcare,123.6,,,,,,,case rate,123.6,123.6,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Meritain Health PPO CPD,Meritain Health PPO CPD,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Aetna/Commercial Product,Aetna/Commercial Product,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Meritain Health CPD,Meritain Health CPD,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Starmark CPD,Starmark CPD,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Aetna Medicare,Aetna Medicare,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Ambetter ,Ambetter ,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Blue Access,Anthem Blue Access,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Blue Access Choice,Anthem Blue Access Choice,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Blue Preferred,Anthem Blue Preferred,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Pathway,Anthem Pathway,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Alliance,Anthem Alliance,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Anthem Medicare,Anthem Medicare,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Cigna,Cigna,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Cigna PPO,Cigna PPO,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Cigna Medicare Advantage,Cigna Medicare Advantage,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Essence,Essence,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Healthlink HMO,Healthlink HMO,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Healthlink PPO,Healthlink PPO,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,HomeState Health Plan,HomeState Health Plan,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Humana Gold,Humana Gold,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Medicaid MO,Medicaid MO,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Medica,Medica,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Tricare,Tricare,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,UHC All Payer,UHC All Payer,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,UHC Exchange,UHC Exchange,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,UHC Medicaid,UHC Medicaid,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,UMR CPD,UMR CPD,260.46,,,,,,,per diem,260.46,260.46,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,UHC Medicare,UHC Medicare,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EA PANEL       ,38300180,CDM,300,RC,86870,CPT,,,,Inpatient,,,260.46,260.46,Wellcare,Wellcare,260.46,,,,,,,case rate,260.46,260.46,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Meritain Health PPO CPD,Meritain Health PPO CPD,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Aetna/Commercial Product,Aetna/Commercial Product,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Meritain Health CPD,Meritain Health CPD,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Starmark CPD,Starmark CPD,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Aetna Medicare,Aetna Medicare,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Ambetter ,Ambetter ,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Blue Access,Anthem Blue Access,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Blue Access Choice,Anthem Blue Access Choice,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Blue Preferred,Anthem Blue Preferred,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Pathway,Anthem Pathway,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Alliance,Anthem Alliance,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Anthem Medicare,Anthem Medicare,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Cigna,Cigna,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Cigna PPO,Cigna PPO,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Cigna Medicare Advantage,Cigna Medicare Advantage,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Essence,Essence,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Healthlink HMO,Healthlink HMO,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Healthlink PPO,Healthlink PPO,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,HomeState Health Plan,HomeState Health Plan,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Humana Gold,Humana Gold,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Medicaid MO,Medicaid MO,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Medica,Medica,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Tricare,Tricare,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,UHC All Payer,UHC All Payer,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,UHC Exchange,UHC Exchange,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,UHC Medicaid,UHC Medicaid,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,UMR CPD,UMR CPD,423.3,,,,,,,per diem,423.3,423.3,"Per diem rate, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,UHC Medicare,UHC Medicare,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
PROGRAF LEVEL (TACROLIMUS)    ,38300185,CDM,301,RC,80197,CPT,,,,Inpatient,,,423.3,423.3,Wellcare,Wellcare,423.3,,,,,,,case rate,423.3,423.3,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Meritain Health PPO CPD,Meritain Health PPO CPD,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Aetna/Commercial Product,Aetna/Commercial Product,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Meritain Health CPD,Meritain Health CPD,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Starmark CPD,Starmark CPD,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Aetna Medicare,Aetna Medicare,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Ambetter ,Ambetter ,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Blue Access,Anthem Blue Access,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Blue Access Choice,Anthem Blue Access Choice,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Blue Preferred,Anthem Blue Preferred,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Pathway,Anthem Pathway,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Alliance,Anthem Alliance,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Anthem Medicare,Anthem Medicare,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Cigna,Cigna,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Cigna PPO,Cigna PPO,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Cigna Medicare Advantage,Cigna Medicare Advantage,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Essence,Essence,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Healthlink HMO,Healthlink HMO,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Healthlink PPO,Healthlink PPO,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,HomeState Health Plan,HomeState Health Plan,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Humana Gold,Humana Gold,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Medicaid MO,Medicaid MO,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Medica,Medica,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Tricare,Tricare,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,UHC All Payer,UHC All Payer,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,UHC Exchange,UHC Exchange,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,UHC Medicaid,UHC Medicaid,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,UMR CPD,UMR CPD,124.79,,,,,,,per diem,124.79,124.79,"Per diem rate, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,UHC Medicare,UHC Medicare,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-DNA ANTIBODY             ,38300197,CDM,302,RC,86225,CPT,,,,Inpatient,,,124.79,124.79,Wellcare,Wellcare,124.79,,,,,,,case rate,124.79,124.79,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Meritain Health PPO CPD,Meritain Health PPO CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Aetna/Commercial Product,Aetna/Commercial Product,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Meritain Health CPD,Meritain Health CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Starmark CPD,Starmark CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Aetna Medicare,Aetna Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Ambetter ,Ambetter ,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Access,Anthem Blue Access,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Access Choice,Anthem Blue Access Choice,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Blue Preferred,Anthem Blue Preferred,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Pathway,Anthem Pathway,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Alliance,Anthem Alliance,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Anthem Medicare,Anthem Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Cigna,Cigna,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Cigna PPO,Cigna PPO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Cigna Medicare Advantage,Cigna Medicare Advantage,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Essence,Essence,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Healthlink HMO,Healthlink HMO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Healthlink PPO,Healthlink PPO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,HomeState Health Plan,HomeState Health Plan,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Humana Gold,Humana Gold,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Medicaid MO,Medicaid MO,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Medica,Medica,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Tricare,Tricare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,UHC All Payer,UHC All Payer,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,UHC Exchange,UHC Exchange,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,UHC Medicaid,UHC Medicaid,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,UMR CPD,UMR CPD,264.16,,,,,,,per diem,264.16,264.16,"Per diem rate, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,UHC Medicare,UHC Medicare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-PLATELET ANTIB           ,38300200,CDM,302,RC,86022,CPT,,,,Inpatient,,,264.16,264.16,Wellcare,Wellcare,264.16,,,,,,,case rate,264.16,264.16,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Meritain Health PPO CPD,Meritain Health PPO CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Aetna/Commercial Product,Aetna/Commercial Product,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Meritain Health CPD,Meritain Health CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Starmark CPD,Starmark CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Aetna Medicare,Aetna Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Ambetter ,Ambetter ,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Access,Anthem Blue Access,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Access Choice,Anthem Blue Access Choice,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Preferred,Anthem Blue Preferred,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Pathway,Anthem Pathway,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Alliance,Anthem Alliance,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Anthem Medicare,Anthem Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Cigna,Cigna,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Cigna PPO,Cigna PPO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Cigna Medicare Advantage,Cigna Medicare Advantage,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Essence,Essence,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Healthlink HMO,Healthlink HMO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Healthlink PPO,Healthlink PPO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,HomeState Health Plan,HomeState Health Plan,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Humana Gold,Humana Gold,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Medicaid MO,Medicaid MO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Medica,Medica,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Tricare,Tricare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,UHC All Payer,UHC All Payer,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,UHC Exchange,UHC Exchange,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,UHC Medicaid,UHC Medicaid,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,UMR CPD,UMR CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,UHC Medicare,UHC Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
ANTI-THYROGLOBIN              ,38300205,CDM,302,RC,86800,CPT,,,,Inpatient,,,182.47,182.47,Wellcare,Wellcare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Meritain Health PPO CPD,Meritain Health PPO CPD,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Aetna/Commercial Product,Aetna/Commercial Product,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Meritain Health CPD,Meritain Health CPD,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Starmark CPD,Starmark CPD,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Aetna Medicare,Aetna Medicare,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Ambetter ,Ambetter ,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Blue Access,Anthem Blue Access,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Blue Access Choice,Anthem Blue Access Choice,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Blue Preferred,Anthem Blue Preferred,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Pathway,Anthem Pathway,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Alliance,Anthem Alliance,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Anthem Medicare,Anthem Medicare,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Cigna,Cigna,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Cigna PPO,Cigna PPO,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Cigna Medicare Advantage,Cigna Medicare Advantage,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Essence,Essence,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Healthlink HMO,Healthlink HMO,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Healthlink PPO,Healthlink PPO,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,HomeState Health Plan,HomeState Health Plan,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Humana Gold,Humana Gold,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Medicaid MO,Medicaid MO,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Medica,Medica,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Tricare,Tricare,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,UHC All Payer,UHC All Payer,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,UHC Exchange,UHC Exchange,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,UHC Medicaid,UHC Medicaid,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,UMR CPD,UMR CPD,469.98,,,,,,,per diem,469.98,469.98,"Per diem rate, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,UHC Medicare,UHC Medicare,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
PROTEIN C ACTIVITY            ,38300212,CDM,305,RC,85303,CPT,,,,Inpatient,,,469.98,469.98,Wellcare,Wellcare,469.98,,,,,,,case rate,469.98,469.98,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Meritain Health PPO CPD,Meritain Health PPO CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Aetna/Commercial Product,Aetna/Commercial Product,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Meritain Health CPD,Meritain Health CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Starmark CPD,Starmark CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Aetna Medicare,Aetna Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Ambetter ,Ambetter ,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Access,Anthem Blue Access,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Access Choice,Anthem Blue Access Choice,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Blue Preferred,Anthem Blue Preferred,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Pathway,Anthem Pathway,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Alliance,Anthem Alliance,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Anthem Medicare,Anthem Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Cigna,Cigna,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Cigna PPO,Cigna PPO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Cigna Medicare Advantage,Cigna Medicare Advantage,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Essence,Essence,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Healthlink HMO,Healthlink HMO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Healthlink PPO,Healthlink PPO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,HomeState Health Plan,HomeState Health Plan,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Humana Gold,Humana Gold,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Medicaid MO,Medicaid MO,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Medica,Medica,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Tricare,Tricare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,UHC All Payer,UHC All Payer,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,UHC Exchange,UHC Exchange,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,UHC Medicaid,UHC Medicaid,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,UMR CPD,UMR CPD,98.66,,,,,,,per diem,98.66,98.66,"Per diem rate, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,UHC Medicare,UHC Medicare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
CRYPTOCOCCUS ANTIGEN SERUM    ,38300216,CDM,306,RC,87899,CPT,,,,Inpatient,,,98.66,98.66,Wellcare,Wellcare,98.66,,,,,,,case rate,98.66,98.66,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Meritain Health PPO CPD,Meritain Health PPO CPD,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Aetna/Commercial Product,Aetna/Commercial Product,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Meritain Health CPD,Meritain Health CPD,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Starmark CPD,Starmark CPD,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Aetna Medicare,Aetna Medicare,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Ambetter ,Ambetter ,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Blue Access,Anthem Blue Access,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Blue Access Choice,Anthem Blue Access Choice,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Blue Preferred,Anthem Blue Preferred,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Pathway,Anthem Pathway,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Alliance,Anthem Alliance,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Anthem Medicare,Anthem Medicare,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Cigna,Cigna,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Cigna PPO,Cigna PPO,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Cigna Medicare Advantage,Cigna Medicare Advantage,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Essence,Essence,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Healthlink HMO,Healthlink HMO,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Healthlink PPO,Healthlink PPO,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,HomeState Health Plan,HomeState Health Plan,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Humana Gold,Humana Gold,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Medicaid MO,Medicaid MO,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Medica,Medica,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Tricare,Tricare,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,UHC All Payer,UHC All Payer,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,UHC Exchange,UHC Exchange,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,UHC Medicaid,UHC Medicaid,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,UMR CPD,UMR CPD,957.99,,,,,,,per diem,957.99,957.99,"Per diem rate, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,UHC Medicare,UHC Medicare,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
HEP C GENOTYPE DNA/RNA        ,38300220,CDM,306,RC,87902,CPT,,,,Inpatient,,,957.99,957.99,Wellcare,Wellcare,957.99,,,,,,,case rate,957.99,957.99,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Meritain Health PPO CPD,Meritain Health PPO CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Aetna/Commercial Product,Aetna/Commercial Product,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Meritain Health CPD,Meritain Health CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Starmark CPD,Starmark CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Aetna Medicare,Aetna Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Ambetter ,Ambetter ,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Access,Anthem Blue Access,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Access Choice,Anthem Blue Access Choice,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Preferred,Anthem Blue Preferred,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Pathway,Anthem Pathway,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Alliance,Anthem Alliance,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Anthem Medicare,Anthem Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Cigna,Cigna,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Cigna PPO,Cigna PPO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Cigna Medicare Advantage,Cigna Medicare Advantage,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Essence,Essence,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Healthlink HMO,Healthlink HMO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Healthlink PPO,Healthlink PPO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,HomeState Health Plan,HomeState Health Plan,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Humana Gold,Humana Gold,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Medicaid MO,Medicaid MO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Medica,Medica,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Tricare,Tricare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,UHC All Payer,UHC All Payer,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,UHC Exchange,UHC Exchange,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,UHC Medicaid,UHC Medicaid,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,UMR CPD,UMR CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,UHC Medicare,UHC Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PROSTATE SPECIFIC ATG (FREE)  ,38300302,CDM,301,RC,84154,CPT,,,,Inpatient,,,183.54,183.54,Wellcare,Wellcare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health PPO CPD,Meritain Health PPO CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Aetna/Commercial Product,Aetna/Commercial Product,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health CPD,Meritain Health CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Starmark CPD,Starmark CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Aetna Medicare,Aetna Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Ambetter ,Ambetter ,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access,Anthem Blue Access,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access Choice,Anthem Blue Access Choice,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Preferred,Anthem Blue Preferred,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Pathway,Anthem Pathway,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Alliance,Anthem Alliance,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Anthem Medicare,Anthem Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Cigna,Cigna,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Cigna PPO,Cigna PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Cigna Medicare Advantage,Cigna Medicare Advantage,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Essence,Essence,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Healthlink HMO,Healthlink HMO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Healthlink PPO,Healthlink PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,HomeState Health Plan,HomeState Health Plan,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Humana Gold,Humana Gold,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Medicaid MO,Medicaid MO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Medica,Medica,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Tricare,Tricare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,UHC All Payer,UHC All Payer,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,UHC Exchange,UHC Exchange,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicaid,UHC Medicaid,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,UMR CPD,UMR CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicare,UHC Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
BUN (UREANITROGEN)            ,38300310,CDM,301,RC,84520,CPT,,,,Inpatient,,,74.26,74.26,Wellcare,Wellcare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Meritain Health PPO CPD,Meritain Health PPO CPD,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Aetna/Commercial Product,Aetna/Commercial Product,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Meritain Health CPD,Meritain Health CPD,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Starmark CPD,Starmark CPD,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Aetna Medicare,Aetna Medicare,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Ambetter ,Ambetter ,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Blue Access,Anthem Blue Access,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Blue Access Choice,Anthem Blue Access Choice,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Blue Preferred,Anthem Blue Preferred,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Pathway,Anthem Pathway,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Alliance,Anthem Alliance,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Anthem Medicare,Anthem Medicare,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Cigna,Cigna,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Cigna PPO,Cigna PPO,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Cigna Medicare Advantage,Cigna Medicare Advantage,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Essence,Essence,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Healthlink HMO,Healthlink HMO,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Healthlink PPO,Healthlink PPO,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,HomeState Health Plan,HomeState Health Plan,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Humana Gold,Humana Gold,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Medicaid MO,Medicaid MO,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Medica,Medica,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Tricare,Tricare,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,UHC All Payer,UHC All Payer,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,UHC Exchange,UHC Exchange,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,UHC Medicaid,UHC Medicaid,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,UMR CPD,UMR CPD,407.39,,,,,,,per diem,407.39,407.39,"Per diem rate, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,UHC Medicare,UHC Medicare,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
NEPHELOMETRY                  ,38300315,CDM,301,RC,83883,CPT,,,,Inpatient,,,407.39,407.39,Wellcare,Wellcare,407.39,,,,,,,case rate,407.39,407.39,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Meritain Health PPO CPD,Meritain Health PPO CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna/Commercial Product,Aetna/Commercial Product,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Meritain Health CPD,Meritain Health CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Starmark CPD,Starmark CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Aetna Medicare,Aetna Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Ambetter ,Ambetter ,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Access,Anthem Blue Access,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Access Choice,Anthem Blue Access Choice,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Blue Preferred,Anthem Blue Preferred,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Pathway,Anthem Pathway,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Alliance,Anthem Alliance,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Anthem Medicare,Anthem Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna,Cigna,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna PPO,Cigna PPO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Cigna Medicare Advantage,Cigna Medicare Advantage,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Essence,Essence,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthlink HMO,Healthlink HMO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Healthlink PPO,Healthlink PPO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,HomeState Health Plan,HomeState Health Plan,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Humana Gold,Humana Gold,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Medicaid MO,Medicaid MO,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Medica,Medica,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Tricare,Tricare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC All Payer,UHC All Payer,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Exchange,UHC Exchange,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Medicaid,UHC Medicaid,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UMR CPD,UMR CPD,380.72,,,,,,,per diem,380.72,380.72,"Per diem rate, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,UHC Medicare,UHC Medicare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CA 125 ANTIBODY               ,38300360,CDM,302,RC,86304,CPT,,,,Inpatient,,,380.72,380.72,Wellcare,Wellcare,380.72,,,,,,,case rate,380.72,380.72,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Meritain Health PPO CPD,Meritain Health PPO CPD,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Aetna/Commercial Product,Aetna/Commercial Product,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Meritain Health CPD,Meritain Health CPD,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Starmark CPD,Starmark CPD,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Aetna Medicare,Aetna Medicare,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Ambetter ,Ambetter ,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Blue Access,Anthem Blue Access,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Blue Access Choice,Anthem Blue Access Choice,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Blue Preferred,Anthem Blue Preferred,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Pathway,Anthem Pathway,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Alliance,Anthem Alliance,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Anthem Medicare,Anthem Medicare,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Cigna,Cigna,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Cigna PPO,Cigna PPO,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Cigna Medicare Advantage,Cigna Medicare Advantage,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Essence,Essence,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Healthlink HMO,Healthlink HMO,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Healthlink PPO,Healthlink PPO,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,HomeState Health Plan,HomeState Health Plan,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Humana Gold,Humana Gold,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Medicaid MO,Medicaid MO,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Medica,Medica,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Tricare,Tricare,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,UHC All Payer,UHC All Payer,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,UHC Exchange,UHC Exchange,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,UHC Medicaid,UHC Medicaid,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,UMR CPD,UMR CPD,27.68,,,,,,,per diem,27.68,27.68,"Per diem rate, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,UHC Medicare,UHC Medicare,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CARCINOEMBRYONIC-(CEA)        ,38300405,CDM,301,RC,82378,CPT,,,,Inpatient,,,27.68,27.68,Wellcare,Wellcare,27.68,,,,,,,case rate,27.68,27.68,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Meritain Health PPO CPD,Meritain Health PPO CPD,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Aetna/Commercial Product,Aetna/Commercial Product,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Meritain Health CPD,Meritain Health CPD,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Starmark CPD,Starmark CPD,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Aetna Medicare,Aetna Medicare,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Ambetter ,Ambetter ,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Blue Access,Anthem Blue Access,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Blue Access Choice,Anthem Blue Access Choice,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Blue Preferred,Anthem Blue Preferred,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Pathway,Anthem Pathway,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Alliance,Anthem Alliance,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Anthem Medicare,Anthem Medicare,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Cigna,Cigna,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Cigna PPO,Cigna PPO,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Cigna Medicare Advantage,Cigna Medicare Advantage,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Essence,Essence,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Healthlink HMO,Healthlink HMO,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Healthlink PPO,Healthlink PPO,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,HomeState Health Plan,HomeState Health Plan,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Humana Gold,Humana Gold,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Medicaid MO,Medicaid MO,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Medica,Medica,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Tricare,Tricare,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,UHC All Payer,UHC All Payer,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,UHC Exchange,UHC Exchange,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,UHC Medicaid,UHC Medicaid,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,UMR CPD,UMR CPD,349.04,,,,,,,per diem,349.04,349.04,"Per diem rate, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,UHC Medicare,UHC Medicare,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
CATECHOLAMINES BLOOD FRACT    ,38300436,CDM,301,RC,82384,CPT,,,,Inpatient,,,349.04,349.04,Wellcare,Wellcare,349.04,,,,,,,case rate,349.04,349.04,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Meritain Health PPO CPD,Meritain Health PPO CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Aetna/Commercial Product,Aetna/Commercial Product,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Meritain Health CPD,Meritain Health CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Starmark CPD,Starmark CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Aetna Medicare,Aetna Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Ambetter ,Ambetter ,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Access,Anthem Blue Access,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Access Choice,Anthem Blue Access Choice,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Blue Preferred,Anthem Blue Preferred,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Pathway,Anthem Pathway,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Alliance,Anthem Alliance,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Anthem Medicare,Anthem Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Cigna,Cigna,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Cigna PPO,Cigna PPO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Cigna Medicare Advantage,Cigna Medicare Advantage,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Essence,Essence,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Healthlink HMO,Healthlink HMO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Healthlink PPO,Healthlink PPO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,HomeState Health Plan,HomeState Health Plan,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Humana Gold,Humana Gold,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Medicaid MO,Medicaid MO,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Medica,Medica,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Tricare,Tricare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,UHC All Payer,UHC All Payer,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,UHC Exchange,UHC Exchange,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,UHC Medicaid,UHC Medicaid,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,UMR CPD,UMR CPD,397.84,,,,,,,per diem,397.84,397.84,"Per diem rate, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,UHC Medicare,UHC Medicare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
ACTH STIMULATION PANEL        ,38300456,CDM,301,RC,80400,CPT,,,,Inpatient,,,397.84,397.84,Wellcare,Wellcare,397.84,,,,,,,case rate,397.84,397.84,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health PPO CPD,Meritain Health PPO CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Aetna/Commercial Product,Aetna/Commercial Product,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Meritain Health CPD,Meritain Health CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Starmark CPD,Starmark CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Aetna Medicare,Aetna Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Ambetter ,Ambetter ,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access,Anthem Blue Access,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Access Choice,Anthem Blue Access Choice,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Blue Preferred,Anthem Blue Preferred,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Pathway,Anthem Pathway,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Alliance,Anthem Alliance,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Anthem Medicare,Anthem Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Cigna,Cigna,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Cigna PPO,Cigna PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Cigna Medicare Advantage,Cigna Medicare Advantage,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Essence,Essence,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Healthlink HMO,Healthlink HMO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Healthlink PPO,Healthlink PPO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,HomeState Health Plan,HomeState Health Plan,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Humana Gold,Humana Gold,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Medicaid MO,Medicaid MO,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Medica,Medica,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Tricare,Tricare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,UHC All Payer,UHC All Payer,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,UHC Exchange,UHC Exchange,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicaid,UHC Medicaid,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,UMR CPD,UMR CPD,145.34,,,,,,,per diem,145.34,145.34,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,UHC Medicare,UHC Medicare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/O DIFF    ,38300490,CDM,300,RC,89050,CPT,,,,Inpatient,,,145.34,145.34,Wellcare,Wellcare,145.34,,,,,,,case rate,145.34,145.34,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Meritain Health PPO CPD,Meritain Health PPO CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Aetna/Commercial Product,Aetna/Commercial Product,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Meritain Health CPD,Meritain Health CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Starmark CPD,Starmark CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Aetna Medicare,Aetna Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Ambetter ,Ambetter ,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Access,Anthem Blue Access,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Access Choice,Anthem Blue Access Choice,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Blue Preferred,Anthem Blue Preferred,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Pathway,Anthem Pathway,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Alliance,Anthem Alliance,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Anthem Medicare,Anthem Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Cigna,Cigna,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Cigna PPO,Cigna PPO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Cigna Medicare Advantage,Cigna Medicare Advantage,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Essence,Essence,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Healthlink HMO,Healthlink HMO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Healthlink PPO,Healthlink PPO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,HomeState Health Plan,HomeState Health Plan,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Humana Gold,Humana Gold,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Medicaid MO,Medicaid MO,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Medica,Medica,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Tricare,Tricare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,UHC All Payer,UHC All Payer,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,UHC Exchange,UHC Exchange,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,UHC Medicaid,UHC Medicaid,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,UMR CPD,UMR CPD,182.47,,,,,,,per diem,182.47,182.47,"Per diem rate, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,UHC Medicare,UHC Medicare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CELL COUNT FLUIDS W/ DIFF     ,38300491,CDM,300,RC,89051,CPT,,,,Inpatient,,,182.47,182.47,Wellcare,Wellcare,182.47,,,,,,,case rate,182.47,182.47,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health PPO CPD,Meritain Health PPO CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Aetna/Commercial Product,Aetna/Commercial Product,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health CPD,Meritain Health CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Starmark CPD,Starmark CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Aetna Medicare,Aetna Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Ambetter ,Ambetter ,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access,Anthem Blue Access,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access Choice,Anthem Blue Access Choice,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Preferred,Anthem Blue Preferred,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Pathway,Anthem Pathway,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Alliance,Anthem Alliance,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Anthem Medicare,Anthem Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Cigna,Cigna,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Cigna PPO,Cigna PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Cigna Medicare Advantage,Cigna Medicare Advantage,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Essence,Essence,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Healthlink HMO,Healthlink HMO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Healthlink PPO,Healthlink PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,HomeState Health Plan,HomeState Health Plan,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Humana Gold,Humana Gold,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Medicaid MO,Medicaid MO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Medica,Medica,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Tricare,Tricare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,UHC All Payer,UHC All Payer,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,UHC Exchange,UHC Exchange,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicaid,UHC Medicaid,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,UMR CPD,UMR CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicare,UHC Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CERULOPLASMIN                 ,38300495,CDM,301,RC,82390,CPT,,,,Inpatient,,,154.89,154.89,Wellcare,Wellcare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Meritain Health PPO CPD,Meritain Health PPO CPD,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Aetna/Commercial Product,Aetna/Commercial Product,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Meritain Health CPD,Meritain Health CPD,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Starmark CPD,Starmark CPD,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Aetna Medicare,Aetna Medicare,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Ambetter ,Ambetter ,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Blue Access,Anthem Blue Access,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Blue Access Choice,Anthem Blue Access Choice,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Blue Preferred,Anthem Blue Preferred,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Pathway,Anthem Pathway,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Alliance,Anthem Alliance,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Anthem Medicare,Anthem Medicare,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Cigna,Cigna,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Cigna PPO,Cigna PPO,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Cigna Medicare Advantage,Cigna Medicare Advantage,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Essence,Essence,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Healthlink HMO,Healthlink HMO,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Healthlink PPO,Healthlink PPO,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,HomeState Health Plan,HomeState Health Plan,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Humana Gold,Humana Gold,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Medicaid MO,Medicaid MO,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Medica,Medica,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Tricare,Tricare,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,UHC All Payer,UHC All Payer,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,UHC Exchange,UHC Exchange,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,UHC Medicaid,UHC Medicaid,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,UMR CPD,UMR CPD,271.56,,,,,,,per diem,271.56,271.56,"Per diem rate, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,UHC Medicare,UHC Medicare,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
CH50 TOTAL COMPLEMENT         ,38300498,CDM,302,RC,86162,CPT,,,,Inpatient,,,271.56,271.56,Wellcare,Wellcare,271.56,,,,,,,case rate,271.56,271.56,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Meritain Health PPO CPD,Meritain Health PPO CPD,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Aetna/Commercial Product,Aetna/Commercial Product,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Meritain Health CPD,Meritain Health CPD,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Starmark CPD,Starmark CPD,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Aetna Medicare,Aetna Medicare,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Ambetter ,Ambetter ,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Blue Access,Anthem Blue Access,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Blue Access Choice,Anthem Blue Access Choice,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Blue Preferred,Anthem Blue Preferred,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Pathway,Anthem Pathway,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Alliance,Anthem Alliance,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Anthem Medicare,Anthem Medicare,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Cigna,Cigna,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Cigna PPO,Cigna PPO,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Cigna Medicare Advantage,Cigna Medicare Advantage,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Essence,Essence,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Healthlink HMO,Healthlink HMO,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Healthlink PPO,Healthlink PPO,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,HomeState Health Plan,HomeState Health Plan,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Humana Gold,Humana Gold,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Medicaid MO,Medicaid MO,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Medica,Medica,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Tricare,Tricare,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,UHC All Payer,UHC All Payer,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,UHC Exchange,UHC Exchange,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,UHC Medicaid,UHC Medicaid,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,UMR CPD,UMR CPD,125.19,,,,,,,per diem,125.19,125.19,"Per diem rate, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,UHC Medicare,UHC Medicare,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
SEX HORMONE BINDING GLOBULIN  ,38300505,CDM,301,RC,84270,CPT,,,,Inpatient,,,125.19,125.19,Wellcare,Wellcare,125.19,,,,,,,case rate,125.19,125.19,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Meritain Health PPO CPD,Meritain Health PPO CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Aetna/Commercial Product,Aetna/Commercial Product,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Meritain Health CPD,Meritain Health CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Starmark CPD,Starmark CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Aetna Medicare,Aetna Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Ambetter ,Ambetter ,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Blue Access,Anthem Blue Access,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Blue Access Choice,Anthem Blue Access Choice,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Blue Preferred,Anthem Blue Preferred,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Pathway,Anthem Pathway,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Alliance,Anthem Alliance,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Anthem Medicare,Anthem Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Cigna,Cigna,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Cigna PPO,Cigna PPO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Cigna Medicare Advantage,Cigna Medicare Advantage,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Essence,Essence,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Healthlink HMO,Healthlink HMO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Healthlink PPO,Healthlink PPO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,HomeState Health Plan,HomeState Health Plan,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Humana Gold,Humana Gold,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Medicaid MO,Medicaid MO,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Medica,Medica,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Tricare,Tricare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,UHC All Payer,UHC All Payer,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,UHC Exchange,UHC Exchange,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,UHC Medicaid,UHC Medicaid,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,UMR CPD,UMR CPD,109.18,,,,,,,per diem,109.18,109.18,"Per diem rate, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,UHC Medicare,UHC Medicare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
MICROALBUMIN 24 HOUR URINE    ,38300513,CDM,301,RC,82043,CPT,,,,Inpatient,,,109.18,109.18,Wellcare,Wellcare,109.18,,,,,,,case rate,109.18,109.18,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Meritain Health PPO CPD,Meritain Health PPO CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Aetna/Commercial Product,Aetna/Commercial Product,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Meritain Health CPD,Meritain Health CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Starmark CPD,Starmark CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Aetna Medicare,Aetna Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Ambetter ,Ambetter ,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Access,Anthem Blue Access,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Access Choice,Anthem Blue Access Choice,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Blue Preferred,Anthem Blue Preferred,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Pathway,Anthem Pathway,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Alliance,Anthem Alliance,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Anthem Medicare,Anthem Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Cigna,Cigna,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Cigna PPO,Cigna PPO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Cigna Medicare Advantage,Cigna Medicare Advantage,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Essence,Essence,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Healthlink HMO,Healthlink HMO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Healthlink PPO,Healthlink PPO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,HomeState Health Plan,HomeState Health Plan,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Humana Gold,Humana Gold,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Medicaid MO,Medicaid MO,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Medica,Medica,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Tricare,Tricare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,UHC All Payer,UHC All Payer,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,UHC Exchange,UHC Exchange,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,UHC Medicaid,UHC Medicaid,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,UMR CPD,UMR CPD,205.81,,,,,,,per diem,205.81,205.81,"Per diem rate, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,UHC Medicare,UHC Medicare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHLAMYDIA TRACHOMATIS(AMP)    ,38300517,CDM,306,RC,87491,CPT,,,,Inpatient,,,205.81,205.81,Wellcare,Wellcare,205.81,,,,,,,case rate,205.81,205.81,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CHOLESTEROL (TOTAL)           ,38300540,CDM,301,RC,82465,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Meritain Health PPO CPD,Meritain Health PPO CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Aetna/Commercial Product,Aetna/Commercial Product,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Meritain Health CPD,Meritain Health CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Starmark CPD,Starmark CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Aetna Medicare,Aetna Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Ambetter ,Ambetter ,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Access,Anthem Blue Access,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Access Choice,Anthem Blue Access Choice,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Blue Preferred,Anthem Blue Preferred,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Pathway,Anthem Pathway,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Alliance,Anthem Alliance,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Anthem Medicare,Anthem Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Cigna,Cigna,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Cigna PPO,Cigna PPO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Cigna Medicare Advantage,Cigna Medicare Advantage,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Essence,Essence,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Healthlink HMO,Healthlink HMO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Healthlink PPO,Healthlink PPO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,HomeState Health Plan,HomeState Health Plan,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Humana Gold,Humana Gold,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Medicaid MO,Medicaid MO,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Medica,Medica,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Tricare,Tricare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,UHC All Payer,UHC All Payer,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,UHC Exchange,UHC Exchange,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,UHC Medicaid,UHC Medicaid,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,UMR CPD,UMR CPD,207.03,,,,,,,per diem,207.03,207.03,"Per diem rate, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,UHC Medicare,UHC Medicare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV TITER                     ,38300570,CDM,306,RC,86644,CPT,,,,Inpatient,,,207.03,207.03,Wellcare,Wellcare,207.03,,,,,,,case rate,207.03,207.03,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Meritain Health PPO CPD,Meritain Health PPO CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna/Commercial Product,Aetna/Commercial Product,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Meritain Health CPD,Meritain Health CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Starmark CPD,Starmark CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Aetna Medicare,Aetna Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Ambetter ,Ambetter ,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Access,Anthem Blue Access,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Access Choice,Anthem Blue Access Choice,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Blue Preferred,Anthem Blue Preferred,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Pathway,Anthem Pathway,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Alliance,Anthem Alliance,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Anthem Medicare,Anthem Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna,Cigna,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna PPO,Cigna PPO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Cigna Medicare Advantage,Cigna Medicare Advantage,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Essence,Essence,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthlink HMO,Healthlink HMO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Healthlink PPO,Healthlink PPO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,HomeState Health Plan,HomeState Health Plan,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Humana Gold,Humana Gold,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Medicaid MO,Medicaid MO,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Medica,Medica,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Tricare,Tricare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC All Payer,UHC All Payer,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Exchange,UHC Exchange,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Medicaid,UHC Medicaid,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UMR CPD,UMR CPD,312.1,,,,,,,per diem,312.1,312.1,"Per diem rate, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,UHC Medicare,UHC Medicare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CMV IGM ANTIBODY              ,38300571,CDM,302,RC,86645,CPT,,,,Inpatient,,,312.1,312.1,Wellcare,Wellcare,312.1,,,,,,,case rate,312.1,312.1,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Meritain Health PPO CPD,Meritain Health PPO CPD,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Aetna/Commercial Product,Aetna/Commercial Product,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Meritain Health CPD,Meritain Health CPD,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Starmark CPD,Starmark CPD,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Aetna Medicare,Aetna Medicare,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Ambetter ,Ambetter ,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Blue Access,Anthem Blue Access,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Blue Access Choice,Anthem Blue Access Choice,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Blue Preferred,Anthem Blue Preferred,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Pathway,Anthem Pathway,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Alliance,Anthem Alliance,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Anthem Medicare,Anthem Medicare,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Cigna,Cigna,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Cigna PPO,Cigna PPO,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Cigna Medicare Advantage,Cigna Medicare Advantage,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Essence,Essence,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Healthlink HMO,Healthlink HMO,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Healthlink PPO,Healthlink PPO,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,HomeState Health Plan,HomeState Health Plan,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Humana Gold,Humana Gold,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Medicaid MO,Medicaid MO,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Medica,Medica,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Tricare,Tricare,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,UHC All Payer,UHC All Payer,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,UHC Exchange,UHC Exchange,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,UHC Medicaid,UHC Medicaid,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,UMR CPD,UMR CPD,294.93,,,,,,,per diem,294.93,294.93,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,UHC Medicare,UHC Medicare,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR VIII          ,38300590,CDM,305,RC,85240,CPT,,,,Inpatient,,,294.93,294.93,Wellcare,Wellcare,294.93,,,,,,,case rate,294.93,294.93,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Meritain Health PPO CPD,Meritain Health PPO CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Aetna/Commercial Product,Aetna/Commercial Product,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Meritain Health CPD,Meritain Health CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Starmark CPD,Starmark CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Aetna Medicare,Aetna Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Ambetter ,Ambetter ,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Access,Anthem Blue Access,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Access Choice,Anthem Blue Access Choice,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Preferred,Anthem Blue Preferred,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Pathway,Anthem Pathway,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Alliance,Anthem Alliance,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Anthem Medicare,Anthem Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Cigna,Cigna,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Cigna PPO,Cigna PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Cigna Medicare Advantage,Cigna Medicare Advantage,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Essence,Essence,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Healthlink HMO,Healthlink HMO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Healthlink PPO,Healthlink PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,HomeState Health Plan,HomeState Health Plan,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Humana Gold,Humana Gold,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Medicaid MO,Medicaid MO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Medica,Medica,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Tricare,Tricare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,UHC All Payer,UHC All Payer,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,UHC Exchange,UHC Exchange,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,UHC Medicaid,UHC Medicaid,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,UMR CPD,UMR CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,UHC Medicare,UHC Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COMPLEMENT C-3                ,38300630,CDM,302,RC,86160,CPT,,,,Inpatient,,,196.27,196.27,Wellcare,Wellcare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Meritain Health PPO CPD,Meritain Health PPO CPD,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Aetna/Commercial Product,Aetna/Commercial Product,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Meritain Health CPD,Meritain Health CPD,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Starmark CPD,Starmark CPD,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Aetna Medicare,Aetna Medicare,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Ambetter ,Ambetter ,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Blue Access,Anthem Blue Access,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Blue Access Choice,Anthem Blue Access Choice,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Blue Preferred,Anthem Blue Preferred,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Pathway,Anthem Pathway,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Alliance,Anthem Alliance,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Anthem Medicare,Anthem Medicare,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Cigna,Cigna,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Cigna PPO,Cigna PPO,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Cigna Medicare Advantage,Cigna Medicare Advantage,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Essence,Essence,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Healthlink HMO,Healthlink HMO,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Healthlink PPO,Healthlink PPO,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,HomeState Health Plan,HomeState Health Plan,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Humana Gold,Humana Gold,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Medicaid MO,Medicaid MO,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Medica,Medica,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Tricare,Tricare,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,UHC All Payer,UHC All Payer,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,UHC Exchange,UHC Exchange,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,UHC Medicaid,UHC Medicaid,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,UMR CPD,UMR CPD,173.99,,,,,,,per diem,173.99,173.99,"Per diem rate, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,UHC Medicare,UHC Medicare,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
COPPER                        ,38300675,CDM,301,RC,82525,CPT,,,,Inpatient,,,173.99,173.99,Wellcare,Wellcare,173.99,,,,,,,case rate,173.99,173.99,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health PPO CPD,Meritain Health PPO CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Aetna/Commercial Product,Aetna/Commercial Product,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health CPD,Meritain Health CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Starmark CPD,Starmark CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Aetna Medicare,Aetna Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Ambetter ,Ambetter ,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access,Anthem Blue Access,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access Choice,Anthem Blue Access Choice,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Preferred,Anthem Blue Preferred,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Pathway,Anthem Pathway,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Alliance,Anthem Alliance,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Anthem Medicare,Anthem Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Cigna,Cigna,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Cigna PPO,Cigna PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Cigna Medicare Advantage,Cigna Medicare Advantage,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Essence,Essence,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Healthlink HMO,Healthlink HMO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Healthlink PPO,Healthlink PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,HomeState Health Plan,HomeState Health Plan,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Humana Gold,Humana Gold,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Medicaid MO,Medicaid MO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Medica,Medica,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Tricare,Tricare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,UHC All Payer,UHC All Payer,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,UHC Exchange,UHC Exchange,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicaid,UHC Medicaid,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,UMR CPD,UMR CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicare,UHC Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
CORTISOL TOTAL                ,38300680,CDM,301,RC,82533,CPT,,,,Inpatient,,,102.91,102.91,Wellcare,Wellcare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Meritain Health PPO CPD,Meritain Health PPO CPD,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Aetna/Commercial Product,Aetna/Commercial Product,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Meritain Health CPD,Meritain Health CPD,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Starmark CPD,Starmark CPD,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Aetna Medicare,Aetna Medicare,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Ambetter ,Ambetter ,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Blue Access,Anthem Blue Access,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Blue Access Choice,Anthem Blue Access Choice,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Blue Preferred,Anthem Blue Preferred,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Pathway,Anthem Pathway,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Alliance,Anthem Alliance,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Anthem Medicare,Anthem Medicare,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Cigna,Cigna,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Cigna PPO,Cigna PPO,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Cigna Medicare Advantage,Cigna Medicare Advantage,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Essence,Essence,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Healthlink HMO,Healthlink HMO,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Healthlink PPO,Healthlink PPO,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,HomeState Health Plan,HomeState Health Plan,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Humana Gold,Humana Gold,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Medicaid MO,Medicaid MO,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Medica,Medica,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Tricare,Tricare,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,UHC All Payer,UHC All Payer,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,UHC Exchange,UHC Exchange,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,UHC Medicaid,UHC Medicaid,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,UMR CPD,UMR CPD,276.89,,,,,,,per diem,276.89,276.89,"Per diem rate, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,UHC Medicare,UHC Medicare,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
T CELLS CD4 & CD8 W/RATIO     ,38300685,CDM,302,RC,86360,CPT,,,,Inpatient,,,276.89,276.89,Wellcare,Wellcare,276.89,,,,,,,case rate,276.89,276.89,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Meritain Health PPO CPD,Meritain Health PPO CPD,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Aetna/Commercial Product,Aetna/Commercial Product,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Meritain Health CPD,Meritain Health CPD,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Starmark CPD,Starmark CPD,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Aetna Medicare,Aetna Medicare,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Ambetter ,Ambetter ,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Blue Access,Anthem Blue Access,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Blue Access Choice,Anthem Blue Access Choice,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Blue Preferred,Anthem Blue Preferred,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Pathway,Anthem Pathway,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Alliance,Anthem Alliance,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Anthem Medicare,Anthem Medicare,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Cigna,Cigna,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Cigna PPO,Cigna PPO,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Cigna Medicare Advantage,Cigna Medicare Advantage,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Essence,Essence,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Healthlink HMO,Healthlink HMO,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Healthlink PPO,Healthlink PPO,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,HomeState Health Plan,HomeState Health Plan,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Humana Gold,Humana Gold,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Medicaid MO,Medicaid MO,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Medica,Medica,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Tricare,Tricare,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,UHC All Payer,UHC All Payer,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,UHC Exchange,UHC Exchange,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,UHC Medicaid,UHC Medicaid,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,UMR CPD,UMR CPD,230.22,,,,,,,per diem,230.22,230.22,"Per diem rate, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,UHC Medicare,UHC Medicare,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
TISSUE TRANSGLUTAMINASE AB    ,38300691,CDM,301,RC,83516,CPT,,,,Inpatient,,,230.22,230.22,Wellcare,Wellcare,230.22,,,,,,,case rate,230.22,230.22,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Meritain Health PPO CPD,Meritain Health PPO CPD,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Aetna/Commercial Product,Aetna/Commercial Product,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Meritain Health CPD,Meritain Health CPD,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Starmark CPD,Starmark CPD,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Aetna Medicare,Aetna Medicare,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Ambetter ,Ambetter ,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Blue Access,Anthem Blue Access,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Blue Access Choice,Anthem Blue Access Choice,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Blue Preferred,Anthem Blue Preferred,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Pathway,Anthem Pathway,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Alliance,Anthem Alliance,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Anthem Medicare,Anthem Medicare,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Cigna,Cigna,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Cigna PPO,Cigna PPO,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Cigna Medicare Advantage,Cigna Medicare Advantage,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Essence,Essence,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Healthlink HMO,Healthlink HMO,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Healthlink PPO,Healthlink PPO,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,HomeState Health Plan,HomeState Health Plan,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Humana Gold,Humana Gold,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Medicaid MO,Medicaid MO,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Medica,Medica,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Tricare,Tricare,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,UHC All Payer,UHC All Payer,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,UHC Exchange,UHC Exchange,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,UHC Medicaid,UHC Medicaid,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,UMR CPD,UMR CPD,55.62,,,,,,,per diem,55.62,55.62,"Per diem rate, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,UHC Medicare,UHC Medicare,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
C-PEPTIDE                     ,38300700,CDM,301,RC,84681,CPT,,,,Inpatient,,,55.62,55.62,Wellcare,Wellcare,55.62,,,,,,,case rate,55.62,55.62,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Meritain Health PPO CPD,Meritain Health PPO CPD,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Aetna/Commercial Product,Aetna/Commercial Product,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Meritain Health CPD,Meritain Health CPD,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Starmark CPD,Starmark CPD,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Aetna Medicare,Aetna Medicare,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Ambetter ,Ambetter ,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Blue Access,Anthem Blue Access,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Blue Access Choice,Anthem Blue Access Choice,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Blue Preferred,Anthem Blue Preferred,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Pathway,Anthem Pathway,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Alliance,Anthem Alliance,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Anthem Medicare,Anthem Medicare,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Cigna,Cigna,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Cigna PPO,Cigna PPO,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Cigna Medicare Advantage,Cigna Medicare Advantage,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Essence,Essence,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Healthlink HMO,Healthlink HMO,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Healthlink PPO,Healthlink PPO,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,HomeState Health Plan,HomeState Health Plan,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Humana Gold,Humana Gold,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Medicaid MO,Medicaid MO,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Medica,Medica,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Tricare,Tricare,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,UHC All Payer,UHC All Payer,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,UHC Exchange,UHC Exchange,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,UHC Medicaid,UHC Medicaid,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,UMR CPD,UMR CPD,212.45,,,,,,,per diem,212.45,212.45,"Per diem rate, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,UHC Medicare,UHC Medicare,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
CREATININE CLEARANCE          ,38300750,CDM,301,RC,82575,CPT,,,,Inpatient,,,212.45,212.45,Wellcare,Wellcare,212.45,,,,,,,case rate,212.45,212.45,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Meritain Health PPO CPD,Meritain Health PPO CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Aetna/Commercial Product,Aetna/Commercial Product,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Meritain Health CPD,Meritain Health CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Starmark CPD,Starmark CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Aetna Medicare,Aetna Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Ambetter ,Ambetter ,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Access,Anthem Blue Access,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Access Choice,Anthem Blue Access Choice,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Blue Preferred,Anthem Blue Preferred,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Pathway,Anthem Pathway,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Alliance,Anthem Alliance,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Anthem Medicare,Anthem Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Cigna,Cigna,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Cigna PPO,Cigna PPO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Cigna Medicare Advantage,Cigna Medicare Advantage,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Essence,Essence,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Healthlink HMO,Healthlink HMO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Healthlink PPO,Healthlink PPO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,HomeState Health Plan,HomeState Health Plan,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Humana Gold,Humana Gold,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Medicaid MO,Medicaid MO,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Medica,Medica,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Tricare,Tricare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,UHC All Payer,UHC All Payer,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,UHC Exchange,UHC Exchange,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,UHC Medicaid,UHC Medicaid,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,UMR CPD,UMR CPD,165.5,,,,,,,per diem,165.5,165.5,"Per diem rate, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,UHC Medicare,UHC Medicare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
IMMEDIATE SPIN CROSSMATCH     ,38300770,CDM,302,RC,86920,CPT,,,,Inpatient,,,165.5,165.5,Wellcare,Wellcare,165.5,,,,,,,case rate,165.5,165.5,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Meritain Health PPO CPD,Meritain Health PPO CPD,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Aetna/Commercial Product,Aetna/Commercial Product,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Meritain Health CPD,Meritain Health CPD,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Starmark CPD,Starmark CPD,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Aetna Medicare,Aetna Medicare,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Ambetter ,Ambetter ,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Blue Access,Anthem Blue Access,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Blue Access Choice,Anthem Blue Access Choice,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Blue Preferred,Anthem Blue Preferred,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Pathway,Anthem Pathway,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Alliance,Anthem Alliance,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Anthem Medicare,Anthem Medicare,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Cigna,Cigna,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Cigna PPO,Cigna PPO,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Cigna Medicare Advantage,Cigna Medicare Advantage,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Essence,Essence,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Healthlink HMO,Healthlink HMO,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Healthlink PPO,Healthlink PPO,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,HomeState Health Plan,HomeState Health Plan,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Humana Gold,Humana Gold,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Medicaid MO,Medicaid MO,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Medica,Medica,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Tricare,Tricare,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,UHC All Payer,UHC All Payer,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,UHC Exchange,UHC Exchange,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,UHC Medicaid,UHC Medicaid,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,UMR CPD,UMR CPD,382.85,,,,,,,per diem,382.85,382.85,"Per diem rate, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,UHC Medicare,UHC Medicare,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
QUANTIFERON TB GOLD           ,38300795,CDM,302,RC,86480,CPT,,,,Inpatient,,,382.85,382.85,Wellcare,Wellcare,382.85,,,,,,,case rate,382.85,382.85,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health PPO CPD,Meritain Health PPO CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Aetna/Commercial Product,Aetna/Commercial Product,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health CPD,Meritain Health CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Starmark CPD,Starmark CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Aetna Medicare,Aetna Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Ambetter ,Ambetter ,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access,Anthem Blue Access,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access Choice,Anthem Blue Access Choice,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Preferred,Anthem Blue Preferred,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Pathway,Anthem Pathway,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Alliance,Anthem Alliance,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Anthem Medicare,Anthem Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Cigna,Cigna,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Cigna PPO,Cigna PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Cigna Medicare Advantage,Cigna Medicare Advantage,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Essence,Essence,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Healthlink HMO,Healthlink HMO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Healthlink PPO,Healthlink PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,HomeState Health Plan,HomeState Health Plan,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Humana Gold,Humana Gold,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Medicaid MO,Medicaid MO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Medica,Medica,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Tricare,Tricare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,UHC All Payer,UHC All Payer,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,UHC Exchange,UHC Exchange,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicaid,UHC Medicaid,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,UMR CPD,UMR CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicare,UHC Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
"GLUCOSE, BODY FLUID           ",38300810,CDM,301,RC,82945,CPT,,,,Inpatient,,,119.88,119.88,Wellcare,Wellcare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Meritain Health PPO CPD,Meritain Health PPO CPD,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Aetna/Commercial Product,Aetna/Commercial Product,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Meritain Health CPD,Meritain Health CPD,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Starmark CPD,Starmark CPD,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Aetna Medicare,Aetna Medicare,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Ambetter ,Ambetter ,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Blue Access,Anthem Blue Access,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Blue Access Choice,Anthem Blue Access Choice,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Blue Preferred,Anthem Blue Preferred,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Pathway,Anthem Pathway,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Alliance,Anthem Alliance,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Anthem Medicare,Anthem Medicare,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Cigna,Cigna,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Cigna PPO,Cigna PPO,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Cigna Medicare Advantage,Cigna Medicare Advantage,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Essence,Essence,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Healthlink HMO,Healthlink HMO,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Healthlink PPO,Healthlink PPO,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,HomeState Health Plan,HomeState Health Plan,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Humana Gold,Humana Gold,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Medicaid MO,Medicaid MO,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Medica,Medica,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Tricare,Tricare,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,UHC All Payer,UHC All Payer,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,UHC Exchange,UHC Exchange,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,UHC Medicaid,UHC Medicaid,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,UMR CPD,UMR CPD,209.53,,,,,,,per diem,209.53,209.53,"Per diem rate, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,UHC Medicare,UHC Medicare,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE-FUNGUS-OTHER SOURCE   ,38300830,CDM,306,RC,87102,CPT,,,,Inpatient,,,209.53,209.53,Wellcare,Wellcare,209.53,,,,,,,case rate,209.53,209.53,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Meritain Health PPO CPD,Meritain Health PPO CPD,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Aetna/Commercial Product,Aetna/Commercial Product,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Meritain Health CPD,Meritain Health CPD,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Starmark CPD,Starmark CPD,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Aetna Medicare,Aetna Medicare,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Ambetter ,Ambetter ,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Blue Access,Anthem Blue Access,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Blue Access Choice,Anthem Blue Access Choice,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Blue Preferred,Anthem Blue Preferred,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Pathway,Anthem Pathway,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Alliance,Anthem Alliance,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Anthem Medicare,Anthem Medicare,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Cigna,Cigna,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Cigna PPO,Cigna PPO,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Cigna Medicare Advantage,Cigna Medicare Advantage,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Essence,Essence,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Healthlink HMO,Healthlink HMO,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Healthlink PPO,Healthlink PPO,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,HomeState Health Plan,HomeState Health Plan,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Humana Gold,Humana Gold,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Medicaid MO,Medicaid MO,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Medica,Medica,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Tricare,Tricare,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,UHC All Payer,UHC All Payer,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,UHC Exchange,UHC Exchange,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,UHC Medicaid,UHC Medicaid,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,UMR CPD,UMR CPD,117.49,,,,,,,per diem,117.49,117.49,"Per diem rate, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,UHC Medicare,UHC Medicare,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE ANAEROBIC             ,38300850,CDM,306,RC,87075,CPT,,,,Inpatient,,,117.49,117.49,Wellcare,Wellcare,117.49,,,,,,,case rate,117.49,117.49,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Meritain Health PPO CPD,Meritain Health PPO CPD,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Aetna/Commercial Product,Aetna/Commercial Product,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Meritain Health CPD,Meritain Health CPD,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Starmark CPD,Starmark CPD,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Aetna Medicare,Aetna Medicare,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Ambetter ,Ambetter ,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Blue Access,Anthem Blue Access,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Blue Access Choice,Anthem Blue Access Choice,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Blue Preferred,Anthem Blue Preferred,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Pathway,Anthem Pathway,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Alliance,Anthem Alliance,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Anthem Medicare,Anthem Medicare,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Cigna,Cigna,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Cigna PPO,Cigna PPO,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Cigna Medicare Advantage,Cigna Medicare Advantage,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Essence,Essence,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Healthlink HMO,Healthlink HMO,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Healthlink PPO,Healthlink PPO,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,HomeState Health Plan,HomeState Health Plan,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Humana Gold,Humana Gold,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Medicaid MO,Medicaid MO,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Medica,Medica,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Tricare,Tricare,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,UHC All Payer,UHC All Payer,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,UHC Exchange,UHC Exchange,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,UHC Medicaid,UHC Medicaid,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,UMR CPD,UMR CPD,214.3,,,,,,,per diem,214.3,214.3,"Per diem rate, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,UHC Medicare,UHC Medicare,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE TB                    ,38300960,CDM,306,RC,87116,CPT,,,,Inpatient,,,214.3,214.3,Wellcare,Wellcare,214.3,,,,,,,case rate,214.3,214.3,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Meritain Health PPO CPD,Meritain Health PPO CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Aetna/Commercial Product,Aetna/Commercial Product,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Meritain Health CPD,Meritain Health CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Starmark CPD,Starmark CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Aetna Medicare,Aetna Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Ambetter ,Ambetter ,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Blue Access,Anthem Blue Access,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Blue Access Choice,Anthem Blue Access Choice,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Blue Preferred,Anthem Blue Preferred,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Pathway,Anthem Pathway,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Alliance,Anthem Alliance,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Anthem Medicare,Anthem Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Cigna,Cigna,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Cigna PPO,Cigna PPO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Cigna Medicare Advantage,Cigna Medicare Advantage,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Essence,Essence,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Healthlink HMO,Healthlink HMO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Healthlink PPO,Healthlink PPO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,HomeState Health Plan,HomeState Health Plan,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Humana Gold,Humana Gold,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Medicaid MO,Medicaid MO,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Medica,Medica,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Tricare,Tricare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,UHC All Payer,UHC All Payer,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,UHC Exchange,UHC Exchange,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,UHC Medicaid,UHC Medicaid,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,UMR CPD,UMR CPD,185.4,,,,,,,per diem,185.4,185.4,"Per diem rate, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,UHC Medicare,UHC Medicare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
CULTURE URINE                 ,38300980,CDM,306,RC,87088,CPT,,,,Inpatient,,,185.4,185.4,Wellcare,Wellcare,185.4,,,,,,,case rate,185.4,185.4,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Meritain Health PPO CPD,Meritain Health PPO CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Aetna/Commercial Product,Aetna/Commercial Product,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Meritain Health CPD,Meritain Health CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Starmark CPD,Starmark CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Aetna Medicare,Aetna Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Ambetter ,Ambetter ,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Access,Anthem Blue Access,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Access Choice,Anthem Blue Access Choice,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Blue Preferred,Anthem Blue Preferred,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Pathway,Anthem Pathway,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Alliance,Anthem Alliance,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Anthem Medicare,Anthem Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Cigna,Cigna,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Cigna PPO,Cigna PPO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Cigna Medicare Advantage,Cigna Medicare Advantage,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Essence,Essence,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Healthlink HMO,Healthlink HMO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Healthlink PPO,Healthlink PPO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,HomeState Health Plan,HomeState Health Plan,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Humana Gold,Humana Gold,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Medicaid MO,Medicaid MO,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Medica,Medica,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Tricare,Tricare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,UHC All Payer,UHC All Payer,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,UHC Exchange,UHC Exchange,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,UHC Medicaid,UHC Medicaid,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,UMR CPD,UMR CPD,62.83,,,,,,,per diem,62.83,62.83,"Per diem rate, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,UHC Medicare,UHC Medicare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
BLOOD SMR W/ MAN DIFF WBC CNT ,38301020,CDM,305,RC,85007,CPT,,,,Inpatient,,,62.83,62.83,Wellcare,Wellcare,62.83,,,,,,,case rate,62.83,62.83,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Meritain Health PPO CPD,Meritain Health PPO CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Aetna/Commercial Product,Aetna/Commercial Product,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Meritain Health CPD,Meritain Health CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Starmark CPD,Starmark CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Aetna Medicare,Aetna Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Ambetter ,Ambetter ,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Access,Anthem Blue Access,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Access Choice,Anthem Blue Access Choice,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Blue Preferred,Anthem Blue Preferred,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Pathway,Anthem Pathway,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Alliance,Anthem Alliance,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Anthem Medicare,Anthem Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Cigna,Cigna,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Cigna PPO,Cigna PPO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Cigna Medicare Advantage,Cigna Medicare Advantage,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Essence,Essence,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Healthlink HMO,Healthlink HMO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Healthlink PPO,Healthlink PPO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,HomeState Health Plan,HomeState Health Plan,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Humana Gold,Humana Gold,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Medicaid MO,Medicaid MO,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Medica,Medica,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Tricare,Tricare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,UHC All Payer,UHC All Payer,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,UHC Exchange,UHC Exchange,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,UHC Medicaid,UHC Medicaid,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,UMR CPD,UMR CPD,210.85,,,,,,,per diem,210.85,210.85,"Per diem rate, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,UHC Medicare,UHC Medicare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FREE DILANTIN                 ,38301051,CDM,301,RC,80186,CPT,,,,Inpatient,,,210.85,210.85,Wellcare,Wellcare,210.85,,,,,,,case rate,210.85,210.85,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Meritain Health PPO CPD,Meritain Health PPO CPD,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Aetna/Commercial Product,Aetna/Commercial Product,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Meritain Health CPD,Meritain Health CPD,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Starmark CPD,Starmark CPD,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Aetna Medicare,Aetna Medicare,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Ambetter ,Ambetter ,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Blue Access,Anthem Blue Access,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Blue Access Choice,Anthem Blue Access Choice,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Blue Preferred,Anthem Blue Preferred,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Pathway,Anthem Pathway,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Alliance,Anthem Alliance,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Anthem Medicare,Anthem Medicare,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Cigna,Cigna,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Cigna PPO,Cigna PPO,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Cigna Medicare Advantage,Cigna Medicare Advantage,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Essence,Essence,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Healthlink HMO,Healthlink HMO,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Healthlink PPO,Healthlink PPO,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,HomeState Health Plan,HomeState Health Plan,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Humana Gold,Humana Gold,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Medicaid MO,Medicaid MO,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Medica,Medica,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Tricare,Tricare,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,UHC All Payer,UHC All Payer,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,UHC Exchange,UHC Exchange,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,UHC Medicaid,UHC Medicaid,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,UMR CPD,UMR CPD,143.22,,,,,,,per diem,143.22,143.22,"Per diem rate, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,UHC Medicare,UHC Medicare,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
FIBRINOGEN                    ,38301220,CDM,305,RC,85384,CPT,,,,Inpatient,,,143.22,143.22,Wellcare,Wellcare,143.22,,,,,,,case rate,143.22,143.22,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Meritain Health PPO CPD,Meritain Health PPO CPD,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Aetna/Commercial Product,Aetna/Commercial Product,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Meritain Health CPD,Meritain Health CPD,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Starmark CPD,Starmark CPD,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Aetna Medicare,Aetna Medicare,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Ambetter ,Ambetter ,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Blue Access,Anthem Blue Access,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Blue Access Choice,Anthem Blue Access Choice,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Blue Preferred,Anthem Blue Preferred,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Pathway,Anthem Pathway,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Alliance,Anthem Alliance,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Anthem Medicare,Anthem Medicare,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Cigna,Cigna,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Cigna PPO,Cigna PPO,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Cigna Medicare Advantage,Cigna Medicare Advantage,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Essence,Essence,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Healthlink HMO,Healthlink HMO,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Healthlink PPO,Healthlink PPO,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,HomeState Health Plan,HomeState Health Plan,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Humana Gold,Humana Gold,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Medicaid MO,Medicaid MO,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Medica,Medica,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Tricare,Tricare,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,UHC All Payer,UHC All Payer,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,UHC Exchange,UHC Exchange,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,UHC Medicaid,UHC Medicaid,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,UMR CPD,UMR CPD,94.42,,,,,,,per diem,94.42,94.42,"Per diem rate, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,UHC Medicare,UHC Medicare,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
WET MOUNT SMEAR               ,38301260,CDM,306,RC,87210,CPT,,,,Inpatient,,,94.42,94.42,Wellcare,Wellcare,94.42,,,,,,,case rate,94.42,94.42,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Meritain Health PPO CPD,Meritain Health PPO CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Aetna/Commercial Product,Aetna/Commercial Product,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Meritain Health CPD,Meritain Health CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Starmark CPD,Starmark CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Aetna Medicare,Aetna Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Ambetter ,Ambetter ,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Access,Anthem Blue Access,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Access Choice,Anthem Blue Access Choice,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Preferred,Anthem Blue Preferred,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Pathway,Anthem Pathway,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Alliance,Anthem Alliance,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Anthem Medicare,Anthem Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Cigna,Cigna,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Cigna PPO,Cigna PPO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Cigna Medicare Advantage,Cigna Medicare Advantage,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Essence,Essence,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Healthlink HMO,Healthlink HMO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Healthlink PPO,Healthlink PPO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,HomeState Health Plan,HomeState Health Plan,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Humana Gold,Humana Gold,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Medicaid MO,Medicaid MO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Medica,Medica,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Tricare,Tricare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,UHC All Payer,UHC All Payer,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,UHC Exchange,UHC Exchange,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,UHC Medicaid,UHC Medicaid,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,UMR CPD,UMR CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,UHC Medicare,UHC Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GENTAMICIN                    ,38301290,CDM,301,RC,80170,CPT,,,,Inpatient,,,206.88,206.88,Wellcare,Wellcare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Meritain Health PPO CPD,Meritain Health PPO CPD,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Aetna/Commercial Product,Aetna/Commercial Product,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Meritain Health CPD,Meritain Health CPD,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Starmark CPD,Starmark CPD,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Aetna Medicare,Aetna Medicare,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Ambetter ,Ambetter ,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Blue Access,Anthem Blue Access,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Blue Access Choice,Anthem Blue Access Choice,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Blue Preferred,Anthem Blue Preferred,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Pathway,Anthem Pathway,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Alliance,Anthem Alliance,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Anthem Medicare,Anthem Medicare,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Cigna,Cigna,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Cigna PPO,Cigna PPO,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Cigna Medicare Advantage,Cigna Medicare Advantage,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Essence,Essence,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Healthlink HMO,Healthlink HMO,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Healthlink PPO,Healthlink PPO,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,HomeState Health Plan,HomeState Health Plan,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Humana Gold,Humana Gold,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Medicaid MO,Medicaid MO,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Medica,Medica,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Tricare,Tricare,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,UHC All Payer,UHC All Payer,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,UHC Exchange,UHC Exchange,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,UHC Medicaid,UHC Medicaid,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,UMR CPD,UMR CPD,88.58,,,,,,,per diem,88.58,88.58,"Per diem rate, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,UHC Medicare,UHC Medicare,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
GLUC BLOOD NOVA STAT STRIP    ,38301321,CDM,301,RC,82947,CPT,,,,Inpatient,,,88.58,88.58,Wellcare,Wellcare,88.58,,,,,,,case rate,88.58,88.58,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Meritain Health PPO CPD,Meritain Health PPO CPD,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Aetna/Commercial Product,Aetna/Commercial Product,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Meritain Health CPD,Meritain Health CPD,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Starmark CPD,Starmark CPD,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Aetna Medicare,Aetna Medicare,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Ambetter ,Ambetter ,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Blue Access,Anthem Blue Access,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Blue Access Choice,Anthem Blue Access Choice,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Blue Preferred,Anthem Blue Preferred,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Pathway,Anthem Pathway,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Alliance,Anthem Alliance,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Anthem Medicare,Anthem Medicare,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Cigna,Cigna,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Cigna PPO,Cigna PPO,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Cigna Medicare Advantage,Cigna Medicare Advantage,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Essence,Essence,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Healthlink HMO,Healthlink HMO,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Healthlink PPO,Healthlink PPO,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,HomeState Health Plan,HomeState Health Plan,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Humana Gold,Humana Gold,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Medicaid MO,Medicaid MO,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Medica,Medica,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Tricare,Tricare,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,UHC All Payer,UHC All Payer,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,UHC Exchange,UHC Exchange,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,UHC Medicaid,UHC Medicaid,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,UMR CPD,UMR CPD,181.68,,,,,,,per diem,181.68,181.68,"Per diem rate, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,UHC Medicare,UHC Medicare,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HAPTOGLOBIN                   ,38301400,CDM,301,RC,83010,CPT,,,,Inpatient,,,181.68,181.68,Wellcare,Wellcare,181.68,,,,,,,case rate,181.68,181.68,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS A ANTIBODY IGM      ,38301455,CDM,302,RC,86709,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Meritain Health PPO CPD,Meritain Health PPO CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Aetna/Commercial Product,Aetna/Commercial Product,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Meritain Health CPD,Meritain Health CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Starmark CPD,Starmark CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Aetna Medicare,Aetna Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Ambetter ,Ambetter ,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Access,Anthem Blue Access,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Access Choice,Anthem Blue Access Choice,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Preferred,Anthem Blue Preferred,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Pathway,Anthem Pathway,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Alliance,Anthem Alliance,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Anthem Medicare,Anthem Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Cigna,Cigna,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Cigna PPO,Cigna PPO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Cigna Medicare Advantage,Cigna Medicare Advantage,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Essence,Essence,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Healthlink HMO,Healthlink HMO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Healthlink PPO,Healthlink PPO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,HomeState Health Plan,HomeState Health Plan,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Humana Gold,Humana Gold,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Medicaid MO,Medicaid MO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Medica,Medica,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Tricare,Tricare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,UHC All Payer,UHC All Payer,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,UHC Exchange,UHC Exchange,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,UHC Medicaid,UHC Medicaid,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,UMR CPD,UMR CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,UHC Medicare,UHC Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AB        ,38301460,CDM,302,RC,86706,CPT,,,,Inpatient,,,369.19,369.19,Wellcare,Wellcare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health PPO CPD,Meritain Health PPO CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Aetna/Commercial Product,Aetna/Commercial Product,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health CPD,Meritain Health CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Starmark CPD,Starmark CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Aetna Medicare,Aetna Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Ambetter ,Ambetter ,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access,Anthem Blue Access,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access Choice,Anthem Blue Access Choice,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Preferred,Anthem Blue Preferred,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Pathway,Anthem Pathway,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Alliance,Anthem Alliance,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Anthem Medicare,Anthem Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Cigna,Cigna,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Cigna PPO,Cigna PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Cigna Medicare Advantage,Cigna Medicare Advantage,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Essence,Essence,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Healthlink HMO,Healthlink HMO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Healthlink PPO,Healthlink PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,HomeState Health Plan,HomeState Health Plan,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Humana Gold,Humana Gold,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Medicaid MO,Medicaid MO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Medica,Medica,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Tricare,Tricare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,UHC All Payer,UHC All Payer,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,UHC Exchange,UHC Exchange,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicaid,UHC Medicaid,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,UMR CPD,UMR CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicare,UHC Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS BE ANTIBODY         ,38301465,CDM,302,RC,86707,CPT,,,,Inpatient,,,162.32,162.32,Wellcare,Wellcare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Meritain Health PPO CPD,Meritain Health PPO CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Aetna/Commercial Product,Aetna/Commercial Product,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Meritain Health CPD,Meritain Health CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Starmark CPD,Starmark CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Aetna Medicare,Aetna Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Ambetter ,Ambetter ,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Access,Anthem Blue Access,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Access Choice,Anthem Blue Access Choice,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Blue Preferred,Anthem Blue Preferred,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Pathway,Anthem Pathway,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Alliance,Anthem Alliance,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Anthem Medicare,Anthem Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Cigna,Cigna,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Cigna PPO,Cigna PPO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Cigna Medicare Advantage,Cigna Medicare Advantage,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Essence,Essence,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Healthlink HMO,Healthlink HMO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Healthlink PPO,Healthlink PPO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,HomeState Health Plan,HomeState Health Plan,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Humana Gold,Humana Gold,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Medicaid MO,Medicaid MO,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Medica,Medica,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Tricare,Tricare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,UHC All Payer,UHC All Payer,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,UHC Exchange,UHC Exchange,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,UHC Medicaid,UHC Medicaid,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,UMR CPD,UMR CPD,369.19,,,,,,,per diem,369.19,369.19,"Per diem rate, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,UHC Medicare,UHC Medicare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B SURFACE AG (HBSAG),38301470,CDM,306,RC,87340,CPT,,,,Inpatient,,,369.19,369.19,Wellcare,Wellcare,369.19,,,,,,,case rate,369.19,369.19,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health PPO CPD,Meritain Health PPO CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Aetna/Commercial Product,Aetna/Commercial Product,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Meritain Health CPD,Meritain Health CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Starmark CPD,Starmark CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Aetna Medicare,Aetna Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Ambetter ,Ambetter ,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access,Anthem Blue Access,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Access Choice,Anthem Blue Access Choice,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Blue Preferred,Anthem Blue Preferred,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Pathway,Anthem Pathway,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Alliance,Anthem Alliance,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Anthem Medicare,Anthem Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Cigna,Cigna,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Cigna PPO,Cigna PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Cigna Medicare Advantage,Cigna Medicare Advantage,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Essence,Essence,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Healthlink HMO,Healthlink HMO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Healthlink PPO,Healthlink PPO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,HomeState Health Plan,HomeState Health Plan,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Humana Gold,Humana Gold,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Medicaid MO,Medicaid MO,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Medica,Medica,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Tricare,Tricare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,UHC All Payer,UHC All Payer,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,UHC Exchange,UHC Exchange,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicaid,UHC Medicaid,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,UMR CPD,UMR CPD,162.32,,,,,,,per diem,162.32,162.32,"Per diem rate, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,UHC Medicare,UHC Medicare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
HEPATITIS B CORE ANTIBODY     ,38301472,CDM,302,RC,86704,CPT,,,,Inpatient,,,162.32,162.32,Wellcare,Wellcare,162.32,,,,,,,case rate,162.32,162.32,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health PPO CPD,Meritain Health PPO CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Aetna/Commercial Product,Aetna/Commercial Product,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Meritain Health CPD,Meritain Health CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Starmark CPD,Starmark CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Aetna Medicare,Aetna Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Ambetter ,Ambetter ,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access,Anthem Blue Access,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Access Choice,Anthem Blue Access Choice,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Blue Preferred,Anthem Blue Preferred,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Pathway,Anthem Pathway,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Alliance,Anthem Alliance,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Anthem Medicare,Anthem Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Cigna,Cigna,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Cigna PPO,Cigna PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Cigna Medicare Advantage,Cigna Medicare Advantage,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Essence,Essence,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Healthlink HMO,Healthlink HMO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Healthlink PPO,Healthlink PPO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,HomeState Health Plan,HomeState Health Plan,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Humana Gold,Humana Gold,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Medicaid MO,Medicaid MO,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Medica,Medica,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Tricare,Tricare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,UHC All Payer,UHC All Payer,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,UHC Exchange,UHC Exchange,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicaid,UHC Medicaid,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,UMR CPD,UMR CPD,147.47,,,,,,,per diem,147.47,147.47,"Per diem rate, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,UHC Medicare,UHC Medicare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
"HEPATITIS BE ANTIGEN, EIA     ",38301475,CDM,306,RC,87350,CPT,,,,Inpatient,,,147.47,147.47,Wellcare,Wellcare,147.47,,,,,,,case rate,147.47,147.47,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Meritain Health PPO CPD,Meritain Health PPO CPD,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Aetna/Commercial Product,Aetna/Commercial Product,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Meritain Health CPD,Meritain Health CPD,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Starmark CPD,Starmark CPD,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Aetna Medicare,Aetna Medicare,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Ambetter ,Ambetter ,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Blue Access,Anthem Blue Access,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Blue Access Choice,Anthem Blue Access Choice,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Blue Preferred,Anthem Blue Preferred,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Pathway,Anthem Pathway,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Alliance,Anthem Alliance,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Anthem Medicare,Anthem Medicare,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Cigna,Cigna,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Cigna PPO,Cigna PPO,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Cigna Medicare Advantage,Cigna Medicare Advantage,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Essence,Essence,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Healthlink HMO,Healthlink HMO,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Healthlink PPO,Healthlink PPO,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,HomeState Health Plan,HomeState Health Plan,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Humana Gold,Humana Gold,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Medicaid MO,Medicaid MO,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Medica,Medica,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Tricare,Tricare,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,UHC All Payer,UHC All Payer,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,UHC Exchange,UHC Exchange,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,UHC Medicaid,UHC Medicaid,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,UMR CPD,UMR CPD,213.51,,,,,,,per diem,213.51,213.51,"Per diem rate, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,UHC Medicare,UHC Medicare,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS C AB                ,38301480,CDM,302,RC,86803,CPT,,,,Inpatient,,,213.51,213.51,Wellcare,Wellcare,213.51,,,,,,,case rate,213.51,213.51,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Meritain Health PPO CPD,Meritain Health PPO CPD,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Aetna/Commercial Product,Aetna/Commercial Product,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Meritain Health CPD,Meritain Health CPD,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Starmark CPD,Starmark CPD,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Aetna Medicare,Aetna Medicare,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Ambetter ,Ambetter ,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Blue Access,Anthem Blue Access,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Blue Access Choice,Anthem Blue Access Choice,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Blue Preferred,Anthem Blue Preferred,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Pathway,Anthem Pathway,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Alliance,Anthem Alliance,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Anthem Medicare,Anthem Medicare,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Cigna,Cigna,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Cigna PPO,Cigna PPO,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Cigna Medicare Advantage,Cigna Medicare Advantage,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Essence,Essence,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Healthlink HMO,Healthlink HMO,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Healthlink PPO,Healthlink PPO,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,HomeState Health Plan,HomeState Health Plan,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Humana Gold,Humana Gold,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Medicaid MO,Medicaid MO,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Medica,Medica,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Tricare,Tricare,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,UHC All Payer,UHC All Payer,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,UHC Exchange,UHC Exchange,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,UHC Medicaid,UHC Medicaid,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,UMR CPD,UMR CPD,552.08,,,,,,,per diem,552.08,552.08,"Per diem rate, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,UHC Medicare,UHC Medicare,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
HEPATITIS PANEL (ACUTE)       ,38301498,CDM,301,RC,80074,CPT,,,,Inpatient,,,552.08,552.08,Wellcare,Wellcare,552.08,,,,,,,case rate,552.08,552.08,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Meritain Health PPO CPD,Meritain Health PPO CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna/Commercial Product,Aetna/Commercial Product,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Meritain Health CPD,Meritain Health CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Starmark CPD,Starmark CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Aetna Medicare,Aetna Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Ambetter ,Ambetter ,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Access,Anthem Blue Access,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Access Choice,Anthem Blue Access Choice,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Blue Preferred,Anthem Blue Preferred,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Pathway,Anthem Pathway,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Alliance,Anthem Alliance,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Anthem Medicare,Anthem Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna,Cigna,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna PPO,Cigna PPO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Cigna Medicare Advantage,Cigna Medicare Advantage,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Essence,Essence,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthlink HMO,Healthlink HMO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Healthlink PPO,Healthlink PPO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,HomeState Health Plan,HomeState Health Plan,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Humana Gold,Humana Gold,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Medicaid MO,Medicaid MO,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Medica,Medica,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Tricare,Tricare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC All Payer,UHC All Payer,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Exchange,UHC Exchange,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Medicaid,UHC Medicaid,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UMR CPD,UMR CPD,320.83,,,,,,,per diem,320.83,320.83,"Per diem rate, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,UHC Medicare,UHC Medicare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
RUSSELL VIPER VNM TIME-DIL    ,38301501,CDM,305,RC,85613,CPT,,,,Inpatient,,,320.83,320.83,Wellcare,Wellcare,320.83,,,,,,,case rate,320.83,320.83,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health PPO CPD,Meritain Health PPO CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Aetna/Commercial Product,Aetna/Commercial Product,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Meritain Health CPD,Meritain Health CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Starmark CPD,Starmark CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Aetna Medicare,Aetna Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Ambetter ,Ambetter ,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access,Anthem Blue Access,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Access Choice,Anthem Blue Access Choice,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Blue Preferred,Anthem Blue Preferred,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Pathway,Anthem Pathway,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Alliance,Anthem Alliance,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Anthem Medicare,Anthem Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Cigna,Cigna,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Cigna PPO,Cigna PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Cigna Medicare Advantage,Cigna Medicare Advantage,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Essence,Essence,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Healthlink HMO,Healthlink HMO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Healthlink PPO,Healthlink PPO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,HomeState Health Plan,HomeState Health Plan,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Humana Gold,Humana Gold,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Medicaid MO,Medicaid MO,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Medica,Medica,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Tricare,Tricare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,UHC All Payer,UHC All Payer,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,UHC Exchange,UHC Exchange,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicaid,UHC Medicaid,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,UMR CPD,UMR CPD,130.49,,,,,,,per diem,130.49,130.49,"Per diem rate, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,UHC Medicare,UHC Medicare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
HIV-1 ANTIBODY                ,38301540,CDM,302,RC,86701,CPT,,,,Inpatient,,,130.49,130.49,Wellcare,Wellcare,130.49,,,,,,,case rate,130.49,130.49,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Meritain Health PPO CPD,Meritain Health PPO CPD,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Aetna/Commercial Product,Aetna/Commercial Product,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Meritain Health CPD,Meritain Health CPD,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Starmark CPD,Starmark CPD,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Aetna Medicare,Aetna Medicare,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Ambetter ,Ambetter ,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Blue Access,Anthem Blue Access,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Blue Access Choice,Anthem Blue Access Choice,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Blue Preferred,Anthem Blue Preferred,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Pathway,Anthem Pathway,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Alliance,Anthem Alliance,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Anthem Medicare,Anthem Medicare,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Cigna,Cigna,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Cigna PPO,Cigna PPO,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Cigna Medicare Advantage,Cigna Medicare Advantage,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Essence,Essence,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Healthlink HMO,Healthlink HMO,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Healthlink PPO,Healthlink PPO,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,HomeState Health Plan,HomeState Health Plan,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Humana Gold,Humana Gold,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Medicaid MO,Medicaid MO,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Medica,Medica,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Tricare,Tricare,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,UHC All Payer,UHC All Payer,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,UHC Exchange,UHC Exchange,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,UHC Medicaid,UHC Medicaid,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,UMR CPD,UMR CPD,140.04,,,,,,,per diem,140.04,140.04,"Per diem rate, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,UHC Medicare,UHC Medicare,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
"HIV VIRAL LOAD, QUANT (DNA)   ",38301555,CDM,306,RC,87536,CPT,,,,Inpatient,,,140.04,140.04,Wellcare,Wellcare,140.04,,,,,,,case rate,140.04,140.04,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health PPO CPD,Meritain Health PPO CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Aetna/Commercial Product,Aetna/Commercial Product,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Meritain Health CPD,Meritain Health CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Starmark CPD,Starmark CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Aetna Medicare,Aetna Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Ambetter ,Ambetter ,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access,Anthem Blue Access,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Access Choice,Anthem Blue Access Choice,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Blue Preferred,Anthem Blue Preferred,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Pathway,Anthem Pathway,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Alliance,Anthem Alliance,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Anthem Medicare,Anthem Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Cigna,Cigna,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Cigna PPO,Cigna PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Cigna Medicare Advantage,Cigna Medicare Advantage,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Essence,Essence,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Healthlink HMO,Healthlink HMO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Healthlink PPO,Healthlink PPO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,HomeState Health Plan,HomeState Health Plan,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Humana Gold,Humana Gold,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Medicaid MO,Medicaid MO,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Medica,Medica,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Tricare,Tricare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,UHC All Payer,UHC All Payer,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,UHC Exchange,UHC Exchange,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicaid,UHC Medicaid,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,UMR CPD,UMR CPD,159.14,,,,,,,per diem,159.14,159.14,"Per diem rate, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,UHC Medicare,UHC Medicare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC SERUM              ,38301570,CDM,302,RC,86320,CPT,,,,Inpatient,,,159.14,159.14,Wellcare,Wellcare,159.14,,,,,,,case rate,159.14,159.14,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Meritain Health PPO CPD,Meritain Health PPO CPD,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Aetna/Commercial Product,Aetna/Commercial Product,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Meritain Health CPD,Meritain Health CPD,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Starmark CPD,Starmark CPD,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Aetna Medicare,Aetna Medicare,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Ambetter ,Ambetter ,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Blue Access,Anthem Blue Access,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Blue Access Choice,Anthem Blue Access Choice,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Blue Preferred,Anthem Blue Preferred,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Pathway,Anthem Pathway,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Alliance,Anthem Alliance,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Anthem Medicare,Anthem Medicare,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Cigna,Cigna,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Cigna PPO,Cigna PPO,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Cigna Medicare Advantage,Cigna Medicare Advantage,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Essence,Essence,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Healthlink HMO,Healthlink HMO,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Healthlink PPO,Healthlink PPO,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,HomeState Health Plan,HomeState Health Plan,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Humana Gold,Humana Gold,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Medicaid MO,Medicaid MO,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Medica,Medica,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Tricare,Tricare,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,UHC All Payer,UHC All Payer,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,UHC Exchange,UHC Exchange,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,UHC Medicaid,UHC Medicaid,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,UMR CPD,UMR CPD,223.51,,,,,,,per diem,223.51,223.51,"Per diem rate, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,UHC Medicare,UHC Medicare,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
IMMUNOELEC FLUIDS             ,38301571,CDM,302,RC,86325,CPT,,,,Inpatient,,,223.51,223.51,Wellcare,Wellcare,223.51,,,,,,,case rate,223.51,223.51,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Meritain Health PPO CPD,Meritain Health PPO CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Aetna/Commercial Product,Aetna/Commercial Product,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Meritain Health CPD,Meritain Health CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Starmark CPD,Starmark CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Aetna Medicare,Aetna Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Ambetter ,Ambetter ,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Blue Access,Anthem Blue Access,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Blue Access Choice,Anthem Blue Access Choice,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Blue Preferred,Anthem Blue Preferred,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Pathway,Anthem Pathway,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Alliance,Anthem Alliance,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Anthem Medicare,Anthem Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Cigna,Cigna,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Cigna PPO,Cigna PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Cigna Medicare Advantage,Cigna Medicare Advantage,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Essence,Essence,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Healthlink HMO,Healthlink HMO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Healthlink PPO,Healthlink PPO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,HomeState Health Plan,HomeState Health Plan,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Humana Gold,Humana Gold,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Medicaid MO,Medicaid MO,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Medica,Medica,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Tricare,Tricare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,UHC All Payer,UHC All Payer,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,UHC Exchange,UHC Exchange,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,UHC Medicaid,UHC Medicaid,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,UMR CPD,UMR CPD,46.35,,,,,,,per diem,46.35,46.35,"Per diem rate, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,UHC Medicare,UHC Medicare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
INSULIN                       ,38301580,CDM,301,RC,83525,CPT,,,,Inpatient,,,46.35,46.35,Wellcare,Wellcare,46.35,,,,,,,case rate,46.35,46.35,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Meritain Health PPO CPD,Meritain Health PPO CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Aetna/Commercial Product,Aetna/Commercial Product,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Meritain Health CPD,Meritain Health CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Starmark CPD,Starmark CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Aetna Medicare,Aetna Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Ambetter ,Ambetter ,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Access,Anthem Blue Access,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Access Choice,Anthem Blue Access Choice,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Blue Preferred,Anthem Blue Preferred,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Pathway,Anthem Pathway,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Alliance,Anthem Alliance,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Anthem Medicare,Anthem Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Cigna,Cigna,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Cigna PPO,Cigna PPO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Cigna Medicare Advantage,Cigna Medicare Advantage,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Essence,Essence,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Healthlink HMO,Healthlink HMO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Healthlink PPO,Healthlink PPO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,HomeState Health Plan,HomeState Health Plan,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Humana Gold,Humana Gold,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Medicaid MO,Medicaid MO,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Medica,Medica,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Tricare,Tricare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,UHC All Payer,UHC All Payer,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,UHC Exchange,UHC Exchange,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,UHC Medicaid,UHC Medicaid,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,UMR CPD,UMR CPD,141.64,,,,,,,per diem,141.64,141.64,"Per diem rate, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,UHC Medicare,UHC Medicare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LITHIUM                       ,38301730,CDM,301,RC,80178,CPT,,,,Inpatient,,,141.64,141.64,Wellcare,Wellcare,141.64,,,,,,,case rate,141.64,141.64,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health PPO CPD,Meritain Health PPO CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Aetna/Commercial Product,Aetna/Commercial Product,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health CPD,Meritain Health CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Starmark CPD,Starmark CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Aetna Medicare,Aetna Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Ambetter ,Ambetter ,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access,Anthem Blue Access,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access Choice,Anthem Blue Access Choice,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Preferred,Anthem Blue Preferred,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Pathway,Anthem Pathway,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Alliance,Anthem Alliance,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Anthem Medicare,Anthem Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Cigna,Cigna,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Cigna PPO,Cigna PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Cigna Medicare Advantage,Cigna Medicare Advantage,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Essence,Essence,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Healthlink HMO,Healthlink HMO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Healthlink PPO,Healthlink PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,HomeState Health Plan,HomeState Health Plan,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Humana Gold,Humana Gold,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Medicaid MO,Medicaid MO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Medica,Medica,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Tricare,Tricare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,UHC All Payer,UHC All Payer,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,UHC Exchange,UHC Exchange,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicaid,UHC Medicaid,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,UMR CPD,UMR CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicare,UHC Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
LYME DISEASE TITER            ,38301750,CDM,302,RC,86618,CPT,,,,Inpatient,,,235.52,235.52,Wellcare,Wellcare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health PPO CPD,Meritain Health PPO CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Aetna/Commercial Product,Aetna/Commercial Product,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Meritain Health CPD,Meritain Health CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Starmark CPD,Starmark CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Aetna Medicare,Aetna Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Ambetter ,Ambetter ,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access,Anthem Blue Access,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Access Choice,Anthem Blue Access Choice,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Blue Preferred,Anthem Blue Preferred,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Pathway,Anthem Pathway,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Alliance,Anthem Alliance,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Anthem Medicare,Anthem Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Cigna,Cigna,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Cigna PPO,Cigna PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Cigna Medicare Advantage,Cigna Medicare Advantage,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Essence,Essence,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Healthlink HMO,Healthlink HMO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Healthlink PPO,Healthlink PPO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,HomeState Health Plan,HomeState Health Plan,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Humana Gold,Humana Gold,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Medicaid MO,Medicaid MO,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Medica,Medica,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Tricare,Tricare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,UHC All Payer,UHC All Payer,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,UHC Exchange,UHC Exchange,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicaid,UHC Medicaid,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,UMR CPD,UMR CPD,154.89,,,,,,,per diem,154.89,154.89,"Per diem rate, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,UHC Medicare,UHC Medicare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
OVA AND PARASITES             ,38301830,CDM,306,RC,87177,CPT,,,,Inpatient,,,154.89,154.89,Wellcare,Wellcare,154.89,,,,,,,case rate,154.89,154.89,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Meritain Health PPO CPD,Meritain Health PPO CPD,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Aetna/Commercial Product,Aetna/Commercial Product,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Meritain Health CPD,Meritain Health CPD,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Starmark CPD,Starmark CPD,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Aetna Medicare,Aetna Medicare,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Ambetter ,Ambetter ,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Blue Access,Anthem Blue Access,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Blue Access Choice,Anthem Blue Access Choice,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Blue Preferred,Anthem Blue Preferred,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Pathway,Anthem Pathway,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Alliance,Anthem Alliance,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Anthem Medicare,Anthem Medicare,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Cigna,Cigna,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Cigna PPO,Cigna PPO,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Cigna Medicare Advantage,Cigna Medicare Advantage,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Essence,Essence,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Healthlink HMO,Healthlink HMO,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Healthlink PPO,Healthlink PPO,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,HomeState Health Plan,HomeState Health Plan,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Humana Gold,Humana Gold,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Medicaid MO,Medicaid MO,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Medica,Medica,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Tricare,Tricare,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,UHC All Payer,UHC All Payer,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,UHC Exchange,UHC Exchange,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,UHC Medicaid,UHC Medicaid,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,UMR CPD,UMR CPD,75.57,,,,,,,per diem,75.57,75.57,"Per diem rate, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,UHC Medicare,UHC Medicare,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"PHENOBARBITAL, QUANT          ",38301880,CDM,301,RC,80184,CPT,,,,Inpatient,,,75.57,75.57,Wellcare,Wellcare,75.57,,,,,,,case rate,75.57,75.57,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health PPO CPD,Meritain Health PPO CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Aetna/Commercial Product,Aetna/Commercial Product,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health CPD,Meritain Health CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Starmark CPD,Starmark CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Aetna Medicare,Aetna Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Ambetter ,Ambetter ,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access,Anthem Blue Access,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access Choice,Anthem Blue Access Choice,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Preferred,Anthem Blue Preferred,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Pathway,Anthem Pathway,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Alliance,Anthem Alliance,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Anthem Medicare,Anthem Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Cigna,Cigna,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Cigna PPO,Cigna PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Cigna Medicare Advantage,Cigna Medicare Advantage,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Essence,Essence,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Healthlink HMO,Healthlink HMO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Healthlink PPO,Healthlink PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,HomeState Health Plan,HomeState Health Plan,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Humana Gold,Humana Gold,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Medicaid MO,Medicaid MO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Medica,Medica,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Tricare,Tricare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,UHC All Payer,UHC All Payer,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,UHC Exchange,UHC Exchange,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicaid,UHC Medicaid,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,UMR CPD,UMR CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicare,UHC Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"SODIUM, URINE                 ",38301882,CDM,301,RC,84300,CPT,,,,Inpatient,,,70.02,70.02,Wellcare,Wellcare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health PPO CPD,Meritain Health PPO CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Aetna/Commercial Product,Aetna/Commercial Product,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Meritain Health CPD,Meritain Health CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Starmark CPD,Starmark CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Aetna Medicare,Aetna Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Ambetter ,Ambetter ,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access,Anthem Blue Access,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Access Choice,Anthem Blue Access Choice,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Blue Preferred,Anthem Blue Preferred,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Pathway,Anthem Pathway,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Alliance,Anthem Alliance,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Anthem Medicare,Anthem Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Cigna,Cigna,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Cigna PPO,Cigna PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Cigna Medicare Advantage,Cigna Medicare Advantage,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Essence,Essence,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Healthlink HMO,Healthlink HMO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Healthlink PPO,Healthlink PPO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,HomeState Health Plan,HomeState Health Plan,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Humana Gold,Humana Gold,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Medicaid MO,Medicaid MO,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Medica,Medica,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Tricare,Tricare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,UHC All Payer,UHC All Payer,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,UHC Exchange,UHC Exchange,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicaid,UHC Medicaid,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,UMR CPD,UMR CPD,70.02,,,,,,,per diem,70.02,70.02,"Per diem rate, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,UHC Medicare,UHC Medicare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"CHLORIDE, URINE               ",38301883,CDM,301,RC,82436,CPT,,,,Inpatient,,,70.02,70.02,Wellcare,Wellcare,70.02,,,,,,,case rate,70.02,70.02,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Meritain Health PPO CPD,Meritain Health PPO CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Aetna/Commercial Product,Aetna/Commercial Product,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Meritain Health CPD,Meritain Health CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Starmark CPD,Starmark CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Aetna Medicare,Aetna Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Ambetter ,Ambetter ,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Access,Anthem Blue Access,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Access Choice,Anthem Blue Access Choice,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Blue Preferred,Anthem Blue Preferred,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Pathway,Anthem Pathway,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Alliance,Anthem Alliance,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Anthem Medicare,Anthem Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Cigna,Cigna,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Cigna PPO,Cigna PPO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Cigna Medicare Advantage,Cigna Medicare Advantage,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Essence,Essence,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Healthlink HMO,Healthlink HMO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Healthlink PPO,Healthlink PPO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,HomeState Health Plan,HomeState Health Plan,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Humana Gold,Humana Gold,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Medicaid MO,Medicaid MO,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Medica,Medica,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Tricare,Tricare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,UHC All Payer,UHC All Payer,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,UHC Exchange,UHC Exchange,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,UHC Medicaid,UHC Medicaid,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,UMR CPD,UMR CPD,72.1,,,,,,,per diem,72.1,72.1,"Per diem rate, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,UHC Medicare,UHC Medicare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
"PH,OTHER BODY FLUIDS          ",38301890,CDM,301,RC,83986,CPT,,,,Inpatient,,,72.1,72.1,Wellcare,Wellcare,72.1,,,,,,,case rate,72.1,72.1,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Meritain Health PPO CPD,Meritain Health PPO CPD,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Aetna/Commercial Product,Aetna/Commercial Product,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Meritain Health CPD,Meritain Health CPD,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Starmark CPD,Starmark CPD,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Aetna Medicare,Aetna Medicare,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Ambetter ,Ambetter ,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Blue Access,Anthem Blue Access,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Blue Access Choice,Anthem Blue Access Choice,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Blue Preferred,Anthem Blue Preferred,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Pathway,Anthem Pathway,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Alliance,Anthem Alliance,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Anthem Medicare,Anthem Medicare,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Cigna,Cigna,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Cigna PPO,Cigna PPO,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Cigna Medicare Advantage,Cigna Medicare Advantage,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Essence,Essence,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Healthlink HMO,Healthlink HMO,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Healthlink PPO,Healthlink PPO,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,HomeState Health Plan,HomeState Health Plan,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Humana Gold,Humana Gold,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Medicaid MO,Medicaid MO,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Medica,Medica,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Tricare,Tricare,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,UHC All Payer,UHC All Payer,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,UHC Exchange,UHC Exchange,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,UHC Medicaid,UHC Medicaid,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,UMR CPD,UMR CPD,150.65,,,,,,,per diem,150.65,150.65,"Per diem rate, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,UHC Medicare,UHC Medicare,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
TOPUMAX-TOPIRAMATE            ,38301928,CDM,301,RC,80201,CPT,,,,Inpatient,,,150.65,150.65,Wellcare,Wellcare,150.65,,,,,,,case rate,150.65,150.65,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Meritain Health PPO CPD,Meritain Health PPO CPD,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Aetna/Commercial Product,Aetna/Commercial Product,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Meritain Health CPD,Meritain Health CPD,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Starmark CPD,Starmark CPD,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Aetna Medicare,Aetna Medicare,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Ambetter ,Ambetter ,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Blue Access,Anthem Blue Access,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Blue Access Choice,Anthem Blue Access Choice,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Blue Preferred,Anthem Blue Preferred,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Pathway,Anthem Pathway,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Alliance,Anthem Alliance,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Anthem Medicare,Anthem Medicare,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Cigna,Cigna,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Cigna PPO,Cigna PPO,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Cigna Medicare Advantage,Cigna Medicare Advantage,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Essence,Essence,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Healthlink HMO,Healthlink HMO,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Healthlink PPO,Healthlink PPO,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,HomeState Health Plan,HomeState Health Plan,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Humana Gold,Humana Gold,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Medicaid MO,Medicaid MO,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Medica,Medica,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Tricare,Tricare,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,UHC All Payer,UHC All Payer,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,UHC Exchange,UHC Exchange,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,UHC Medicaid,UHC Medicaid,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,UMR CPD,UMR CPD,66.31,,,,,,,per diem,66.31,66.31,"Per diem rate, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,UHC Medicare,UHC Medicare,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
POTASSIUM URINE               ,38301940,CDM,301,RC,84133,CPT,,,,Inpatient,,,66.31,66.31,Wellcare,Wellcare,66.31,,,,,,,case rate,66.31,66.31,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Meritain Health PPO CPD,Meritain Health PPO CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Aetna/Commercial Product,Aetna/Commercial Product,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Meritain Health CPD,Meritain Health CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Starmark CPD,Starmark CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Aetna Medicare,Aetna Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Ambetter ,Ambetter ,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Access,Anthem Blue Access,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Access Choice,Anthem Blue Access Choice,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Blue Preferred,Anthem Blue Preferred,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Pathway,Anthem Pathway,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Alliance,Anthem Alliance,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Anthem Medicare,Anthem Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Cigna,Cigna,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Cigna PPO,Cigna PPO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Cigna Medicare Advantage,Cigna Medicare Advantage,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Essence,Essence,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Healthlink HMO,Healthlink HMO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Healthlink PPO,Healthlink PPO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,HomeState Health Plan,HomeState Health Plan,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Humana Gold,Humana Gold,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Medicaid MO,Medicaid MO,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Medica,Medica,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Tricare,Tricare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,UHC All Payer,UHC All Payer,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,UHC Exchange,UHC Exchange,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,UHC Medicaid,UHC Medicaid,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,UMR CPD,UMR CPD,261.52,,,,,,,per diem,261.52,261.52,"Per diem rate, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,UHC Medicare,UHC Medicare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
PROLACTIN                     ,38301990,CDM,301,RC,84146,CPT,,,,Inpatient,,,261.52,261.52,Wellcare,Wellcare,261.52,,,,,,,case rate,261.52,261.52,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health PPO CPD,Meritain Health PPO CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Aetna/Commercial Product,Aetna/Commercial Product,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Meritain Health CPD,Meritain Health CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Starmark CPD,Starmark CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Aetna Medicare,Aetna Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Ambetter ,Ambetter ,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access,Anthem Blue Access,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Access Choice,Anthem Blue Access Choice,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Blue Preferred,Anthem Blue Preferred,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Pathway,Anthem Pathway,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Alliance,Anthem Alliance,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Anthem Medicare,Anthem Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Cigna,Cigna,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Cigna PPO,Cigna PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Cigna Medicare Advantage,Cigna Medicare Advantage,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Essence,Essence,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Healthlink HMO,Healthlink HMO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Healthlink PPO,Healthlink PPO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,HomeState Health Plan,HomeState Health Plan,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Humana Gold,Humana Gold,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Medicaid MO,Medicaid MO,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Medica,Medica,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Tricare,Tricare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,UHC All Payer,UHC All Payer,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,UHC Exchange,UHC Exchange,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicaid,UHC Medicaid,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,UMR CPD,UMR CPD,120.94,,,,,,,per diem,120.94,120.94,"Per diem rate, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,UHC Medicare,UHC Medicare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
"PROTEIN, TOTAL, OTHER SOURCE  ",38302011,CDM,301,RC,84157,CPT,,,,Inpatient,,,120.94,120.94,Wellcare,Wellcare,120.94,,,,,,,case rate,120.94,120.94,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health PPO CPD,Meritain Health PPO CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna/Commercial Product,Aetna/Commercial Product,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Meritain Health CPD,Meritain Health CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Starmark CPD,Starmark CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Aetna Medicare,Aetna Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Ambetter ,Ambetter ,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access,Anthem Blue Access,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Access Choice,Anthem Blue Access Choice,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Blue Preferred,Anthem Blue Preferred,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Pathway,Anthem Pathway,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Alliance,Anthem Alliance,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Anthem Medicare,Anthem Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna,Cigna,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna PPO,Cigna PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Cigna Medicare Advantage,Cigna Medicare Advantage,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Essence,Essence,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthlink HMO,Healthlink HMO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Healthlink PPO,Healthlink PPO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,HomeState Health Plan,HomeState Health Plan,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Humana Gold,Humana Gold,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Medicaid MO,Medicaid MO,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Medica,Medica,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Tricare,Tricare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC All Payer,UHC All Payer,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Exchange,UHC Exchange,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicaid,UHC Medicaid,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UMR CPD,UMR CPD,153.83,,,,,,,per diem,153.83,153.83,"Per diem rate, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,UHC Medicare,UHC Medicare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
IMMUNO OTHER INFECT AGENT AB  ,38302055,CDM,302,RC,86317,CPT,,,,Inpatient,,,153.83,153.83,Wellcare,Wellcare,153.83,,,,,,,case rate,153.83,153.83,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Meritain Health PPO CPD,Meritain Health PPO CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Aetna/Commercial Product,Aetna/Commercial Product,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Meritain Health CPD,Meritain Health CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Starmark CPD,Starmark CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Aetna Medicare,Aetna Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Ambetter ,Ambetter ,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Access,Anthem Blue Access,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Access Choice,Anthem Blue Access Choice,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Blue Preferred,Anthem Blue Preferred,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Pathway,Anthem Pathway,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Alliance,Anthem Alliance,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Anthem Medicare,Anthem Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Cigna,Cigna,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Cigna PPO,Cigna PPO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Cigna Medicare Advantage,Cigna Medicare Advantage,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Essence,Essence,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Healthlink HMO,Healthlink HMO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Healthlink PPO,Healthlink PPO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,HomeState Health Plan,HomeState Health Plan,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Humana Gold,Humana Gold,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Medicaid MO,Medicaid MO,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Medica,Medica,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Tricare,Tricare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,UHC All Payer,UHC All Payer,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,UHC Exchange,UHC Exchange,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,UHC Medicaid,UHC Medicaid,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,UMR CPD,UMR CPD,242.95,,,,,,,per diem,242.95,242.95,"Per diem rate, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,UHC Medicare,UHC Medicare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RENIN-PLASMA                  ,38302115,CDM,301,RC,84244,CPT,,,,Inpatient,,,242.95,242.95,Wellcare,Wellcare,242.95,,,,,,,case rate,242.95,242.95,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
RPR                           ,38302140,CDM,302,RC,86592,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Meritain Health PPO CPD,Meritain Health PPO CPD,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Aetna/Commercial Product,Aetna/Commercial Product,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Meritain Health CPD,Meritain Health CPD,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Starmark CPD,Starmark CPD,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Aetna Medicare,Aetna Medicare,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Ambetter ,Ambetter ,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Blue Access,Anthem Blue Access,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Blue Access Choice,Anthem Blue Access Choice,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Blue Preferred,Anthem Blue Preferred,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Pathway,Anthem Pathway,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Alliance,Anthem Alliance,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Anthem Medicare,Anthem Medicare,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Cigna,Cigna,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Cigna PPO,Cigna PPO,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Cigna Medicare Advantage,Cigna Medicare Advantage,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Essence,Essence,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Healthlink HMO,Healthlink HMO,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Healthlink PPO,Healthlink PPO,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,HomeState Health Plan,HomeState Health Plan,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Humana Gold,Humana Gold,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Medicaid MO,Medicaid MO,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Medica,Medica,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Tricare,Tricare,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,UHC All Payer,UHC All Payer,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,UHC Exchange,UHC Exchange,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,UHC Medicaid,UHC Medicaid,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,UMR CPD,UMR CPD,77.71,,,,,,,per diem,77.71,77.71,"Per diem rate, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,UHC Medicare,UHC Medicare,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
CHLAMYDOPHILIA PNEYMONIAE     ,38302185,CDM,306,RC,87486,CPT,,,,Inpatient,,,77.71,77.71,Wellcare,Wellcare,77.71,,,,,,,case rate,77.71,77.71,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Meritain Health PPO CPD,Meritain Health PPO CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Aetna/Commercial Product,Aetna/Commercial Product,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Meritain Health CPD,Meritain Health CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Starmark CPD,Starmark CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Aetna Medicare,Aetna Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Ambetter ,Ambetter ,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Access,Anthem Blue Access,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Access Choice,Anthem Blue Access Choice,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Blue Preferred,Anthem Blue Preferred,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Pathway,Anthem Pathway,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Alliance,Anthem Alliance,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Anthem Medicare,Anthem Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Cigna,Cigna,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Cigna PPO,Cigna PPO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Cigna Medicare Advantage,Cigna Medicare Advantage,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Essence,Essence,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Healthlink HMO,Healthlink HMO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Healthlink PPO,Healthlink PPO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,HomeState Health Plan,HomeState Health Plan,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Humana Gold,Humana Gold,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Medicaid MO,Medicaid MO,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Medica,Medica,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Tricare,Tricare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,UHC All Payer,UHC All Payer,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,UHC Exchange,UHC Exchange,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,UHC Medicaid,UHC Medicaid,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,UMR CPD,UMR CPD,163.38,,,,,,,per diem,163.38,163.38,"Per diem rate, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,UHC Medicare,UHC Medicare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
MYCOPLASMA PNEUMONIAE         ,38302188,CDM,306,RC,87581,CPT,,,,Inpatient,,,163.38,163.38,Wellcare,Wellcare,163.38,,,,,,,case rate,163.38,163.38,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health PPO CPD,Meritain Health PPO CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Aetna/Commercial Product,Aetna/Commercial Product,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Meritain Health CPD,Meritain Health CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Starmark CPD,Starmark CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Aetna Medicare,Aetna Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Ambetter ,Ambetter ,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access,Anthem Blue Access,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Access Choice,Anthem Blue Access Choice,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Blue Preferred,Anthem Blue Preferred,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Pathway,Anthem Pathway,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Alliance,Anthem Alliance,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Anthem Medicare,Anthem Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Cigna,Cigna,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Cigna PPO,Cigna PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Cigna Medicare Advantage,Cigna Medicare Advantage,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Essence,Essence,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Healthlink HMO,Healthlink HMO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Healthlink PPO,Healthlink PPO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,HomeState Health Plan,HomeState Health Plan,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Humana Gold,Humana Gold,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Medicaid MO,Medicaid MO,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Medica,Medica,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Tricare,Tricare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,UHC All Payer,UHC All Payer,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,UHC Exchange,UHC Exchange,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicaid,UHC Medicaid,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,UMR CPD,UMR CPD,86.99,,,,,,,per diem,86.99,86.99,"Per diem rate, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,UHC Medicare,UHC Medicare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
"BLOOD COUNT-PLATELET, AUTO    ",38302212,CDM,305,RC,85049,CPT,,,,Inpatient,,,86.99,86.99,Wellcare,Wellcare,86.99,,,,,,,case rate,86.99,86.99,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Meritain Health PPO CPD,Meritain Health PPO CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Aetna/Commercial Product,Aetna/Commercial Product,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Meritain Health CPD,Meritain Health CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Starmark CPD,Starmark CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Aetna Medicare,Aetna Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Ambetter ,Ambetter ,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Access,Anthem Blue Access,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Access Choice,Anthem Blue Access Choice,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Blue Preferred,Anthem Blue Preferred,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Pathway,Anthem Pathway,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Alliance,Anthem Alliance,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Anthem Medicare,Anthem Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Cigna,Cigna,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Cigna PPO,Cigna PPO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Cigna Medicare Advantage,Cigna Medicare Advantage,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Essence,Essence,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Healthlink HMO,Healthlink HMO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Healthlink PPO,Healthlink PPO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,HomeState Health Plan,HomeState Health Plan,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Humana Gold,Humana Gold,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Medicaid MO,Medicaid MO,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Medica,Medica,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Tricare,Tricare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,UHC All Payer,UHC All Payer,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,UHC Exchange,UHC Exchange,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,UHC Medicaid,UHC Medicaid,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,UMR CPD,UMR CPD,231.28,,,,,,,per diem,231.28,231.28,"Per diem rate, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,UHC Medicare,UHC Medicare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 FREE                       ,38302290,CDM,301,RC,84481,CPT,,,,Inpatient,,,231.28,231.28,Wellcare,Wellcare,231.28,,,,,,,case rate,231.28,231.28,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Meritain Health PPO CPD,Meritain Health PPO CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna/Commercial Product,Aetna/Commercial Product,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Meritain Health CPD,Meritain Health CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Starmark CPD,Starmark CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Aetna Medicare,Aetna Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Ambetter ,Ambetter ,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Access,Anthem Blue Access,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Access Choice,Anthem Blue Access Choice,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Blue Preferred,Anthem Blue Preferred,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Pathway,Anthem Pathway,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Alliance,Anthem Alliance,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Anthem Medicare,Anthem Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna,Cigna,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna PPO,Cigna PPO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Cigna Medicare Advantage,Cigna Medicare Advantage,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Essence,Essence,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthlink HMO,Healthlink HMO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Healthlink PPO,Healthlink PPO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,HomeState Health Plan,HomeState Health Plan,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Humana Gold,Humana Gold,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Medicaid MO,Medicaid MO,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Medica,Medica,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Tricare,Tricare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC All Payer,UHC All Payer,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Exchange,UHC Exchange,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Medicaid,UHC Medicaid,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UMR CPD,UMR CPD,155.39,,,,,,,per diem,155.39,155.39,"Per diem rate, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,UHC Medicare,UHC Medicare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
T3 TOTAL                      ,38302303,CDM,301,RC,84480,CPT,,,,Inpatient,,,155.39,155.39,Wellcare,Wellcare,155.39,,,,,,,case rate,155.39,155.39,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health PPO CPD,Meritain Health PPO CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Aetna/Commercial Product,Aetna/Commercial Product,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Meritain Health CPD,Meritain Health CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Starmark CPD,Starmark CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Aetna Medicare,Aetna Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Ambetter ,Ambetter ,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access,Anthem Blue Access,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Access Choice,Anthem Blue Access Choice,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Blue Preferred,Anthem Blue Preferred,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Pathway,Anthem Pathway,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Alliance,Anthem Alliance,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Anthem Medicare,Anthem Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Cigna,Cigna,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Cigna PPO,Cigna PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Cigna Medicare Advantage,Cigna Medicare Advantage,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Essence,Essence,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Healthlink HMO,Healthlink HMO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Healthlink PPO,Healthlink PPO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,HomeState Health Plan,HomeState Health Plan,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Humana Gold,Humana Gold,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Medicaid MO,Medicaid MO,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Medica,Medica,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Tricare,Tricare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,UHC All Payer,UHC All Payer,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,UHC Exchange,UHC Exchange,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicaid,UHC Medicaid,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,UMR CPD,UMR CPD,210.12,,,,,,,per diem,210.12,210.12,"Per diem rate, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,UHC Medicare,UHC Medicare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TEGRETOL-TOTAL                ,38302330,CDM,301,RC,80156,CPT,,,,Inpatient,,,210.12,210.12,Wellcare,Wellcare,210.12,,,,,,,case rate,210.12,210.12,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Meritain Health PPO CPD,Meritain Health PPO CPD,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Aetna/Commercial Product,Aetna/Commercial Product,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Meritain Health CPD,Meritain Health CPD,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Starmark CPD,Starmark CPD,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Aetna Medicare,Aetna Medicare,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Ambetter ,Ambetter ,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Blue Access,Anthem Blue Access,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Blue Access Choice,Anthem Blue Access Choice,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Blue Preferred,Anthem Blue Preferred,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Pathway,Anthem Pathway,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Alliance,Anthem Alliance,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Anthem Medicare,Anthem Medicare,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Cigna,Cigna,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Cigna PPO,Cigna PPO,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Cigna Medicare Advantage,Cigna Medicare Advantage,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Essence,Essence,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Healthlink HMO,Healthlink HMO,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Healthlink PPO,Healthlink PPO,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,HomeState Health Plan,HomeState Health Plan,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Humana Gold,Humana Gold,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Medicaid MO,Medicaid MO,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Medica,Medica,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Tricare,Tricare,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,UHC All Payer,UHC All Payer,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,UHC Exchange,UHC Exchange,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,UHC Medicaid,UHC Medicaid,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,UMR CPD,UMR CPD,259.4,,,,,,,per diem,259.4,259.4,"Per diem rate, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,UHC Medicare,UHC Medicare,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TESTOSTERONE TOTAL            ,38302340,CDM,301,RC,84403,CPT,,,,Inpatient,,,259.4,259.4,Wellcare,Wellcare,259.4,,,,,,,case rate,259.4,259.4,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Meritain Health PPO CPD,Meritain Health PPO CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Aetna/Commercial Product,Aetna/Commercial Product,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Meritain Health CPD,Meritain Health CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Starmark CPD,Starmark CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Aetna Medicare,Aetna Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Ambetter ,Ambetter ,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Access,Anthem Blue Access,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Access Choice,Anthem Blue Access Choice,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Blue Preferred,Anthem Blue Preferred,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Pathway,Anthem Pathway,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Alliance,Anthem Alliance,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Anthem Medicare,Anthem Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Cigna,Cigna,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Cigna PPO,Cigna PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Cigna Medicare Advantage,Cigna Medicare Advantage,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Essence,Essence,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Healthlink HMO,Healthlink HMO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Healthlink PPO,Healthlink PPO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,HomeState Health Plan,HomeState Health Plan,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Humana Gold,Humana Gold,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Medicaid MO,Medicaid MO,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Medica,Medica,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Tricare,Tricare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,UHC All Payer,UHC All Payer,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,UHC Exchange,UHC Exchange,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,UHC Medicaid,UHC Medicaid,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,UMR CPD,UMR CPD,167.89,,,,,,,per diem,167.89,167.89,"Per diem rate, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,UHC Medicare,UHC Medicare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRANSFERRIN SERUM             ,38302400,CDM,301,RC,84466,CPT,,,,Inpatient,,,167.89,167.89,Wellcare,Wellcare,167.89,,,,,,,case rate,167.89,167.89,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health PPO CPD,Meritain Health PPO CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Aetna/Commercial Product,Aetna/Commercial Product,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Meritain Health CPD,Meritain Health CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Starmark CPD,Starmark CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Aetna Medicare,Aetna Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Ambetter ,Ambetter ,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access,Anthem Blue Access,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Access Choice,Anthem Blue Access Choice,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Blue Preferred,Anthem Blue Preferred,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Pathway,Anthem Pathway,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Alliance,Anthem Alliance,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Anthem Medicare,Anthem Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Cigna,Cigna,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Cigna PPO,Cigna PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Cigna Medicare Advantage,Cigna Medicare Advantage,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Essence,Essence,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Healthlink HMO,Healthlink HMO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Healthlink PPO,Healthlink PPO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,HomeState Health Plan,HomeState Health Plan,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Humana Gold,Humana Gold,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Medicaid MO,Medicaid MO,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Medica,Medica,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Tricare,Tricare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,UHC All Payer,UHC All Payer,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,UHC Exchange,UHC Exchange,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicaid,UHC Medicaid,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,UMR CPD,UMR CPD,103.97,,,,,,,per diem,103.97,103.97,"Per diem rate, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,UHC Medicare,UHC Medicare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
TRIGLYCERIDES                 ,38302410,CDM,301,RC,84478,CPT,,,,Inpatient,,,103.97,103.97,Wellcare,Wellcare,103.97,,,,,,,case rate,103.97,103.97,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Meritain Health PPO CPD,Meritain Health PPO CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Aetna/Commercial Product,Aetna/Commercial Product,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Meritain Health CPD,Meritain Health CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Starmark CPD,Starmark CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Aetna Medicare,Aetna Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Ambetter ,Ambetter ,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Access,Anthem Blue Access,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Access Choice,Anthem Blue Access Choice,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Blue Preferred,Anthem Blue Preferred,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Pathway,Anthem Pathway,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Alliance,Anthem Alliance,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Anthem Medicare,Anthem Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Cigna,Cigna,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Cigna PPO,Cigna PPO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Cigna Medicare Advantage,Cigna Medicare Advantage,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Essence,Essence,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Healthlink HMO,Healthlink HMO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Healthlink PPO,Healthlink PPO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,HomeState Health Plan,HomeState Health Plan,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Humana Gold,Humana Gold,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Medicaid MO,Medicaid MO,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Medica,Medica,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Tricare,Tricare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,UHC All Payer,UHC All Payer,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,UHC Exchange,UHC Exchange,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,UHC Medicaid,UHC Medicaid,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,UMR CPD,UMR CPD,97.6,,,,,,,per diem,97.6,97.6,"Per diem rate, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,UHC Medicare,UHC Medicare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
UREA NITROGEN (URINE)         ,38302480,CDM,301,RC,84540,CPT,,,,Inpatient,,,97.6,97.6,Wellcare,Wellcare,97.6,,,,,,,case rate,97.6,97.6,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Meritain Health PPO CPD,Meritain Health PPO CPD,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Aetna/Commercial Product,Aetna/Commercial Product,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Meritain Health CPD,Meritain Health CPD,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Starmark CPD,Starmark CPD,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Aetna Medicare,Aetna Medicare,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Ambetter ,Ambetter ,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Blue Access,Anthem Blue Access,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Blue Access Choice,Anthem Blue Access Choice,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Blue Preferred,Anthem Blue Preferred,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Pathway,Anthem Pathway,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Alliance,Anthem Alliance,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Anthem Medicare,Anthem Medicare,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Cigna,Cigna,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Cigna PPO,Cigna PPO,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Cigna Medicare Advantage,Cigna Medicare Advantage,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Essence,Essence,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Healthlink HMO,Healthlink HMO,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Healthlink PPO,Healthlink PPO,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,HomeState Health Plan,HomeState Health Plan,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Humana Gold,Humana Gold,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Medicaid MO,Medicaid MO,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Medica,Medica,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Tricare,Tricare,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,UHC All Payer,UHC All Payer,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,UHC Exchange,UHC Exchange,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,UHC Medicaid,UHC Medicaid,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,UMR CPD,UMR CPD,180.62,,,,,,,per diem,180.62,180.62,"Per diem rate, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,UHC Medicare,UHC Medicare,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VALPROIC ACID                 ,38302500,CDM,301,RC,80164,CPT,,,,Inpatient,,,180.62,180.62,Wellcare,Wellcare,180.62,,,,,,,case rate,180.62,180.62,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health PPO CPD,Meritain Health PPO CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Aetna/Commercial Product,Aetna/Commercial Product,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Meritain Health CPD,Meritain Health CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Starmark CPD,Starmark CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Aetna Medicare,Aetna Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Ambetter ,Ambetter ,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access,Anthem Blue Access,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Access Choice,Anthem Blue Access Choice,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Blue Preferred,Anthem Blue Preferred,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Pathway,Anthem Pathway,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Alliance,Anthem Alliance,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Anthem Medicare,Anthem Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Cigna,Cigna,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Cigna PPO,Cigna PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Cigna Medicare Advantage,Cigna Medicare Advantage,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Essence,Essence,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Healthlink HMO,Healthlink HMO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Healthlink PPO,Healthlink PPO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,HomeState Health Plan,HomeState Health Plan,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Humana Gold,Humana Gold,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Medicaid MO,Medicaid MO,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Medica,Medica,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Tricare,Tricare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,UHC All Payer,UHC All Payer,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,UHC Exchange,UHC Exchange,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicaid,UHC Medicaid,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,UMR CPD,UMR CPD,235.52,,,,,,,per diem,235.52,235.52,"Per diem rate, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,UHC Medicare,UHC Medicare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
VMA (URINE)                   ,38302545,CDM,301,RC,84585,CPT,,,,Inpatient,,,235.52,235.52,Wellcare,Wellcare,235.52,,,,,,,case rate,235.52,235.52,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Meritain Health PPO CPD,Meritain Health PPO CPD,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Aetna/Commercial Product,Aetna/Commercial Product,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Meritain Health CPD,Meritain Health CPD,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Starmark CPD,Starmark CPD,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Aetna Medicare,Aetna Medicare,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Ambetter ,Ambetter ,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Blue Access,Anthem Blue Access,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Blue Access Choice,Anthem Blue Access Choice,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Blue Preferred,Anthem Blue Preferred,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Pathway,Anthem Pathway,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Alliance,Anthem Alliance,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Anthem Medicare,Anthem Medicare,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Cigna,Cigna,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Cigna PPO,Cigna PPO,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Cigna Medicare Advantage,Cigna Medicare Advantage,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Essence,Essence,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Healthlink HMO,Healthlink HMO,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Healthlink PPO,Healthlink PPO,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,HomeState Health Plan,HomeState Health Plan,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Humana Gold,Humana Gold,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Medicaid MO,Medicaid MO,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Medica,Medica,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Tricare,Tricare,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,UHC All Payer,UHC All Payer,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,UHC Exchange,UHC Exchange,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,UHC Medicaid,UHC Medicaid,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,UMR CPD,UMR CPD,129.93,,,,,,,per diem,129.93,129.93,"Per diem rate, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,UHC Medicare,UHC Medicare,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ZINC                          ,38302590,CDM,301,RC,84630,CPT,,,,Inpatient,,,129.93,129.93,Wellcare,Wellcare,129.93,,,,,,,case rate,129.93,129.93,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health PPO CPD,Meritain Health PPO CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna/Commercial Product,Aetna/Commercial Product,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Meritain Health CPD,Meritain Health CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Starmark CPD,Starmark CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Aetna Medicare,Aetna Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Ambetter ,Ambetter ,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access,Anthem Blue Access,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Access Choice,Anthem Blue Access Choice,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Blue Preferred,Anthem Blue Preferred,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Pathway,Anthem Pathway,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Alliance,Anthem Alliance,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Anthem Medicare,Anthem Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna,Cigna,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna PPO,Cigna PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Cigna Medicare Advantage,Cigna Medicare Advantage,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Essence,Essence,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthlink HMO,Healthlink HMO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Healthlink PPO,Healthlink PPO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,HomeState Health Plan,HomeState Health Plan,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Humana Gold,Humana Gold,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Medicaid MO,Medicaid MO,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Medica,Medica,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Tricare,Tricare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC All Payer,UHC All Payer,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Exchange,UHC Exchange,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicaid,UHC Medicaid,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UMR CPD,UMR CPD,119.88,,,,,,,per diem,119.88,119.88,"Per diem rate, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,UHC Medicare,UHC Medicare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ANAEROBIC ORGANISM ID         ,38302650,CDM,306,RC,87076,CPT,,,,Inpatient,,,119.88,119.88,Wellcare,Wellcare,119.88,,,,,,,case rate,119.88,119.88,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Meritain Health PPO CPD,Meritain Health PPO CPD,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Aetna/Commercial Product,Aetna/Commercial Product,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Meritain Health CPD,Meritain Health CPD,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Starmark CPD,Starmark CPD,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Aetna Medicare,Aetna Medicare,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Ambetter ,Ambetter ,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Blue Access,Anthem Blue Access,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Blue Access Choice,Anthem Blue Access Choice,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Blue Preferred,Anthem Blue Preferred,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Pathway,Anthem Pathway,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Alliance,Anthem Alliance,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Anthem Medicare,Anthem Medicare,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Cigna,Cigna,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Cigna PPO,Cigna PPO,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Cigna Medicare Advantage,Cigna Medicare Advantage,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Essence,Essence,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Healthlink HMO,Healthlink HMO,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Healthlink PPO,Healthlink PPO,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,HomeState Health Plan,HomeState Health Plan,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Humana Gold,Humana Gold,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Medicaid MO,Medicaid MO,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Medica,Medica,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Tricare,Tricare,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,UHC All Payer,UHC All Payer,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,UHC Exchange,UHC Exchange,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,UHC Medicaid,UHC Medicaid,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,UMR CPD,UMR CPD,197.33,,,,,,,per diem,197.33,197.33,"Per diem rate, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,UHC Medicare,UHC Medicare,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
ARSENIC                       ,38302670,CDM,301,RC,82175,CPT,,,,Inpatient,,,197.33,197.33,Wellcare,Wellcare,197.33,,,,,,,case rate,197.33,197.33,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health PPO CPD,Meritain Health PPO CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Aetna/Commercial Product,Aetna/Commercial Product,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health CPD,Meritain Health CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Starmark CPD,Starmark CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Aetna Medicare,Aetna Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Ambetter ,Ambetter ,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access,Anthem Blue Access,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access Choice,Anthem Blue Access Choice,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Preferred,Anthem Blue Preferred,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Pathway,Anthem Pathway,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Alliance,Anthem Alliance,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Anthem Medicare,Anthem Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Cigna,Cigna,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Cigna PPO,Cigna PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Cigna Medicare Advantage,Cigna Medicare Advantage,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Essence,Essence,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Healthlink HMO,Healthlink HMO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Healthlink PPO,Healthlink PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,HomeState Health Plan,HomeState Health Plan,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Humana Gold,Humana Gold,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Medicaid MO,Medicaid MO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Medica,Medica,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Tricare,Tricare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,UHC All Payer,UHC All Payer,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,UHC Exchange,UHC Exchange,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicaid,UHC Medicaid,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,UMR CPD,UMR CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicare,UHC Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
MERCURY QUANTITATIVE          ,38302693,CDM,301,RC,83825,CPT,,,,Inpatient,,,176.11,176.11,Wellcare,Wellcare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Meritain Health PPO CPD,Meritain Health PPO CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna/Commercial Product,Aetna/Commercial Product,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Meritain Health CPD,Meritain Health CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Starmark CPD,Starmark CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Aetna Medicare,Aetna Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Ambetter ,Ambetter ,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Access,Anthem Blue Access,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Access Choice,Anthem Blue Access Choice,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Blue Preferred,Anthem Blue Preferred,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Pathway,Anthem Pathway,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Alliance,Anthem Alliance,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Anthem Medicare,Anthem Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna,Cigna,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna PPO,Cigna PPO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Cigna Medicare Advantage,Cigna Medicare Advantage,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Essence,Essence,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthlink HMO,Healthlink HMO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Healthlink PPO,Healthlink PPO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,HomeState Health Plan,HomeState Health Plan,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Humana Gold,Humana Gold,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Medicaid MO,Medicaid MO,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Medica,Medica,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Tricare,Tricare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC All Payer,UHC All Payer,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Exchange,UHC Exchange,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Medicaid,UHC Medicaid,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UMR CPD,UMR CPD,115.49,,,,,,,per diem,115.49,115.49,"Per diem rate, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,UHC Medicare,UHC Medicare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
"CALCIUM, URINE                ",38302745,CDM,301,RC,82340,CPT,,,,Inpatient,,,115.49,115.49,Wellcare,Wellcare,115.49,,,,,,,case rate,115.49,115.49,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Meritain Health PPO CPD,Meritain Health PPO CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna/Commercial Product,Aetna/Commercial Product,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Meritain Health CPD,Meritain Health CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Starmark CPD,Starmark CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Aetna Medicare,Aetna Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Ambetter ,Ambetter ,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Access,Anthem Blue Access,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Access Choice,Anthem Blue Access Choice,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Blue Preferred,Anthem Blue Preferred,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Pathway,Anthem Pathway,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Alliance,Anthem Alliance,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Anthem Medicare,Anthem Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna,Cigna,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna PPO,Cigna PPO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Cigna Medicare Advantage,Cigna Medicare Advantage,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Essence,Essence,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthlink HMO,Healthlink HMO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Healthlink PPO,Healthlink PPO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,HomeState Health Plan,HomeState Health Plan,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Humana Gold,Humana Gold,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Medicaid MO,Medicaid MO,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Medica,Medica,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Tricare,Tricare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC All Payer,UHC All Payer,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Exchange,UHC Exchange,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Medicaid,UHC Medicaid,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UMR CPD,UMR CPD,188.84,,,,,,,per diem,188.84,188.84,"Per diem rate, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,UHC Medicare,UHC Medicare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CHEMILUMINES                  ,38302774,CDM,301,RC,82397,CPT,,,,Inpatient,,,188.84,188.84,Wellcare,Wellcare,188.84,,,,,,,case rate,188.84,188.84,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health PPO CPD,Meritain Health PPO CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Aetna/Commercial Product,Aetna/Commercial Product,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Meritain Health CPD,Meritain Health CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Starmark CPD,Starmark CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Aetna Medicare,Aetna Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Ambetter ,Ambetter ,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access,Anthem Blue Access,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Access Choice,Anthem Blue Access Choice,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Blue Preferred,Anthem Blue Preferred,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Pathway,Anthem Pathway,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Alliance,Anthem Alliance,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Anthem Medicare,Anthem Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Cigna,Cigna,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Cigna PPO,Cigna PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Cigna Medicare Advantage,Cigna Medicare Advantage,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Essence,Essence,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Healthlink HMO,Healthlink HMO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Healthlink PPO,Healthlink PPO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,HomeState Health Plan,HomeState Health Plan,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Humana Gold,Humana Gold,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Medicaid MO,Medicaid MO,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Medica,Medica,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Tricare,Tricare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,UHC All Payer,UHC All Payer,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,UHC Exchange,UHC Exchange,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicaid,UHC Medicaid,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,UMR CPD,UMR CPD,74.26,,,,,,,per diem,74.26,74.26,"Per diem rate, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,UHC Medicare,UHC Medicare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
CORTISOL FREE                 ,38302850,CDM,301,RC,82530,CPT,,,,Inpatient,,,74.26,74.26,Wellcare,Wellcare,74.26,,,,,,,case rate,74.26,74.26,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Meritain Health PPO CPD,Meritain Health PPO CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Aetna/Commercial Product,Aetna/Commercial Product,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Meritain Health CPD,Meritain Health CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Starmark CPD,Starmark CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Aetna Medicare,Aetna Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Ambetter ,Ambetter ,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Blue Access,Anthem Blue Access,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Blue Access Choice,Anthem Blue Access Choice,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Blue Preferred,Anthem Blue Preferred,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Pathway,Anthem Pathway,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Alliance,Anthem Alliance,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Anthem Medicare,Anthem Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Cigna,Cigna,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Cigna PPO,Cigna PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Cigna Medicare Advantage,Cigna Medicare Advantage,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Essence,Essence,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Healthlink HMO,Healthlink HMO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Healthlink PPO,Healthlink PPO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,HomeState Health Plan,HomeState Health Plan,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Humana Gold,Humana Gold,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Medicaid MO,Medicaid MO,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Medica,Medica,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Tricare,Tricare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,UHC All Payer,UHC All Payer,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,UHC Exchange,UHC Exchange,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,UHC Medicaid,UHC Medicaid,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,UMR CPD,UMR CPD,154.5,,,,,,,per diem,154.5,154.5,"Per diem rate, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,UHC Medicare,UHC Medicare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
EBV NUCLEAR ANTIGEN IGM (VCA) ,38302935,CDM,302,RC,86664,CPT,,,,Inpatient,,,154.5,154.5,Wellcare,Wellcare,154.5,,,,,,,case rate,154.5,154.5,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Meritain Health PPO CPD,Meritain Health PPO CPD,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Aetna/Commercial Product,Aetna/Commercial Product,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Meritain Health CPD,Meritain Health CPD,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Starmark CPD,Starmark CPD,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Aetna Medicare,Aetna Medicare,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Ambetter ,Ambetter ,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Blue Access,Anthem Blue Access,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Blue Access Choice,Anthem Blue Access Choice,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Blue Preferred,Anthem Blue Preferred,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Pathway,Anthem Pathway,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Alliance,Anthem Alliance,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Anthem Medicare,Anthem Medicare,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Cigna,Cigna,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Cigna PPO,Cigna PPO,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Cigna Medicare Advantage,Cigna Medicare Advantage,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Essence,Essence,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Healthlink HMO,Healthlink HMO,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Healthlink PPO,Healthlink PPO,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,HomeState Health Plan,HomeState Health Plan,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Humana Gold,Humana Gold,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Medicaid MO,Medicaid MO,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Medica,Medica,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Tricare,Tricare,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,UHC All Payer,UHC All Payer,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,UHC Exchange,UHC Exchange,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,UHC Medicaid,UHC Medicaid,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,UMR CPD,UMR CPD,1060.9,,,,,,,per diem,1060.9,1060.9,"Per diem rate, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,UHC Medicare,UHC Medicare,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
FUNGI MOLD ID                 ,38303030,CDM,306,RC,87106,CPT,,,,Inpatient,,,1060.9,1060.9,Wellcare,Wellcare,1060.9,,,,,,,case rate,1060.9,1060.9,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Meritain Health PPO CPD,Meritain Health PPO CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Aetna/Commercial Product,Aetna/Commercial Product,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Meritain Health CPD,Meritain Health CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Starmark CPD,Starmark CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Aetna Medicare,Aetna Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Ambetter ,Ambetter ,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Blue Access,Anthem Blue Access,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Blue Access Choice,Anthem Blue Access Choice,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Blue Preferred,Anthem Blue Preferred,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Pathway,Anthem Pathway,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Alliance,Anthem Alliance,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Anthem Medicare,Anthem Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Cigna,Cigna,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Cigna PPO,Cigna PPO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Cigna Medicare Advantage,Cigna Medicare Advantage,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Essence,Essence,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Healthlink HMO,Healthlink HMO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Healthlink PPO,Healthlink PPO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,HomeState Health Plan,HomeState Health Plan,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Humana Gold,Humana Gold,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Medicaid MO,Medicaid MO,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Medica,Medica,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Tricare,Tricare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,UHC All Payer,UHC All Payer,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,UHC Exchange,UHC Exchange,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,UHC Medicaid,UHC Medicaid,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,UMR CPD,UMR CPD,169.74,,,,,,,per diem,169.74,169.74,"Per diem rate, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,UHC Medicare,UHC Medicare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
IMMUNOFIXATION ELECTROPHORESIS,38303160,CDM,302,RC,86334,CPT,,,,Inpatient,,,169.74,169.74,Wellcare,Wellcare,169.74,,,,,,,case rate,169.74,169.74,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Meritain Health PPO CPD,Meritain Health PPO CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Aetna/Commercial Product,Aetna/Commercial Product,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Meritain Health CPD,Meritain Health CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Starmark CPD,Starmark CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Aetna Medicare,Aetna Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Ambetter ,Ambetter ,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Access,Anthem Blue Access,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Access Choice,Anthem Blue Access Choice,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Blue Preferred,Anthem Blue Preferred,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Pathway,Anthem Pathway,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Alliance,Anthem Alliance,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Anthem Medicare,Anthem Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Cigna,Cigna,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Cigna PPO,Cigna PPO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Cigna Medicare Advantage,Cigna Medicare Advantage,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Essence,Essence,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Healthlink HMO,Healthlink HMO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Healthlink PPO,Healthlink PPO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,HomeState Health Plan,HomeState Health Plan,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Humana Gold,Humana Gold,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Medicaid MO,Medicaid MO,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Medica,Medica,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Tricare,Tricare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,UHC All Payer,UHC All Payer,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,UHC Exchange,UHC Exchange,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,UHC Medicaid,UHC Medicaid,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,UMR CPD,UMR CPD,124.13,,,,,,,per diem,124.13,124.13,"Per diem rate, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,UHC Medicare,UHC Medicare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
LEAD LEVEL                    ,38303180,CDM,301,RC,83655,CPT,,,,Inpatient,,,124.13,124.13,Wellcare,Wellcare,124.13,,,,,,,case rate,124.13,124.13,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Meritain Health PPO CPD,Meritain Health PPO CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna/Commercial Product,Aetna/Commercial Product,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Meritain Health CPD,Meritain Health CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Starmark CPD,Starmark CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Aetna Medicare,Aetna Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Ambetter ,Ambetter ,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Access,Anthem Blue Access,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Access Choice,Anthem Blue Access Choice,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Blue Preferred,Anthem Blue Preferred,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Pathway,Anthem Pathway,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Alliance,Anthem Alliance,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Anthem Medicare,Anthem Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna,Cigna,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna PPO,Cigna PPO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Cigna Medicare Advantage,Cigna Medicare Advantage,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Essence,Essence,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthlink HMO,Healthlink HMO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Healthlink PPO,Healthlink PPO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,HomeState Health Plan,HomeState Health Plan,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Humana Gold,Humana Gold,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Medicaid MO,Medicaid MO,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Medica,Medica,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Tricare,Tricare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC All Payer,UHC All Payer,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Exchange,UHC Exchange,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Medicaid,UHC Medicaid,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UMR CPD,UMR CPD,321.79,,,,,,,per diem,321.79,321.79,"Per diem rate, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,UHC Medicare,UHC Medicare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
METANEPHRINES (FRACTION)      ,38303220,CDM,301,RC,83835,CPT,,,,Inpatient,,,321.79,321.79,Wellcare,Wellcare,321.79,,,,,,,case rate,321.79,321.79,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Meritain Health PPO CPD,Meritain Health PPO CPD,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Aetna/Commercial Product,Aetna/Commercial Product,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Meritain Health CPD,Meritain Health CPD,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Starmark CPD,Starmark CPD,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Aetna Medicare,Aetna Medicare,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Ambetter ,Ambetter ,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Blue Access,Anthem Blue Access,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Blue Access Choice,Anthem Blue Access Choice,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Blue Preferred,Anthem Blue Preferred,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Pathway,Anthem Pathway,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Alliance,Anthem Alliance,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Anthem Medicare,Anthem Medicare,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Cigna,Cigna,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Cigna PPO,Cigna PPO,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Cigna Medicare Advantage,Cigna Medicare Advantage,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Essence,Essence,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Healthlink HMO,Healthlink HMO,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Healthlink PPO,Healthlink PPO,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,HomeState Health Plan,HomeState Health Plan,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Humana Gold,Humana Gold,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Medicaid MO,Medicaid MO,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Medica,Medica,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Tricare,Tricare,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,UHC All Payer,UHC All Payer,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,UHC Exchange,UHC Exchange,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,UHC Medicaid,UHC Medicaid,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,UMR CPD,UMR CPD,415.87,,,,,,,per diem,415.87,415.87,"Per diem rate, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,UHC Medicare,UHC Medicare,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
"VITAMIN D, 1, 25-DIHYDROXY    ",38303310,CDM,301,RC,82652,CPT,,,,Inpatient,,,415.87,415.87,Wellcare,Wellcare,415.87,,,,,,,case rate,415.87,415.87,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Meritain Health PPO CPD,Meritain Health PPO CPD,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Aetna/Commercial Product,Aetna/Commercial Product,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Meritain Health CPD,Meritain Health CPD,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Starmark CPD,Starmark CPD,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Aetna Medicare,Aetna Medicare,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Ambetter ,Ambetter ,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Blue Access,Anthem Blue Access,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Blue Access Choice,Anthem Blue Access Choice,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Blue Preferred,Anthem Blue Preferred,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Pathway,Anthem Pathway,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Alliance,Anthem Alliance,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Anthem Medicare,Anthem Medicare,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Cigna,Cigna,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Cigna PPO,Cigna PPO,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Cigna Medicare Advantage,Cigna Medicare Advantage,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Essence,Essence,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Healthlink HMO,Healthlink HMO,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Healthlink PPO,Healthlink PPO,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,HomeState Health Plan,HomeState Health Plan,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Humana Gold,Humana Gold,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Medicaid MO,Medicaid MO,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Medica,Medica,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Tricare,Tricare,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,UHC All Payer,UHC All Payer,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,UHC Exchange,UHC Exchange,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,UHC Medicaid,UHC Medicaid,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,UMR CPD,UMR CPD,127.31,,,,,,,per diem,127.31,127.31,"Per diem rate, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,UHC Medicare,UHC Medicare,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
OXALATE                       ,38303330,CDM,301,RC,83945,CPT,,,,Inpatient,,,127.31,127.31,Wellcare,Wellcare,127.31,,,,,,,case rate,127.31,127.31,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Meritain Health PPO CPD,Meritain Health PPO CPD,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Aetna/Commercial Product,Aetna/Commercial Product,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Meritain Health CPD,Meritain Health CPD,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Starmark CPD,Starmark CPD,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Aetna Medicare,Aetna Medicare,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Ambetter ,Ambetter ,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Blue Access,Anthem Blue Access,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Blue Access Choice,Anthem Blue Access Choice,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Blue Preferred,Anthem Blue Preferred,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Pathway,Anthem Pathway,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Alliance,Anthem Alliance,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Anthem Medicare,Anthem Medicare,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Cigna,Cigna,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Cigna PPO,Cigna PPO,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Cigna Medicare Advantage,Cigna Medicare Advantage,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Essence,Essence,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Healthlink HMO,Healthlink HMO,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Healthlink PPO,Healthlink PPO,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,HomeState Health Plan,HomeState Health Plan,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Humana Gold,Humana Gold,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Medicaid MO,Medicaid MO,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Medica,Medica,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Tricare,Tricare,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,UHC All Payer,UHC All Payer,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,UHC Exchange,UHC Exchange,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,UHC Medicaid,UHC Medicaid,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,UMR CPD,UMR CPD,300.5,,,,,,,per diem,300.5,300.5,"Per diem rate, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,UHC Medicare,UHC Medicare,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
TESTOSTERONE FREE             ,38303500,CDM,301,RC,84402,CPT,,,,Inpatient,,,300.5,300.5,Wellcare,Wellcare,300.5,,,,,,,case rate,300.5,300.5,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health PPO CPD,Meritain Health PPO CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Aetna/Commercial Product,Aetna/Commercial Product,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Meritain Health CPD,Meritain Health CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Starmark CPD,Starmark CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Aetna Medicare,Aetna Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Ambetter ,Ambetter ,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access,Anthem Blue Access,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Access Choice,Anthem Blue Access Choice,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Blue Preferred,Anthem Blue Preferred,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Pathway,Anthem Pathway,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Alliance,Anthem Alliance,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Anthem Medicare,Anthem Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Cigna,Cigna,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Cigna PPO,Cigna PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Cigna Medicare Advantage,Cigna Medicare Advantage,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Essence,Essence,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Healthlink HMO,Healthlink HMO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Healthlink PPO,Healthlink PPO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,HomeState Health Plan,HomeState Health Plan,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Humana Gold,Humana Gold,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Medicaid MO,Medicaid MO,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Medica,Medica,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Tricare,Tricare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,UHC All Payer,UHC All Payer,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,UHC Exchange,UHC Exchange,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicaid,UHC Medicaid,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,UMR CPD,UMR CPD,180.35,,,,,,,per diem,180.35,180.35,"Per diem rate, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,UHC Medicare,UHC Medicare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
MICROSOMAL ANTIBODIES         ,38303533,CDM,302,RC,86376,CPT,,,,Inpatient,,,180.35,180.35,Wellcare,Wellcare,180.35,,,,,,,case rate,180.35,180.35,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Meritain Health PPO CPD,Meritain Health PPO CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna/Commercial Product,Aetna/Commercial Product,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Meritain Health CPD,Meritain Health CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Starmark CPD,Starmark CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Aetna Medicare,Aetna Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Ambetter ,Ambetter ,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Access,Anthem Blue Access,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Access Choice,Anthem Blue Access Choice,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Blue Preferred,Anthem Blue Preferred,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Pathway,Anthem Pathway,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Alliance,Anthem Alliance,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Anthem Medicare,Anthem Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna,Cigna,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna PPO,Cigna PPO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Cigna Medicare Advantage,Cigna Medicare Advantage,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Essence,Essence,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthlink HMO,Healthlink HMO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Healthlink PPO,Healthlink PPO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,HomeState Health Plan,HomeState Health Plan,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Humana Gold,Humana Gold,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Medicaid MO,Medicaid MO,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Medica,Medica,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Tricare,Tricare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC All Payer,UHC All Payer,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Exchange,UHC Exchange,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Medicaid,UHC Medicaid,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UMR CPD,UMR CPD,46.12,,,,,,,per diem,46.12,46.12,"Per diem rate, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,UHC Medicare,UHC Medicare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE MICRO                   ,38303580,CDM,307,RC,81015,CPT,,,,Inpatient,,,46.12,46.12,Wellcare,Wellcare,46.12,,,,,,,case rate,46.12,46.12,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Meritain Health PPO CPD,Meritain Health PPO CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Aetna/Commercial Product,Aetna/Commercial Product,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Meritain Health CPD,Meritain Health CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Starmark CPD,Starmark CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Aetna Medicare,Aetna Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Ambetter ,Ambetter ,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Access,Anthem Blue Access,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Access Choice,Anthem Blue Access Choice,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Blue Preferred,Anthem Blue Preferred,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Pathway,Anthem Pathway,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Alliance,Anthem Alliance,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Anthem Medicare,Anthem Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Cigna,Cigna,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Cigna PPO,Cigna PPO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Cigna Medicare Advantage,Cigna Medicare Advantage,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Essence,Essence,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Healthlink HMO,Healthlink HMO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Healthlink PPO,Healthlink PPO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,HomeState Health Plan,HomeState Health Plan,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Humana Gold,Humana Gold,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Medicaid MO,Medicaid MO,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Medica,Medica,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Tricare,Tricare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,UHC All Payer,UHC All Payer,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,UHC Exchange,UHC Exchange,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,UHC Medicaid,UHC Medicaid,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,UMR CPD,UMR CPD,151.98,,,,,,,per diem,151.98,151.98,"Per diem rate, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,UHC Medicare,UHC Medicare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
URINE VOLUME MEASUREMENT      ,38303585,CDM,307,RC,81050,CPT,,,,Inpatient,,,151.98,151.98,Wellcare,Wellcare,151.98,,,,,,,case rate,151.98,151.98,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Meritain Health PPO CPD,Meritain Health PPO CPD,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Aetna/Commercial Product,Aetna/Commercial Product,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Meritain Health CPD,Meritain Health CPD,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Starmark CPD,Starmark CPD,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Aetna Medicare,Aetna Medicare,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Ambetter ,Ambetter ,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Blue Access,Anthem Blue Access,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Blue Access Choice,Anthem Blue Access Choice,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Blue Preferred,Anthem Blue Preferred,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Pathway,Anthem Pathway,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Alliance,Anthem Alliance,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Anthem Medicare,Anthem Medicare,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Cigna,Cigna,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Cigna PPO,Cigna PPO,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Cigna Medicare Advantage,Cigna Medicare Advantage,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Essence,Essence,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Healthlink HMO,Healthlink HMO,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Healthlink PPO,Healthlink PPO,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,HomeState Health Plan,HomeState Health Plan,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Humana Gold,Humana Gold,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Medicaid MO,Medicaid MO,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Medica,Medica,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Tricare,Tricare,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,UHC All Payer,UHC All Payer,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,UHC Exchange,UHC Exchange,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,UHC Medicaid,UHC Medicaid,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,UMR CPD,UMR CPD,365.66,,,,,,,per diem,365.66,365.66,"Per diem rate, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,UHC Medicare,UHC Medicare,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
RESPIRATORY VIRUS 12-25 TARG  ,38303652,CDM,306,RC,87633,CPT,,,,Inpatient,,,365.66,365.66,Wellcare,Wellcare,365.66,,,,,,,case rate,365.66,365.66,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Meritain Health PPO CPD,Meritain Health PPO CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Aetna/Commercial Product,Aetna/Commercial Product,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Meritain Health CPD,Meritain Health CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Starmark CPD,Starmark CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Aetna Medicare,Aetna Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Ambetter ,Ambetter ,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Access,Anthem Blue Access,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Access Choice,Anthem Blue Access Choice,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Blue Preferred,Anthem Blue Preferred,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Pathway,Anthem Pathway,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Alliance,Anthem Alliance,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Anthem Medicare,Anthem Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Cigna,Cigna,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Cigna PPO,Cigna PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Cigna Medicare Advantage,Cigna Medicare Advantage,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Essence,Essence,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Healthlink HMO,Healthlink HMO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Healthlink PPO,Healthlink PPO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,HomeState Health Plan,HomeState Health Plan,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Humana Gold,Humana Gold,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Medicaid MO,Medicaid MO,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Medica,Medica,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Tricare,Tricare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,UHC All Payer,UHC All Payer,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,UHC Exchange,UHC Exchange,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,UHC Medicaid,UHC Medicaid,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,UMR CPD,UMR CPD,118.82,,,,,,,per diem,118.82,118.82,"Per diem rate, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,UHC Medicare,UHC Medicare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
SPEC STAIN FOR O & P          ,38303723,CDM,306,RC,87209,CPT,,,,Inpatient,,,118.82,118.82,Wellcare,Wellcare,118.82,,,,,,,case rate,118.82,118.82,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health PPO CPD,Meritain Health PPO CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Aetna/Commercial Product,Aetna/Commercial Product,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Meritain Health CPD,Meritain Health CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Starmark CPD,Starmark CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Aetna Medicare,Aetna Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Ambetter ,Ambetter ,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access,Anthem Blue Access,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Access Choice,Anthem Blue Access Choice,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Blue Preferred,Anthem Blue Preferred,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Pathway,Anthem Pathway,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Alliance,Anthem Alliance,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Anthem Medicare,Anthem Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Cigna,Cigna,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Cigna PPO,Cigna PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Cigna Medicare Advantage,Cigna Medicare Advantage,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Essence,Essence,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Healthlink HMO,Healthlink HMO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Healthlink PPO,Healthlink PPO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,HomeState Health Plan,HomeState Health Plan,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Humana Gold,Humana Gold,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Medicaid MO,Medicaid MO,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Medica,Medica,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Tricare,Tricare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,UHC All Payer,UHC All Payer,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,UHC Exchange,UHC Exchange,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicaid,UHC Medicaid,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,UMR CPD,UMR CPD,102.91,,,,,,,per diem,102.91,102.91,"Per diem rate, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,UHC Medicare,UHC Medicare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
"ALBUMIN, FLUID                ",38303777,CDM,301,RC,82042,CPT,,,,Inpatient,,,102.91,102.91,Wellcare,Wellcare,102.91,,,,,,,case rate,102.91,102.91,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Meritain Health PPO CPD,Meritain Health PPO CPD,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Aetna/Commercial Product,Aetna/Commercial Product,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Meritain Health CPD,Meritain Health CPD,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Starmark CPD,Starmark CPD,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Aetna Medicare,Aetna Medicare,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Ambetter ,Ambetter ,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Blue Access,Anthem Blue Access,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Blue Access Choice,Anthem Blue Access Choice,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Blue Preferred,Anthem Blue Preferred,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Pathway,Anthem Pathway,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Alliance,Anthem Alliance,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Anthem Medicare,Anthem Medicare,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Cigna,Cigna,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Cigna PPO,Cigna PPO,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Cigna Medicare Advantage,Cigna Medicare Advantage,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Essence,Essence,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Healthlink HMO,Healthlink HMO,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Healthlink PPO,Healthlink PPO,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,HomeState Health Plan,HomeState Health Plan,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Humana Gold,Humana Gold,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Medicaid MO,Medicaid MO,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Medica,Medica,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Tricare,Tricare,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,UHC All Payer,UHC All Payer,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,UHC Exchange,UHC Exchange,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,UHC Medicaid,UHC Medicaid,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,UMR CPD,UMR CPD,211.12,,,,,,,per diem,211.12,211.12,"Per diem rate, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,UHC Medicare,UHC Medicare,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
PROTEIN-ELECTROPHOR-OTH FLUID ,38303865,CDM,300,RC,84166,CPT,,,,Inpatient,,,211.12,211.12,Wellcare,Wellcare,211.12,,,,,,,case rate,211.12,211.12,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Meritain Health PPO CPD,Meritain Health PPO CPD,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Aetna/Commercial Product,Aetna/Commercial Product,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Meritain Health CPD,Meritain Health CPD,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Starmark CPD,Starmark CPD,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Aetna Medicare,Aetna Medicare,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Ambetter ,Ambetter ,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Blue Access,Anthem Blue Access,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Blue Access Choice,Anthem Blue Access Choice,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Blue Preferred,Anthem Blue Preferred,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Pathway,Anthem Pathway,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Alliance,Anthem Alliance,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Anthem Medicare,Anthem Medicare,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Cigna,Cigna,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Cigna PPO,Cigna PPO,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Cigna Medicare Advantage,Cigna Medicare Advantage,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Essence,Essence,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Healthlink HMO,Healthlink HMO,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Healthlink PPO,Healthlink PPO,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,HomeState Health Plan,HomeState Health Plan,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Humana Gold,Humana Gold,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Medicaid MO,Medicaid MO,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Medica,Medica,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Tricare,Tricare,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,UHC All Payer,UHC All Payer,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,UHC Exchange,UHC Exchange,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,UHC Medicaid,UHC Medicaid,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,UMR CPD,UMR CPD,275.83,,,,,,,per diem,275.83,275.83,"Per diem rate, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,UHC Medicare,UHC Medicare,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
IMMUNOFIX ELECTROPHOR-FLUID   ,38303875,CDM,300,RC,86335,CPT,,,,Inpatient,,,275.83,275.83,Wellcare,Wellcare,275.83,,,,,,,case rate,275.83,275.83,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Meritain Health PPO CPD,Meritain Health PPO CPD,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Aetna/Commercial Product,Aetna/Commercial Product,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Meritain Health CPD,Meritain Health CPD,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Starmark CPD,Starmark CPD,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Aetna Medicare,Aetna Medicare,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Ambetter ,Ambetter ,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Blue Access,Anthem Blue Access,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Blue Access Choice,Anthem Blue Access Choice,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Blue Preferred,Anthem Blue Preferred,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Pathway,Anthem Pathway,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Alliance,Anthem Alliance,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Anthem Medicare,Anthem Medicare,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Cigna,Cigna,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Cigna PPO,Cigna PPO,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Cigna Medicare Advantage,Cigna Medicare Advantage,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Essence,Essence,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Healthlink HMO,Healthlink HMO,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Healthlink PPO,Healthlink PPO,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,HomeState Health Plan,HomeState Health Plan,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Humana Gold,Humana Gold,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Medicaid MO,Medicaid MO,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Medica,Medica,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Tricare,Tricare,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,UHC All Payer,UHC All Payer,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,UHC Exchange,UHC Exchange,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,UHC Medicaid,UHC Medicaid,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,UMR CPD,UMR CPD,261.62,,,,,,,per diem,261.62,261.62,"Per diem rate, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,UHC Medicare,UHC Medicare,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
COLUMN CHROMATOG/MASS SPECT QT,38303885,CDM,301,RC,82542,CPT,,,,Inpatient,,,261.62,261.62,Wellcare,Wellcare,261.62,,,,,,,case rate,261.62,261.62,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Meritain Health PPO CPD,Meritain Health PPO CPD,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Aetna/Commercial Product,Aetna/Commercial Product,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Meritain Health CPD,Meritain Health CPD,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Starmark CPD,Starmark CPD,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Aetna Medicare,Aetna Medicare,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Ambetter ,Ambetter ,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Blue Access,Anthem Blue Access,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Blue Access Choice,Anthem Blue Access Choice,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Blue Preferred,Anthem Blue Preferred,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Pathway,Anthem Pathway,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Alliance,Anthem Alliance,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Anthem Medicare,Anthem Medicare,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Cigna,Cigna,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Cigna PPO,Cigna PPO,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Cigna Medicare Advantage,Cigna Medicare Advantage,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Essence,Essence,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Healthlink HMO,Healthlink HMO,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Healthlink PPO,Healthlink PPO,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,HomeState Health Plan,HomeState Health Plan,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Humana Gold,Humana Gold,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Medicaid MO,Medicaid MO,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Medica,Medica,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Tricare,Tricare,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,UHC All Payer,UHC All Payer,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,UHC Exchange,UHC Exchange,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,UHC Medicaid,UHC Medicaid,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,UMR CPD,UMR CPD,191.58,,,,,,,per diem,191.58,191.58,"Per diem rate, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,UHC Medicare,UHC Medicare,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
EPSTEIN BARR ANTIBODY VCA     ,38303890,CDM,302,RC,86665,CPT,,,,Inpatient,,,191.58,191.58,Wellcare,Wellcare,191.58,,,,,,,case rate,191.58,191.58,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Meritain Health PPO CPD,Meritain Health PPO CPD,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Aetna/Commercial Product,Aetna/Commercial Product,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Meritain Health CPD,Meritain Health CPD,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Starmark CPD,Starmark CPD,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Aetna Medicare,Aetna Medicare,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Ambetter ,Ambetter ,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Blue Access,Anthem Blue Access,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Blue Access Choice,Anthem Blue Access Choice,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Blue Preferred,Anthem Blue Preferred,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Pathway,Anthem Pathway,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Alliance,Anthem Alliance,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Anthem Medicare,Anthem Medicare,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Cigna,Cigna,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Cigna PPO,Cigna PPO,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Cigna Medicare Advantage,Cigna Medicare Advantage,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Essence,Essence,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Healthlink HMO,Healthlink HMO,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Healthlink PPO,Healthlink PPO,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,HomeState Health Plan,HomeState Health Plan,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Humana Gold,Humana Gold,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Medicaid MO,Medicaid MO,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Medica,Medica,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Tricare,Tricare,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,UHC All Payer,UHC All Payer,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,UHC Exchange,UHC Exchange,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,UHC Medicaid,UHC Medicaid,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,UMR CPD,UMR CPD,521.96,,,,,,,per diem,521.96,521.96,"Per diem rate, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,UHC Medicare,UHC Medicare,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CYTOMEGALOVIRUS DNA QUANT     ,38303895,CDM,306,RC,87497,CPT,,,,Inpatient,,,521.96,521.96,Wellcare,Wellcare,521.96,,,,,,,case rate,521.96,521.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Meritain Health PPO CPD,Meritain Health PPO CPD,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Aetna/Commercial Product,Aetna/Commercial Product,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Meritain Health CPD,Meritain Health CPD,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Starmark CPD,Starmark CPD,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Aetna Medicare,Aetna Medicare,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Ambetter ,Ambetter ,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Blue Access,Anthem Blue Access,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Blue Access Choice,Anthem Blue Access Choice,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Blue Preferred,Anthem Blue Preferred,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Pathway,Anthem Pathway,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Alliance,Anthem Alliance,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Anthem Medicare,Anthem Medicare,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Cigna,Cigna,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Cigna PPO,Cigna PPO,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Cigna Medicare Advantage,Cigna Medicare Advantage,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Essence,Essence,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Healthlink HMO,Healthlink HMO,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Healthlink PPO,Healthlink PPO,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,HomeState Health Plan,HomeState Health Plan,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Humana Gold,Humana Gold,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Medicaid MO,Medicaid MO,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Medica,Medica,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Tricare,Tricare,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,UHC All Payer,UHC All Payer,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,UHC Exchange,UHC Exchange,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,UHC Medicaid,UHC Medicaid,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,UMR CPD,UMR CPD,55.96,,,,,,,per diem,55.96,55.96,"Per diem rate, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,UHC Medicare,UHC Medicare,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
CROSSMATCH INCUBATION         ,38303910,CDM,302,RC,86921,CPT,,,,Inpatient,,,55.96,55.96,Wellcare,Wellcare,55.96,,,,,,,case rate,55.96,55.96,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health PPO CPD,Meritain Health PPO CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Aetna/Commercial Product,Aetna/Commercial Product,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Meritain Health CPD,Meritain Health CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Starmark CPD,Starmark CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Aetna Medicare,Aetna Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Ambetter ,Ambetter ,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access,Anthem Blue Access,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Access Choice,Anthem Blue Access Choice,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Blue Preferred,Anthem Blue Preferred,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Pathway,Anthem Pathway,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Alliance,Anthem Alliance,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Anthem Medicare,Anthem Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Cigna,Cigna,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Cigna PPO,Cigna PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Cigna Medicare Advantage,Cigna Medicare Advantage,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Essence,Essence,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Healthlink HMO,Healthlink HMO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Healthlink PPO,Healthlink PPO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,HomeState Health Plan,HomeState Health Plan,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Humana Gold,Humana Gold,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Medicaid MO,Medicaid MO,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Medica,Medica,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Tricare,Tricare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,UHC All Payer,UHC All Payer,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,UHC Exchange,UHC Exchange,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicaid,UHC Medicaid,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,UMR CPD,UMR CPD,176.11,,,,,,,per diem,176.11,176.11,"Per diem rate, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,UHC Medicare,UHC Medicare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN E LEVEL               ,38305066,CDM,301,RC,84446,CPT,,,,Inpatient,,,176.11,176.11,Wellcare,Wellcare,176.11,,,,,,,case rate,176.11,176.11,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Meritain Health PPO CPD,Meritain Health PPO CPD,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Aetna/Commercial Product,Aetna/Commercial Product,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Meritain Health CPD,Meritain Health CPD,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Starmark CPD,Starmark CPD,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Aetna Medicare,Aetna Medicare,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Ambetter ,Ambetter ,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Blue Access,Anthem Blue Access,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Blue Access Choice,Anthem Blue Access Choice,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Blue Preferred,Anthem Blue Preferred,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Pathway,Anthem Pathway,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Alliance,Anthem Alliance,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Anthem Medicare,Anthem Medicare,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Cigna,Cigna,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Cigna PPO,Cigna PPO,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Cigna Medicare Advantage,Cigna Medicare Advantage,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Essence,Essence,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Healthlink HMO,Healthlink HMO,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Healthlink PPO,Healthlink PPO,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,HomeState Health Plan,HomeState Health Plan,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Humana Gold,Humana Gold,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Medicaid MO,Medicaid MO,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Medica,Medica,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Tricare,Tricare,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,UHC All Payer,UHC All Payer,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,UHC Exchange,UHC Exchange,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,UHC Medicaid,UHC Medicaid,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,UMR CPD,UMR CPD,160.99,,,,,,,per diem,160.99,160.99,"Per diem rate, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,UHC Medicare,UHC Medicare,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN B6 LEVEL              ,38305067,CDM,301,RC,84207,CPT,,,,Inpatient,,,160.99,160.99,Wellcare,Wellcare,160.99,,,,,,,case rate,160.99,160.99,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Meritain Health PPO CPD,Meritain Health PPO CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Aetna/Commercial Product,Aetna/Commercial Product,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Meritain Health CPD,Meritain Health CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Starmark CPD,Starmark CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Aetna Medicare,Aetna Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Ambetter ,Ambetter ,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Access,Anthem Blue Access,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Access Choice,Anthem Blue Access Choice,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Blue Preferred,Anthem Blue Preferred,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Pathway,Anthem Pathway,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Alliance,Anthem Alliance,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Anthem Medicare,Anthem Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Cigna,Cigna,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Cigna PPO,Cigna PPO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Cigna Medicare Advantage,Cigna Medicare Advantage,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Essence,Essence,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Healthlink HMO,Healthlink HMO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Healthlink PPO,Healthlink PPO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,HomeState Health Plan,HomeState Health Plan,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Humana Gold,Humana Gold,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Medicaid MO,Medicaid MO,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Medica,Medica,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Tricare,Tricare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,UHC All Payer,UHC All Payer,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,UHC Exchange,UHC Exchange,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,UHC Medicaid,UHC Medicaid,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,UMR CPD,UMR CPD,183.54,,,,,,,per diem,183.54,183.54,"Per diem rate, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,UHC Medicare,UHC Medicare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
VITAMIN A LEVEL               ,38305069,CDM,301,RC,84590,CPT,,,,Inpatient,,,183.54,183.54,Wellcare,Wellcare,183.54,,,,,,,case rate,183.54,183.54,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Meritain Health PPO CPD,Meritain Health PPO CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Aetna/Commercial Product,Aetna/Commercial Product,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Meritain Health CPD,Meritain Health CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Starmark CPD,Starmark CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Aetna Medicare,Aetna Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Ambetter ,Ambetter ,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Access,Anthem Blue Access,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Access Choice,Anthem Blue Access Choice,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Blue Preferred,Anthem Blue Preferred,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Pathway,Anthem Pathway,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Alliance,Anthem Alliance,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Anthem Medicare,Anthem Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Cigna,Cigna,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Cigna PPO,Cigna PPO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Cigna Medicare Advantage,Cigna Medicare Advantage,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Essence,Essence,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Healthlink HMO,Healthlink HMO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Healthlink PPO,Healthlink PPO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,HomeState Health Plan,HomeState Health Plan,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Humana Gold,Humana Gold,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Medicaid MO,Medicaid MO,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Medica,Medica,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Tricare,Tricare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,UHC All Payer,UHC All Payer,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,UHC Exchange,UHC Exchange,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,UHC Medicaid,UHC Medicaid,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,UMR CPD,UMR CPD,248.25,,,,,,,per diem,248.25,248.25,"Per diem rate, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,UHC Medicare,UHC Medicare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
PLATELET FUNCTION ANALYSIS    ,38305569,CDM,305,RC,85576,CPT,,,,Inpatient,,,248.25,248.25,Wellcare,Wellcare,248.25,,,,,,,case rate,248.25,248.25,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Meritain Health PPO CPD,Meritain Health PPO CPD,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Aetna/Commercial Product,Aetna/Commercial Product,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Meritain Health CPD,Meritain Health CPD,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Starmark CPD,Starmark CPD,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Aetna Medicare,Aetna Medicare,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Ambetter ,Ambetter ,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Blue Access,Anthem Blue Access,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Blue Access Choice,Anthem Blue Access Choice,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Blue Preferred,Anthem Blue Preferred,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Pathway,Anthem Pathway,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Alliance,Anthem Alliance,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Anthem Medicare,Anthem Medicare,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Cigna,Cigna,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Cigna PPO,Cigna PPO,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Cigna Medicare Advantage,Cigna Medicare Advantage,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Essence,Essence,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Healthlink HMO,Healthlink HMO,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Healthlink PPO,Healthlink PPO,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,HomeState Health Plan,HomeState Health Plan,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Humana Gold,Humana Gold,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Medicaid MO,Medicaid MO,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Medica,Medica,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Tricare,Tricare,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,UHC All Payer,UHC All Payer,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,UHC Exchange,UHC Exchange,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,UHC Medicaid,UHC Medicaid,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,UMR CPD,UMR CPD,222.79,,,,,,,per diem,222.79,222.79,"Per diem rate, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,UHC Medicare,UHC Medicare,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
HIV-1&2 AB SCREEN             ,38305601,CDM,302,RC,86703,CPT,,,,Inpatient,,,222.79,222.79,Wellcare,Wellcare,222.79,,,,,,,case rate,222.79,222.79,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health PPO CPD,Meritain Health PPO CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Aetna/Commercial Product,Aetna/Commercial Product,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Meritain Health CPD,Meritain Health CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Starmark CPD,Starmark CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Aetna Medicare,Aetna Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Ambetter ,Ambetter ,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access,Anthem Blue Access,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Access Choice,Anthem Blue Access Choice,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Blue Preferred,Anthem Blue Preferred,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Pathway,Anthem Pathway,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Alliance,Anthem Alliance,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Anthem Medicare,Anthem Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Cigna,Cigna,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Cigna PPO,Cigna PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Cigna Medicare Advantage,Cigna Medicare Advantage,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Essence,Essence,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Healthlink HMO,Healthlink HMO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Healthlink PPO,Healthlink PPO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,HomeState Health Plan,HomeState Health Plan,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Humana Gold,Humana Gold,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Medicaid MO,Medicaid MO,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Medica,Medica,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Tricare,Tricare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,UHC All Payer,UHC All Payer,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,UHC Exchange,UHC Exchange,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicaid,UHC Medicaid,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,UMR CPD,UMR CPD,95.48,,,,,,,per diem,95.48,95.48,"Per diem rate, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,UHC Medicare,UHC Medicare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
AHG COMPLEMENT                ,38305612,CDM,302,RC,86880,CPT,,,,Inpatient,,,95.48,95.48,Wellcare,Wellcare,95.48,,,,,,,case rate,95.48,95.48,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health PPO CPD,Meritain Health PPO CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Aetna/Commercial Product,Aetna/Commercial Product,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Meritain Health CPD,Meritain Health CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Starmark CPD,Starmark CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Aetna Medicare,Aetna Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Ambetter ,Ambetter ,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access,Anthem Blue Access,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Access Choice,Anthem Blue Access Choice,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Blue Preferred,Anthem Blue Preferred,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Pathway,Anthem Pathway,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Alliance,Anthem Alliance,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Anthem Medicare,Anthem Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Cigna,Cigna,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Cigna PPO,Cigna PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Cigna Medicare Advantage,Cigna Medicare Advantage,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Essence,Essence,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Healthlink HMO,Healthlink HMO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Healthlink PPO,Healthlink PPO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,HomeState Health Plan,HomeState Health Plan,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Humana Gold,Humana Gold,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Medicaid MO,Medicaid MO,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Medica,Medica,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Tricare,Tricare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,UHC All Payer,UHC All Payer,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,UHC Exchange,UHC Exchange,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicaid,UHC Medicaid,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,UMR CPD,UMR CPD,132.61,,,,,,,per diem,132.61,132.61,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,UHC Medicare,UHC Medicare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE - DIRECT         ,38305615,CDM,302,RC,86905,CPT,,,,Inpatient,,,132.61,132.61,Wellcare,Wellcare,132.61,,,,,,,case rate,132.61,132.61,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Meritain Health PPO CPD,Meritain Health PPO CPD,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Aetna/Commercial Product,Aetna/Commercial Product,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Meritain Health CPD,Meritain Health CPD,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Starmark CPD,Starmark CPD,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Aetna Medicare,Aetna Medicare,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Ambetter ,Ambetter ,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Blue Access,Anthem Blue Access,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Blue Access Choice,Anthem Blue Access Choice,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Blue Preferred,Anthem Blue Preferred,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Pathway,Anthem Pathway,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Alliance,Anthem Alliance,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Anthem Medicare,Anthem Medicare,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Cigna,Cigna,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Cigna PPO,Cigna PPO,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Cigna Medicare Advantage,Cigna Medicare Advantage,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Essence,Essence,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Healthlink HMO,Healthlink HMO,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Healthlink PPO,Healthlink PPO,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,HomeState Health Plan,HomeState Health Plan,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Humana Gold,Humana Gold,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Medicaid MO,Medicaid MO,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Medica,Medica,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Tricare,Tricare,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,UHC All Payer,UHC All Payer,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,UHC Exchange,UHC Exchange,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,UHC Medicaid,UHC Medicaid,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,UMR CPD,UMR CPD,124.39,,,,,,,per diem,124.39,124.39,"Per diem rate, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,UHC Medicare,UHC Medicare,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
AHG CROSSMATCH COMPATIBLE     ,38305619,CDM,302,RC,86922,CPT,,,,Inpatient,,,124.39,124.39,Wellcare,Wellcare,124.39,,,,,,,case rate,124.39,124.39,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Meritain Health PPO CPD,Meritain Health PPO CPD,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Aetna/Commercial Product,Aetna/Commercial Product,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Meritain Health CPD,Meritain Health CPD,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Starmark CPD,Starmark CPD,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Aetna Medicare,Aetna Medicare,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Ambetter ,Ambetter ,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Blue Access,Anthem Blue Access,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Blue Access Choice,Anthem Blue Access Choice,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Blue Preferred,Anthem Blue Preferred,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Pathway,Anthem Pathway,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Alliance,Anthem Alliance,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Anthem Medicare,Anthem Medicare,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Cigna,Cigna,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Cigna PPO,Cigna PPO,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Cigna Medicare Advantage,Cigna Medicare Advantage,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Essence,Essence,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Healthlink HMO,Healthlink HMO,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Healthlink PPO,Healthlink PPO,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,HomeState Health Plan,HomeState Health Plan,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Humana Gold,Humana Gold,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Medicaid MO,Medicaid MO,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Medica,Medica,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Tricare,Tricare,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,UHC All Payer,UHC All Payer,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,UHC Exchange,UHC Exchange,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,UHC Medicaid,UHC Medicaid,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,UMR CPD,UMR CPD,49.86,,,,,,,per diem,49.86,49.86,"Per diem rate, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,UHC Medicare,UHC Medicare,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
PARASITE EXAM                 ,38305622,CDM,306,RC,87015,CPT,,,,Inpatient,,,49.86,49.86,Wellcare,Wellcare,49.86,,,,,,,case rate,49.86,49.86,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health PPO CPD,Meritain Health PPO CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Aetna/Commercial Product,Aetna/Commercial Product,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Meritain Health CPD,Meritain Health CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Starmark CPD,Starmark CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Aetna Medicare,Aetna Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Ambetter ,Ambetter ,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access,Anthem Blue Access,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Access Choice,Anthem Blue Access Choice,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Blue Preferred,Anthem Blue Preferred,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Pathway,Anthem Pathway,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Alliance,Anthem Alliance,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Anthem Medicare,Anthem Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Cigna,Cigna,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Cigna PPO,Cigna PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Cigna Medicare Advantage,Cigna Medicare Advantage,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Essence,Essence,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Healthlink HMO,Healthlink HMO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Healthlink PPO,Healthlink PPO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,HomeState Health Plan,HomeState Health Plan,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Humana Gold,Humana Gold,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Medicaid MO,Medicaid MO,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Medica,Medica,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Tricare,Tricare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,UHC All Payer,UHC All Payer,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,UHC Exchange,UHC Exchange,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicaid,UHC Medicaid,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,UMR CPD,UMR CPD,137.92,,,,,,,per diem,137.92,137.92,"Per diem rate, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,UHC Medicare,UHC Medicare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
ERM CONFIRM                   ,38305629,CDM,306,RC,87184,CPT,,,,Inpatient,,,137.92,137.92,Wellcare,Wellcare,137.92,,,,,,,case rate,137.92,137.92,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Meritain Health PPO CPD,Meritain Health PPO CPD,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Aetna/Commercial Product,Aetna/Commercial Product,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Meritain Health CPD,Meritain Health CPD,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Starmark CPD,Starmark CPD,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Aetna Medicare,Aetna Medicare,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Ambetter ,Ambetter ,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Blue Access,Anthem Blue Access,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Blue Access Choice,Anthem Blue Access Choice,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Blue Preferred,Anthem Blue Preferred,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Pathway,Anthem Pathway,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Alliance,Anthem Alliance,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Anthem Medicare,Anthem Medicare,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Cigna,Cigna,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Cigna PPO,Cigna PPO,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Cigna Medicare Advantage,Cigna Medicare Advantage,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Essence,Essence,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Healthlink HMO,Healthlink HMO,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Healthlink PPO,Healthlink PPO,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,HomeState Health Plan,HomeState Health Plan,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Humana Gold,Humana Gold,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Medicaid MO,Medicaid MO,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Medica,Medica,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Tricare,Tricare,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,UHC All Payer,UHC All Payer,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,UHC Exchange,UHC Exchange,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,UHC Medicaid,UHC Medicaid,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,UMR CPD,UMR CPD,224.54,,,,,,,per diem,224.54,224.54,"Per diem rate, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,UHC Medicare,UHC Medicare,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
CARDIOLIPIN ANTIBODY          ,38306700,CDM,302,RC,86147,CPT,,,,Inpatient,,,224.54,224.54,Wellcare,Wellcare,224.54,,,,,,,case rate,224.54,224.54,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Meritain Health PPO CPD,Meritain Health PPO CPD,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Aetna/Commercial Product,Aetna/Commercial Product,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Meritain Health CPD,Meritain Health CPD,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Starmark CPD,Starmark CPD,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Aetna Medicare,Aetna Medicare,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Ambetter ,Ambetter ,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Blue Access,Anthem Blue Access,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Blue Access Choice,Anthem Blue Access Choice,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Blue Preferred,Anthem Blue Preferred,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Pathway,Anthem Pathway,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Alliance,Anthem Alliance,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Anthem Medicare,Anthem Medicare,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Cigna,Cigna,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Cigna PPO,Cigna PPO,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Cigna Medicare Advantage,Cigna Medicare Advantage,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Essence,Essence,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Healthlink HMO,Healthlink HMO,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Healthlink PPO,Healthlink PPO,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,HomeState Health Plan,HomeState Health Plan,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Humana Gold,Humana Gold,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Medicaid MO,Medicaid MO,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Medica,Medica,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Tricare,Tricare,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,UHC All Payer,UHC All Payer,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,UHC Exchange,UHC Exchange,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,UHC Medicaid,UHC Medicaid,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,UMR CPD,UMR CPD,204.49,,,,,,,per diem,204.49,204.49,"Per diem rate, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,UHC Medicare,UHC Medicare,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HOMOCYSTINE                   ,38306757,CDM,301,RC,83090,CPT,,,,Inpatient,,,204.49,204.49,Wellcare,Wellcare,204.49,,,,,,,case rate,204.49,204.49,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Meritain Health PPO CPD,Meritain Health PPO CPD,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Aetna/Commercial Product,Aetna/Commercial Product,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Meritain Health CPD,Meritain Health CPD,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Starmark CPD,Starmark CPD,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Aetna Medicare,Aetna Medicare,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Ambetter ,Ambetter ,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Blue Access,Anthem Blue Access,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Blue Access Choice,Anthem Blue Access Choice,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Blue Preferred,Anthem Blue Preferred,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Pathway,Anthem Pathway,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Alliance,Anthem Alliance,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Anthem Medicare,Anthem Medicare,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Cigna,Cigna,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Cigna PPO,Cigna PPO,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Cigna Medicare Advantage,Cigna Medicare Advantage,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Essence,Essence,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Healthlink HMO,Healthlink HMO,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Healthlink PPO,Healthlink PPO,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,HomeState Health Plan,HomeState Health Plan,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Humana Gold,Humana Gold,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Medicaid MO,Medicaid MO,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Medica,Medica,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Tricare,Tricare,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,UHC All Payer,UHC All Payer,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,UHC Exchange,UHC Exchange,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,UHC Medicaid,UHC Medicaid,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,UMR CPD,UMR CPD,663.86,,,,,,,per diem,663.86,663.86,"Per diem rate, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,UHC Medicare,UHC Medicare,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
HEPATITIS B VIRUS QUANT       ,38306802,CDM,306,RC,87517,CPT,,,,Inpatient,,,663.86,663.86,Wellcare,Wellcare,663.86,,,,,,,case rate,663.86,663.86,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Meritain Health PPO CPD,Meritain Health PPO CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna/Commercial Product,Aetna/Commercial Product,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Meritain Health CPD,Meritain Health CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Starmark CPD,Starmark CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Aetna Medicare,Aetna Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Ambetter ,Ambetter ,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Access,Anthem Blue Access,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Access Choice,Anthem Blue Access Choice,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Blue Preferred,Anthem Blue Preferred,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Pathway,Anthem Pathway,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Alliance,Anthem Alliance,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Anthem Medicare,Anthem Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna,Cigna,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna PPO,Cigna PPO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Cigna Medicare Advantage,Cigna Medicare Advantage,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Essence,Essence,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthlink HMO,Healthlink HMO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Healthlink PPO,Healthlink PPO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,HomeState Health Plan,HomeState Health Plan,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Humana Gold,Humana Gold,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Medicaid MO,Medicaid MO,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Medica,Medica,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Tricare,Tricare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC All Payer,UHC All Payer,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Exchange,UHC Exchange,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Medicaid,UHC Medicaid,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UMR CPD,UMR CPD,42.44,,,,,,,per diem,42.44,42.44,"Per diem rate, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,UHC Medicare,UHC Medicare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
"ENZYME DETECTION, PER ENZYME  ",38307001,CDM,306,RC,87185,CPT,,,,Inpatient,,,42.44,42.44,Wellcare,Wellcare,42.44,,,,,,,case rate,42.44,42.44,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Meritain Health PPO CPD,Meritain Health PPO CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Aetna/Commercial Product,Aetna/Commercial Product,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Meritain Health CPD,Meritain Health CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Starmark CPD,Starmark CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Aetna Medicare,Aetna Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Ambetter ,Ambetter ,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Blue Access,Anthem Blue Access,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Blue Access Choice,Anthem Blue Access Choice,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Blue Preferred,Anthem Blue Preferred,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Pathway,Anthem Pathway,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Alliance,Anthem Alliance,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Anthem Medicare,Anthem Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Cigna,Cigna,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Cigna PPO,Cigna PPO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Cigna Medicare Advantage,Cigna Medicare Advantage,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Essence,Essence,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Healthlink HMO,Healthlink HMO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Healthlink PPO,Healthlink PPO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,HomeState Health Plan,HomeState Health Plan,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Humana Gold,Humana Gold,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Medicaid MO,Medicaid MO,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Medica,Medica,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Tricare,Tricare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,UHC All Payer,UHC All Payer,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,UHC Exchange,UHC Exchange,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,UHC Medicaid,UHC Medicaid,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,UMR CPD,UMR CPD,8.49,,,,,,,per diem,8.49,8.49,"Per diem rate, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,UHC Medicare,UHC Medicare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
HEELSTICK                     ,38307002,CDM,300,RC,36416,CPT,,,,Inpatient,,,8.49,8.49,Wellcare,Wellcare,8.49,,,,,,,case rate,8.49,8.49,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Meritain Health PPO CPD,Meritain Health PPO CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna/Commercial Product,Aetna/Commercial Product,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Meritain Health CPD,Meritain Health CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Starmark CPD,Starmark CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Aetna Medicare,Aetna Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Ambetter ,Ambetter ,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Access,Anthem Blue Access,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Access Choice,Anthem Blue Access Choice,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Blue Preferred,Anthem Blue Preferred,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Pathway,Anthem Pathway,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Alliance,Anthem Alliance,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Anthem Medicare,Anthem Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna,Cigna,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna PPO,Cigna PPO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Cigna Medicare Advantage,Cigna Medicare Advantage,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Essence,Essence,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthlink HMO,Healthlink HMO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Healthlink PPO,Healthlink PPO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,HomeState Health Plan,HomeState Health Plan,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Humana Gold,Humana Gold,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Medicaid MO,Medicaid MO,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Medica,Medica,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Tricare,Tricare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC All Payer,UHC All Payer,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Exchange,UHC Exchange,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Medicaid,UHC Medicaid,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UMR CPD,UMR CPD,177.56,,,,,,,per diem,177.56,177.56,"Per diem rate, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,UHC Medicare,UHC Medicare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
CULTURE FUNGUS BLOOD          ,38307014,CDM,306,RC,87103,CPT,,,,Inpatient,,,177.56,177.56,Wellcare,Wellcare,177.56,,,,,,,case rate,177.56,177.56,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Meritain Health PPO CPD,Meritain Health PPO CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Aetna/Commercial Product,Aetna/Commercial Product,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Meritain Health CPD,Meritain Health CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Starmark CPD,Starmark CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Aetna Medicare,Aetna Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Ambetter ,Ambetter ,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Blue Access,Anthem Blue Access,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Blue Access Choice,Anthem Blue Access Choice,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Blue Preferred,Anthem Blue Preferred,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Pathway,Anthem Pathway,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Alliance,Anthem Alliance,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Anthem Medicare,Anthem Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Cigna,Cigna,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Cigna PPO,Cigna PPO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Cigna Medicare Advantage,Cigna Medicare Advantage,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Essence,Essence,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Healthlink HMO,Healthlink HMO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Healthlink PPO,Healthlink PPO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,HomeState Health Plan,HomeState Health Plan,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Humana Gold,Humana Gold,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Medicaid MO,Medicaid MO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Medica,Medica,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Tricare,Tricare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,UHC All Payer,UHC All Payer,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,UHC Exchange,UHC Exchange,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,UHC Medicaid,UHC Medicaid,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,UMR CPD,UMR CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,UHC Medicare,UHC Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PROTEIN S FUNCTIONAL          ,38307016,CDM,305,RC,85306,CPT,,,,Inpatient,,,827.5,827.5,Wellcare,Wellcare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Meritain Health PPO CPD,Meritain Health PPO CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Aetna/Commercial Product,Aetna/Commercial Product,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Meritain Health CPD,Meritain Health CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Starmark CPD,Starmark CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Aetna Medicare,Aetna Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Ambetter ,Ambetter ,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Access,Anthem Blue Access,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Access Choice,Anthem Blue Access Choice,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Blue Preferred,Anthem Blue Preferred,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Pathway,Anthem Pathway,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Alliance,Anthem Alliance,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Anthem Medicare,Anthem Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Cigna,Cigna,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Cigna PPO,Cigna PPO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Cigna Medicare Advantage,Cigna Medicare Advantage,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Essence,Essence,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Healthlink HMO,Healthlink HMO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Healthlink PPO,Healthlink PPO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,HomeState Health Plan,HomeState Health Plan,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Humana Gold,Humana Gold,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Medicaid MO,Medicaid MO,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Medica,Medica,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Tricare,Tricare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,UHC All Payer,UHC All Payer,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,UHC Exchange,UHC Exchange,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,UHC Medicaid,UHC Medicaid,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,UMR CPD,UMR CPD,173.04,,,,,,,per diem,173.04,173.04,"Per diem rate, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,UHC Medicare,UHC Medicare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
SUSCEPT STUDY AGAR(ESTRIP)    ,38307020,CDM,306,RC,87181,CPT,,,,Inpatient,,,173.04,173.04,Wellcare,Wellcare,173.04,,,,,,,case rate,173.04,173.04,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Meritain Health PPO CPD,Meritain Health PPO CPD,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Aetna/Commercial Product,Aetna/Commercial Product,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Meritain Health CPD,Meritain Health CPD,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Starmark CPD,Starmark CPD,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Aetna Medicare,Aetna Medicare,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Ambetter ,Ambetter ,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Blue Access,Anthem Blue Access,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Blue Access Choice,Anthem Blue Access Choice,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Blue Preferred,Anthem Blue Preferred,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Pathway,Anthem Pathway,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Alliance,Anthem Alliance,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Anthem Medicare,Anthem Medicare,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Cigna,Cigna,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Cigna PPO,Cigna PPO,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Cigna Medicare Advantage,Cigna Medicare Advantage,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Essence,Essence,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Healthlink HMO,Healthlink HMO,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Healthlink PPO,Healthlink PPO,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,HomeState Health Plan,HomeState Health Plan,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Humana Gold,Humana Gold,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Medicaid MO,Medicaid MO,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Medica,Medica,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Tricare,Tricare,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,UHC All Payer,UHC All Payer,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,UHC Exchange,UHC Exchange,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,UHC Medicaid,UHC Medicaid,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,UMR CPD,UMR CPD,225.57,,,,,,,per diem,225.57,225.57,"Per diem rate, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,UHC Medicare,UHC Medicare,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
PROINSULIN                    ,38343613,CDM,301,RC,84206,CPT,,,,Inpatient,,,225.57,225.57,Wellcare,Wellcare,225.57,,,,,,,case rate,225.57,225.57,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Meritain Health PPO CPD,Meritain Health PPO CPD,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Aetna/Commercial Product,Aetna/Commercial Product,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Meritain Health CPD,Meritain Health CPD,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Starmark CPD,Starmark CPD,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Aetna Medicare,Aetna Medicare,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Ambetter ,Ambetter ,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Blue Access,Anthem Blue Access,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Blue Access Choice,Anthem Blue Access Choice,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Blue Preferred,Anthem Blue Preferred,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Pathway,Anthem Pathway,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Alliance,Anthem Alliance,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Anthem Medicare,Anthem Medicare,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Cigna,Cigna,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Cigna PPO,Cigna PPO,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Cigna Medicare Advantage,Cigna Medicare Advantage,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Essence,Essence,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Healthlink HMO,Healthlink HMO,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Healthlink PPO,Healthlink PPO,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,HomeState Health Plan,HomeState Health Plan,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Humana Gold,Humana Gold,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Medicaid MO,Medicaid MO,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Medica,Medica,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Tricare,Tricare,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,UHC All Payer,UHC All Payer,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,UHC Exchange,UHC Exchange,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,UHC Medicaid,UHC Medicaid,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,UMR CPD,UMR CPD,135.8,,,,,,,per diem,135.8,135.8,"Per diem rate, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,UHC Medicare,UHC Medicare,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
"RHEUMATOID FACTOR, QUANT      ",38343614,CDM,302,RC,86431,CPT,,,,Inpatient,,,135.8,135.8,Wellcare,Wellcare,135.8,,,,,,,case rate,135.8,135.8,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Meritain Health PPO CPD,Meritain Health PPO CPD,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Aetna/Commercial Product,Aetna/Commercial Product,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Meritain Health CPD,Meritain Health CPD,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Starmark CPD,Starmark CPD,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Aetna Medicare,Aetna Medicare,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Ambetter ,Ambetter ,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Blue Access,Anthem Blue Access,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Blue Access Choice,Anthem Blue Access Choice,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Blue Preferred,Anthem Blue Preferred,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Pathway,Anthem Pathway,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Alliance,Anthem Alliance,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Anthem Medicare,Anthem Medicare,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Cigna,Cigna,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Cigna PPO,Cigna PPO,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Cigna Medicare Advantage,Cigna Medicare Advantage,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Essence,Essence,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Healthlink HMO,Healthlink HMO,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Healthlink PPO,Healthlink PPO,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,HomeState Health Plan,HomeState Health Plan,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Humana Gold,Humana Gold,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Medicaid MO,Medicaid MO,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Medica,Medica,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Tricare,Tricare,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,UHC All Payer,UHC All Payer,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,UHC Exchange,UHC Exchange,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,UHC Medicaid,UHC Medicaid,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,UMR CPD,UMR CPD,312.97,,,,,,,per diem,312.97,312.97,"Per diem rate, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,UHC Medicare,UHC Medicare,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
CLOTTING FACTOR X             ,38343620,CDM,305,RC,85260,CPT,,,,Inpatient,,,312.97,312.97,Wellcare,Wellcare,312.97,,,,,,,case rate,312.97,312.97,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Meritain Health PPO CPD,Meritain Health PPO CPD,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Aetna/Commercial Product,Aetna/Commercial Product,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Meritain Health CPD,Meritain Health CPD,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Starmark CPD,Starmark CPD,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Aetna Medicare,Aetna Medicare,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Ambetter ,Ambetter ,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Blue Access,Anthem Blue Access,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Blue Access Choice,Anthem Blue Access Choice,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Blue Preferred,Anthem Blue Preferred,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Pathway,Anthem Pathway,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Alliance,Anthem Alliance,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Anthem Medicare,Anthem Medicare,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Cigna,Cigna,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Cigna PPO,Cigna PPO,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Cigna Medicare Advantage,Cigna Medicare Advantage,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Essence,Essence,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Healthlink HMO,Healthlink HMO,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Healthlink PPO,Healthlink PPO,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,HomeState Health Plan,HomeState Health Plan,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Humana Gold,Humana Gold,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Medicaid MO,Medicaid MO,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Medica,Medica,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Tricare,Tricare,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,UHC All Payer,UHC All Payer,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,UHC Exchange,UHC Exchange,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,UHC Medicaid,UHC Medicaid,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,UMR CPD,UMR CPD,590.92,,,,,,,per diem,590.92,590.92,"Per diem rate, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,UHC Medicare,UHC Medicare,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPATITIS C VIRUS AB RNA      ,38343624,CDM,306,RC,87522,CPT,,,,Inpatient,,,590.92,590.92,Wellcare,Wellcare,590.92,,,,,,,case rate,590.92,590.92,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Meritain Health PPO CPD,Meritain Health PPO CPD,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Aetna/Commercial Product,Aetna/Commercial Product,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Meritain Health CPD,Meritain Health CPD,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Starmark CPD,Starmark CPD,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Aetna Medicare,Aetna Medicare,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Ambetter ,Ambetter ,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Blue Access,Anthem Blue Access,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Blue Access Choice,Anthem Blue Access Choice,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Blue Preferred,Anthem Blue Preferred,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Pathway,Anthem Pathway,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Alliance,Anthem Alliance,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Anthem Medicare,Anthem Medicare,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Cigna,Cigna,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Cigna PPO,Cigna PPO,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Cigna Medicare Advantage,Cigna Medicare Advantage,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Essence,Essence,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Healthlink HMO,Healthlink HMO,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Healthlink PPO,Healthlink PPO,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,HomeState Health Plan,HomeState Health Plan,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Humana Gold,Humana Gold,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Medicaid MO,Medicaid MO,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Medica,Medica,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Tricare,Tricare,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,UHC All Payer,UHC All Payer,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,UHC Exchange,UHC Exchange,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,UHC Medicaid,UHC Medicaid,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,UMR CPD,UMR CPD,175.84,,,,,,,per diem,175.84,175.84,"Per diem rate, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,UHC Medicare,UHC Medicare,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
HEPB CORE AB IGM (HBCIGM)     ,38393920,CDM,302,RC,86705,CPT,,,,Inpatient,,,175.84,175.84,Wellcare,Wellcare,175.84,,,,,,,case rate,175.84,175.84,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Meritain Health PPO CPD,Meritain Health PPO CPD,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Aetna/Commercial Product,Aetna/Commercial Product,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Meritain Health CPD,Meritain Health CPD,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Starmark CPD,Starmark CPD,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Aetna Medicare,Aetna Medicare,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Ambetter ,Ambetter ,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Blue Access,Anthem Blue Access,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Blue Access Choice,Anthem Blue Access Choice,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Blue Preferred,Anthem Blue Preferred,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Pathway,Anthem Pathway,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Alliance,Anthem Alliance,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Anthem Medicare,Anthem Medicare,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Cigna,Cigna,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Cigna PPO,Cigna PPO,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Cigna Medicare Advantage,Cigna Medicare Advantage,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Essence,Essence,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Healthlink HMO,Healthlink HMO,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Healthlink PPO,Healthlink PPO,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,HomeState Health Plan,HomeState Health Plan,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Humana Gold,Humana Gold,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Medicaid MO,Medicaid MO,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Medica,Medica,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Tricare,Tricare,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,UHC All Payer,UHC All Payer,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,UHC Exchange,UHC Exchange,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,UHC Medicaid,UHC Medicaid,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,UMR CPD,UMR CPD,248.49,,,,,,,per diem,248.49,248.49,"Per diem rate, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,UHC Medicare,UHC Medicare,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
OXYGEN SATURATION CHECK       ,38399305,CDM,301,RC,82805,CPT,,,,Inpatient,,,248.49,248.49,Wellcare,Wellcare,248.49,,,,,,,case rate,248.49,248.49,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health PPO CPD,Meritain Health PPO CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Aetna/Commercial Product,Aetna/Commercial Product,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health CPD,Meritain Health CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Starmark CPD,Starmark CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Aetna Medicare,Aetna Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Ambetter ,Ambetter ,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access,Anthem Blue Access,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access Choice,Anthem Blue Access Choice,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Preferred,Anthem Blue Preferred,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Pathway,Anthem Pathway,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Alliance,Anthem Alliance,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Anthem Medicare,Anthem Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Cigna,Cigna,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Cigna PPO,Cigna PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Cigna Medicare Advantage,Cigna Medicare Advantage,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Essence,Essence,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Healthlink HMO,Healthlink HMO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Healthlink PPO,Healthlink PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,HomeState Health Plan,HomeState Health Plan,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Humana Gold,Humana Gold,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Medicaid MO,Medicaid MO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Medica,Medica,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Tricare,Tricare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,UHC All Payer,UHC All Payer,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,UHC Exchange,UHC Exchange,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicaid,UHC Medicaid,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,UMR CPD,UMR CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicare,UHC Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DTT CELL TREATMENT            ,38399317,CDM,302,RC,86970,CPT,,,,Inpatient,,,177.17,177.17,Wellcare,Wellcare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
T CELL TOTAL COUNT            ,38399318,CDM,302,RC,86359,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Meritain Health PPO CPD,Meritain Health PPO CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Aetna/Commercial Product,Aetna/Commercial Product,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Meritain Health CPD,Meritain Health CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Starmark CPD,Starmark CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Aetna Medicare,Aetna Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Ambetter ,Ambetter ,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Access,Anthem Blue Access,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Access Choice,Anthem Blue Access Choice,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Blue Preferred,Anthem Blue Preferred,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Pathway,Anthem Pathway,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Alliance,Anthem Alliance,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Anthem Medicare,Anthem Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Cigna,Cigna,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Cigna PPO,Cigna PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Cigna Medicare Advantage,Cigna Medicare Advantage,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Essence,Essence,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Healthlink HMO,Healthlink HMO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Healthlink PPO,Healthlink PPO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,HomeState Health Plan,HomeState Health Plan,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Humana Gold,Humana Gold,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Medicaid MO,Medicaid MO,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Medica,Medica,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Tricare,Tricare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,UHC All Payer,UHC All Payer,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,UHC Exchange,UHC Exchange,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,UHC Medicaid,UHC Medicaid,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,UMR CPD,UMR CPD,196.27,,,,,,,per diem,196.27,196.27,"Per diem rate, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,UHC Medicare,UHC Medicare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
INF AGT NAP AMP PRB TECH MRSA ,38399324,CDM,306,RC,87641,CPT,,,,Inpatient,,,196.27,196.27,Wellcare,Wellcare,196.27,,,,,,,case rate,196.27,196.27,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Meritain Health PPO CPD,Meritain Health PPO CPD,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Aetna/Commercial Product,Aetna/Commercial Product,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Meritain Health CPD,Meritain Health CPD,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Starmark CPD,Starmark CPD,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Aetna Medicare,Aetna Medicare,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Ambetter ,Ambetter ,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Blue Access,Anthem Blue Access,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Blue Access Choice,Anthem Blue Access Choice,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Blue Preferred,Anthem Blue Preferred,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Pathway,Anthem Pathway,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Alliance,Anthem Alliance,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Anthem Medicare,Anthem Medicare,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Cigna,Cigna,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Cigna PPO,Cigna PPO,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Cigna Medicare Advantage,Cigna Medicare Advantage,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Essence,Essence,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Healthlink HMO,Healthlink HMO,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Healthlink PPO,Healthlink PPO,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,HomeState Health Plan,HomeState Health Plan,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Humana Gold,Humana Gold,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Medicaid MO,Medicaid MO,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Medica,Medica,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Tricare,Tricare,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,UHC All Payer,UHC All Payer,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,UHC Exchange,UHC Exchange,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,UHC Medicaid,UHC Medicaid,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,UMR CPD,UMR CPD,133.89,,,,,,,per diem,133.89,133.89,"Per diem rate, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,UHC Medicare,UHC Medicare,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
"HERPES SIMP VIRUS,PCR,        ",38399341,CDM,306,RC,87529,CPT,,,,Inpatient,,,133.89,133.89,Wellcare,Wellcare,133.89,,,,,,,case rate,133.89,133.89,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Meritain Health PPO CPD,Meritain Health PPO CPD,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Aetna/Commercial Product,Aetna/Commercial Product,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Meritain Health CPD,Meritain Health CPD,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Starmark CPD,Starmark CPD,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Aetna Medicare,Aetna Medicare,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Ambetter ,Ambetter ,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Blue Access,Anthem Blue Access,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Blue Access Choice,Anthem Blue Access Choice,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Blue Preferred,Anthem Blue Preferred,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Pathway,Anthem Pathway,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Alliance,Anthem Alliance,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Anthem Medicare,Anthem Medicare,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Cigna,Cigna,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Cigna PPO,Cigna PPO,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Cigna Medicare Advantage,Cigna Medicare Advantage,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Essence,Essence,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Healthlink HMO,Healthlink HMO,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Healthlink PPO,Healthlink PPO,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,HomeState Health Plan,HomeState Health Plan,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Humana Gold,Humana Gold,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Medicaid MO,Medicaid MO,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Medica,Medica,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Tricare,Tricare,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,UHC All Payer,UHC All Payer,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,UHC Exchange,UHC Exchange,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,UHC Medicaid,UHC Medicaid,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,UMR CPD,UMR CPD,317.21,,,,,,,per diem,317.21,317.21,"Per diem rate, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,UHC Medicare,UHC Medicare,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
ASSAY VITAMIN K               ,38399352,CDM,301,RC,84597,CPT,,,,Inpatient,,,317.21,317.21,Wellcare,Wellcare,317.21,,,,,,,case rate,317.21,317.21,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Meritain Health PPO CPD,Meritain Health PPO CPD,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Aetna/Commercial Product,Aetna/Commercial Product,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Meritain Health CPD,Meritain Health CPD,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Starmark CPD,Starmark CPD,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Aetna Medicare,Aetna Medicare,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Ambetter ,Ambetter ,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Blue Access,Anthem Blue Access,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Blue Access Choice,Anthem Blue Access Choice,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Blue Preferred,Anthem Blue Preferred,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Pathway,Anthem Pathway,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Alliance,Anthem Alliance,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Anthem Medicare,Anthem Medicare,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Cigna,Cigna,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Cigna PPO,Cigna PPO,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Cigna Medicare Advantage,Cigna Medicare Advantage,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Essence,Essence,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Healthlink HMO,Healthlink HMO,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Healthlink PPO,Healthlink PPO,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,HomeState Health Plan,HomeState Health Plan,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Humana Gold,Humana Gold,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Medicaid MO,Medicaid MO,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Medica,Medica,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Tricare,Tricare,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,UHC All Payer,UHC All Payer,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,UHC Exchange,UHC Exchange,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,UHC Medicaid,UHC Medicaid,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,UMR CPD,UMR CPD,145.43,,,,,,,per diem,145.43,145.43,"Per diem rate, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,UHC Medicare,UHC Medicare,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
CYCLIC CITRULLINATD PEPTIDE AB,38399354,CDM,302,RC,86200,CPT,,,,Inpatient,,,145.43,145.43,Wellcare,Wellcare,145.43,,,,,,,case rate,145.43,145.43,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Meritain Health PPO CPD,Meritain Health PPO CPD,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Aetna/Commercial Product,Aetna/Commercial Product,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Meritain Health CPD,Meritain Health CPD,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Starmark CPD,Starmark CPD,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Aetna Medicare,Aetna Medicare,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Ambetter ,Ambetter ,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Blue Access,Anthem Blue Access,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Blue Access Choice,Anthem Blue Access Choice,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Blue Preferred,Anthem Blue Preferred,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Pathway,Anthem Pathway,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Alliance,Anthem Alliance,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Anthem Medicare,Anthem Medicare,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Cigna,Cigna,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Cigna PPO,Cigna PPO,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Cigna Medicare Advantage,Cigna Medicare Advantage,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Essence,Essence,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Healthlink HMO,Healthlink HMO,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Healthlink PPO,Healthlink PPO,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,HomeState Health Plan,HomeState Health Plan,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Humana Gold,Humana Gold,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Medicaid MO,Medicaid MO,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Medica,Medica,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Tricare,Tricare,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,UHC All Payer,UHC All Payer,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,UHC Exchange,UHC Exchange,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,UHC Medicaid,UHC Medicaid,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,UMR CPD,UMR CPD,45.89,,,,,,,per diem,45.89,45.89,"Per diem rate, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,UHC Medicare,UHC Medicare,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
OCCULT BLOOD 1-3 DETERM       ,38399356,CDM,301,RC,82272,CPT,,,,Inpatient,,,45.89,45.89,Wellcare,Wellcare,45.89,,,,,,,case rate,45.89,45.89,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Meritain Health PPO CPD,Meritain Health PPO CPD,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Aetna/Commercial Product,Aetna/Commercial Product,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Meritain Health CPD,Meritain Health CPD,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Starmark CPD,Starmark CPD,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Aetna Medicare,Aetna Medicare,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Ambetter ,Ambetter ,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Blue Access,Anthem Blue Access,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Blue Access Choice,Anthem Blue Access Choice,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Blue Preferred,Anthem Blue Preferred,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Pathway,Anthem Pathway,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Alliance,Anthem Alliance,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Anthem Medicare,Anthem Medicare,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Cigna,Cigna,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Cigna PPO,Cigna PPO,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Cigna Medicare Advantage,Cigna Medicare Advantage,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Essence,Essence,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Healthlink HMO,Healthlink HMO,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Healthlink PPO,Healthlink PPO,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,HomeState Health Plan,HomeState Health Plan,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Humana Gold,Humana Gold,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Medicaid MO,Medicaid MO,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Medica,Medica,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Tricare,Tricare,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,UHC All Payer,UHC All Payer,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,UHC Exchange,UHC Exchange,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,UHC Medicaid,UHC Medicaid,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,UMR CPD,UMR CPD,1450.24,,,,,,,per diem,1450.24,1450.24,"Per diem rate, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,UHC Medicare,UHC Medicare,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
CVC LINE PLACEMENT (PIC)      ,38500505,CDM,761,RC,36569,CPT,,,,Inpatient,,,1450.24,1450.24,Wellcare,Wellcare,1450.24,,,,,,,case rate,1450.24,1450.24,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Meritain Health PPO CPD,Meritain Health PPO CPD,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Aetna/Commercial Product,Aetna/Commercial Product,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Meritain Health CPD,Meritain Health CPD,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Starmark CPD,Starmark CPD,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Aetna Medicare,Aetna Medicare,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Ambetter ,Ambetter ,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Blue Access,Anthem Blue Access,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Blue Access Choice,Anthem Blue Access Choice,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Blue Preferred,Anthem Blue Preferred,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Pathway,Anthem Pathway,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Alliance,Anthem Alliance,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Anthem Medicare,Anthem Medicare,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Cigna,Cigna,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Cigna PPO,Cigna PPO,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Cigna Medicare Advantage,Cigna Medicare Advantage,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Essence,Essence,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Healthlink HMO,Healthlink HMO,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Healthlink PPO,Healthlink PPO,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,HomeState Health Plan,HomeState Health Plan,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Humana Gold,Humana Gold,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Medicaid MO,Medicaid MO,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Medica,Medica,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Tricare,Tricare,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,UHC All Payer,UHC All Payer,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,UHC Exchange,UHC Exchange,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,UHC Medicaid,UHC Medicaid,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,UMR CPD,UMR CPD,2066.28,,,,,,,per diem,2066.28,2066.28,"Per diem rate, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,UHC Medicare,UHC Medicare,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
THORACENTESIS W/IMG GD        ,38501221,CDM,761,RC,32555,CPT,,,,Inpatient,,,2066.28,2066.28,Wellcare,Wellcare,2066.28,,,,,,,case rate,2066.28,2066.28,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Meritain Health PPO CPD,Meritain Health PPO CPD,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Aetna/Commercial Product,Aetna/Commercial Product,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Meritain Health CPD,Meritain Health CPD,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Starmark CPD,Starmark CPD,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Aetna Medicare,Aetna Medicare,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Ambetter ,Ambetter ,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Blue Access,Anthem Blue Access,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Blue Access Choice,Anthem Blue Access Choice,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Blue Preferred,Anthem Blue Preferred,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Pathway,Anthem Pathway,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Alliance,Anthem Alliance,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Anthem Medicare,Anthem Medicare,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Cigna,Cigna,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Cigna PPO,Cigna PPO,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Cigna Medicare Advantage,Cigna Medicare Advantage,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Essence,Essence,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Healthlink HMO,Healthlink HMO,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Healthlink PPO,Healthlink PPO,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,HomeState Health Plan,HomeState Health Plan,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Humana Gold,Humana Gold,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Medicaid MO,Medicaid MO,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Medica,Medica,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Tricare,Tricare,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,UHC All Payer,UHC All Payer,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,UHC Exchange,UHC Exchange,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,UHC Medicaid,UHC Medicaid,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,UMR CPD,UMR CPD,1259.69,,,,,,,per diem,1259.69,1259.69,"Per diem rate, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,UHC Medicare,UHC Medicare,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
BRONCHOSCOPY DIAGNOSTIC       ,38504019,CDM,361,RC,31622,CPT,,,,Inpatient,,,1259.69,1259.69,Wellcare,Wellcare,1259.69,,,,,,,case rate,1259.69,1259.69,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Meritain Health PPO CPD,Meritain Health PPO CPD,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Aetna/Commercial Product,Aetna/Commercial Product,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Meritain Health CPD,Meritain Health CPD,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Starmark CPD,Starmark CPD,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Aetna Medicare,Aetna Medicare,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Ambetter ,Ambetter ,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Blue Access,Anthem Blue Access,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Blue Access Choice,Anthem Blue Access Choice,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Blue Preferred,Anthem Blue Preferred,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Pathway,Anthem Pathway,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Alliance,Anthem Alliance,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Anthem Medicare,Anthem Medicare,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Cigna,Cigna,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Cigna PPO,Cigna PPO,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Cigna Medicare Advantage,Cigna Medicare Advantage,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Essence,Essence,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Healthlink HMO,Healthlink HMO,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Healthlink PPO,Healthlink PPO,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,HomeState Health Plan,HomeState Health Plan,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Humana Gold,Humana Gold,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Medicaid MO,Medicaid MO,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Medica,Medica,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Tricare,Tricare,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,UHC All Payer,UHC All Payer,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,UHC Exchange,UHC Exchange,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,UHC Medicaid,UHC Medicaid,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,UMR CPD,UMR CPD,954.81,,,,,,,per diem,954.81,954.81,"Per diem rate, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,UHC Medicare,UHC Medicare,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT PICC LINE              ,38504029,CDM,761,RC,36569,CPT,,,,Inpatient,,,954.81,954.81,Wellcare,Wellcare,954.81,,,,,,,case rate,954.81,954.81,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Meritain Health PPO CPD,Meritain Health PPO CPD,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Aetna/Commercial Product,Aetna/Commercial Product,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Meritain Health CPD,Meritain Health CPD,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Starmark CPD,Starmark CPD,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Aetna Medicare,Aetna Medicare,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Ambetter ,Ambetter ,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Blue Access,Anthem Blue Access,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Blue Access Choice,Anthem Blue Access Choice,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Blue Preferred,Anthem Blue Preferred,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Pathway,Anthem Pathway,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Alliance,Anthem Alliance,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Anthem Medicare,Anthem Medicare,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Cigna,Cigna,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Cigna PPO,Cigna PPO,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Cigna Medicare Advantage,Cigna Medicare Advantage,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Essence,Essence,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Healthlink HMO,Healthlink HMO,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Healthlink PPO,Healthlink PPO,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,HomeState Health Plan,HomeState Health Plan,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Humana Gold,Humana Gold,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Medicaid MO,Medicaid MO,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Medica,Medica,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Tricare,Tricare,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,UHC All Payer,UHC All Payer,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,UHC Exchange,UHC Exchange,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,UHC Medicaid,UHC Medicaid,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,UMR CPD,UMR CPD,5590.06,,,,,,,per diem,5590.06,5590.06,"Per diem rate, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,UHC Medicare,UHC Medicare,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
INSERT VENA CAVA FILTER       ,38504035,CDM,761,RC,37191,CPT,,,,Inpatient,,,5590.06,5590.06,Wellcare,Wellcare,5590.06,,,,,,,case rate,5590.06,5590.06,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Meritain Health PPO CPD,Meritain Health PPO CPD,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Aetna/Commercial Product,Aetna/Commercial Product,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Meritain Health CPD,Meritain Health CPD,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Starmark CPD,Starmark CPD,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Aetna Medicare,Aetna Medicare,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Ambetter ,Ambetter ,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Blue Access,Anthem Blue Access,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Blue Access Choice,Anthem Blue Access Choice,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Blue Preferred,Anthem Blue Preferred,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Pathway,Anthem Pathway,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Alliance,Anthem Alliance,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Anthem Medicare,Anthem Medicare,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Cigna,Cigna,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Cigna PPO,Cigna PPO,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Cigna Medicare Advantage,Cigna Medicare Advantage,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Essence,Essence,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Healthlink HMO,Healthlink HMO,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Healthlink PPO,Healthlink PPO,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,HomeState Health Plan,HomeState Health Plan,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Humana Gold,Humana Gold,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Medicaid MO,Medicaid MO,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Medica,Medica,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Tricare,Tricare,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,UHC All Payer,UHC All Payer,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,UHC Exchange,UHC Exchange,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,UHC Medicaid,UHC Medicaid,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,UMR CPD,UMR CPD,4523.91,,,,,,,per diem,4523.91,4523.91,"Per diem rate, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,UHC Medicare,UHC Medicare,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
EGD W/PEG TUBE PLCMT          ,38504061,CDM,750,RC,43246,CPT,,,,Inpatient,,,4523.91,4523.91,Wellcare,Wellcare,4523.91,,,,,,,case rate,4523.91,4523.91,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Meritain Health PPO CPD,Meritain Health PPO CPD,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Aetna/Commercial Product,Aetna/Commercial Product,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Meritain Health CPD,Meritain Health CPD,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Starmark CPD,Starmark CPD,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Aetna Medicare,Aetna Medicare,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Ambetter ,Ambetter ,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Blue Access,Anthem Blue Access,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Blue Access Choice,Anthem Blue Access Choice,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Blue Preferred,Anthem Blue Preferred,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Pathway,Anthem Pathway,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Alliance,Anthem Alliance,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Anthem Medicare,Anthem Medicare,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Cigna,Cigna,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Cigna PPO,Cigna PPO,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Cigna Medicare Advantage,Cigna Medicare Advantage,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Essence,Essence,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Healthlink HMO,Healthlink HMO,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Healthlink PPO,Healthlink PPO,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,HomeState Health Plan,HomeState Health Plan,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Humana Gold,Humana Gold,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Medicaid MO,Medicaid MO,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Medica,Medica,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Tricare,Tricare,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,UHC All Payer,UHC All Payer,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,UHC Exchange,UHC Exchange,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,UHC Medicaid,UHC Medicaid,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,UMR CPD,UMR CPD,376.98,,,,,,,per diem,376.98,376.98,"Per diem rate, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,UHC Medicare,UHC Medicare,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG PLCMT REQ PHYS/FLUOR      ,38504063,CDM,750,RC,43752,CPT,,,,Inpatient,,,376.98,376.98,Wellcare,Wellcare,376.98,,,,,,,case rate,376.98,376.98,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Meritain Health PPO CPD,Meritain Health PPO CPD,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Aetna/Commercial Product,Aetna/Commercial Product,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Meritain Health CPD,Meritain Health CPD,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Starmark CPD,Starmark CPD,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Aetna Medicare,Aetna Medicare,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Ambetter ,Ambetter ,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Blue Access,Anthem Blue Access,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Blue Access Choice,Anthem Blue Access Choice,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Blue Preferred,Anthem Blue Preferred,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Pathway,Anthem Pathway,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Alliance,Anthem Alliance,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Anthem Medicare,Anthem Medicare,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Cigna,Cigna,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Cigna PPO,Cigna PPO,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Cigna Medicare Advantage,Cigna Medicare Advantage,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Essence,Essence,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Healthlink HMO,Healthlink HMO,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Healthlink PPO,Healthlink PPO,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,HomeState Health Plan,HomeState Health Plan,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Humana Gold,Humana Gold,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Medicaid MO,Medicaid MO,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Medica,Medica,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Tricare,Tricare,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,UHC All Payer,UHC All Payer,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,UHC Exchange,UHC Exchange,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,UHC Medicaid,UHC Medicaid,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,UMR CPD,UMR CPD,1448.44,,,,,,,per diem,1448.44,1448.44,"Per diem rate, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,UHC Medicare,UHC Medicare,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PEG CHANGE                    ,38504067,CDM,361,RC,43762,CPT,,,,Inpatient,,,1448.44,1448.44,Wellcare,Wellcare,1448.44,,,,,,,case rate,1448.44,1448.44,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Meritain Health PPO CPD,Meritain Health PPO CPD,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Aetna/Commercial Product,Aetna/Commercial Product,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Meritain Health CPD,Meritain Health CPD,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Starmark CPD,Starmark CPD,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Aetna Medicare,Aetna Medicare,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Ambetter ,Ambetter ,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Blue Access,Anthem Blue Access,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Blue Access Choice,Anthem Blue Access Choice,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Blue Preferred,Anthem Blue Preferred,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Pathway,Anthem Pathway,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Alliance,Anthem Alliance,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Anthem Medicare,Anthem Medicare,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Cigna,Cigna,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Cigna PPO,Cigna PPO,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Cigna Medicare Advantage,Cigna Medicare Advantage,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Essence,Essence,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Healthlink HMO,Healthlink HMO,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Healthlink PPO,Healthlink PPO,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,HomeState Health Plan,HomeState Health Plan,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Humana Gold,Humana Gold,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Medicaid MO,Medicaid MO,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Medica,Medica,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Tricare,Tricare,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,UHC All Payer,UHC All Payer,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,UHC Exchange,UHC Exchange,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,UHC Medicaid,UHC Medicaid,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,UMR CPD,UMR CPD,3139.55,,,,,,,per diem,3139.55,3139.55,"Per diem rate, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,UHC Medicare,UHC Medicare,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
PLACE J/G TUBE W/FLUORO       ,38504085,CDM,761,RC,49440,CPT,,,,Inpatient,,,3139.55,3139.55,Wellcare,Wellcare,3139.55,,,,,,,case rate,3139.55,3139.55,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Meritain Health PPO CPD,Meritain Health PPO CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Aetna/Commercial Product,Aetna/Commercial Product,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Meritain Health CPD,Meritain Health CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Starmark CPD,Starmark CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Aetna Medicare,Aetna Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Ambetter ,Ambetter ,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Blue Access,Anthem Blue Access,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Blue Access Choice,Anthem Blue Access Choice,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Blue Preferred,Anthem Blue Preferred,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Pathway,Anthem Pathway,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Alliance,Anthem Alliance,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Anthem Medicare,Anthem Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Cigna,Cigna,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Cigna PPO,Cigna PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Cigna Medicare Advantage,Cigna Medicare Advantage,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Essence,Essence,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Healthlink HMO,Healthlink HMO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Healthlink PPO,Healthlink PPO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,HomeState Health Plan,HomeState Health Plan,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Humana Gold,Humana Gold,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Medicaid MO,Medicaid MO,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Medica,Medica,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Tricare,Tricare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,UHC All Payer,UHC All Payer,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,UHC Exchange,UHC Exchange,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,UHC Medicaid,UHC Medicaid,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,UMR CPD,UMR CPD,342.62,,,,,,,per diem,342.62,342.62,"Per diem rate, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,UHC Medicare,UHC Medicare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
HEMO/COMPOSITE                ,38504086,CDM,761,RC,,,,,,Inpatient,,,342.62,342.62,Wellcare,Wellcare,342.62,,,,,,,case rate,342.62,342.62,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Meritain Health PPO CPD,Meritain Health PPO CPD,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Aetna/Commercial Product,Aetna/Commercial Product,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Meritain Health CPD,Meritain Health CPD,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Starmark CPD,Starmark CPD,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Aetna Medicare,Aetna Medicare,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Ambetter ,Ambetter ,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Blue Access,Anthem Blue Access,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Blue Access Choice,Anthem Blue Access Choice,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Blue Preferred,Anthem Blue Preferred,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Pathway,Anthem Pathway,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Alliance,Anthem Alliance,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Anthem Medicare,Anthem Medicare,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Cigna,Cigna,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Cigna PPO,Cigna PPO,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Cigna Medicare Advantage,Cigna Medicare Advantage,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Essence,Essence,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Healthlink HMO,Healthlink HMO,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Healthlink PPO,Healthlink PPO,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,HomeState Health Plan,HomeState Health Plan,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Humana Gold,Humana Gold,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Medicaid MO,Medicaid MO,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Medica,Medica,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Tricare,Tricare,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,UHC All Payer,UHC All Payer,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,UHC Exchange,UHC Exchange,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,UHC Medicaid,UHC Medicaid,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,UMR CPD,UMR CPD,708.08,,,,,,,per diem,708.08,708.08,"Per diem rate, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,UHC Medicare,UHC Medicare,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
FRACTURE CARE INCL CAST -     ,38504087,CDM,761,RC,,,,,,Inpatient,,,708.08,708.08,Wellcare,Wellcare,708.08,,,,,,,case rate,708.08,708.08,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Meritain Health PPO CPD,Meritain Health PPO CPD,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Aetna/Commercial Product,Aetna/Commercial Product,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Meritain Health CPD,Meritain Health CPD,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Starmark CPD,Starmark CPD,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Aetna Medicare,Aetna Medicare,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Ambetter ,Ambetter ,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Blue Access,Anthem Blue Access,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Blue Access Choice,Anthem Blue Access Choice,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Blue Preferred,Anthem Blue Preferred,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Pathway,Anthem Pathway,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Alliance,Anthem Alliance,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Anthem Medicare,Anthem Medicare,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Cigna,Cigna,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Cigna PPO,Cigna PPO,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Cigna Medicare Advantage,Cigna Medicare Advantage,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Essence,Essence,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Healthlink HMO,Healthlink HMO,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Healthlink PPO,Healthlink PPO,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,HomeState Health Plan,HomeState Health Plan,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Humana Gold,Humana Gold,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Medicaid MO,Medicaid MO,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Medica,Medica,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Tricare,Tricare,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,UHC All Payer,UHC All Payer,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,UHC Exchange,UHC Exchange,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,UHC Medicaid,UHC Medicaid,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,UMR CPD,UMR CPD,202.46,,,,,,,per diem,202.46,202.46,"Per diem rate, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,UHC Medicare,UHC Medicare,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
ESTABLISHED PAT - LEVEL 2     ,38504088,CDM,761,RC,,,,,,Inpatient,,,202.46,202.46,Wellcare,Wellcare,202.46,,,,,,,case rate,202.46,202.46,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Meritain Health PPO CPD,Meritain Health PPO CPD,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Aetna/Commercial Product,Aetna/Commercial Product,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Meritain Health CPD,Meritain Health CPD,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Starmark CPD,Starmark CPD,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Aetna Medicare,Aetna Medicare,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Ambetter ,Ambetter ,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Blue Access,Anthem Blue Access,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Blue Access Choice,Anthem Blue Access Choice,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Blue Preferred,Anthem Blue Preferred,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Pathway,Anthem Pathway,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Alliance,Anthem Alliance,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Anthem Medicare,Anthem Medicare,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Cigna,Cigna,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Cigna PPO,Cigna PPO,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Cigna Medicare Advantage,Cigna Medicare Advantage,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Essence,Essence,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Healthlink HMO,Healthlink HMO,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Healthlink PPO,Healthlink PPO,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,HomeState Health Plan,HomeState Health Plan,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Humana Gold,Humana Gold,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Medicaid MO,Medicaid MO,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Medica,Medica,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Tricare,Tricare,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,UHC All Payer,UHC All Payer,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,UHC Exchange,UHC Exchange,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,UHC Medicaid,UHC Medicaid,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,UMR CPD,UMR CPD,889.78,,,,,,,per diem,889.78,889.78,"Per diem rate, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,UHC Medicare,UHC Medicare,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBR SUBS TISS 1ST 20         ,38504089,CDM,761,RC,,,,,,Inpatient,,,889.78,889.78,Wellcare,Wellcare,889.78,,,,,,,case rate,889.78,889.78,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Meritain Health PPO CPD,Meritain Health PPO CPD,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Aetna/Commercial Product,Aetna/Commercial Product,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Meritain Health CPD,Meritain Health CPD,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Starmark CPD,Starmark CPD,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Aetna Medicare,Aetna Medicare,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Ambetter ,Ambetter ,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Blue Access,Anthem Blue Access,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Blue Access Choice,Anthem Blue Access Choice,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Blue Preferred,Anthem Blue Preferred,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Pathway,Anthem Pathway,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Alliance,Anthem Alliance,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Anthem Medicare,Anthem Medicare,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Cigna,Cigna,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Cigna PPO,Cigna PPO,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Cigna Medicare Advantage,Cigna Medicare Advantage,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Essence,Essence,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Healthlink HMO,Healthlink HMO,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Healthlink PPO,Healthlink PPO,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,HomeState Health Plan,HomeState Health Plan,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Humana Gold,Humana Gold,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Medicaid MO,Medicaid MO,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Medica,Medica,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Tricare,Tricare,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,UHC All Payer,UHC All Payer,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,UHC Exchange,UHC Exchange,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,UHC Medicaid,UHC Medicaid,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,UMR CPD,UMR CPD,806.72,,,,,,,per diem,806.72,806.72,"Per diem rate, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,UHC Medicare,UHC Medicare,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
DEBRID SUBC TISS/ADD 20 S     ,38504090,CDM,761,RC,,,,,,Inpatient,,,806.72,806.72,Wellcare,Wellcare,806.72,,,,,,,case rate,806.72,806.72,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Meritain Health PPO CPD,Meritain Health PPO CPD,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Aetna/Commercial Product,Aetna/Commercial Product,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Meritain Health CPD,Meritain Health CPD,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Starmark CPD,Starmark CPD,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Aetna Medicare,Aetna Medicare,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Ambetter ,Ambetter ,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Blue Access,Anthem Blue Access,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Blue Access Choice,Anthem Blue Access Choice,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Blue Preferred,Anthem Blue Preferred,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Pathway,Anthem Pathway,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Alliance,Anthem Alliance,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Anthem Medicare,Anthem Medicare,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Cigna,Cigna,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Cigna PPO,Cigna PPO,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Cigna Medicare Advantage,Cigna Medicare Advantage,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Essence,Essence,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Healthlink HMO,Healthlink HMO,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Healthlink PPO,Healthlink PPO,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,HomeState Health Plan,HomeState Health Plan,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Humana Gold,Humana Gold,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Medicaid MO,Medicaid MO,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Medica,Medica,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Tricare,Tricare,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,UHC All Payer,UHC All Payer,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,UHC Exchange,UHC Exchange,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,UHC Medicaid,UHC Medicaid,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,UMR CPD,UMR CPD,2410.8,,,,,,,per diem,2410.8,2410.8,"Per diem rate, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,UHC Medicare,UHC Medicare,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
"DEBRIB, BONE, EACH ADD 20     ",38504091,CDM,761,RC,,,,,,Inpatient,,,2410.8,2410.8,Wellcare,Wellcare,2410.8,,,,,,,case rate,2410.8,2410.8,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Meritain Health PPO CPD,Meritain Health PPO CPD,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Aetna/Commercial Product,Aetna/Commercial Product,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Meritain Health CPD,Meritain Health CPD,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Starmark CPD,Starmark CPD,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Aetna Medicare,Aetna Medicare,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Ambetter ,Ambetter ,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Blue Access,Anthem Blue Access,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Blue Access Choice,Anthem Blue Access Choice,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Blue Preferred,Anthem Blue Preferred,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Pathway,Anthem Pathway,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Alliance,Anthem Alliance,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Anthem Medicare,Anthem Medicare,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Cigna,Cigna,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Cigna PPO,Cigna PPO,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Cigna Medicare Advantage,Cigna Medicare Advantage,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Essence,Essence,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Healthlink HMO,Healthlink HMO,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Healthlink PPO,Healthlink PPO,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,HomeState Health Plan,HomeState Health Plan,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Humana Gold,Humana Gold,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Medicaid MO,Medicaid MO,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Medica,Medica,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Tricare,Tricare,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,UHC All Payer,UHC All Payer,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,UHC Exchange,UHC Exchange,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,UHC Medicaid,UHC Medicaid,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,UMR CPD,UMR CPD,526.21,,,,,,,per diem,526.21,526.21,"Per diem rate, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,UHC Medicare,UHC Medicare,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
OP VISIT LEVEL III E          ,38504093,CDM,761,RC,,,,,,Inpatient,,,526.21,526.21,Wellcare,Wellcare,526.21,,,,,,,case rate,526.21,526.21,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Meritain Health PPO CPD,Meritain Health PPO CPD,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Aetna/Commercial Product,Aetna/Commercial Product,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Meritain Health CPD,Meritain Health CPD,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Starmark CPD,Starmark CPD,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Aetna Medicare,Aetna Medicare,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Ambetter ,Ambetter ,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Blue Access,Anthem Blue Access,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Blue Access Choice,Anthem Blue Access Choice,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Blue Preferred,Anthem Blue Preferred,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Pathway,Anthem Pathway,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Alliance,Anthem Alliance,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Anthem Medicare,Anthem Medicare,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Cigna,Cigna,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Cigna PPO,Cigna PPO,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Cigna Medicare Advantage,Cigna Medicare Advantage,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Essence,Essence,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Healthlink HMO,Healthlink HMO,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Healthlink PPO,Healthlink PPO,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,HomeState Health Plan,HomeState Health Plan,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Humana Gold,Humana Gold,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Medicaid MO,Medicaid MO,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Medica,Medica,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Tricare,Tricare,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,UHC All Payer,UHC All Payer,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,UHC Exchange,UHC Exchange,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,UHC Medicaid,UHC Medicaid,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,UMR CPD,UMR CPD,1591.35,,,,,,,per diem,1591.35,1591.35,"Per diem rate, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,UHC Medicare,UHC Medicare,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
RAD MODIFIED BARIUM SWALLOW   ,38504096,CDM,750,RC,,,,,,Inpatient,,,1591.35,1591.35,Wellcare,Wellcare,1591.35,,,,,,,case rate,1591.35,1591.35,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Meritain Health PPO CPD,Meritain Health PPO CPD,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Aetna/Commercial Product,Aetna/Commercial Product,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Meritain Health CPD,Meritain Health CPD,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Starmark CPD,Starmark CPD,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Aetna Medicare,Aetna Medicare,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Ambetter ,Ambetter ,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Blue Access,Anthem Blue Access,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Blue Access Choice,Anthem Blue Access Choice,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Blue Preferred,Anthem Blue Preferred,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Pathway,Anthem Pathway,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Alliance,Anthem Alliance,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Anthem Medicare,Anthem Medicare,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Cigna,Cigna,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Cigna PPO,Cigna PPO,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Cigna Medicare Advantage,Cigna Medicare Advantage,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Essence,Essence,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Healthlink HMO,Healthlink HMO,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Healthlink PPO,Healthlink PPO,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,HomeState Health Plan,HomeState Health Plan,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Humana Gold,Humana Gold,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Medicaid MO,Medicaid MO,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Medica,Medica,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Tricare,Tricare,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,UHC All Payer,UHC All Payer,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,UHC Exchange,UHC Exchange,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,UHC Medicaid,UHC Medicaid,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,UMR CPD,UMR CPD,311.82,,,,,,,per diem,311.82,311.82,"Per diem rate, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,UHC Medicare,UHC Medicare,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
EKG TRACING ONLY              ,39200210,CDM,730,RC,93005,CPT,,,,Inpatient,,,311.82,311.82,Wellcare,Wellcare,311.82,,,,,,,case rate,311.82,311.82,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Meritain Health PPO CPD,Meritain Health PPO CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna/Commercial Product,Aetna/Commercial Product,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Meritain Health CPD,Meritain Health CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Starmark CPD,Starmark CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna Medicare,Aetna Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Ambetter ,Ambetter ,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Access,Anthem Blue Access,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Access Choice,Anthem Blue Access Choice,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Preferred,Anthem Blue Preferred,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Pathway,Anthem Pathway,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Alliance,Anthem Alliance,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Medicare,Anthem Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna,Cigna,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna PPO,Cigna PPO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna Medicare Advantage,Cigna Medicare Advantage,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Essence,Essence,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Healthlink HMO,Healthlink HMO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Healthlink PPO,Healthlink PPO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,HomeState Health Plan,HomeState Health Plan,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Humana Gold,Humana Gold,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Medicaid MO,Medicaid MO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Medica,Medica,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Tricare,Tricare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,UHC All Payer,UHC All Payer,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Exchange,UHC Exchange,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Medicaid,UHC Medicaid,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,UMR CPD,UMR CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Medicare,UHC Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/DOPPLER     ,39200257,CDM,480,RC,93306,CPT,,,,Inpatient,,,1113.95,1113.95,Wellcare,Wellcare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Meritain Health PPO CPD,Meritain Health PPO CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna/Commercial Product,Aetna/Commercial Product,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Meritain Health CPD,Meritain Health CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Starmark CPD,Starmark CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Aetna Medicare,Aetna Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Ambetter ,Ambetter ,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Access,Anthem Blue Access,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Access Choice,Anthem Blue Access Choice,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Blue Preferred,Anthem Blue Preferred,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Pathway,Anthem Pathway,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Alliance,Anthem Alliance,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Anthem Medicare,Anthem Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna,Cigna,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna PPO,Cigna PPO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Cigna Medicare Advantage,Cigna Medicare Advantage,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Essence,Essence,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Healthlink HMO,Healthlink HMO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Healthlink PPO,Healthlink PPO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,HomeState Health Plan,HomeState Health Plan,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Humana Gold,Humana Gold,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Medicaid MO,Medicaid MO,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Medica,Medica,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Tricare,Tricare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,UHC All Payer,UHC All Payer,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Exchange,UHC Exchange,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Medicaid,UHC Medicaid,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,UMR CPD,UMR CPD,1113.95,,,,,,,per diem,1113.95,1113.95,"Per diem rate, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,UHC Medicare,UHC Medicare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECHO 2-D&M-MODE W/IMAGE       ,39200259,CDM,483,RC,93350,CPT,,,,Inpatient,,,1113.95,1113.95,Wellcare,Wellcare,1113.95,,,,,,,case rate,1113.95,1113.95,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Meritain Health PPO CPD,Meritain Health PPO CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Aetna/Commercial Product,Aetna/Commercial Product,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Meritain Health CPD,Meritain Health CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Starmark CPD,Starmark CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Aetna Medicare,Aetna Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Ambetter ,Ambetter ,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Access,Anthem Blue Access,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Access Choice,Anthem Blue Access Choice,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Preferred,Anthem Blue Preferred,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Pathway,Anthem Pathway,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Alliance,Anthem Alliance,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Anthem Medicare,Anthem Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Cigna,Cigna,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Cigna PPO,Cigna PPO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Cigna Medicare Advantage,Cigna Medicare Advantage,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Essence,Essence,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Healthlink HMO,Healthlink HMO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Healthlink PPO,Healthlink PPO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,HomeState Health Plan,HomeState Health Plan,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Humana Gold,Humana Gold,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Medicaid MO,Medicaid MO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Medica,Medica,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Tricare,Tricare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,UHC All Payer,UHC All Payer,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,UHC Exchange,UHC Exchange,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,UHC Medicaid,UHC Medicaid,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,UMR CPD,UMR CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,UHC Medicare,UHC Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,39200260,CDM,483,RC,93303,CPT,,,,Inpatient,,,1660.36,1660.36,Wellcare,Wellcare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Meritain Health PPO CPD,Meritain Health PPO CPD,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Aetna/Commercial Product,Aetna/Commercial Product,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Meritain Health CPD,Meritain Health CPD,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Starmark CPD,Starmark CPD,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Aetna Medicare,Aetna Medicare,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Ambetter ,Ambetter ,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Blue Access,Anthem Blue Access,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Blue Access Choice,Anthem Blue Access Choice,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Blue Preferred,Anthem Blue Preferred,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Pathway,Anthem Pathway,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Alliance,Anthem Alliance,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Anthem Medicare,Anthem Medicare,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Cigna,Cigna,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Cigna PPO,Cigna PPO,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Cigna Medicare Advantage,Cigna Medicare Advantage,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Essence,Essence,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Healthlink HMO,Healthlink HMO,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Healthlink PPO,Healthlink PPO,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,HomeState Health Plan,HomeState Health Plan,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Humana Gold,Humana Gold,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Medicaid MO,Medicaid MO,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Medica,Medica,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Tricare,Tricare,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,UHC All Payer,UHC All Payer,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,UHC Exchange,UHC Exchange,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,UHC Medicaid,UHC Medicaid,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,UMR CPD,UMR CPD,77.98,,,,,,,per diem,77.98,77.98,"Per diem rate, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,UHC Medicare,UHC Medicare,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
EKG                           ,39200261,CDM,730,RC,93000,CPT,,,,Inpatient,,,77.98,77.98,Wellcare,Wellcare,77.98,,,,,,,case rate,77.98,77.98,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Meritain Health PPO CPD,Meritain Health PPO CPD,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Aetna/Commercial Product,Aetna/Commercial Product,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Meritain Health CPD,Meritain Health CPD,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Starmark CPD,Starmark CPD,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Aetna Medicare,Aetna Medicare,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Ambetter ,Ambetter ,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Blue Access,Anthem Blue Access,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Blue Access Choice,Anthem Blue Access Choice,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Blue Preferred,Anthem Blue Preferred,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Pathway,Anthem Pathway,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Alliance,Anthem Alliance,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Anthem Medicare,Anthem Medicare,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Cigna,Cigna,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Cigna PPO,Cigna PPO,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Cigna Medicare Advantage,Cigna Medicare Advantage,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Essence,Essence,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Healthlink HMO,Healthlink HMO,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Healthlink PPO,Healthlink PPO,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,HomeState Health Plan,HomeState Health Plan,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Humana Gold,Humana Gold,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Medicaid MO,Medicaid MO,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Medica,Medica,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Tricare,Tricare,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,UHC All Payer,UHC All Payer,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,UHC Exchange,UHC Exchange,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,UHC Medicaid,UHC Medicaid,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,UMR CPD,UMR CPD,171.43,,,,,,,per diem,171.43,171.43,"Per diem rate, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,UHC Medicare,UHC Medicare,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC PHASE1 RECOVERY PER 30     ,39200263,CDM,760,RC,,,,,,Inpatient,,,171.43,171.43,Wellcare,Wellcare,171.43,,,,,,,case rate,171.43,171.43,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Meritain Health PPO CPD,Meritain Health PPO CPD,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Aetna/Commercial Product,Aetna/Commercial Product,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Meritain Health CPD,Meritain Health CPD,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Starmark CPD,Starmark CPD,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Aetna Medicare,Aetna Medicare,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Ambetter ,Ambetter ,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Blue Access,Anthem Blue Access,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Blue Access Choice,Anthem Blue Access Choice,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Blue Preferred,Anthem Blue Preferred,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Pathway,Anthem Pathway,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Alliance,Anthem Alliance,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Anthem Medicare,Anthem Medicare,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Cigna,Cigna,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Cigna PPO,Cigna PPO,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Cigna Medicare Advantage,Cigna Medicare Advantage,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Essence,Essence,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Healthlink HMO,Healthlink HMO,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Healthlink PPO,Healthlink PPO,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,HomeState Health Plan,HomeState Health Plan,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Humana Gold,Humana Gold,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Medicaid MO,Medicaid MO,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Medica,Medica,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Tricare,Tricare,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,UHC All Payer,UHC All Payer,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,UHC Exchange,UHC Exchange,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,UHC Medicaid,UHC Medicaid,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,UMR CPD,UMR CPD,208.1,,,,,,,per diem,208.1,208.1,"Per diem rate, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,UHC Medicare,UHC Medicare,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
HC WND EST EVAL/MANAGE LE     ,39200264,CDM,761,RC,,,,,,Inpatient,,,208.1,208.1,Wellcare,Wellcare,208.1,,,,,,,case rate,208.1,208.1,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Meritain Health PPO CPD,Meritain Health PPO CPD,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Aetna/Commercial Product,Aetna/Commercial Product,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Meritain Health CPD,Meritain Health CPD,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Starmark CPD,Starmark CPD,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Aetna Medicare,Aetna Medicare,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Ambetter ,Ambetter ,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Blue Access,Anthem Blue Access,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Blue Access Choice,Anthem Blue Access Choice,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Blue Preferred,Anthem Blue Preferred,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Pathway,Anthem Pathway,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Alliance,Anthem Alliance,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Anthem Medicare,Anthem Medicare,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Cigna,Cigna,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Cigna PPO,Cigna PPO,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Cigna Medicare Advantage,Cigna Medicare Advantage,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Essence,Essence,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Healthlink HMO,Healthlink HMO,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Healthlink PPO,Healthlink PPO,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,HomeState Health Plan,HomeState Health Plan,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Humana Gold,Humana Gold,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Medicaid MO,Medicaid MO,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Medica,Medica,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Tricare,Tricare,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,UHC All Payer,UHC All Payer,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,UHC Exchange,UHC Exchange,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,UHC Medicaid,UHC Medicaid,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,UMR CPD,UMR CPD,1538.09,,,,,,,per diem,1538.09,1538.09,"Per diem rate, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,UHC Medicare,UHC Medicare,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
24 HOUR HOLTER HOOK-UP WL RT  ,39200272,CDM,731,RC,,,,,,Inpatient,,,1538.09,1538.09,Wellcare,Wellcare,1538.09,,,,,,,case rate,1538.09,1538.09,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Meritain Health PPO CPD,Meritain Health PPO CPD,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Aetna/Commercial Product,Aetna/Commercial Product,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Meritain Health CPD,Meritain Health CPD,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Starmark CPD,Starmark CPD,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Aetna Medicare,Aetna Medicare,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Ambetter ,Ambetter ,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Blue Access,Anthem Blue Access,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Blue Access Choice,Anthem Blue Access Choice,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Blue Preferred,Anthem Blue Preferred,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Pathway,Anthem Pathway,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Alliance,Anthem Alliance,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Anthem Medicare,Anthem Medicare,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Cigna,Cigna,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Cigna PPO,Cigna PPO,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Cigna Medicare Advantage,Cigna Medicare Advantage,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Essence,Essence,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Healthlink HMO,Healthlink HMO,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Healthlink PPO,Healthlink PPO,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,HomeState Health Plan,HomeState Health Plan,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Humana Gold,Humana Gold,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Medicaid MO,Medicaid MO,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Medica,Medica,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Tricare,Tricare,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,UHC All Payer,UHC All Payer,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,UHC Exchange,UHC Exchange,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,UHC Medicaid,UHC Medicaid,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,UMR CPD,UMR CPD,799.46,,,,,,,per diem,799.46,799.46,"Per diem rate, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,UHC Medicare,UHC Medicare,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
EKG - 24 HR (HOLTER MONITOR)  ,39200274,CDM,731,RC,93225,CPT,,,,Inpatient,,,799.46,799.46,Wellcare,Wellcare,799.46,,,,,,,case rate,799.46,799.46,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Meritain Health PPO CPD,Meritain Health PPO CPD,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Aetna/Commercial Product,Aetna/Commercial Product,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Meritain Health CPD,Meritain Health CPD,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Starmark CPD,Starmark CPD,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Aetna Medicare,Aetna Medicare,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Ambetter ,Ambetter ,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Blue Access,Anthem Blue Access,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Blue Access Choice,Anthem Blue Access Choice,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Blue Preferred,Anthem Blue Preferred,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Pathway,Anthem Pathway,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Alliance,Anthem Alliance,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Anthem Medicare,Anthem Medicare,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Cigna,Cigna,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Cigna PPO,Cigna PPO,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Cigna Medicare Advantage,Cigna Medicare Advantage,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Essence,Essence,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Healthlink HMO,Healthlink HMO,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Healthlink PPO,Healthlink PPO,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,HomeState Health Plan,HomeState Health Plan,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Humana Gold,Humana Gold,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Medicaid MO,Medicaid MO,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Medica,Medica,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Tricare,Tricare,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,UHC All Payer,UHC All Payer,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,UHC Exchange,UHC Exchange,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,UHC Medicaid,UHC Medicaid,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,UMR CPD,UMR CPD,2.58,,,,,,,per diem,2.58,2.58,"Per diem rate, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,UHC Medicare,UHC Medicare,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
PROPRANOLOL TAB 5MG           ,39228890,CDM,250,RC,,,,,,Inpatient,1,EA,2.58,2.58,Wellcare,Wellcare,2.58,,,,,,,case rate,2.58,2.58,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Meritain Health PPO CPD,Meritain Health PPO CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Aetna/Commercial Product,Aetna/Commercial Product,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Meritain Health CPD,Meritain Health CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Starmark CPD,Starmark CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Aetna Medicare,Aetna Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Ambetter ,Ambetter ,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Blue Access,Anthem Blue Access,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Blue Access Choice,Anthem Blue Access Choice,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Blue Preferred,Anthem Blue Preferred,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Pathway,Anthem Pathway,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Alliance,Anthem Alliance,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Anthem Medicare,Anthem Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Cigna,Cigna,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Cigna PPO,Cigna PPO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Cigna Medicare Advantage,Cigna Medicare Advantage,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Essence,Essence,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Healthlink HMO,Healthlink HMO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Healthlink PPO,Healthlink PPO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,HomeState Health Plan,HomeState Health Plan,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Humana Gold,Humana Gold,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Medicaid MO,Medicaid MO,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Medica,Medica,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Tricare,Tricare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,UHC All Payer,UHC All Payer,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,UHC Exchange,UHC Exchange,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,UHC Medicaid,UHC Medicaid,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,UMR CPD,UMR CPD,22.68,,,,,,,per diem,22.68,22.68,"Per diem rate, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,UHC Medicare,UHC Medicare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
MENTHOL GEL 118ML 4% GEL      ,39228891,CDM,250,RC,,,,,,Inpatient,1,EA,22.68,22.68,Wellcare,Wellcare,22.68,,,,,,,case rate,22.68,22.68,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Meritain Health PPO CPD,Meritain Health PPO CPD,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Aetna/Commercial Product,Aetna/Commercial Product,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Meritain Health CPD,Meritain Health CPD,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Starmark CPD,Starmark CPD,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Aetna Medicare,Aetna Medicare,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Ambetter ,Ambetter ,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Blue Access,Anthem Blue Access,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Blue Access Choice,Anthem Blue Access Choice,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Blue Preferred,Anthem Blue Preferred,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Pathway,Anthem Pathway,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Alliance,Anthem Alliance,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Anthem Medicare,Anthem Medicare,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Cigna,Cigna,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Cigna PPO,Cigna PPO,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Cigna Medicare Advantage,Cigna Medicare Advantage,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Essence,Essence,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Healthlink HMO,Healthlink HMO,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Healthlink PPO,Healthlink PPO,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,HomeState Health Plan,HomeState Health Plan,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Humana Gold,Humana Gold,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Medicaid MO,Medicaid MO,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Medica,Medica,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Tricare,Tricare,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,UHC All Payer,UHC All Payer,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,UHC Exchange,UHC Exchange,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,UHC Medicaid,UHC Medicaid,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,UMR CPD,UMR CPD,698.11,,,,,,,per diem,698.11,698.11,"Per diem rate, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,UHC Medicare,UHC Medicare,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
DECLOT VASCULAR DEVICE        ,61010205,CDM,761,RC,36593,CPT,,,,Inpatient,,,698.11,698.11,Wellcare,Wellcare,698.11,,,,,,,case rate,698.11,698.11,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Meritain Health PPO CPD,Meritain Health PPO CPD,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Aetna/Commercial Product,Aetna/Commercial Product,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Meritain Health CPD,Meritain Health CPD,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Starmark CPD,Starmark CPD,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Aetna Medicare,Aetna Medicare,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Ambetter ,Ambetter ,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Blue Access,Anthem Blue Access,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Blue Access Choice,Anthem Blue Access Choice,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Blue Preferred,Anthem Blue Preferred,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Pathway,Anthem Pathway,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Alliance,Anthem Alliance,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Anthem Medicare,Anthem Medicare,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Cigna,Cigna,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Cigna PPO,Cigna PPO,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Cigna Medicare Advantage,Cigna Medicare Advantage,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Essence,Essence,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Healthlink HMO,Healthlink HMO,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Healthlink PPO,Healthlink PPO,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,HomeState Health Plan,HomeState Health Plan,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Humana Gold,Humana Gold,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Medicaid MO,Medicaid MO,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Medica,Medica,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Tricare,Tricare,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,UHC All Payer,UHC All Payer,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,UHC Exchange,UHC Exchange,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,UHC Medicaid,UHC Medicaid,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,UMR CPD,UMR CPD,2279.84,,,,,,,per diem,2279.84,2279.84,"Per diem rate, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,UHC Medicare,UHC Medicare,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
REPLACE CENT VEN CATH TUNNELED,61010209,CDM,761,RC,36581,CPT,,,,Inpatient,,,2279.84,2279.84,Wellcare,Wellcare,2279.84,,,,,,,case rate,2279.84,2279.84,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Meritain Health PPO CPD,Meritain Health PPO CPD,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Aetna/Commercial Product,Aetna/Commercial Product,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Meritain Health CPD,Meritain Health CPD,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Starmark CPD,Starmark CPD,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Aetna Medicare,Aetna Medicare,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Ambetter ,Ambetter ,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Blue Access,Anthem Blue Access,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Blue Access Choice,Anthem Blue Access Choice,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Blue Preferred,Anthem Blue Preferred,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Pathway,Anthem Pathway,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Alliance,Anthem Alliance,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Anthem Medicare,Anthem Medicare,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Cigna,Cigna,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Cigna PPO,Cigna PPO,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Cigna Medicare Advantage,Cigna Medicare Advantage,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Essence,Essence,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Healthlink HMO,Healthlink HMO,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Healthlink PPO,Healthlink PPO,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,HomeState Health Plan,HomeState Health Plan,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Humana Gold,Humana Gold,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Medicaid MO,Medicaid MO,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Medica,Medica,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Tricare,Tricare,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,UHC All Payer,UHC All Payer,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,UHC Exchange,UHC Exchange,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,UHC Medicaid,UHC Medicaid,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,UMR CPD,UMR CPD,657.14,,,,,,,per diem,657.14,657.14,"Per diem rate, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,UHC Medicare,UHC Medicare,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
PICC INSERT MIDLINE           ,61010211,CDM,361,RC,36410,CPT,,,,Inpatient,,,657.14,657.14,Wellcare,Wellcare,657.14,,,,,,,case rate,657.14,657.14,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Meritain Health PPO CPD,Meritain Health PPO CPD,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Aetna/Commercial Product,Aetna/Commercial Product,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Meritain Health CPD,Meritain Health CPD,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Starmark CPD,Starmark CPD,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Aetna Medicare,Aetna Medicare,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Ambetter ,Ambetter ,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Blue Access,Anthem Blue Access,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Blue Access Choice,Anthem Blue Access Choice,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Blue Preferred,Anthem Blue Preferred,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Pathway,Anthem Pathway,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Alliance,Anthem Alliance,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Anthem Medicare,Anthem Medicare,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Cigna,Cigna,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Cigna PPO,Cigna PPO,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Cigna Medicare Advantage,Cigna Medicare Advantage,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Essence,Essence,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Healthlink HMO,Healthlink HMO,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Healthlink PPO,Healthlink PPO,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,HomeState Health Plan,HomeState Health Plan,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Humana Gold,Humana Gold,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Medicaid MO,Medicaid MO,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Medica,Medica,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Tricare,Tricare,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,UHC All Payer,UHC All Payer,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,UHC Exchange,UHC Exchange,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,UHC Medicaid,UHC Medicaid,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,UMR CPD,UMR CPD,489.84,,,,,,,per diem,489.84,489.84,"Per diem rate, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,UHC Medicare,UHC Medicare,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
LUMBAR PUNCTURE DIAGNOSTIC    ,61010312,CDM,360,RC,62270,CPT,,,,Inpatient,,,489.84,489.84,Wellcare,Wellcare,489.84,,,,,,,case rate,489.84,489.84,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Meritain Health PPO CPD,Meritain Health PPO CPD,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Aetna/Commercial Product,Aetna/Commercial Product,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Meritain Health CPD,Meritain Health CPD,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Starmark CPD,Starmark CPD,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Aetna Medicare,Aetna Medicare,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Ambetter ,Ambetter ,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Blue Access,Anthem Blue Access,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Blue Access Choice,Anthem Blue Access Choice,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Blue Preferred,Anthem Blue Preferred,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Pathway,Anthem Pathway,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Alliance,Anthem Alliance,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Anthem Medicare,Anthem Medicare,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Cigna,Cigna,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Cigna PPO,Cigna PPO,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Cigna Medicare Advantage,Cigna Medicare Advantage,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Essence,Essence,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Healthlink HMO,Healthlink HMO,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Healthlink PPO,Healthlink PPO,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,HomeState Health Plan,HomeState Health Plan,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Humana Gold,Humana Gold,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Medicaid MO,Medicaid MO,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Medica,Medica,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Tricare,Tricare,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,UHC All Payer,UHC All Payer,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,UHC Exchange,UHC Exchange,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,UHC Medicaid,UHC Medicaid,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,UMR CPD,UMR CPD,911.57,,,,,,,per diem,911.57,911.57,"Per diem rate, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,UHC Medicare,UHC Medicare,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - IV                       ,67001001,CDM,450,RC,,,,,,Inpatient,,,911.57,911.57,Wellcare,Wellcare,911.57,,,,,,,case rate,911.57,911.57,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Meritain Health PPO CPD,Meritain Health PPO CPD,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Aetna/Commercial Product,Aetna/Commercial Product,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Meritain Health CPD,Meritain Health CPD,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Starmark CPD,Starmark CPD,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Aetna Medicare,Aetna Medicare,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Ambetter ,Ambetter ,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Blue Access,Anthem Blue Access,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Blue Access Choice,Anthem Blue Access Choice,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Blue Preferred,Anthem Blue Preferred,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Pathway,Anthem Pathway,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Alliance,Anthem Alliance,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Anthem Medicare,Anthem Medicare,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Cigna,Cigna,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Cigna PPO,Cigna PPO,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Cigna Medicare Advantage,Cigna Medicare Advantage,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Essence,Essence,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Healthlink HMO,Healthlink HMO,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Healthlink PPO,Healthlink PPO,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,HomeState Health Plan,HomeState Health Plan,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Humana Gold,Humana Gold,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Medicaid MO,Medicaid MO,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Medica,Medica,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Tricare,Tricare,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,UHC All Payer,UHC All Payer,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,UHC Exchange,UHC Exchange,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,UHC Medicaid,UHC Medicaid,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,UMR CPD,UMR CPD,1772.73,,,,,,,per diem,1772.73,1772.73,"Per diem rate, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,UHC Medicare,UHC Medicare,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001002,CDM,450,RC,,,,,,Inpatient,,,1772.73,1772.73,Wellcare,Wellcare,1772.73,,,,,,,case rate,1772.73,1772.73,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Meritain Health PPO CPD,Meritain Health PPO CPD,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Aetna/Commercial Product,Aetna/Commercial Product,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Meritain Health CPD,Meritain Health CPD,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Starmark CPD,Starmark CPD,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Aetna Medicare,Aetna Medicare,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Ambetter ,Ambetter ,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Blue Access,Anthem Blue Access,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Blue Access Choice,Anthem Blue Access Choice,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Blue Preferred,Anthem Blue Preferred,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Pathway,Anthem Pathway,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Alliance,Anthem Alliance,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Anthem Medicare,Anthem Medicare,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Cigna,Cigna,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Cigna PPO,Cigna PPO,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Cigna Medicare Advantage,Cigna Medicare Advantage,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Essence,Essence,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Healthlink HMO,Healthlink HMO,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Healthlink PPO,Healthlink PPO,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,HomeState Health Plan,HomeState Health Plan,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Humana Gold,Humana Gold,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Medicaid MO,Medicaid MO,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Medica,Medica,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Tricare,Tricare,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,UHC All Payer,UHC All Payer,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,UHC Exchange,UHC Exchange,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,UHC Medicaid,UHC Medicaid,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,UMR CPD,UMR CPD,1576.22,,,,,,,per diem,1576.22,1576.22,"Per diem rate, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,UHC Medicare,UHC Medicare,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
ER - V                        ,67001003,CDM,450,RC,,,,,,Inpatient,,,1576.22,1576.22,Wellcare,Wellcare,1576.22,,,,,,,case rate,1576.22,1576.22,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Meritain Health PPO CPD,Meritain Health PPO CPD,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Aetna/Commercial Product,Aetna/Commercial Product,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Meritain Health CPD,Meritain Health CPD,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Starmark CPD,Starmark CPD,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Aetna Medicare,Aetna Medicare,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Ambetter ,Ambetter ,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Blue Access,Anthem Blue Access,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Blue Access Choice,Anthem Blue Access Choice,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Blue Preferred,Anthem Blue Preferred,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Pathway,Anthem Pathway,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Alliance,Anthem Alliance,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Anthem Medicare,Anthem Medicare,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Cigna,Cigna,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Cigna PPO,Cigna PPO,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Cigna Medicare Advantage,Cigna Medicare Advantage,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Essence,Essence,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Healthlink HMO,Healthlink HMO,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Healthlink PPO,Healthlink PPO,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,HomeState Health Plan,HomeState Health Plan,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Humana Gold,Humana Gold,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Medicaid MO,Medicaid MO,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Medica,Medica,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Tricare,Tricare,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,UHC All Payer,UHC All Payer,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,UHC Exchange,UHC Exchange,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,UHC Medicaid,UHC Medicaid,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,UMR CPD,UMR CPD,1071.2,,,,,,,per diem,1071.2,1071.2,"Per diem rate, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,UHC Medicare,UHC Medicare,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
EMERGENCY ROOM VISIT          ,67001004,CDM,450,RC,,,,,,Inpatient,,,1071.2,1071.2,Wellcare,Wellcare,1071.2,,,,,,,case rate,1071.2,1071.2,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Meritain Health PPO CPD,Meritain Health PPO CPD,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Aetna/Commercial Product,Aetna/Commercial Product,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Meritain Health CPD,Meritain Health CPD,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Starmark CPD,Starmark CPD,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Aetna Medicare,Aetna Medicare,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Ambetter ,Ambetter ,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Blue Access,Anthem Blue Access,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Blue Access Choice,Anthem Blue Access Choice,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Blue Preferred,Anthem Blue Preferred,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Pathway,Anthem Pathway,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Alliance,Anthem Alliance,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Anthem Medicare,Anthem Medicare,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Cigna,Cigna,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Cigna PPO,Cigna PPO,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Cigna Medicare Advantage,Cigna Medicare Advantage,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Essence,Essence,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Healthlink HMO,Healthlink HMO,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Healthlink PPO,Healthlink PPO,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,HomeState Health Plan,HomeState Health Plan,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Humana Gold,Humana Gold,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Medicaid MO,Medicaid MO,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Medica,Medica,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Tricare,Tricare,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,UHC All Payer,UHC All Payer,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,UHC Exchange,UHC Exchange,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,UHC Medicaid,UHC Medicaid,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,UMR CPD,UMR CPD,1342.09,,,,,,,per diem,1342.09,1342.09,"Per diem rate, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,UHC Medicare,UHC Medicare,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
ED VISIT CARE LEVEL           ,67001006,CDM,450,RC,,,,,,Inpatient,,,1342.09,1342.09,Wellcare,Wellcare,1342.09,,,,,,,case rate,1342.09,1342.09,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Meritain Health PPO CPD,Meritain Health PPO CPD,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Aetna/Commercial Product,Aetna/Commercial Product,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Meritain Health CPD,Meritain Health CPD,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Starmark CPD,Starmark CPD,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Aetna Medicare,Aetna Medicare,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Ambetter ,Ambetter ,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Blue Access,Anthem Blue Access,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Blue Access Choice,Anthem Blue Access Choice,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Blue Preferred,Anthem Blue Preferred,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Pathway,Anthem Pathway,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Alliance,Anthem Alliance,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Anthem Medicare,Anthem Medicare,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Cigna,Cigna,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Cigna PPO,Cigna PPO,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Cigna Medicare Advantage,Cigna Medicare Advantage,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Essence,Essence,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Healthlink HMO,Healthlink HMO,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Healthlink PPO,Healthlink PPO,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,HomeState Health Plan,HomeState Health Plan,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Humana Gold,Humana Gold,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Medicaid MO,Medicaid MO,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Medica,Medica,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Tricare,Tricare,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,UHC All Payer,UHC All Payer,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,UHC Exchange,UHC Exchange,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,UHC Medicaid,UHC Medicaid,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,UMR CPD,UMR CPD,447.17,,,,,,,per diem,447.17,447.17,"Per diem rate, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,UHC Medicare,UHC Medicare,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
RENAL-HEMODIALYSIS            ,68000100,CDM,801,RC,90935,CPT,,,,Inpatient,,,447.17,447.17,Wellcare,Wellcare,447.17,,,,,,,case rate,447.17,447.17,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Meritain Health PPO CPD,Meritain Health PPO CPD,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Aetna/Commercial Product,Aetna/Commercial Product,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Meritain Health CPD,Meritain Health CPD,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Starmark CPD,Starmark CPD,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Aetna Medicare,Aetna Medicare,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Ambetter ,Ambetter ,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Blue Access,Anthem Blue Access,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Blue Access Choice,Anthem Blue Access Choice,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Blue Preferred,Anthem Blue Preferred,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Pathway,Anthem Pathway,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Alliance,Anthem Alliance,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Anthem Medicare,Anthem Medicare,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Cigna,Cigna,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Cigna PPO,Cigna PPO,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Cigna Medicare Advantage,Cigna Medicare Advantage,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Essence,Essence,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Healthlink HMO,Healthlink HMO,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Healthlink PPO,Healthlink PPO,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,HomeState Health Plan,HomeState Health Plan,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Humana Gold,Humana Gold,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Medicaid MO,Medicaid MO,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Medica,Medica,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Tricare,Tricare,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,UHC All Payer,UHC All Payer,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,UHC Exchange,UHC Exchange,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,UHC Medicaid,UHC Medicaid,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,UMR CPD,UMR CPD,212.18,,,,,,,per diem,212.18,212.18,"Per diem rate, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,UHC Medicare,UHC Medicare,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
PERITONEAL DIALYSIS           ,68000300,CDM,802,RC,90945,CPT,,,,Inpatient,,,212.18,212.18,Wellcare,Wellcare,212.18,,,,,,,case rate,212.18,212.18,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Meritain Health PPO CPD,Meritain Health PPO CPD,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Aetna/Commercial Product,Aetna/Commercial Product,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Meritain Health CPD,Meritain Health CPD,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Starmark CPD,Starmark CPD,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Aetna Medicare,Aetna Medicare,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Ambetter ,Ambetter ,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Blue Access,Anthem Blue Access,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Blue Access Choice,Anthem Blue Access Choice,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Blue Preferred,Anthem Blue Preferred,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Pathway,Anthem Pathway,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Alliance,Anthem Alliance,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Anthem Medicare,Anthem Medicare,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Cigna,Cigna,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Cigna PPO,Cigna PPO,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Cigna Medicare Advantage,Cigna Medicare Advantage,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Essence,Essence,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Healthlink HMO,Healthlink HMO,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Healthlink PPO,Healthlink PPO,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,HomeState Health Plan,HomeState Health Plan,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Humana Gold,Humana Gold,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Medicaid MO,Medicaid MO,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Medica,Medica,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Tricare,Tricare,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,UHC All Payer,UHC All Payer,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,UHC Exchange,UHC Exchange,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,UHC Medicaid,UHC Medicaid,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,UMR CPD,UMR CPD,1780.19,,,,,,,per diem,1780.19,1780.19,"Per diem rate, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,UHC Medicare,UHC Medicare,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
ACUTE DIALYSIS INPATIENT      ,68000453,CDM,801,RC,,,,,,Inpatient,,,1780.19,1780.19,Wellcare,Wellcare,1780.19,,,,,,,case rate,1780.19,1780.19,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Meritain Health PPO CPD,Meritain Health PPO CPD,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Aetna/Commercial Product,Aetna/Commercial Product,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Meritain Health CPD,Meritain Health CPD,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Starmark CPD,Starmark CPD,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Aetna Medicare,Aetna Medicare,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Ambetter ,Ambetter ,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Blue Access,Anthem Blue Access,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Blue Access Choice,Anthem Blue Access Choice,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Blue Preferred,Anthem Blue Preferred,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Pathway,Anthem Pathway,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Alliance,Anthem Alliance,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Anthem Medicare,Anthem Medicare,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Cigna,Cigna,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Cigna PPO,Cigna PPO,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Cigna Medicare Advantage,Cigna Medicare Advantage,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Essence,Essence,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Healthlink HMO,Healthlink HMO,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Healthlink PPO,Healthlink PPO,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,HomeState Health Plan,HomeState Health Plan,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Humana Gold,Humana Gold,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Medicaid MO,Medicaid MO,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Medica,Medica,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Tricare,Tricare,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,UHC All Payer,UHC All Payer,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,UHC Exchange,UHC Exchange,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,UHC Medicaid,UHC Medicaid,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,UMR CPD,UMR CPD,504.59,,,,,,,per diem,504.59,504.59,"Per diem rate, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,UHC Medicare,UHC Medicare,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS MISC CHRGS       ,68000454,CDM,800,RC,,,,,,Inpatient,,,504.59,504.59,Wellcare,Wellcare,504.59,,,,,,,case rate,504.59,504.59,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health PPO CPD,Meritain Health PPO CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/Commercial Product,Aetna/Commercial Product,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health CPD,Meritain Health CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Starmark CPD,Starmark CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna Medicare,Aetna Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Ambetter ,Ambetter ,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access,Anthem Blue Access,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access Choice,Anthem Blue Access Choice,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Preferred,Anthem Blue Preferred,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Pathway,Anthem Pathway,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Alliance,Anthem Alliance,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Medicare,Anthem Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna,Cigna,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna PPO,Cigna PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna Medicare Advantage,Cigna Medicare Advantage,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Essence,Essence,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink HMO,Healthlink HMO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink PPO,Healthlink PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,HomeState Health Plan,HomeState Health Plan,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Humana Gold,Humana Gold,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Medicaid MO,Medicaid MO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Medica,Medica,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Tricare,Tricare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC All Payer,UHC All Payer,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Exchange,UHC Exchange,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicaid,UHC Medicaid,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UMR CPD,UMR CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicare,UHC Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000455,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Wellcare,Wellcare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Meritain Health PPO CPD,Meritain Health PPO CPD,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Aetna/Commercial Product,Aetna/Commercial Product,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Meritain Health CPD,Meritain Health CPD,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Starmark CPD,Starmark CPD,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Aetna Medicare,Aetna Medicare,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Ambetter ,Ambetter ,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Blue Access,Anthem Blue Access,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Blue Access Choice,Anthem Blue Access Choice,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Blue Preferred,Anthem Blue Preferred,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Pathway,Anthem Pathway,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Alliance,Anthem Alliance,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Anthem Medicare,Anthem Medicare,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Cigna,Cigna,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Cigna PPO,Cigna PPO,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Cigna Medicare Advantage,Cigna Medicare Advantage,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Essence,Essence,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Healthlink HMO,Healthlink HMO,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Healthlink PPO,Healthlink PPO,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,HomeState Health Plan,HomeState Health Plan,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Humana Gold,Humana Gold,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Medicaid MO,Medicaid MO,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Medica,Medica,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Tricare,Tricare,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,UHC All Payer,UHC All Payer,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,UHC Exchange,UHC Exchange,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,UHC Medicaid,UHC Medicaid,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,UMR CPD,UMR CPD,100.92,,,,,,,per diem,100.92,100.92,"Per diem rate, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,UHC Medicare,UHC Medicare,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS                  ,68000456,CDM,801,RC,90937,CPT,,,,Inpatient,,,100.92,100.92,Wellcare,Wellcare,100.92,,,,,,,case rate,100.92,100.92,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Meritain Health PPO CPD,Meritain Health PPO CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Aetna/Commercial Product,Aetna/Commercial Product,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Meritain Health CPD,Meritain Health CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Starmark CPD,Starmark CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Aetna Medicare,Aetna Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Ambetter ,Ambetter ,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Access,Anthem Blue Access,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Access Choice,Anthem Blue Access Choice,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Preferred,Anthem Blue Preferred,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Pathway,Anthem Pathway,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Alliance,Anthem Alliance,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Anthem Medicare,Anthem Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Cigna,Cigna,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Cigna PPO,Cigna PPO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Cigna Medicare Advantage,Cigna Medicare Advantage,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Essence,Essence,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Healthlink HMO,Healthlink HMO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Healthlink PPO,Healthlink PPO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,HomeState Health Plan,HomeState Health Plan,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Humana Gold,Humana Gold,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Medicaid MO,Medicaid MO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Medica,Medica,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Tricare,Tricare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,UHC All Payer,UHC All Payer,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,UHC Exchange,UHC Exchange,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,UHC Medicaid,UHC Medicaid,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,UMR CPD,UMR CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,UHC Medicare,UHC Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS BED SIDE         ,68000457,CDM,801,RC,,,,,,Inpatient,,,1681.95,1681.95,Wellcare,Wellcare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Meritain Health PPO CPD,Meritain Health PPO CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Aetna/Commercial Product,Aetna/Commercial Product,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Meritain Health CPD,Meritain Health CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Starmark CPD,Starmark CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Aetna Medicare,Aetna Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Ambetter ,Ambetter ,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Access,Anthem Blue Access,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Access Choice,Anthem Blue Access Choice,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Blue Preferred,Anthem Blue Preferred,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Pathway,Anthem Pathway,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Alliance,Anthem Alliance,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Anthem Medicare,Anthem Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Cigna,Cigna,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Cigna PPO,Cigna PPO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Cigna Medicare Advantage,Cigna Medicare Advantage,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Essence,Essence,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Healthlink HMO,Healthlink HMO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Healthlink PPO,Healthlink PPO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,HomeState Health Plan,HomeState Health Plan,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Humana Gold,Humana Gold,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Medicaid MO,Medicaid MO,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Medica,Medica,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Tricare,Tricare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,UHC All Payer,UHC All Payer,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,UHC Exchange,UHC Exchange,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,UHC Medicaid,UHC Medicaid,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,UMR CPD,UMR CPD,1681.95,,,,,,,per diem,1681.95,1681.95,"Per diem rate, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,UHC Medicare,UHC Medicare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
CCPD                          ,68000458,CDM,804,RC,90947,CPT,,,,Inpatient,,,1681.95,1681.95,Wellcare,Wellcare,1681.95,,,,,,,case rate,1681.95,1681.95,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health PPO CPD,Meritain Health PPO CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/Commercial Product,Aetna/Commercial Product,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health CPD,Meritain Health CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Starmark CPD,Starmark CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Aetna Medicare,Aetna Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Ambetter ,Ambetter ,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access,Anthem Blue Access,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access Choice,Anthem Blue Access Choice,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Preferred,Anthem Blue Preferred,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Pathway,Anthem Pathway,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Alliance,Anthem Alliance,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Medicare,Anthem Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Cigna,Cigna,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Cigna PPO,Cigna PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Cigna Medicare Advantage,Cigna Medicare Advantage,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Essence,Essence,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink HMO,Healthlink HMO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink PPO,Healthlink PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,HomeState Health Plan,HomeState Health Plan,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Humana Gold,Humana Gold,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Medicaid MO,Medicaid MO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Medica,Medica,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Tricare,Tricare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,UHC All Payer,UHC All Payer,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,UHC Exchange,UHC Exchange,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicaid,UHC Medicaid,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,UMR CPD,UMR CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicare,UHC Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS - ADDL CHARGES   ,68000459,CDM,801,RC,,,,,,Inpatient,,,336.39,336.39,Wellcare,Wellcare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health PPO CPD,Meritain Health PPO CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/Commercial Product,Aetna/Commercial Product,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health CPD,Meritain Health CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Starmark CPD,Starmark CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna Medicare,Aetna Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Ambetter ,Ambetter ,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access,Anthem Blue Access,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access Choice,Anthem Blue Access Choice,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Preferred,Anthem Blue Preferred,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Pathway,Anthem Pathway,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Alliance,Anthem Alliance,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Medicare,Anthem Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna,Cigna,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna PPO,Cigna PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna Medicare Advantage,Cigna Medicare Advantage,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Essence,Essence,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink HMO,Healthlink HMO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink PPO,Healthlink PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,HomeState Health Plan,HomeState Health Plan,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Humana Gold,Humana Gold,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Medicaid MO,Medicaid MO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Medica,Medica,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Tricare,Tricare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC All Payer,UHC All Payer,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Exchange,UHC Exchange,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicaid,UHC Medicaid,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UMR CPD,UMR CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicare,UHC Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 0700-1900            ,68000460,CDM,801,RC,,,,,,Inpatient,,,1719.43,1719.43,Wellcare,Wellcare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Meritain Health PPO CPD,Meritain Health PPO CPD,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Aetna/Commercial Product,Aetna/Commercial Product,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Meritain Health CPD,Meritain Health CPD,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Starmark CPD,Starmark CPD,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Aetna Medicare,Aetna Medicare,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Ambetter ,Ambetter ,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Blue Access,Anthem Blue Access,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Blue Access Choice,Anthem Blue Access Choice,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Blue Preferred,Anthem Blue Preferred,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Pathway,Anthem Pathway,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Alliance,Anthem Alliance,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Anthem Medicare,Anthem Medicare,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Cigna,Cigna,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Cigna PPO,Cigna PPO,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Cigna Medicare Advantage,Cigna Medicare Advantage,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Essence,Essence,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Healthlink HMO,Healthlink HMO,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Healthlink PPO,Healthlink PPO,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,HomeState Health Plan,HomeState Health Plan,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Humana Gold,Humana Gold,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Medicaid MO,Medicaid MO,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Medica,Medica,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Tricare,Tricare,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,UHC All Payer,UHC All Payer,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,UHC Exchange,UHC Exchange,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,UHC Medicaid,UHC Medicaid,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,UMR CPD,UMR CPD,492.53,,,,,,,per diem,492.53,492.53,"Per diem rate, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,UHC Medicare,UHC Medicare,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
HEMO HRS 1900-0700            ,68000461,CDM,801,RC,,,,,,Inpatient,,,492.53,492.53,Wellcare,Wellcare,492.53,,,,,,,case rate,492.53,492.53,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Meritain Health PPO CPD,Meritain Health PPO CPD,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Aetna/Commercial Product,Aetna/Commercial Product,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Meritain Health CPD,Meritain Health CPD,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Starmark CPD,Starmark CPD,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Aetna Medicare,Aetna Medicare,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Ambetter ,Ambetter ,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Blue Access,Anthem Blue Access,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Blue Access Choice,Anthem Blue Access Choice,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Blue Preferred,Anthem Blue Preferred,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Pathway,Anthem Pathway,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Alliance,Anthem Alliance,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Anthem Medicare,Anthem Medicare,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Cigna,Cigna,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Cigna PPO,Cigna PPO,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Cigna Medicare Advantage,Cigna Medicare Advantage,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Essence,Essence,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Healthlink HMO,Healthlink HMO,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Healthlink PPO,Healthlink PPO,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,HomeState Health Plan,HomeState Health Plan,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Humana Gold,Humana Gold,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Medicaid MO,Medicaid MO,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Medica,Medica,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Tricare,Tricare,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,UHC All Payer,UHC All Payer,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,UHC Exchange,UHC Exchange,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,UHC Medicaid,UHC Medicaid,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,UMR CPD,UMR CPD,1211,,,,,,,per diem,1211,1211,"Per diem rate, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,UHC Medicare,UHC Medicare,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
CAPD                          ,68000462,CDM,801,RC,,,,,,Inpatient,,,1211,1211,Wellcare,Wellcare,1211,,,,,,,case rate,1211,1211,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Meritain Health PPO CPD,Meritain Health PPO CPD,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Aetna/Commercial Product,Aetna/Commercial Product,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Meritain Health CPD,Meritain Health CPD,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Starmark CPD,Starmark CPD,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Aetna Medicare,Aetna Medicare,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Ambetter ,Ambetter ,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Blue Access,Anthem Blue Access,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Blue Access Choice,Anthem Blue Access Choice,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Blue Preferred,Anthem Blue Preferred,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Pathway,Anthem Pathway,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Alliance,Anthem Alliance,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Anthem Medicare,Anthem Medicare,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Cigna,Cigna,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Cigna PPO,Cigna PPO,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Cigna Medicare Advantage,Cigna Medicare Advantage,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Essence,Essence,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Healthlink HMO,Healthlink HMO,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Healthlink PPO,Healthlink PPO,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,HomeState Health Plan,HomeState Health Plan,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Humana Gold,Humana Gold,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Medicaid MO,Medicaid MO,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Medica,Medica,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Tricare,Tricare,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,UHC All Payer,UHC All Payer,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,UHC Exchange,UHC Exchange,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,UHC Medicaid,UHC Medicaid,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,UMR CPD,UMR CPD,84.1,,,,,,,per diem,84.1,84.1,"Per diem rate, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,UHC Medicare,UHC Medicare,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HIGH FLUX DIALYZER            ,68000463,CDM,801,RC,,,,,,Inpatient,,,84.1,84.1,Wellcare,Wellcare,84.1,,,,,,,case rate,84.1,84.1,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Meritain Health PPO CPD,Meritain Health PPO CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna/Commercial Product,Aetna/Commercial Product,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Meritain Health CPD,Meritain Health CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Starmark CPD,Starmark CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna Medicare,Aetna Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Ambetter ,Ambetter ,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Access,Anthem Blue Access,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Access Choice,Anthem Blue Access Choice,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Preferred,Anthem Blue Preferred,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Pathway,Anthem Pathway,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Alliance,Anthem Alliance,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Medicare,Anthem Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna,Cigna,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna PPO,Cigna PPO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna Medicare Advantage,Cigna Medicare Advantage,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Essence,Essence,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthlink HMO,Healthlink HMO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthlink PPO,Healthlink PPO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,HomeState Health Plan,HomeState Health Plan,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Humana Gold,Humana Gold,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Medicaid MO,Medicaid MO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Medica,Medica,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Tricare,Tricare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC All Payer,UHC All Payer,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Exchange,UHC Exchange,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Medicaid,UHC Medicaid,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UMR CPD,UMR CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Medicare,UHC Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HEMO EXCESS TIME (1 OR MORE HR,68000465,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Wellcare,Wellcare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health PPO CPD,Meritain Health PPO CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna/Commercial Product,Aetna/Commercial Product,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Meritain Health CPD,Meritain Health CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Starmark CPD,Starmark CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Aetna Medicare,Aetna Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Ambetter ,Ambetter ,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access,Anthem Blue Access,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Access Choice,Anthem Blue Access Choice,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Blue Preferred,Anthem Blue Preferred,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Pathway,Anthem Pathway,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Alliance,Anthem Alliance,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Anthem Medicare,Anthem Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna,Cigna,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna PPO,Cigna PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Cigna Medicare Advantage,Cigna Medicare Advantage,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Essence,Essence,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink HMO,Healthlink HMO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Healthlink PPO,Healthlink PPO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,HomeState Health Plan,HomeState Health Plan,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Humana Gold,Humana Gold,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Medicaid MO,Medicaid MO,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Medica,Medica,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Tricare,Tricare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC All Payer,UHC All Payer,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Exchange,UHC Exchange,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicaid,UHC Medicaid,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UMR CPD,UMR CPD,1719.43,,,,,,,per diem,1719.43,1719.43,"Per diem rate, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,UHC Medicare,UHC Medicare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD-AFTER HOURS SUNDAY HOL   ,68000466,CDM,804,RC,,,,,,Inpatient,,,1719.43,1719.43,Wellcare,Wellcare,1719.43,,,,,,,case rate,1719.43,1719.43,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Meritain Health PPO CPD,Meritain Health PPO CPD,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Aetna/Commercial Product,Aetna/Commercial Product,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Meritain Health CPD,Meritain Health CPD,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Starmark CPD,Starmark CPD,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Aetna Medicare,Aetna Medicare,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Ambetter ,Ambetter ,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Blue Access,Anthem Blue Access,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Blue Access Choice,Anthem Blue Access Choice,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Blue Preferred,Anthem Blue Preferred,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Pathway,Anthem Pathway,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Alliance,Anthem Alliance,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Anthem Medicare,Anthem Medicare,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Cigna,Cigna,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Cigna PPO,Cigna PPO,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Cigna Medicare Advantage,Cigna Medicare Advantage,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Essence,Essence,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Healthlink HMO,Healthlink HMO,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Healthlink PPO,Healthlink PPO,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,HomeState Health Plan,HomeState Health Plan,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Humana Gold,Humana Gold,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Medicaid MO,Medicaid MO,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Medica,Medica,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Tricare,Tricare,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,UHC All Payer,UHC All Payer,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,UHC Exchange,UHC Exchange,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,UHC Medicaid,UHC Medicaid,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,UMR CPD,UMR CPD,840.97,,,,,,,per diem,840.97,840.97,"Per diem rate, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,UHC Medicare,UHC Medicare,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELED AFTER SET UP    ,68000467,CDM,804,RC,,,,,,Inpatient,,,840.97,840.97,Wellcare,Wellcare,840.97,,,,,,,case rate,840.97,840.97,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health PPO CPD,Meritain Health PPO CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/Commercial Product,Aetna/Commercial Product,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health CPD,Meritain Health CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Starmark CPD,Starmark CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna Medicare,Aetna Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Ambetter ,Ambetter ,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access,Anthem Blue Access,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access Choice,Anthem Blue Access Choice,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Preferred,Anthem Blue Preferred,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Pathway,Anthem Pathway,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Alliance,Anthem Alliance,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Medicare,Anthem Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna,Cigna,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna PPO,Cigna PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna Medicare Advantage,Cigna Medicare Advantage,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Essence,Essence,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink HMO,Healthlink HMO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink PPO,Healthlink PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,HomeState Health Plan,HomeState Health Plan,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Humana Gold,Humana Gold,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medicaid MO,Medicaid MO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medica,Medica,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Tricare,Tricare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC All Payer,UHC All Payer,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Exchange,UHC Exchange,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicaid,UHC Medicaid,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UMR CPD,UMR CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicare,UHC Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
CCPD CANCELLED BEFORE SETUP   ,68000468,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Wellcare,Wellcare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Meritain Health PPO CPD,Meritain Health PPO CPD,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Aetna/Commercial Product,Aetna/Commercial Product,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Meritain Health CPD,Meritain Health CPD,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Starmark CPD,Starmark CPD,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Aetna Medicare,Aetna Medicare,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Ambetter ,Ambetter ,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Blue Access,Anthem Blue Access,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Blue Access Choice,Anthem Blue Access Choice,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Blue Preferred,Anthem Blue Preferred,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Pathway,Anthem Pathway,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Alliance,Anthem Alliance,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Anthem Medicare,Anthem Medicare,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Cigna,Cigna,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Cigna PPO,Cigna PPO,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Cigna Medicare Advantage,Cigna Medicare Advantage,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Essence,Essence,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Healthlink HMO,Healthlink HMO,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Healthlink PPO,Healthlink PPO,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,HomeState Health Plan,HomeState Health Plan,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Humana Gold,Humana Gold,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Medicaid MO,Medicaid MO,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Medica,Medica,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Tricare,Tricare,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,UHC All Payer,UHC All Payer,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,UHC Exchange,UHC Exchange,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,UHC Medicaid,UHC Medicaid,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,UMR CPD,UMR CPD,117.74,,,,,,,per diem,117.74,117.74,"Per diem rate, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,UHC Medicare,UHC Medicare,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
HEMODIALYSIS AFTER HOURS      ,68000469,CDM,801,RC,90937,CPT,,,,Inpatient,,,117.74,117.74,Wellcare,Wellcare,117.74,,,,,,,case rate,117.74,117.74,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Meritain Health PPO CPD,Meritain Health PPO CPD,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Aetna/Commercial Product,Aetna/Commercial Product,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Meritain Health CPD,Meritain Health CPD,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Starmark CPD,Starmark CPD,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Aetna Medicare,Aetna Medicare,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Ambetter ,Ambetter ,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Blue Access,Anthem Blue Access,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Blue Access Choice,Anthem Blue Access Choice,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Blue Preferred,Anthem Blue Preferred,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Pathway,Anthem Pathway,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Alliance,Anthem Alliance,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Anthem Medicare,Anthem Medicare,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Cigna,Cigna,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Cigna PPO,Cigna PPO,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Cigna Medicare Advantage,Cigna Medicare Advantage,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Essence,Essence,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Healthlink HMO,Healthlink HMO,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Healthlink PPO,Healthlink PPO,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,HomeState Health Plan,HomeState Health Plan,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Humana Gold,Humana Gold,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Medicaid MO,Medicaid MO,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Medica,Medica,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Tricare,Tricare,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,UHC All Payer,UHC All Payer,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,UHC Exchange,UHC Exchange,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,UHC Medicaid,UHC Medicaid,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,UMR CPD,UMR CPD,1738.13,,,,,,,per diem,1738.13,1738.13,"Per diem rate, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,UHC Medicare,UHC Medicare,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - WEEKEND            ,68000470,CDM,801,RC,,,,,,Inpatient,,,1738.13,1738.13,Wellcare,Wellcare,1738.13,,,,,,,case rate,1738.13,1738.13,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Meritain Health PPO CPD,Meritain Health PPO CPD,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Aetna/Commercial Product,Aetna/Commercial Product,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Meritain Health CPD,Meritain Health CPD,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Starmark CPD,Starmark CPD,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Aetna Medicare,Aetna Medicare,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Ambetter ,Ambetter ,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Blue Access,Anthem Blue Access,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Blue Access Choice,Anthem Blue Access Choice,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Blue Preferred,Anthem Blue Preferred,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Pathway,Anthem Pathway,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Alliance,Anthem Alliance,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Anthem Medicare,Anthem Medicare,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Cigna,Cigna,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Cigna PPO,Cigna PPO,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Cigna Medicare Advantage,Cigna Medicare Advantage,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Essence,Essence,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Healthlink HMO,Healthlink HMO,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Healthlink PPO,Healthlink PPO,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,HomeState Health Plan,HomeState Health Plan,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Humana Gold,Humana Gold,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Medicaid MO,Medicaid MO,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Medica,Medica,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Tricare,Tricare,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,UHC All Payer,UHC All Payer,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,UHC Exchange,UHC Exchange,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,UHC Medicaid,UHC Medicaid,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,UMR CPD,UMR CPD,1969.88,,,,,,,per diem,1969.88,1969.88,"Per diem rate, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,UHC Medicare,UHC Medicare,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
DIALYSIS - HOLIDAY            ,68000471,CDM,801,RC,,,,,,Inpatient,,,1969.88,1969.88,Wellcare,Wellcare,1969.88,,,,,,,case rate,1969.88,1969.88,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Meritain Health PPO CPD,Meritain Health PPO CPD,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Aetna/Commercial Product,Aetna/Commercial Product,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Meritain Health CPD,Meritain Health CPD,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Starmark CPD,Starmark CPD,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Aetna Medicare,Aetna Medicare,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Ambetter ,Ambetter ,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Blue Access,Anthem Blue Access,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Blue Access Choice,Anthem Blue Access Choice,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Blue Preferred,Anthem Blue Preferred,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Pathway,Anthem Pathway,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Alliance,Anthem Alliance,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Anthem Medicare,Anthem Medicare,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Cigna,Cigna,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Cigna PPO,Cigna PPO,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Cigna Medicare Advantage,Cigna Medicare Advantage,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Essence,Essence,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Healthlink HMO,Healthlink HMO,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Healthlink PPO,Healthlink PPO,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,HomeState Health Plan,HomeState Health Plan,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Humana Gold,Humana Gold,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Medicaid MO,Medicaid MO,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Medica,Medica,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Tricare,Tricare,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,UHC All Payer,UHC All Payer,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,UHC Exchange,UHC Exchange,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,UHC Medicaid,UHC Medicaid,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,UMR CPD,UMR CPD,1513.75,,,,,,,per diem,1513.75,1513.75,"Per diem rate, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,UHC Medicare,UHC Medicare,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HEMODIALYSIS TREATMENT (2:1)  ,68000472,CDM,801,RC,,,,,,Inpatient,,,1513.75,1513.75,Wellcare,Wellcare,1513.75,,,,,,,case rate,1513.75,1513.75,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Meritain Health PPO CPD,Meritain Health PPO CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna/Commercial Product,Aetna/Commercial Product,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Meritain Health CPD,Meritain Health CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Starmark CPD,Starmark CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Aetna Medicare,Aetna Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Ambetter ,Ambetter ,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Access,Anthem Blue Access,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Access Choice,Anthem Blue Access Choice,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Blue Preferred,Anthem Blue Preferred,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Pathway,Anthem Pathway,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Alliance,Anthem Alliance,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Anthem Medicare,Anthem Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna,Cigna,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna PPO,Cigna PPO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Cigna Medicare Advantage,Cigna Medicare Advantage,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Essence,Essence,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthlink HMO,Healthlink HMO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Healthlink PPO,Healthlink PPO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,HomeState Health Plan,HomeState Health Plan,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Humana Gold,Humana Gold,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Medicaid MO,Medicaid MO,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Medica,Medica,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Tricare,Tricare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC All Payer,UHC All Payer,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Exchange,UHC Exchange,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Medicaid,UHC Medicaid,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UMR CPD,UMR CPD,168.2,,,,,,,per diem,168.2,168.2,"Per diem rate, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,UHC Medicare,UHC Medicare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
HD EXCESS TIME (> 4 HRS)      ,68000473,CDM,801,RC,,,,,,Inpatient,,,168.2,168.2,Wellcare,Wellcare,168.2,,,,,,,case rate,168.2,168.2,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Meritain Health PPO CPD,Meritain Health PPO CPD,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Aetna/Commercial Product,Aetna/Commercial Product,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Meritain Health CPD,Meritain Health CPD,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Starmark CPD,Starmark CPD,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Aetna Medicare,Aetna Medicare,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Ambetter ,Ambetter ,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Blue Access,Anthem Blue Access,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Blue Access Choice,Anthem Blue Access Choice,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Blue Preferred,Anthem Blue Preferred,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Pathway,Anthem Pathway,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Alliance,Anthem Alliance,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Anthem Medicare,Anthem Medicare,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Cigna,Cigna,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Cigna PPO,Cigna PPO,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Cigna Medicare Advantage,Cigna Medicare Advantage,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Essence,Essence,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Healthlink HMO,Healthlink HMO,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Healthlink PPO,Healthlink PPO,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,HomeState Health Plan,HomeState Health Plan,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Humana Gold,Humana Gold,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Medicaid MO,Medicaid MO,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Medica,Medica,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Tricare,Tricare,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,UHC All Payer,UHC All Payer,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,UHC Exchange,UHC Exchange,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,UHC Medicaid,UHC Medicaid,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,UMR CPD,UMR CPD,67.28,,,,,,,per diem,67.28,67.28,"Per diem rate, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,UHC Medicare,UHC Medicare,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
CCPD:  ADD'L LITERS (> 12)    ,68000474,CDM,804,RC,,,,,,Inpatient,,,67.28,67.28,Wellcare,Wellcare,67.28,,,,,,,case rate,67.28,67.28,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health PPO CPD,Meritain Health PPO CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/Commercial Product,Aetna/Commercial Product,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health CPD,Meritain Health CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Starmark CPD,Starmark CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna Medicare,Aetna Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Ambetter ,Ambetter ,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access,Anthem Blue Access,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access Choice,Anthem Blue Access Choice,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Preferred,Anthem Blue Preferred,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Pathway,Anthem Pathway,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Alliance,Anthem Alliance,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Medicare,Anthem Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna,Cigna,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna PPO,Cigna PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna Medicare Advantage,Cigna Medicare Advantage,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Essence,Essence,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink HMO,Healthlink HMO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink PPO,Healthlink PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,HomeState Health Plan,HomeState Health Plan,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Humana Gold,Humana Gold,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medicaid MO,Medicaid MO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medica,Medica,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Tricare,Tricare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC All Payer,UHC All Payer,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Exchange,UHC Exchange,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicaid,UHC Medicaid,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UMR CPD,UMR CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicare,UHC Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD:  CATHETER FLUSH           ,68000475,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Wellcare,Wellcare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health PPO CPD,Meritain Health PPO CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna/Commercial Product,Aetna/Commercial Product,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Meritain Health CPD,Meritain Health CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Starmark CPD,Starmark CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Aetna Medicare,Aetna Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Ambetter ,Ambetter ,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access,Anthem Blue Access,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Access Choice,Anthem Blue Access Choice,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Blue Preferred,Anthem Blue Preferred,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Pathway,Anthem Pathway,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Alliance,Anthem Alliance,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Anthem Medicare,Anthem Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna,Cigna,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna PPO,Cigna PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Cigna Medicare Advantage,Cigna Medicare Advantage,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Essence,Essence,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink HMO,Healthlink HMO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Healthlink PPO,Healthlink PPO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,HomeState Health Plan,HomeState Health Plan,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Humana Gold,Humana Gold,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medicaid MO,Medicaid MO,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Medica,Medica,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Tricare,Tricare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC All Payer,UHC All Payer,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Exchange,UHC Exchange,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicaid,UHC Medicaid,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UMR CPD,UMR CPD,336.39,,,,,,,per diem,336.39,336.39,"Per diem rate, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,UHC Medicare,UHC Medicare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
PD: FLUID SAMPLE CULTURE      ,68000476,CDM,804,RC,,,,,,Inpatient,,,336.39,336.39,Wellcare,Wellcare,336.39,,,,,,,case rate,336.39,336.39,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Meritain Health PPO CPD,Meritain Health PPO CPD,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Aetna/Commercial Product,Aetna/Commercial Product,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Meritain Health CPD,Meritain Health CPD,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Starmark CPD,Starmark CPD,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Aetna Medicare,Aetna Medicare,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Ambetter ,Ambetter ,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Blue Access,Anthem Blue Access,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Blue Access Choice,Anthem Blue Access Choice,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Blue Preferred,Anthem Blue Preferred,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Pathway,Anthem Pathway,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Alliance,Anthem Alliance,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Anthem Medicare,Anthem Medicare,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Cigna,Cigna,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Cigna PPO,Cigna PPO,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Cigna Medicare Advantage,Cigna Medicare Advantage,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Essence,Essence,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Healthlink HMO,Healthlink HMO,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Healthlink PPO,Healthlink PPO,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,HomeState Health Plan,HomeState Health Plan,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Humana Gold,Humana Gold,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Medicaid MO,Medicaid MO,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Medica,Medica,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Tricare,Tricare,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,UHC All Payer,UHC All Payer,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,UHC Exchange,UHC Exchange,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,UHC Medicaid,UHC Medicaid,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,UMR CPD,UMR CPD,1854,,,,,,,per diem,1854,1854,"Per diem rate, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,UHC Medicare,UHC Medicare,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - HEMODIALYSIS          ,68000601,CDM,801,RC,,,,,,Inpatient,,,1854,1854,Wellcare,Wellcare,1854,,,,,,,case rate,1854,1854,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Meritain Health PPO CPD,Meritain Health PPO CPD,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Aetna/Commercial Product,Aetna/Commercial Product,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Meritain Health CPD,Meritain Health CPD,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Starmark CPD,Starmark CPD,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Aetna Medicare,Aetna Medicare,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Ambetter ,Ambetter ,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Blue Access,Anthem Blue Access,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Blue Access Choice,Anthem Blue Access Choice,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Blue Preferred,Anthem Blue Preferred,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Pathway,Anthem Pathway,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Alliance,Anthem Alliance,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Anthem Medicare,Anthem Medicare,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Cigna,Cigna,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Cigna PPO,Cigna PPO,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Cigna Medicare Advantage,Cigna Medicare Advantage,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Essence,Essence,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Healthlink HMO,Healthlink HMO,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Healthlink PPO,Healthlink PPO,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,HomeState Health Plan,HomeState Health Plan,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Humana Gold,Humana Gold,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Medicaid MO,Medicaid MO,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Medica,Medica,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Tricare,Tricare,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,UHC All Payer,UHC All Payer,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,UHC Exchange,UHC Exchange,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,UHC Medicaid,UHC Medicaid,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,UMR CPD,UMR CPD,1390.5,,,,,,,per diem,1390.5,1390.5,"Per diem rate, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,UHC Medicare,UHC Medicare,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
TABLO - PERITONEAL DIALYSIS   ,68000602,CDM,802,RC,,,,,,Inpatient,,,1390.5,1390.5,Wellcare,Wellcare,1390.5,,,,,,,case rate,1390.5,1390.5,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Meritain Health PPO CPD,Meritain Health PPO CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna/Commercial Product,Aetna/Commercial Product,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Meritain Health CPD,Meritain Health CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Starmark CPD,Starmark CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Aetna Medicare,Aetna Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Ambetter ,Ambetter ,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Access,Anthem Blue Access,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Access Choice,Anthem Blue Access Choice,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Blue Preferred,Anthem Blue Preferred,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Pathway,Anthem Pathway,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Alliance,Anthem Alliance,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Anthem Medicare,Anthem Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna,Cigna,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna PPO,Cigna PPO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Cigna Medicare Advantage,Cigna Medicare Advantage,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Essence,Essence,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthlink HMO,Healthlink HMO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Healthlink PPO,Healthlink PPO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,HomeState Health Plan,HomeState Health Plan,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Humana Gold,Humana Gold,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Medicaid MO,Medicaid MO,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Medica,Medica,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Tricare,Tricare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC All Payer,UHC All Payer,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Exchange,UHC Exchange,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Medicaid,UHC Medicaid,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UMR CPD,UMR CPD,279.02,,,,,,,per diem,279.02,279.02,"Per diem rate, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,UHC Medicare,UHC Medicare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY IDENT EACH PANEL     ,72000020,CDM,300,RC,86870,CPT,,,,Inpatient,,,279.02,279.02,Wellcare,Wellcare,279.02,,,,,,,case rate,279.02,279.02,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health PPO CPD,Meritain Health PPO CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna/Commercial Product,Aetna/Commercial Product,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Meritain Health CPD,Meritain Health CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Starmark CPD,Starmark CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Aetna Medicare,Aetna Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Ambetter ,Ambetter ,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access,Anthem Blue Access,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Access Choice,Anthem Blue Access Choice,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Blue Preferred,Anthem Blue Preferred,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Pathway,Anthem Pathway,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Alliance,Anthem Alliance,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Anthem Medicare,Anthem Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna,Cigna,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna PPO,Cigna PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Cigna Medicare Advantage,Cigna Medicare Advantage,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Essence,Essence,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink HMO,Healthlink HMO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Healthlink PPO,Healthlink PPO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,HomeState Health Plan,HomeState Health Plan,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Humana Gold,Humana Gold,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medicaid MO,Medicaid MO,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Medica,Medica,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Tricare,Tricare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC All Payer,UHC All Payer,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Exchange,UHC Exchange,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicaid,UHC Medicaid,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UMR CPD,UMR CPD,170.8,,,,,,,per diem,170.8,170.8,"Per diem rate, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,UHC Medicare,UHC Medicare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
ANTIBODY SCREEN               ,72000025,CDM,300,RC,86850,CPT,,,,Inpatient,,,170.8,170.8,Wellcare,Wellcare,170.8,,,,,,,case rate,170.8,170.8,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Meritain Health PPO CPD,Meritain Health PPO CPD,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Aetna/Commercial Product,Aetna/Commercial Product,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Meritain Health CPD,Meritain Health CPD,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Starmark CPD,Starmark CPD,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Aetna Medicare,Aetna Medicare,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Ambetter ,Ambetter ,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Blue Access,Anthem Blue Access,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Blue Access Choice,Anthem Blue Access Choice,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Blue Preferred,Anthem Blue Preferred,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Pathway,Anthem Pathway,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Alliance,Anthem Alliance,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Anthem Medicare,Anthem Medicare,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Cigna,Cigna,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Cigna PPO,Cigna PPO,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Cigna Medicare Advantage,Cigna Medicare Advantage,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Essence,Essence,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Healthlink HMO,Healthlink HMO,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Healthlink PPO,Healthlink PPO,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,HomeState Health Plan,HomeState Health Plan,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Humana Gold,Humana Gold,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Medicaid MO,Medicaid MO,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Medica,Medica,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Tricare,Tricare,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,UHC All Payer,UHC All Payer,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,UHC Exchange,UHC Exchange,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,UHC Medicaid,UHC Medicaid,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,UMR CPD,UMR CPD,172.01,,,,,,,per diem,172.01,172.01,"Per diem rate, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,UHC Medicare,UHC Medicare,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COMPONENT POOLING             ,72000085,CDM,300,RC,86965,CPT,,,,Inpatient,,,172.01,172.01,Wellcare,Wellcare,172.01,,,,,,,case rate,172.01,172.01,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS DIRECT                 ,72000090,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Meritain Health PPO CPD,Meritain Health PPO CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Aetna/Commercial Product,Aetna/Commercial Product,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Meritain Health CPD,Meritain Health CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Starmark CPD,Starmark CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Aetna Medicare,Aetna Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Ambetter ,Ambetter ,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Access,Anthem Blue Access,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Access Choice,Anthem Blue Access Choice,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Blue Preferred,Anthem Blue Preferred,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Pathway,Anthem Pathway,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Alliance,Anthem Alliance,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Anthem Medicare,Anthem Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Cigna,Cigna,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Cigna PPO,Cigna PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Cigna Medicare Advantage,Cigna Medicare Advantage,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Essence,Essence,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Healthlink HMO,Healthlink HMO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Healthlink PPO,Healthlink PPO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,HomeState Health Plan,HomeState Health Plan,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Humana Gold,Humana Gold,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Medicaid MO,Medicaid MO,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Medica,Medica,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Tricare,Tricare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,UHC All Payer,UHC All Payer,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,UHC Exchange,UHC Exchange,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,UHC Medicaid,UHC Medicaid,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,UMR CPD,UMR CPD,101.97,,,,,,,per diem,101.97,101.97,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,UHC Medicare,UHC Medicare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT               ,72000100,CDM,300,RC,86885,CPT,,,,Inpatient,,,101.97,101.97,Wellcare,Wellcare,101.97,,,,,,,case rate,101.97,101.97,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Meritain Health PPO CPD,Meritain Health PPO CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Aetna/Commercial Product,Aetna/Commercial Product,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Meritain Health CPD,Meritain Health CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Starmark CPD,Starmark CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Aetna Medicare,Aetna Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Ambetter ,Ambetter ,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Access,Anthem Blue Access,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Access Choice,Anthem Blue Access Choice,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Blue Preferred,Anthem Blue Preferred,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Pathway,Anthem Pathway,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Alliance,Anthem Alliance,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Anthem Medicare,Anthem Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Cigna,Cigna,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Cigna PPO,Cigna PPO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Cigna Medicare Advantage,Cigna Medicare Advantage,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Essence,Essence,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Healthlink HMO,Healthlink HMO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Healthlink PPO,Healthlink PPO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,HomeState Health Plan,HomeState Health Plan,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Humana Gold,Humana Gold,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Medicaid MO,Medicaid MO,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Medica,Medica,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Tricare,Tricare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,UHC All Payer,UHC All Payer,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,UHC Exchange,UHC Exchange,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,UHC Medicaid,UHC Medicaid,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,UMR CPD,UMR CPD,168.68,,,,,,,per diem,168.68,168.68,"Per diem rate, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,UHC Medicare,UHC Medicare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
CROSSMATCH ANTIGLOBIN         ,72000120,CDM,300,RC,86922,CPT,,,,Inpatient,,,168.68,168.68,Wellcare,Wellcare,168.68,,,,,,,case rate,168.68,168.68,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Meritain Health PPO CPD,Meritain Health PPO CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Aetna/Commercial Product,Aetna/Commercial Product,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Meritain Health CPD,Meritain Health CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Starmark CPD,Starmark CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Aetna Medicare,Aetna Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Ambetter ,Ambetter ,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Access,Anthem Blue Access,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Access Choice,Anthem Blue Access Choice,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Blue Preferred,Anthem Blue Preferred,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Pathway,Anthem Pathway,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Alliance,Anthem Alliance,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Anthem Medicare,Anthem Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Cigna,Cigna,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Cigna PPO,Cigna PPO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Cigna Medicare Advantage,Cigna Medicare Advantage,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Essence,Essence,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Healthlink HMO,Healthlink HMO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Healthlink PPO,Healthlink PPO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,HomeState Health Plan,HomeState Health Plan,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Humana Gold,Humana Gold,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Medicaid MO,Medicaid MO,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Medica,Medica,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Tricare,Tricare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,UHC All Payer,UHC All Payer,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,UHC Exchange,UHC Exchange,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,UHC Medicaid,UHC Medicaid,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,UMR CPD,UMR CPD,229.15,,,,,,,per diem,229.15,229.15,"Per diem rate, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,UHC Medicare,UHC Medicare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
FFP THAWING PREP              ,72000140,CDM,300,RC,86927,CPT,,,,Inpatient,,,229.15,229.15,Wellcare,Wellcare,229.15,,,,,,,case rate,229.15,229.15,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Meritain Health PPO CPD,Meritain Health PPO CPD,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Aetna/Commercial Product,Aetna/Commercial Product,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Meritain Health CPD,Meritain Health CPD,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Starmark CPD,Starmark CPD,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Aetna Medicare,Aetna Medicare,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Ambetter ,Ambetter ,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Blue Access,Anthem Blue Access,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Blue Access Choice,Anthem Blue Access Choice,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Blue Preferred,Anthem Blue Preferred,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Pathway,Anthem Pathway,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Alliance,Anthem Alliance,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Anthem Medicare,Anthem Medicare,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Cigna,Cigna,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Cigna PPO,Cigna PPO,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Cigna Medicare Advantage,Cigna Medicare Advantage,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Essence,Essence,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Healthlink HMO,Healthlink HMO,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Healthlink PPO,Healthlink PPO,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,HomeState Health Plan,HomeState Health Plan,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Humana Gold,Humana Gold,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Medicaid MO,Medicaid MO,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Medica,Medica,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Tricare,Tricare,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,UHC All Payer,UHC All Payer,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,UHC Exchange,UHC Exchange,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,UHC Medicaid,UHC Medicaid,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,UMR CPD,UMR CPD,288.68,,,,,,,per diem,288.68,288.68,"Per diem rate, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,UHC Medicare,UHC Medicare,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TRANS-REACTION INVESTIGAT     ,72000228,CDM,305,RC,86078,CPT,,,,Inpatient,,,288.68,288.68,Wellcare,Wellcare,288.68,,,,,,,case rate,288.68,288.68,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
TYPE AND SCREEN               ,72000230,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Meritain Health PPO CPD,Meritain Health PPO CPD,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Aetna/Commercial Product,Aetna/Commercial Product,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Meritain Health CPD,Meritain Health CPD,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Starmark CPD,Starmark CPD,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Aetna Medicare,Aetna Medicare,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Ambetter ,Ambetter ,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Blue Access,Anthem Blue Access,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Blue Access Choice,Anthem Blue Access Choice,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Blue Preferred,Anthem Blue Preferred,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Pathway,Anthem Pathway,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Alliance,Anthem Alliance,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Anthem Medicare,Anthem Medicare,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Cigna,Cigna,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Cigna PPO,Cigna PPO,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Cigna Medicare Advantage,Cigna Medicare Advantage,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Essence,Essence,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Healthlink HMO,Healthlink HMO,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Healthlink PPO,Healthlink PPO,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,HomeState Health Plan,HomeState Health Plan,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Humana Gold,Humana Gold,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Medicaid MO,Medicaid MO,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Medica,Medica,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Tricare,Tricare,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,UHC All Payer,UHC All Payer,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,UHC Exchange,UHC Exchange,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,UHC Medicaid,UHC Medicaid,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,UMR CPD,UMR CPD,88.47,,,,,,,per diem,88.47,88.47,"Per diem rate, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,UHC Medicare,UHC Medicare,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
RH PHENOTYPING                ,72000280,CDM,300,RC,86906,CPT,,,,Inpatient,,,88.47,88.47,Wellcare,Wellcare,88.47,,,,,,,case rate,88.47,88.47,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Meritain Health PPO CPD,Meritain Health PPO CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Aetna/Commercial Product,Aetna/Commercial Product,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Meritain Health CPD,Meritain Health CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Starmark CPD,Starmark CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Aetna Medicare,Aetna Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Ambetter ,Ambetter ,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Blue Access,Anthem Blue Access,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Blue Access Choice,Anthem Blue Access Choice,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Blue Preferred,Anthem Blue Preferred,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Pathway,Anthem Pathway,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Alliance,Anthem Alliance,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Anthem Medicare,Anthem Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Cigna,Cigna,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Cigna PPO,Cigna PPO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Cigna Medicare Advantage,Cigna Medicare Advantage,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Essence,Essence,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Healthlink HMO,Healthlink HMO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Healthlink PPO,Healthlink PPO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,HomeState Health Plan,HomeState Health Plan,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Humana Gold,Humana Gold,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Medicaid MO,Medicaid MO,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Medica,Medica,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Tricare,Tricare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,UHC All Payer,UHC All Payer,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,UHC Exchange,UHC Exchange,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,UHC Medicaid,UHC Medicaid,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,UMR CPD,UMR CPD,122,,,,,,,per diem,122,122,"Per diem rate, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,UHC Medicare,UHC Medicare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
ANTIGEN TYPE (RBC)            ,72000300,CDM,300,RC,86905,CPT,,,,Inpatient,,,122,122,Wellcare,Wellcare,122,,,,,,,case rate,122,122,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Meritain Health PPO CPD,Meritain Health PPO CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Aetna/Commercial Product,Aetna/Commercial Product,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Meritain Health CPD,Meritain Health CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Starmark CPD,Starmark CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Aetna Medicare,Aetna Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Ambetter ,Ambetter ,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Access,Anthem Blue Access,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Access Choice,Anthem Blue Access Choice,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Blue Preferred,Anthem Blue Preferred,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Pathway,Anthem Pathway,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Alliance,Anthem Alliance,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Anthem Medicare,Anthem Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Cigna,Cigna,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Cigna PPO,Cigna PPO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Cigna Medicare Advantage,Cigna Medicare Advantage,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Essence,Essence,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Healthlink HMO,Healthlink HMO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Healthlink PPO,Healthlink PPO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,HomeState Health Plan,HomeState Health Plan,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Humana Gold,Humana Gold,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Medicaid MO,Medicaid MO,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Medica,Medica,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Tricare,Tricare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,UHC All Payer,UHC All Payer,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,UHC Exchange,UHC Exchange,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,UHC Medicaid,UHC Medicaid,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,UMR CPD,UMR CPD,206.88,,,,,,,per diem,206.88,206.88,"Per diem rate, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,UHC Medicare,UHC Medicare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC ELUTION                   ,72000310,CDM,300,RC,86860,CPT,,,,Inpatient,,,206.88,206.88,Wellcare,Wellcare,206.88,,,,,,,case rate,206.88,206.88,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Meritain Health PPO CPD,Meritain Health PPO CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Aetna/Commercial Product,Aetna/Commercial Product,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Meritain Health CPD,Meritain Health CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Starmark CPD,Starmark CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Aetna Medicare,Aetna Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Ambetter ,Ambetter ,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Access,Anthem Blue Access,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Access Choice,Anthem Blue Access Choice,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Blue Preferred,Anthem Blue Preferred,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Pathway,Anthem Pathway,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Alliance,Anthem Alliance,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Anthem Medicare,Anthem Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Cigna,Cigna,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Cigna PPO,Cigna PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Cigna Medicare Advantage,Cigna Medicare Advantage,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Essence,Essence,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Healthlink HMO,Healthlink HMO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Healthlink PPO,Healthlink PPO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,HomeState Health Plan,HomeState Health Plan,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Humana Gold,Humana Gold,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Medicaid MO,Medicaid MO,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Medica,Medica,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Tricare,Tricare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,UHC All Payer,UHC All Payer,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,UHC Exchange,UHC Exchange,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,UHC Medicaid,UHC Medicaid,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,UMR CPD,UMR CPD,164.94,,,,,,,per diem,164.94,164.94,"Per diem rate, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,UHC Medicare,UHC Medicare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
RBC PRETREAT DIFF RED CELL ABS,72000355,CDM,300,RC,86978,CPT,,,,Inpatient,,,164.94,164.94,Wellcare,Wellcare,164.94,,,,,,,case rate,164.94,164.94,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
BLOOD TYPING ABO              ,72000525,CDM,300,RC,86900,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Meritain Health PPO CPD,Meritain Health PPO CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Aetna/Commercial Product,Aetna/Commercial Product,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Meritain Health CPD,Meritain Health CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Starmark CPD,Starmark CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Aetna Medicare,Aetna Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Ambetter ,Ambetter ,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Access,Anthem Blue Access,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Access Choice,Anthem Blue Access Choice,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Blue Preferred,Anthem Blue Preferred,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Pathway,Anthem Pathway,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Alliance,Anthem Alliance,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Anthem Medicare,Anthem Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Cigna,Cigna,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Cigna PPO,Cigna PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Cigna Medicare Advantage,Cigna Medicare Advantage,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Essence,Essence,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Healthlink HMO,Healthlink HMO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Healthlink PPO,Healthlink PPO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,HomeState Health Plan,HomeState Health Plan,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Humana Gold,Humana Gold,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Medicaid MO,Medicaid MO,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Medica,Medica,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Tricare,Tricare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,UHC All Payer,UHC All Payer,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,UHC Exchange,UHC Exchange,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,UHC Medicaid,UHC Medicaid,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,UMR CPD,UMR CPD,95.6,,,,,,,per diem,95.6,95.6,"Per diem rate, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,UHC Medicare,UHC Medicare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIBODY ID/ENZYMES           ,72000535,CDM,300,RC,86971,CPT,,,,Inpatient,,,95.6,95.6,Wellcare,Wellcare,95.6,,,,,,,case rate,95.6,95.6,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Meritain Health PPO CPD,Meritain Health PPO CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Aetna/Commercial Product,Aetna/Commercial Product,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Meritain Health CPD,Meritain Health CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Starmark CPD,Starmark CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Aetna Medicare,Aetna Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Ambetter ,Ambetter ,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Access,Anthem Blue Access,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Access Choice,Anthem Blue Access Choice,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Blue Preferred,Anthem Blue Preferred,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Pathway,Anthem Pathway,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Alliance,Anthem Alliance,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Anthem Medicare,Anthem Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Cigna,Cigna,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Cigna PPO,Cigna PPO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Cigna Medicare Advantage,Cigna Medicare Advantage,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Essence,Essence,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Healthlink HMO,Healthlink HMO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Healthlink PPO,Healthlink PPO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,HomeState Health Plan,HomeState Health Plan,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Humana Gold,Humana Gold,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Medicaid MO,Medicaid MO,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Medica,Medica,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Tricare,Tricare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,UHC All Payer,UHC All Payer,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,UHC Exchange,UHC Exchange,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,UHC Medicaid,UHC Medicaid,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,UMR CPD,UMR CPD,128.37,,,,,,,per diem,128.37,128.37,"Per diem rate, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,UHC Medicare,UHC Medicare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
ANTIGEN SCREENING (REAGENT)   ,72000540,CDM,300,RC,86902,CPT,,,,Inpatient,,,128.37,128.37,Wellcare,Wellcare,128.37,,,,,,,case rate,128.37,128.37,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health PPO CPD,Meritain Health PPO CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna/Commercial Product,Aetna/Commercial Product,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Meritain Health CPD,Meritain Health CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Starmark CPD,Starmark CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Aetna Medicare,Aetna Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Ambetter ,Ambetter ,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access,Anthem Blue Access,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Access Choice,Anthem Blue Access Choice,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Blue Preferred,Anthem Blue Preferred,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Pathway,Anthem Pathway,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Alliance,Anthem Alliance,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Anthem Medicare,Anthem Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna,Cigna,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna PPO,Cigna PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Cigna Medicare Advantage,Cigna Medicare Advantage,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Essence,Essence,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthlink HMO,Healthlink HMO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Healthlink PPO,Healthlink PPO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,HomeState Health Plan,HomeState Health Plan,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Humana Gold,Humana Gold,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Medicaid MO,Medicaid MO,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Medica,Medica,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Tricare,Tricare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC All Payer,UHC All Payer,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Exchange,UHC Exchange,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicaid,UHC Medicaid,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UMR CPD,UMR CPD,84.87,,,,,,,per diem,84.87,84.87,"Per diem rate, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,UHC Medicare,UHC Medicare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
RH TYPING                     ,72000615,CDM,300,RC,86901,CPT,,,,Inpatient,,,84.87,84.87,Wellcare,Wellcare,84.87,,,,,,,case rate,84.87,84.87,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
IGG COOMBS INT                ,72000745,CDM,302,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health PPO CPD,Meritain Health PPO CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna/Commercial Product,Aetna/Commercial Product,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health CPD,Meritain Health CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Starmark CPD,Starmark CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Aetna Medicare,Aetna Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Ambetter ,Ambetter ,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access,Anthem Blue Access,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access Choice,Anthem Blue Access Choice,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Preferred,Anthem Blue Preferred,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Pathway,Anthem Pathway,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Alliance,Anthem Alliance,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Anthem Medicare,Anthem Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna,Cigna,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna PPO,Cigna PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Cigna Medicare Advantage,Cigna Medicare Advantage,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Essence,Essence,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthlink HMO,Healthlink HMO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Healthlink PPO,Healthlink PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,HomeState Health Plan,HomeState Health Plan,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Humana Gold,Humana Gold,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Medicaid MO,Medicaid MO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Medica,Medica,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Tricare,Tricare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC All Payer,UHC All Payer,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Exchange,UHC Exchange,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicaid,UHC Medicaid,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UMR CPD,UMR CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicare,UHC Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH IMMEDIATE SPIN     ,72000765,CDM,300,RC,86920,CPT,,,,Inpatient,,,177.17,177.17,Wellcare,Wellcare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health PPO CPD,Meritain Health PPO CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna/Commercial Product,Aetna/Commercial Product,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Meritain Health CPD,Meritain Health CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Starmark CPD,Starmark CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Aetna Medicare,Aetna Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Ambetter ,Ambetter ,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access,Anthem Blue Access,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Access Choice,Anthem Blue Access Choice,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Blue Preferred,Anthem Blue Preferred,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Pathway,Anthem Pathway,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Alliance,Anthem Alliance,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Anthem Medicare,Anthem Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna,Cigna,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna PPO,Cigna PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Cigna Medicare Advantage,Cigna Medicare Advantage,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Essence,Essence,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink HMO,Healthlink HMO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Healthlink PPO,Healthlink PPO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,HomeState Health Plan,HomeState Health Plan,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Humana Gold,Humana Gold,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medicaid MO,Medicaid MO,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Medica,Medica,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Tricare,Tricare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC All Payer,UHC All Payer,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Exchange,UHC Exchange,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicaid,UHC Medicaid,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UMR CPD,UMR CPD,89.12,,,,,,,per diem,89.12,89.12,"Per diem rate, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,UHC Medicare,UHC Medicare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
DIRECT ANTIGLOBULIN TEST (EA) ,72000770,CDM,300,RC,86880,CPT,,,,Inpatient,,,89.12,89.12,Wellcare,Wellcare,89.12,,,,,,,case rate,89.12,89.12,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Meritain Health PPO CPD,Meritain Health PPO CPD,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Aetna/Commercial Product,Aetna/Commercial Product,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Meritain Health CPD,Meritain Health CPD,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Starmark CPD,Starmark CPD,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Aetna Medicare,Aetna Medicare,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Ambetter ,Ambetter ,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Blue Access,Anthem Blue Access,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Blue Access Choice,Anthem Blue Access Choice,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Blue Preferred,Anthem Blue Preferred,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Pathway,Anthem Pathway,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Alliance,Anthem Alliance,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Anthem Medicare,Anthem Medicare,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Cigna,Cigna,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Cigna PPO,Cigna PPO,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Cigna Medicare Advantage,Cigna Medicare Advantage,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Essence,Essence,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Healthlink HMO,Healthlink HMO,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Healthlink PPO,Healthlink PPO,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,HomeState Health Plan,HomeState Health Plan,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Humana Gold,Humana Gold,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Medicaid MO,Medicaid MO,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Medica,Medica,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Tricare,Tricare,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,UHC All Payer,UHC All Payer,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,UHC Exchange,UHC Exchange,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,UHC Medicaid,UHC Medicaid,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,UMR CPD,UMR CPD,44.53,,,,,,,per diem,44.53,44.53,"Per diem rate, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,UHC Medicare,UHC Medicare,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
PLATELET ANTIBODY ID          ,72000800,CDM,302,RC,86022,CPT,,,,Inpatient,,,44.53,44.53,Wellcare,Wellcare,44.53,,,,,,,case rate,44.53,44.53,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health PPO CPD,Meritain Health PPO CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/Commercial Product,Aetna/Commercial Product,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health CPD,Meritain Health CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Starmark CPD,Starmark CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna Medicare,Aetna Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Ambetter ,Ambetter ,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access,Anthem Blue Access,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access Choice,Anthem Blue Access Choice,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Preferred,Anthem Blue Preferred,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Pathway,Anthem Pathway,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Alliance,Anthem Alliance,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Medicare,Anthem Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna,Cigna,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna PPO,Cigna PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna Medicare Advantage,Cigna Medicare Advantage,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Essence,Essence,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink HMO,Healthlink HMO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink PPO,Healthlink PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,HomeState Health Plan,HomeState Health Plan,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Humana Gold,Humana Gold,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Medicaid MO,Medicaid MO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Medica,Medica,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Tricare,Tricare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,UHC All Payer,UHC All Payer,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Exchange,UHC Exchange,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicaid,UHC Medicaid,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,UMR CPD,UMR CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicare,UHC Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, WBC    ",72000835,CDM,761,RC,36511,CPT,,,,Inpatient,,,2630.28,2630.28,Wellcare,Wellcare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health PPO CPD,Meritain Health PPO CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/Commercial Product,Aetna/Commercial Product,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health CPD,Meritain Health CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Starmark CPD,Starmark CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna Medicare,Aetna Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Ambetter ,Ambetter ,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access,Anthem Blue Access,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access Choice,Anthem Blue Access Choice,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Preferred,Anthem Blue Preferred,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Pathway,Anthem Pathway,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Alliance,Anthem Alliance,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Medicare,Anthem Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna,Cigna,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna PPO,Cigna PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna Medicare Advantage,Cigna Medicare Advantage,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Essence,Essence,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink HMO,Healthlink HMO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink PPO,Healthlink PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,HomeState Health Plan,HomeState Health Plan,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Humana Gold,Humana Gold,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Medicaid MO,Medicaid MO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Medica,Medica,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Tricare,Tricare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,UHC All Payer,UHC All Payer,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Exchange,UHC Exchange,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicaid,UHC Medicaid,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,UMR CPD,UMR CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicare,UHC Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
"THERAPEUTIC APHERESIS, RBC    ",72000840,CDM,761,RC,36512,CPT,,,,Inpatient,,,2630.28,2630.28,Wellcare,Wellcare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health PPO CPD,Meritain Health PPO CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna/Commercial Product,Aetna/Commercial Product,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Meritain Health CPD,Meritain Health CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Starmark CPD,Starmark CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Aetna Medicare,Aetna Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Ambetter ,Ambetter ,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access,Anthem Blue Access,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Access Choice,Anthem Blue Access Choice,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Blue Preferred,Anthem Blue Preferred,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Pathway,Anthem Pathway,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Alliance,Anthem Alliance,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Anthem Medicare,Anthem Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna,Cigna,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna PPO,Cigna PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Cigna Medicare Advantage,Cigna Medicare Advantage,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Essence,Essence,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink HMO,Healthlink HMO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Healthlink PPO,Healthlink PPO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,HomeState Health Plan,HomeState Health Plan,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Humana Gold,Humana Gold,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Medicaid MO,Medicaid MO,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Medica,Medica,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Tricare,Tricare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,UHC All Payer,UHC All Payer,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Exchange,UHC Exchange,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicaid,UHC Medicaid,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,UMR CPD,UMR CPD,2630.28,,,,,,,per diem,2630.28,2630.28,"Per diem rate, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,UHC Medicare,UHC Medicare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
THERAPEUTIC APHERESIS PLASMA  ,72000842,CDM,761,RC,36514,CPT,,,,Inpatient,,,2630.28,2630.28,Wellcare,Wellcare,2630.28,,,,,,,case rate,2630.28,2630.28,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health PPO CPD,Meritain Health PPO CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Aetna/Commercial Product,Aetna/Commercial Product,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Meritain Health CPD,Meritain Health CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Starmark CPD,Starmark CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Aetna Medicare,Aetna Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Ambetter ,Ambetter ,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access,Anthem Blue Access,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Access Choice,Anthem Blue Access Choice,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Blue Preferred,Anthem Blue Preferred,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Pathway,Anthem Pathway,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Alliance,Anthem Alliance,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Anthem Medicare,Anthem Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Cigna,Cigna,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Cigna PPO,Cigna PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Cigna Medicare Advantage,Cigna Medicare Advantage,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Essence,Essence,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Healthlink HMO,Healthlink HMO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Healthlink PPO,Healthlink PPO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,HomeState Health Plan,HomeState Health Plan,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Humana Gold,Humana Gold,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Medicaid MO,Medicaid MO,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Medica,Medica,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Tricare,Tricare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,UHC All Payer,UHC All Payer,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,UHC Exchange,UHC Exchange,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicaid,UHC Medicaid,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,UMR CPD,UMR CPD,177.17,,,,,,,per diem,177.17,177.17,"Per diem rate, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,UHC Medicare,UHC Medicare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
CROSSMATCH ELECTRONIC         ,72000845,CDM,300,RC,86923,CPT,,,,Inpatient,,,177.17,177.17,Wellcare,Wellcare,177.17,,,,,,,case rate,177.17,177.17,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Meritain Health PPO CPD,Meritain Health PPO CPD,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Aetna/Commercial Product,Aetna/Commercial Product,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Meritain Health CPD,Meritain Health CPD,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Starmark CPD,Starmark CPD,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Aetna Medicare,Aetna Medicare,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Ambetter ,Ambetter ,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Blue Access,Anthem Blue Access,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Blue Access Choice,Anthem Blue Access Choice,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Blue Preferred,Anthem Blue Preferred,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Pathway,Anthem Pathway,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Alliance,Anthem Alliance,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Anthem Medicare,Anthem Medicare,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Cigna,Cigna,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Cigna PPO,Cigna PPO,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Cigna Medicare Advantage,Cigna Medicare Advantage,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Essence,Essence,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Healthlink HMO,Healthlink HMO,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Healthlink PPO,Healthlink PPO,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,HomeState Health Plan,HomeState Health Plan,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Humana Gold,Humana Gold,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Medicaid MO,Medicaid MO,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Medica,Medica,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Tricare,Tricare,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,UHC All Payer,UHC All Payer,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,UHC Exchange,UHC Exchange,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,UHC Medicaid,UHC Medicaid,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,UMR CPD,UMR CPD,818.5,,,,,,,per diem,818.5,818.5,"Per diem rate, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,UHC Medicare,UHC Medicare,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
TRANSFUSION BLOOD/COMPONENT   ,72000900,CDM,391,RC,36430,CPT,,,,Inpatient,,,818.5,818.5,Wellcare,Wellcare,818.5,,,,,,,case rate,818.5,818.5,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Meritain Health PPO CPD,Meritain Health PPO CPD,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Aetna/Commercial Product,Aetna/Commercial Product,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Meritain Health CPD,Meritain Health CPD,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Starmark CPD,Starmark CPD,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Aetna Medicare,Aetna Medicare,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Ambetter ,Ambetter ,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Blue Access,Anthem Blue Access,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Blue Access Choice,Anthem Blue Access Choice,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Blue Preferred,Anthem Blue Preferred,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Pathway,Anthem Pathway,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Alliance,Anthem Alliance,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Anthem Medicare,Anthem Medicare,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Cigna,Cigna,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Cigna PPO,Cigna PPO,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Cigna Medicare Advantage,Cigna Medicare Advantage,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Essence,Essence,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Healthlink HMO,Healthlink HMO,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Healthlink PPO,Healthlink PPO,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,HomeState Health Plan,HomeState Health Plan,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Humana Gold,Humana Gold,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Medicaid MO,Medicaid MO,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Medica,Medica,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Tricare,Tricare,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,UHC All Payer,UHC All Payer,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,UHC Exchange,UHC Exchange,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,UHC Medicaid,UHC Medicaid,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,UMR CPD,UMR CPD,214.39,,,,,,,per diem,214.39,214.39,"Per diem rate, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,UHC Medicare,UHC Medicare,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
COOMBS INDIRECT TITER         ,72000905,CDM,300,RC,86886,CPT,,,,Inpatient,,,214.39,214.39,Wellcare,Wellcare,214.39,,,,,,,case rate,214.39,214.39,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Meritain Health PPO CPD,Meritain Health PPO CPD,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Aetna/Commercial Product,Aetna/Commercial Product,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Meritain Health CPD,Meritain Health CPD,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Starmark CPD,Starmark CPD,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Aetna Medicare,Aetna Medicare,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Ambetter ,Ambetter ,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Blue Access,Anthem Blue Access,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Blue Access Choice,Anthem Blue Access Choice,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Blue Preferred,Anthem Blue Preferred,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Pathway,Anthem Pathway,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Alliance,Anthem Alliance,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Anthem Medicare,Anthem Medicare,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Cigna,Cigna,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Cigna PPO,Cigna PPO,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Cigna Medicare Advantage,Cigna Medicare Advantage,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Essence,Essence,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Healthlink HMO,Healthlink HMO,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Healthlink PPO,Healthlink PPO,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,HomeState Health Plan,HomeState Health Plan,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Humana Gold,Humana Gold,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Medicaid MO,Medicaid MO,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Medica,Medica,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Tricare,Tricare,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,UHC All Payer,UHC All Payer,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,UHC Exchange,UHC Exchange,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,UHC Medicaid,UHC Medicaid,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,UMR CPD,UMR CPD,313.08,,,,,,,per diem,313.08,313.08,"Per diem rate, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,UHC Medicare,UHC Medicare,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
AUTOLOGOUS BLOOD COLLECTION   ,72000910,CDM,300,RC,86890,CPT,,,,Inpatient,,,313.08,313.08,Wellcare,Wellcare,313.08,,,,,,,case rate,313.08,313.08,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Meritain Health PPO CPD,Meritain Health PPO CPD,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Aetna/Commercial Product,Aetna/Commercial Product,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Meritain Health CPD,Meritain Health CPD,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Starmark CPD,Starmark CPD,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Aetna Medicare,Aetna Medicare,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Ambetter ,Ambetter ,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Blue Access,Anthem Blue Access,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Blue Access Choice,Anthem Blue Access Choice,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Blue Preferred,Anthem Blue Preferred,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Pathway,Anthem Pathway,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Alliance,Anthem Alliance,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Anthem Medicare,Anthem Medicare,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Cigna,Cigna,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Cigna PPO,Cigna PPO,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Cigna Medicare Advantage,Cigna Medicare Advantage,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Essence,Essence,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Healthlink HMO,Healthlink HMO,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Healthlink PPO,Healthlink PPO,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,HomeState Health Plan,HomeState Health Plan,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Humana Gold,Humana Gold,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Medicaid MO,Medicaid MO,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Medica,Medica,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Tricare,Tricare,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,UHC All Payer,UHC All Payer,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,UHC Exchange,UHC Exchange,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,UHC Medicaid,UHC Medicaid,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,UMR CPD,UMR CPD,625.93,,,,,,,per diem,625.93,625.93,"Per diem rate, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,UHC Medicare,UHC Medicare,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
LEUKOREDUCED RED BLOOD CELLS  ,72000916,CDM,391,RC,,,,,,Inpatient,,,625.93,625.93,Wellcare,Wellcare,625.93,,,,,,,case rate,625.93,625.93,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Meritain Health PPO CPD,Meritain Health PPO CPD,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Aetna/Commercial Product,Aetna/Commercial Product,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Meritain Health CPD,Meritain Health CPD,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Starmark CPD,Starmark CPD,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Aetna Medicare,Aetna Medicare,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Ambetter ,Ambetter ,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Blue Access,Anthem Blue Access,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Blue Access Choice,Anthem Blue Access Choice,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Blue Preferred,Anthem Blue Preferred,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Pathway,Anthem Pathway,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Alliance,Anthem Alliance,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Anthem Medicare,Anthem Medicare,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Cigna,Cigna,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Cigna PPO,Cigna PPO,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Cigna Medicare Advantage,Cigna Medicare Advantage,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Essence,Essence,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Healthlink HMO,Healthlink HMO,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Healthlink PPO,Healthlink PPO,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,HomeState Health Plan,HomeState Health Plan,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Humana Gold,Humana Gold,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Medicaid MO,Medicaid MO,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Medica,Medica,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Tricare,Tricare,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,UHC All Payer,UHC All Payer,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,UHC Exchange,UHC Exchange,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,UHC Medicaid,UHC Medicaid,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,UMR CPD,UMR CPD,181.38,,,,,,,per diem,181.38,181.38,"Per diem rate, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,UHC Medicare,UHC Medicare,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
ABO - RH                      ,72000917,CDM,391,RC,,,,,,Inpatient,,,181.38,181.38,Wellcare,Wellcare,181.38,,,,,,,case rate,181.38,181.38,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Meritain Health PPO CPD,Meritain Health PPO CPD,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Aetna/Commercial Product,Aetna/Commercial Product,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Meritain Health CPD,Meritain Health CPD,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Starmark CPD,Starmark CPD,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Aetna Medicare,Aetna Medicare,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Ambetter ,Ambetter ,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Blue Access,Anthem Blue Access,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Blue Access Choice,Anthem Blue Access Choice,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Blue Preferred,Anthem Blue Preferred,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Pathway,Anthem Pathway,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Alliance,Anthem Alliance,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Anthem Medicare,Anthem Medicare,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Cigna,Cigna,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Cigna PPO,Cigna PPO,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Cigna Medicare Advantage,Cigna Medicare Advantage,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Essence,Essence,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Healthlink HMO,Healthlink HMO,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Healthlink PPO,Healthlink PPO,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,HomeState Health Plan,HomeState Health Plan,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Humana Gold,Humana Gold,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Medicaid MO,Medicaid MO,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Medica,Medica,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Tricare,Tricare,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,UHC All Payer,UHC All Payer,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,UHC Exchange,UHC Exchange,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,UHC Medicaid,UHC Medicaid,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,UMR CPD,UMR CPD,289.53,,,,,,,per diem,289.53,289.53,"Per diem rate, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,UHC Medicare,UHC Medicare,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
COMPATIBILITY TEST PER UNIT   ,72000918,CDM,391,RC,,,,,,Inpatient,,,289.53,289.53,Wellcare,Wellcare,289.53,,,,,,,case rate,289.53,289.53,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Meritain Health PPO CPD,Meritain Health PPO CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Aetna/Commercial Product,Aetna/Commercial Product,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Meritain Health CPD,Meritain Health CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Starmark CPD,Starmark CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Aetna Medicare,Aetna Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Ambetter ,Ambetter ,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Blue Access,Anthem Blue Access,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Blue Access Choice,Anthem Blue Access Choice,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Blue Preferred,Anthem Blue Preferred,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Pathway,Anthem Pathway,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Alliance,Anthem Alliance,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Anthem Medicare,Anthem Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Cigna,Cigna,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Cigna PPO,Cigna PPO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Cigna Medicare Advantage,Cigna Medicare Advantage,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Essence,Essence,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Healthlink HMO,Healthlink HMO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Healthlink PPO,Healthlink PPO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,HomeState Health Plan,HomeState Health Plan,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Humana Gold,Humana Gold,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Medicaid MO,Medicaid MO,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Medica,Medica,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Tricare,Tricare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,UHC All Payer,UHC All Payer,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,UHC Exchange,UHC Exchange,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,UHC Medicaid,UHC Medicaid,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,UMR CPD,UMR CPD,225.88,,,,,,,per diem,225.88,225.88,"Per diem rate, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,UHC Medicare,UHC Medicare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
BLOOD COMPONENT PREPARATION   ,72000919,CDM,300,RC,,,,,,Inpatient,,,225.88,225.88,Wellcare,Wellcare,225.88,,,,,,,case rate,225.88,225.88,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Meritain Health PPO CPD,Meritain Health PPO CPD,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Aetna/Commercial Product,Aetna/Commercial Product,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Meritain Health CPD,Meritain Health CPD,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Starmark CPD,Starmark CPD,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Aetna Medicare,Aetna Medicare,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Ambetter ,Ambetter ,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Blue Access,Anthem Blue Access,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Blue Access Choice,Anthem Blue Access Choice,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Blue Preferred,Anthem Blue Preferred,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Pathway,Anthem Pathway,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Alliance,Anthem Alliance,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Anthem Medicare,Anthem Medicare,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Cigna,Cigna,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Cigna PPO,Cigna PPO,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Cigna Medicare Advantage,Cigna Medicare Advantage,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Essence,Essence,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Healthlink HMO,Healthlink HMO,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Healthlink PPO,Healthlink PPO,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,HomeState Health Plan,HomeState Health Plan,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Humana Gold,Humana Gold,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Medicaid MO,Medicaid MO,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Medica,Medica,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Tricare,Tricare,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,UHC All Payer,UHC All Payer,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,UHC Exchange,UHC Exchange,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,UHC Medicaid,UHC Medicaid,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,UMR CPD,UMR CPD,143.38,,,,,,,per diem,143.38,143.38,"Per diem rate, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,UHC Medicare,UHC Medicare,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
SPECIMEN TRANSPORT FEE        ,72000920,CDM,300,RC,,,,,,Inpatient,,,143.38,143.38,Wellcare,Wellcare,143.38,,,,,,,case rate,143.38,143.38,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Meritain Health PPO CPD,Meritain Health PPO CPD,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Aetna/Commercial Product,Aetna/Commercial Product,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Meritain Health CPD,Meritain Health CPD,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Starmark CPD,Starmark CPD,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Aetna Medicare,Aetna Medicare,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Ambetter ,Ambetter ,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Blue Access,Anthem Blue Access,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Blue Access Choice,Anthem Blue Access Choice,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Blue Preferred,Anthem Blue Preferred,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Pathway,Anthem Pathway,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Alliance,Anthem Alliance,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Anthem Medicare,Anthem Medicare,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Cigna,Cigna,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Cigna PPO,Cigna PPO,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Cigna Medicare Advantage,Cigna Medicare Advantage,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Essence,Essence,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Healthlink HMO,Healthlink HMO,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Healthlink PPO,Healthlink PPO,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,HomeState Health Plan,HomeState Health Plan,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Humana Gold,Humana Gold,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Medicaid MO,Medicaid MO,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Medica,Medica,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Tricare,Tricare,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,UHC All Payer,UHC All Payer,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,UHC Exchange,UHC Exchange,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,UHC Medicaid,UHC Medicaid,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,UMR CPD,UMR CPD,105.06,,,,,,,per diem,105.06,105.06,"Per diem rate, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,UHC Medicare,UHC Medicare,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
K ANTIGEN TYPE                ,72000921,CDM,391,RC,,,,,,Inpatient,,,105.06,105.06,Wellcare,Wellcare,105.06,,,,,,,case rate,105.06,105.06,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Meritain Health PPO CPD,Meritain Health PPO CPD,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Aetna/Commercial Product,Aetna/Commercial Product,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Meritain Health CPD,Meritain Health CPD,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Starmark CPD,Starmark CPD,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Aetna Medicare,Aetna Medicare,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Ambetter ,Ambetter ,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Blue Access,Anthem Blue Access,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Blue Access Choice,Anthem Blue Access Choice,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Blue Preferred,Anthem Blue Preferred,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Pathway,Anthem Pathway,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Alliance,Anthem Alliance,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Anthem Medicare,Anthem Medicare,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Cigna,Cigna,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Cigna PPO,Cigna PPO,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Cigna Medicare Advantage,Cigna Medicare Advantage,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Essence,Essence,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Healthlink HMO,Healthlink HMO,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Healthlink PPO,Healthlink PPO,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,HomeState Health Plan,HomeState Health Plan,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Humana Gold,Humana Gold,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Medicaid MO,Medicaid MO,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Medica,Medica,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Tricare,Tricare,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,UHC All Payer,UHC All Payer,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,UHC Exchange,UHC Exchange,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,UHC Medicaid,UHC Medicaid,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,UMR CPD,UMR CPD,270.68,,,,,,,per diem,270.68,270.68,"Per diem rate, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,UHC Medicare,UHC Medicare,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
ADDTL RED CELL ANTIBODY PANEL ,72000922,CDM,391,RC,,,,,,Inpatient,,,270.68,270.68,Wellcare,Wellcare,270.68,,,,,,,case rate,270.68,270.68,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Meritain Health PPO CPD,Meritain Health PPO CPD,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Aetna/Commercial Product,Aetna/Commercial Product,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Meritain Health CPD,Meritain Health CPD,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Starmark CPD,Starmark CPD,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Aetna Medicare,Aetna Medicare,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Ambetter ,Ambetter ,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Blue Access,Anthem Blue Access,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Blue Access Choice,Anthem Blue Access Choice,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Blue Preferred,Anthem Blue Preferred,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Pathway,Anthem Pathway,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Alliance,Anthem Alliance,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Anthem Medicare,Anthem Medicare,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Cigna,Cigna,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Cigna PPO,Cigna PPO,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Cigna Medicare Advantage,Cigna Medicare Advantage,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Essence,Essence,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Healthlink HMO,Healthlink HMO,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Healthlink PPO,Healthlink PPO,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,HomeState Health Plan,HomeState Health Plan,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Humana Gold,Humana Gold,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Medicaid MO,Medicaid MO,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Medica,Medica,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Tricare,Tricare,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,UHC All Payer,UHC All Payer,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,UHC Exchange,UHC Exchange,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,UHC Medicaid,UHC Medicaid,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,UMR CPD,UMR CPD,385.01,,,,,,,per diem,385.01,385.01,"Per diem rate, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,UHC Medicare,UHC Medicare,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
COMPAT TEST FULL CROSSMTCH AHG,72000923,CDM,391,RC,,,,,,Inpatient,,,385.01,385.01,Wellcare,Wellcare,385.01,,,,,,,case rate,385.01,385.01,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Meritain Health PPO CPD,Meritain Health PPO CPD,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Aetna/Commercial Product,Aetna/Commercial Product,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Meritain Health CPD,Meritain Health CPD,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Starmark CPD,Starmark CPD,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Aetna Medicare,Aetna Medicare,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Ambetter ,Ambetter ,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Blue Access,Anthem Blue Access,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Blue Access Choice,Anthem Blue Access Choice,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Blue Preferred,Anthem Blue Preferred,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Pathway,Anthem Pathway,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Alliance,Anthem Alliance,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Anthem Medicare,Anthem Medicare,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Cigna,Cigna,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Cigna PPO,Cigna PPO,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Cigna Medicare Advantage,Cigna Medicare Advantage,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Essence,Essence,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Healthlink HMO,Healthlink HMO,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Healthlink PPO,Healthlink PPO,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,HomeState Health Plan,HomeState Health Plan,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Humana Gold,Humana Gold,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Medicaid MO,Medicaid MO,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Medica,Medica,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Tricare,Tricare,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,UHC All Payer,UHC All Payer,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,UHC Exchange,UHC Exchange,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,UHC Medicaid,UHC Medicaid,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,UMR CPD,UMR CPD,2110.13,,,,,,,per diem,2110.13,2110.13,"Per diem rate, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,UHC Medicare,UHC Medicare,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CT EXTREMITY LOWER W          ,72020114,CDM,352,RC,,,,,,Inpatient,,,2110.13,2110.13,Wellcare,Wellcare,2110.13,,,,,,,case rate,2110.13,2110.13,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Meritain Health PPO CPD,Meritain Health PPO CPD,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Aetna/Commercial Product,Aetna/Commercial Product,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Meritain Health CPD,Meritain Health CPD,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Starmark CPD,Starmark CPD,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Aetna Medicare,Aetna Medicare,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Ambetter ,Ambetter ,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Blue Access,Anthem Blue Access,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Blue Access Choice,Anthem Blue Access Choice,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Blue Preferred,Anthem Blue Preferred,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Pathway,Anthem Pathway,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Alliance,Anthem Alliance,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Anthem Medicare,Anthem Medicare,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Cigna,Cigna,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Cigna PPO,Cigna PPO,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Cigna Medicare Advantage,Cigna Medicare Advantage,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Essence,Essence,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Healthlink HMO,Healthlink HMO,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Healthlink PPO,Healthlink PPO,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,HomeState Health Plan,HomeState Health Plan,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Humana Gold,Humana Gold,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Medicaid MO,Medicaid MO,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Medica,Medica,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Tricare,Tricare,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,UHC All Payer,UHC All Payer,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,UHC Exchange,UHC Exchange,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,UHC Medicaid,UHC Medicaid,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,UMR CPD,UMR CPD,4682.81,,,,,,,per diem,4682.81,4682.81,"Per diem rate, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,UHC Medicare,UHC Medicare,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
CTA ABD PELVIS WWO C          ,72020115,CDM,352,RC,,,,,,Inpatient,,,4682.81,4682.81,Wellcare,Wellcare,4682.81,,,,,,,case rate,4682.81,4682.81,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Meritain Health PPO CPD,Meritain Health PPO CPD,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Aetna/Commercial Product,Aetna/Commercial Product,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Meritain Health CPD,Meritain Health CPD,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Starmark CPD,Starmark CPD,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Aetna Medicare,Aetna Medicare,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Ambetter ,Ambetter ,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Blue Access,Anthem Blue Access,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Blue Access Choice,Anthem Blue Access Choice,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Blue Preferred,Anthem Blue Preferred,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Pathway,Anthem Pathway,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Alliance,Anthem Alliance,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Anthem Medicare,Anthem Medicare,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Cigna,Cigna,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Cigna PPO,Cigna PPO,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Cigna Medicare Advantage,Cigna Medicare Advantage,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Essence,Essence,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Healthlink HMO,Healthlink HMO,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Healthlink PPO,Healthlink PPO,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,HomeState Health Plan,HomeState Health Plan,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Humana Gold,Humana Gold,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Medicaid MO,Medicaid MO,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Medica,Medica,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Tricare,Tricare,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,UHC All Payer,UHC All Payer,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,UHC Exchange,UHC Exchange,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,UHC Medicaid,UHC Medicaid,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,UMR CPD,UMR CPD,430.73,,,,,,,per diem,430.73,430.73,"Per diem rate, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,UHC Medicare,UHC Medicare,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RED BLOOD CELLS               ,72050005,CDM,381,RC,P9021,HCPCS,,,,Inpatient,,,430.73,430.73,Wellcare,Wellcare,430.73,,,,,,,case rate,430.73,430.73,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Meritain Health PPO CPD,Meritain Health PPO CPD,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Aetna/Commercial Product,Aetna/Commercial Product,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Meritain Health CPD,Meritain Health CPD,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Starmark CPD,Starmark CPD,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Aetna Medicare,Aetna Medicare,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Ambetter ,Ambetter ,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Blue Access,Anthem Blue Access,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Blue Access Choice,Anthem Blue Access Choice,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Blue Preferred,Anthem Blue Preferred,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Pathway,Anthem Pathway,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Alliance,Anthem Alliance,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Anthem Medicare,Anthem Medicare,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Cigna,Cigna,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Cigna PPO,Cigna PPO,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Cigna Medicare Advantage,Cigna Medicare Advantage,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Essence,Essence,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Healthlink HMO,Healthlink HMO,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Healthlink PPO,Healthlink PPO,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,HomeState Health Plan,HomeState Health Plan,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Humana Gold,Humana Gold,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Medicaid MO,Medicaid MO,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Medica,Medica,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Tricare,Tricare,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,UHC All Payer,UHC All Payer,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,UHC Exchange,UHC Exchange,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,UHC Medicaid,UHC Medicaid,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,UMR CPD,UMR CPD,501.81,,,,,,,per diem,501.81,501.81,"Per diem rate, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,UHC Medicare,UHC Medicare,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC IRRADIATED                ,72050014,CDM,381,RC,P9038,CPT,P9038,HCPCS,BL,Inpatient,,,501.81,501.81,Wellcare,Wellcare,501.81,,,,,,,case rate,501.81,501.81,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Meritain Health PPO CPD,Meritain Health PPO CPD,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Aetna/Commercial Product,Aetna/Commercial Product,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Meritain Health CPD,Meritain Health CPD,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Starmark CPD,Starmark CPD,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Aetna Medicare,Aetna Medicare,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Ambetter ,Ambetter ,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Blue Access,Anthem Blue Access,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Blue Access Choice,Anthem Blue Access Choice,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Blue Preferred,Anthem Blue Preferred,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Pathway,Anthem Pathway,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Alliance,Anthem Alliance,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Anthem Medicare,Anthem Medicare,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Cigna,Cigna,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Cigna PPO,Cigna PPO,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Cigna Medicare Advantage,Cigna Medicare Advantage,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Essence,Essence,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Healthlink HMO,Healthlink HMO,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Healthlink PPO,Healthlink PPO,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,HomeState Health Plan,HomeState Health Plan,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Humana Gold,Humana Gold,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Medicaid MO,Medicaid MO,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Medica,Medica,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Tricare,Tricare,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,UHC All Payer,UHC All Payer,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,UHC Exchange,UHC Exchange,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,UHC Medicaid,UHC Medicaid,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,UMR CPD,UMR CPD,637.85,,,,,,,per diem,637.85,637.85,"Per diem rate, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,UHC Medicare,UHC Medicare,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RBC LEUKOREDUCED-PROC ONLY    ,72060002,CDM,390,RC,P9016,CPT,P9016,HCPCS,,Inpatient,,,637.85,637.85,Wellcare,Wellcare,637.85,,,,,,,case rate,637.85,637.85,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Meritain Health PPO CPD,Meritain Health PPO CPD,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Aetna/Commercial Product,Aetna/Commercial Product,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Meritain Health CPD,Meritain Health CPD,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Starmark CPD,Starmark CPD,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Aetna Medicare,Aetna Medicare,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Ambetter ,Ambetter ,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Blue Access,Anthem Blue Access,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Blue Access Choice,Anthem Blue Access Choice,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Blue Preferred,Anthem Blue Preferred,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Pathway,Anthem Pathway,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Alliance,Anthem Alliance,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Anthem Medicare,Anthem Medicare,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Cigna,Cigna,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Cigna PPO,Cigna PPO,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Cigna Medicare Advantage,Cigna Medicare Advantage,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Essence,Essence,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Healthlink HMO,Healthlink HMO,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Healthlink PPO,Healthlink PPO,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,HomeState Health Plan,HomeState Health Plan,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Humana Gold,Humana Gold,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Medicaid MO,Medicaid MO,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Medica,Medica,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Tricare,Tricare,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,UHC All Payer,UHC All Payer,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,UHC Exchange,UHC Exchange,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,UHC Medicaid,UHC Medicaid,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,UMR CPD,UMR CPD,423.33,,,,,,,per diem,423.33,423.33,"Per diem rate, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,UHC Medicare,UHC Medicare,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
RED BLOOD CELL-PROC ONLY      ,72060005,CDM,390,RC,P9021,CPT,P9021,HCPCS,,Inpatient,,,423.33,423.33,Wellcare,Wellcare,423.33,,,,,,,case rate,423.33,423.33,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Meritain Health PPO CPD,Meritain Health PPO CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Aetna/Commercial Product,Aetna/Commercial Product,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Meritain Health CPD,Meritain Health CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Starmark CPD,Starmark CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Aetna Medicare,Aetna Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Ambetter ,Ambetter ,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Blue Access,Anthem Blue Access,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Blue Access Choice,Anthem Blue Access Choice,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Blue Preferred,Anthem Blue Preferred,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Pathway,Anthem Pathway,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Alliance,Anthem Alliance,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Anthem Medicare,Anthem Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Cigna,Cigna,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Cigna PPO,Cigna PPO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Cigna Medicare Advantage,Cigna Medicare Advantage,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Essence,Essence,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Healthlink HMO,Healthlink HMO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Healthlink PPO,Healthlink PPO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,HomeState Health Plan,HomeState Health Plan,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Humana Gold,Humana Gold,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Medicaid MO,Medicaid MO,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Medica,Medica,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Tricare,Tricare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,UHC All Payer,UHC All Payer,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,UHC Exchange,UHC Exchange,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,UHC Medicaid,UHC Medicaid,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,UMR CPD,UMR CPD,827.5,,,,,,,per diem,827.5,827.5,"Per diem rate, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,UHC Medicare,UHC Medicare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS LR-PROC ONLY        ,72060007,CDM,390,RC,P9031,HCPCS,,,,Inpatient,,,827.5,827.5,Wellcare,Wellcare,827.5,,,,,,,case rate,827.5,827.5,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Meritain Health PPO CPD,Meritain Health PPO CPD,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Aetna/Commercial Product,Aetna/Commercial Product,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Meritain Health CPD,Meritain Health CPD,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Starmark CPD,Starmark CPD,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Aetna Medicare,Aetna Medicare,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Ambetter ,Ambetter ,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Blue Access,Anthem Blue Access,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Blue Access Choice,Anthem Blue Access Choice,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Blue Preferred,Anthem Blue Preferred,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Pathway,Anthem Pathway,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Alliance,Anthem Alliance,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Anthem Medicare,Anthem Medicare,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Cigna,Cigna,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Cigna PPO,Cigna PPO,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Cigna Medicare Advantage,Cigna Medicare Advantage,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Essence,Essence,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Healthlink HMO,Healthlink HMO,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Healthlink PPO,Healthlink PPO,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,HomeState Health Plan,HomeState Health Plan,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Humana Gold,Humana Gold,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Medicaid MO,Medicaid MO,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Medica,Medica,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Tricare,Tricare,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,UHC All Payer,UHC All Payer,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,UHC Exchange,UHC Exchange,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,UHC Medicaid,UHC Medicaid,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,UMR CPD,UMR CPD,1640.15,,,,,,,per diem,1640.15,1640.15,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,UHC Medicare,UHC Medicare,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR-PROC ONLY   ,72060011,CDM,390,RC,P9035,CPT,P9035,HCPCS,,Inpatient,,,1640.15,1640.15,Wellcare,Wellcare,1640.15,,,,,,,case rate,1640.15,1640.15,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Meritain Health PPO CPD,Meritain Health PPO CPD,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Aetna/Commercial Product,Aetna/Commercial Product,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Meritain Health CPD,Meritain Health CPD,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Starmark CPD,Starmark CPD,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Aetna Medicare,Aetna Medicare,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Ambetter ,Ambetter ,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Blue Access,Anthem Blue Access,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Blue Access Choice,Anthem Blue Access Choice,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Blue Preferred,Anthem Blue Preferred,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Pathway,Anthem Pathway,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Alliance,Anthem Alliance,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Anthem Medicare,Anthem Medicare,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Cigna,Cigna,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Cigna PPO,Cigna PPO,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Cigna Medicare Advantage,Cigna Medicare Advantage,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Essence,Essence,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Healthlink HMO,Healthlink HMO,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Healthlink PPO,Healthlink PPO,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,HomeState Health Plan,HomeState Health Plan,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Humana Gold,Humana Gold,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Medicaid MO,Medicaid MO,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Medica,Medica,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Tricare,Tricare,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,UHC All Payer,UHC All Payer,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,UHC Exchange,UHC Exchange,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,UHC Medicaid,UHC Medicaid,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,UMR CPD,UMR CPD,1768.52,,,,,,,per diem,1768.52,1768.52,"Per diem rate, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,UHC Medicare,UHC Medicare,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
PLATELETS PHER LR IRRAD-PROC  ,72060013,CDM,390,RC,P9037,CPT,P9037,HCPCS,,Inpatient,,,1768.52,1768.52,Wellcare,Wellcare,1768.52,,,,,,,case rate,1768.52,1768.52,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Meritain Health PPO CPD,Meritain Health PPO CPD,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Aetna/Commercial Product,Aetna/Commercial Product,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Meritain Health CPD,Meritain Health CPD,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Starmark CPD,Starmark CPD,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Aetna Medicare,Aetna Medicare,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Ambetter ,Ambetter ,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Blue Access,Anthem Blue Access,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Blue Access Choice,Anthem Blue Access Choice,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Blue Preferred,Anthem Blue Preferred,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Pathway,Anthem Pathway,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Alliance,Anthem Alliance,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Anthem Medicare,Anthem Medicare,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Cigna,Cigna,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Cigna PPO,Cigna PPO,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Cigna Medicare Advantage,Cigna Medicare Advantage,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Essence,Essence,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Healthlink HMO,Healthlink HMO,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Healthlink PPO,Healthlink PPO,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,HomeState Health Plan,HomeState Health Plan,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Humana Gold,Humana Gold,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Medicaid MO,Medicaid MO,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Medica,Medica,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Tricare,Tricare,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,UHC All Payer,UHC All Payer,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,UHC Exchange,UHC Exchange,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,UHC Medicaid,UHC Medicaid,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,UMR CPD,UMR CPD,718.36,,,,,,,per diem,718.36,718.36,"Per diem rate, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,UHC Medicare,UHC Medicare,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
RBC LR IRRADIATED-PROC ONLY   ,72060016,CDM,390,RC,P9040,CPT,P9040,HCPCS,,Inpatient,,,718.36,718.36,Wellcare,Wellcare,718.36,,,,,,,case rate,718.36,718.36,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Meritain Health PPO CPD,Meritain Health PPO CPD,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Aetna/Commercial Product,Aetna/Commercial Product,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Meritain Health CPD,Meritain Health CPD,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Starmark CPD,Starmark CPD,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Aetna Medicare,Aetna Medicare,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Ambetter ,Ambetter ,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Blue Access,Anthem Blue Access,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Blue Access Choice,Anthem Blue Access Choice,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Blue Preferred,Anthem Blue Preferred,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Pathway,Anthem Pathway,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Alliance,Anthem Alliance,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Anthem Medicare,Anthem Medicare,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Cigna,Cigna,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Cigna PPO,Cigna PPO,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Cigna Medicare Advantage,Cigna Medicare Advantage,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Essence,Essence,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Healthlink HMO,Healthlink HMO,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Healthlink PPO,Healthlink PPO,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,HomeState Health Plan,HomeState Health Plan,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Humana Gold,Humana Gold,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Medicaid MO,Medicaid MO,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Medica,Medica,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Tricare,Tricare,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,UHC All Payer,UHC All Payer,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,UHC Exchange,UHC Exchange,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,UHC Medicaid,UHC Medicaid,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,UMR CPD,UMR CPD,1161.96,,,,,,,per diem,1161.96,1161.96,"Per diem rate, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,UHC Medicare,UHC Medicare,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG DIGITAL ANALYSIS          ,73500050,CDM,740,RC,95957,CPT,,,,Inpatient,,,1161.96,1161.96,Wellcare,Wellcare,1161.96,,,,,,,case rate,1161.96,1161.96,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Meritain Health PPO CPD,Meritain Health PPO CPD,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Aetna/Commercial Product,Aetna/Commercial Product,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Meritain Health CPD,Meritain Health CPD,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Starmark CPD,Starmark CPD,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Aetna Medicare,Aetna Medicare,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Ambetter ,Ambetter ,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Blue Access,Anthem Blue Access,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Blue Access Choice,Anthem Blue Access Choice,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Blue Preferred,Anthem Blue Preferred,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Pathway,Anthem Pathway,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Alliance,Anthem Alliance,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Anthem Medicare,Anthem Medicare,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Cigna,Cigna,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Cigna PPO,Cigna PPO,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Cigna Medicare Advantage,Cigna Medicare Advantage,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Essence,Essence,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Healthlink HMO,Healthlink HMO,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Healthlink PPO,Healthlink PPO,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,HomeState Health Plan,HomeState Health Plan,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Humana Gold,Humana Gold,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Medicaid MO,Medicaid MO,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Medica,Medica,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Tricare,Tricare,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,UHC All Payer,UHC All Payer,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,UHC Exchange,UHC Exchange,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,UHC Medicaid,UHC Medicaid,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,UMR CPD,UMR CPD,802.66,,,,,,,per diem,802.66,802.66,"Per diem rate, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,UHC Medicare,UHC Medicare,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG COMA OR SLEEP ONLY        ,73500070,CDM,740,RC,95822,CPT,,,,Inpatient,,,802.66,802.66,Wellcare,Wellcare,802.66,,,,,,,case rate,802.66,802.66,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Meritain Health PPO CPD,Meritain Health PPO CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Aetna/Commercial Product,Aetna/Commercial Product,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Meritain Health CPD,Meritain Health CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Starmark CPD,Starmark CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Aetna Medicare,Aetna Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Ambetter ,Ambetter ,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Access,Anthem Blue Access,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Access Choice,Anthem Blue Access Choice,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Blue Preferred,Anthem Blue Preferred,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Pathway,Anthem Pathway,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Alliance,Anthem Alliance,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Anthem Medicare,Anthem Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Cigna,Cigna,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Cigna PPO,Cigna PPO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Cigna Medicare Advantage,Cigna Medicare Advantage,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Essence,Essence,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Healthlink HMO,Healthlink HMO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Healthlink PPO,Healthlink PPO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,HomeState Health Plan,HomeState Health Plan,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Humana Gold,Humana Gold,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Medicaid MO,Medicaid MO,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Medica,Medica,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Tricare,Tricare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,UHC All Payer,UHC All Payer,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,UHC Exchange,UHC Exchange,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,UHC Medicaid,UHC Medicaid,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,UMR CPD,UMR CPD,513.74,,,,,,,per diem,513.74,513.74,"Per diem rate, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,UHC Medicare,UHC Medicare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
EEG CEREBRAL DEATH EVAL       ,73500080,CDM,740,RC,95824,CPT,,,,Inpatient,,,513.74,513.74,Wellcare,Wellcare,513.74,,,,,,,case rate,513.74,513.74,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Meritain Health PPO CPD,Meritain Health PPO CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Aetna/Commercial Product,Aetna/Commercial Product,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Meritain Health CPD,Meritain Health CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Starmark CPD,Starmark CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Aetna Medicare,Aetna Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Ambetter ,Ambetter ,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Access,Anthem Blue Access,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Access Choice,Anthem Blue Access Choice,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Blue Preferred,Anthem Blue Preferred,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Pathway,Anthem Pathway,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Alliance,Anthem Alliance,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Anthem Medicare,Anthem Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Cigna,Cigna,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Cigna PPO,Cigna PPO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Cigna Medicare Advantage,Cigna Medicare Advantage,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Essence,Essence,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Healthlink HMO,Healthlink HMO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Healthlink PPO,Healthlink PPO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,HomeState Health Plan,HomeState Health Plan,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Humana Gold,Humana Gold,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Medicaid MO,Medicaid MO,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Medica,Medica,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Tricare,Tricare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,UHC All Payer,UHC All Payer,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,UHC Exchange,UHC Exchange,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,UHC Medicaid,UHC Medicaid,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,UMR CPD,UMR CPD,1087.37,,,,,,,per diem,1087.37,1087.37,"Per diem rate, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,UHC Medicare,UHC Medicare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
AUDITORY EVOKED POTENTIAL     ,73500090,CDM,471,RC,92585,CPT,,,,Inpatient,,,1087.37,1087.37,Wellcare,Wellcare,1087.37,,,,,,,case rate,1087.37,1087.37,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Meritain Health PPO CPD,Meritain Health PPO CPD,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Aetna/Commercial Product,Aetna/Commercial Product,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Meritain Health CPD,Meritain Health CPD,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Starmark CPD,Starmark CPD,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Aetna Medicare,Aetna Medicare,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Ambetter ,Ambetter ,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Blue Access,Anthem Blue Access,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Blue Access Choice,Anthem Blue Access Choice,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Blue Preferred,Anthem Blue Preferred,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Pathway,Anthem Pathway,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Alliance,Anthem Alliance,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Anthem Medicare,Anthem Medicare,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Cigna,Cigna,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Cigna PPO,Cigna PPO,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Cigna Medicare Advantage,Cigna Medicare Advantage,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Essence,Essence,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Healthlink HMO,Healthlink HMO,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Healthlink PPO,Healthlink PPO,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,HomeState Health Plan,HomeState Health Plan,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Humana Gold,Humana Gold,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Medicaid MO,Medicaid MO,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Medica,Medica,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Tricare,Tricare,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,UHC All Payer,UHC All Payer,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,UHC Exchange,UHC Exchange,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,UHC Medicaid,UHC Medicaid,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,UMR CPD,UMR CPD,977.18,,,,,,,per diem,977.18,977.18,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,UHC Medicare,UHC Medicare,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND ASLEEP         ",73500100,CDM,740,RC,95819,CPT,,,,Inpatient,,,977.18,977.18,Wellcare,Wellcare,977.18,,,,,,,case rate,977.18,977.18,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Meritain Health PPO CPD,Meritain Health PPO CPD,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Aetna/Commercial Product,Aetna/Commercial Product,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Meritain Health CPD,Meritain Health CPD,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Starmark CPD,Starmark CPD,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Aetna Medicare,Aetna Medicare,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Ambetter ,Ambetter ,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Blue Access,Anthem Blue Access,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Blue Access Choice,Anthem Blue Access Choice,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Blue Preferred,Anthem Blue Preferred,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Pathway,Anthem Pathway,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Alliance,Anthem Alliance,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Anthem Medicare,Anthem Medicare,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Cigna,Cigna,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Cigna PPO,Cigna PPO,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Cigna Medicare Advantage,Cigna Medicare Advantage,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Essence,Essence,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Healthlink HMO,Healthlink HMO,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Healthlink PPO,Healthlink PPO,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,HomeState Health Plan,HomeState Health Plan,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Humana Gold,Humana Gold,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Medicaid MO,Medicaid MO,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Medica,Medica,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Tricare,Tricare,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,UHC All Payer,UHC All Payer,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,UHC Exchange,UHC Exchange,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,UHC Medicaid,UHC Medicaid,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,UMR CPD,UMR CPD,1108.68,,,,,,,per diem,1108.68,1108.68,"Per diem rate, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,UHC Medicare,UHC Medicare,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
"EEG, AWAKE AND DROWSY         ",73500110,CDM,740,RC,95816,CPT,,,,Inpatient,,,1108.68,1108.68,Wellcare,Wellcare,1108.68,,,,,,,case rate,1108.68,1108.68,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Meritain Health PPO CPD,Meritain Health PPO CPD,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Aetna/Commercial Product,Aetna/Commercial Product,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Meritain Health CPD,Meritain Health CPD,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Starmark CPD,Starmark CPD,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Aetna Medicare,Aetna Medicare,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Ambetter ,Ambetter ,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Blue Access,Anthem Blue Access,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Blue Access Choice,Anthem Blue Access Choice,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Blue Preferred,Anthem Blue Preferred,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Pathway,Anthem Pathway,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Alliance,Anthem Alliance,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Anthem Medicare,Anthem Medicare,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Cigna,Cigna,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Cigna PPO,Cigna PPO,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Cigna Medicare Advantage,Cigna Medicare Advantage,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Essence,Essence,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Healthlink HMO,Healthlink HMO,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Healthlink PPO,Healthlink PPO,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,HomeState Health Plan,HomeState Health Plan,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Humana Gold,Humana Gold,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Medicaid MO,Medicaid MO,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Medica,Medica,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Tricare,Tricare,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,UHC All Payer,UHC All Payer,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,UHC Exchange,UHC Exchange,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,UHC Medicaid,UHC Medicaid,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,UMR CPD,UMR CPD,824.38,,,,,,,per diem,824.38,824.38,"Per diem rate, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,UHC Medicare,UHC Medicare,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
EEG OVER 1 HR                 ,73500180,CDM,740,RC,95813,CPT,,,,Inpatient,,,824.38,824.38,Wellcare,Wellcare,824.38,,,,,,,case rate,824.38,824.38,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Meritain Health PPO CPD,Meritain Health PPO CPD,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Aetna/Commercial Product,Aetna/Commercial Product,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Meritain Health CPD,Meritain Health CPD,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Starmark CPD,Starmark CPD,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Aetna Medicare,Aetna Medicare,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Ambetter ,Ambetter ,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Blue Access,Anthem Blue Access,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Blue Access Choice,Anthem Blue Access Choice,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Blue Preferred,Anthem Blue Preferred,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Pathway,Anthem Pathway,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Alliance,Anthem Alliance,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Anthem Medicare,Anthem Medicare,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Cigna,Cigna,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Cigna PPO,Cigna PPO,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Cigna Medicare Advantage,Cigna Medicare Advantage,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Essence,Essence,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Healthlink HMO,Healthlink HMO,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Healthlink PPO,Healthlink PPO,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,HomeState Health Plan,HomeState Health Plan,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Humana Gold,Humana Gold,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Medicaid MO,Medicaid MO,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Medica,Medica,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Tricare,Tricare,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,UHC All Payer,UHC All Payer,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,UHC Exchange,UHC Exchange,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,UHC Medicaid,UHC Medicaid,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,UMR CPD,UMR CPD,6102.71,,,,,,,per diem,6102.71,6102.71,"Per diem rate, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,UHC Medicare,UHC Medicare,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
NCB EA NERVE MOTOR W FW 7-8   ,73500328,CDM,922,RC,95910,CPT,,,,Inpatient,,,6102.71,6102.71,Wellcare,Wellcare,6102.71,,,,,,,case rate,6102.71,6102.71,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Meritain Health PPO CPD,Meritain Health PPO CPD,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Aetna/Commercial Product,Aetna/Commercial Product,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Meritain Health CPD,Meritain Health CPD,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Starmark CPD,Starmark CPD,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Aetna Medicare,Aetna Medicare,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Ambetter ,Ambetter ,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Blue Access,Anthem Blue Access,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Blue Access Choice,Anthem Blue Access Choice,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Blue Preferred,Anthem Blue Preferred,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Pathway,Anthem Pathway,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Alliance,Anthem Alliance,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Anthem Medicare,Anthem Medicare,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Cigna,Cigna,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Cigna PPO,Cigna PPO,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Cigna Medicare Advantage,Cigna Medicare Advantage,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Essence,Essence,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Healthlink HMO,Healthlink HMO,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Healthlink PPO,Healthlink PPO,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,HomeState Health Plan,HomeState Health Plan,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Humana Gold,Humana Gold,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Medicaid MO,Medicaid MO,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Medica,Medica,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Tricare,Tricare,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,UHC All Payer,UHC All Payer,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,UHC Exchange,UHC Exchange,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,UHC Medicaid,UHC Medicaid,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,UMR CPD,UMR CPD,747.74,,,,,,,per diem,747.74,747.74,"Per diem rate, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,UHC Medicare,UHC Medicare,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG MONITORING 1 HR           ,73510001,CDM,740,RC,95812,CPT,,,,Inpatient,,,747.74,747.74,Wellcare,Wellcare,747.74,,,,,,,case rate,747.74,747.74,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Meritain Health PPO CPD,Meritain Health PPO CPD,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Aetna/Commercial Product,Aetna/Commercial Product,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Meritain Health CPD,Meritain Health CPD,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Starmark CPD,Starmark CPD,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Aetna Medicare,Aetna Medicare,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Ambetter ,Ambetter ,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Blue Access,Anthem Blue Access,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Blue Access Choice,Anthem Blue Access Choice,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Blue Preferred,Anthem Blue Preferred,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Pathway,Anthem Pathway,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Alliance,Anthem Alliance,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Anthem Medicare,Anthem Medicare,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Cigna,Cigna,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Cigna PPO,Cigna PPO,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Cigna Medicare Advantage,Cigna Medicare Advantage,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Essence,Essence,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Healthlink HMO,Healthlink HMO,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Healthlink PPO,Healthlink PPO,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,HomeState Health Plan,HomeState Health Plan,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Humana Gold,Humana Gold,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Medicaid MO,Medicaid MO,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Medica,Medica,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Tricare,Tricare,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,UHC All Payer,UHC All Payer,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,UHC Exchange,UHC Exchange,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,UHC Medicaid,UHC Medicaid,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,UMR CPD,UMR CPD,2270.35,,,,,,,per diem,2270.35,2270.35,"Per diem rate, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,UHC Medicare,UHC Medicare,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG EIZ EVAL ATTND 16 CHAN    ,73510010,CDM,740,RC,95956,CPT,,,,Inpatient,,,2270.35,2270.35,Wellcare,Wellcare,2270.35,,,,,,,case rate,2270.35,2270.35,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Meritain Health PPO CPD,Meritain Health PPO CPD,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Aetna/Commercial Product,Aetna/Commercial Product,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Meritain Health CPD,Meritain Health CPD,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Starmark CPD,Starmark CPD,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Aetna Medicare,Aetna Medicare,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Ambetter ,Ambetter ,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Blue Access,Anthem Blue Access,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Blue Access Choice,Anthem Blue Access Choice,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Blue Preferred,Anthem Blue Preferred,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Pathway,Anthem Pathway,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Alliance,Anthem Alliance,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Anthem Medicare,Anthem Medicare,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Cigna,Cigna,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Cigna PPO,Cigna PPO,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Cigna Medicare Advantage,Cigna Medicare Advantage,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Essence,Essence,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Healthlink HMO,Healthlink HMO,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Healthlink PPO,Healthlink PPO,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,HomeState Health Plan,HomeState Health Plan,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Humana Gold,Humana Gold,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Medicaid MO,Medicaid MO,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Medica,Medica,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Tricare,Tricare,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,UHC All Payer,UHC All Payer,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,UHC Exchange,UHC Exchange,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,UHC Medicaid,UHC Medicaid,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,UMR CPD,UMR CPD,1707.23,,,,,,,per diem,1707.23,1707.23,"Per diem rate, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,UHC Medicare,UHC Medicare,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
EEG SEIZ EVAL UNATTN 16 CHAN  ,73510011,CDM,740,RC,95953,CPT,,,,Inpatient,,,1707.23,1707.23,Wellcare,Wellcare,1707.23,,,,,,,case rate,1707.23,1707.23,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Meritain Health PPO CPD,Meritain Health PPO CPD,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Aetna/Commercial Product,Aetna/Commercial Product,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Meritain Health CPD,Meritain Health CPD,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Starmark CPD,Starmark CPD,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Aetna Medicare,Aetna Medicare,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Ambetter ,Ambetter ,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Blue Access,Anthem Blue Access,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Blue Access Choice,Anthem Blue Access Choice,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Blue Preferred,Anthem Blue Preferred,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Pathway,Anthem Pathway,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Alliance,Anthem Alliance,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Anthem Medicare,Anthem Medicare,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Cigna,Cigna,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Cigna PPO,Cigna PPO,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Cigna Medicare Advantage,Cigna Medicare Advantage,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Essence,Essence,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Healthlink HMO,Healthlink HMO,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Healthlink PPO,Healthlink PPO,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,HomeState Health Plan,HomeState Health Plan,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Humana Gold,Humana Gold,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Medicaid MO,Medicaid MO,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Medica,Medica,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Tricare,Tricare,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,UHC All Payer,UHC All Payer,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,UHC Exchange,UHC Exchange,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,UHC Medicaid,UHC Medicaid,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,UMR CPD,UMR CPD,629.31,,,,,,,per diem,629.31,629.31,"Per diem rate, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,UHC Medicare,UHC Medicare,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
PF TEE 2D COMPLETE            ,73520000,CDM,983,RC,,,,,,Inpatient,,,629.31,629.31,Wellcare,Wellcare,629.31,,,,,,,case rate,629.31,629.31,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Meritain Health PPO CPD,Meritain Health PPO CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna/Commercial Product,Aetna/Commercial Product,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Meritain Health CPD,Meritain Health CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Starmark CPD,Starmark CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna Medicare,Aetna Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Ambetter ,Ambetter ,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Access,Anthem Blue Access,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Access Choice,Anthem Blue Access Choice,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Preferred,Anthem Blue Preferred,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Pathway,Anthem Pathway,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Alliance,Anthem Alliance,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Medicare,Anthem Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna,Cigna,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna PPO,Cigna PPO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna Medicare Advantage,Cigna Medicare Advantage,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Essence,Essence,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthlink HMO,Healthlink HMO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthlink PPO,Healthlink PPO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,HomeState Health Plan,HomeState Health Plan,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Humana Gold,Humana Gold,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Medicaid MO,Medicaid MO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Medica,Medica,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Tricare,Tricare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC All Payer,UHC All Payer,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Exchange,UHC Exchange,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Medicaid,UHC Medicaid,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UMR CPD,UMR CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Medicare,UHC Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEUROSTM BRAIN 1STHR     ,73520001,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Wellcare,Wellcare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Meritain Health PPO CPD,Meritain Health PPO CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna/Commercial Product,Aetna/Commercial Product,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Meritain Health CPD,Meritain Health CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Starmark CPD,Starmark CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Aetna Medicare,Aetna Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Ambetter ,Ambetter ,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Access,Anthem Blue Access,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Access Choice,Anthem Blue Access Choice,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Blue Preferred,Anthem Blue Preferred,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Pathway,Anthem Pathway,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Alliance,Anthem Alliance,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Anthem Medicare,Anthem Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna,Cigna,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna PPO,Cigna PPO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Cigna Medicare Advantage,Cigna Medicare Advantage,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Essence,Essence,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthlink HMO,Healthlink HMO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Healthlink PPO,Healthlink PPO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,HomeState Health Plan,HomeState Health Plan,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Humana Gold,Humana Gold,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Medicaid MO,Medicaid MO,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Medica,Medica,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Tricare,Tricare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC All Payer,UHC All Payer,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Exchange,UHC Exchange,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Medicaid,UHC Medicaid,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UMR CPD,UMR CPD,690.24,,,,,,,per diem,690.24,690.24,"Per diem rate, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,UHC Medicare,UHC Medicare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
ANLY NEURSTM BRN EA ADD30     ,73520002,CDM,920,RC,,,,,,Inpatient,,,690.24,690.24,Wellcare,Wellcare,690.24,,,,,,,case rate,690.24,690.24,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
BLINK REFLEX TEST             ,73520003,CDM,920,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Meritain Health PPO CPD,Meritain Health PPO CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna/Commercial Product,Aetna/Commercial Product,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Meritain Health CPD,Meritain Health CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Starmark CPD,Starmark CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna Medicare,Aetna Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Ambetter ,Ambetter ,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Access,Anthem Blue Access,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Access Choice,Anthem Blue Access Choice,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Preferred,Anthem Blue Preferred,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Pathway,Anthem Pathway,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Alliance,Anthem Alliance,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Medicare,Anthem Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna,Cigna,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna PPO,Cigna PPO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna Medicare Advantage,Cigna Medicare Advantage,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Essence,Essence,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthlink HMO,Healthlink HMO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthlink PPO,Healthlink PPO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,HomeState Health Plan,HomeState Health Plan,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Humana Gold,Humana Gold,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Medicaid MO,Medicaid MO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Medica,Medica,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Tricare,Tricare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC All Payer,UHC All Payer,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Exchange,UHC Exchange,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Medicaid,UHC Medicaid,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UMR CPD,UMR CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Medicare,UHC Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED LOW EXTREM     ,73520004,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Wellcare,Wellcare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Meritain Health PPO CPD,Meritain Health PPO CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna/Commercial Product,Aetna/Commercial Product,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Meritain Health CPD,Meritain Health CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Starmark CPD,Starmark CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Aetna Medicare,Aetna Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Ambetter ,Ambetter ,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Access,Anthem Blue Access,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Access Choice,Anthem Blue Access Choice,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Blue Preferred,Anthem Blue Preferred,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Pathway,Anthem Pathway,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Alliance,Anthem Alliance,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Anthem Medicare,Anthem Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna,Cigna,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna PPO,Cigna PPO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Cigna Medicare Advantage,Cigna Medicare Advantage,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Essence,Essence,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthlink HMO,Healthlink HMO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Healthlink PPO,Healthlink PPO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,HomeState Health Plan,HomeState Health Plan,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Humana Gold,Humana Gold,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Medicaid MO,Medicaid MO,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Medica,Medica,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Tricare,Tricare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC All Payer,UHC All Payer,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Exchange,UHC Exchange,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Medicaid,UHC Medicaid,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UMR CPD,UMR CPD,901.41,,,,,,,per diem,901.41,901.41,"Per diem rate, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,UHC Medicare,UHC Medicare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
C MOTOR EVOKED UPP EXTREM     ,73520005,CDM,920,RC,,,,,,Inpatient,,,901.41,901.41,Wellcare,Wellcare,901.41,,,,,,,case rate,901.41,901.41,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Meritain Health PPO CPD,Meritain Health PPO CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna/Commercial Product,Aetna/Commercial Product,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Meritain Health CPD,Meritain Health CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Starmark CPD,Starmark CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna Medicare,Aetna Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Ambetter ,Ambetter ,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Access,Anthem Blue Access,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Access Choice,Anthem Blue Access Choice,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Preferred,Anthem Blue Preferred,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Pathway,Anthem Pathway,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Alliance,Anthem Alliance,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Medicare,Anthem Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna,Cigna,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna PPO,Cigna PPO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna Medicare Advantage,Cigna Medicare Advantage,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Essence,Essence,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthlink HMO,Healthlink HMO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthlink PPO,Healthlink PPO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,HomeState Health Plan,HomeState Health Plan,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Humana Gold,Humana Gold,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Medicaid MO,Medicaid MO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Medica,Medica,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Tricare,Tricare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC All Payer,UHC All Payer,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Exchange,UHC Exchange,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Medicaid,UHC Medicaid,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UMR CPD,UMR CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Medicare,UHC Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST W RX       ,73520006,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Wellcare,Wellcare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Meritain Health PPO CPD,Meritain Health PPO CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna/Commercial Product,Aetna/Commercial Product,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Meritain Health CPD,Meritain Health CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Starmark CPD,Starmark CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Aetna Medicare,Aetna Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Ambetter ,Ambetter ,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Access,Anthem Blue Access,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Access Choice,Anthem Blue Access Choice,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Blue Preferred,Anthem Blue Preferred,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Pathway,Anthem Pathway,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Alliance,Anthem Alliance,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Anthem Medicare,Anthem Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna,Cigna,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna PPO,Cigna PPO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Cigna Medicare Advantage,Cigna Medicare Advantage,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Essence,Essence,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthlink HMO,Healthlink HMO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Healthlink PPO,Healthlink PPO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,HomeState Health Plan,HomeState Health Plan,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Humana Gold,Humana Gold,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Medicaid MO,Medicaid MO,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Medica,Medica,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Tricare,Tricare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC All Payer,UHC All Payer,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Exchange,UHC Exchange,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Medicaid,UHC Medicaid,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UMR CPD,UMR CPD,1670.45,,,,,,,per diem,1670.45,1670.45,"Per diem rate, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,UHC Medicare,UHC Medicare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
CARDIOVAS STR TEST WO RX      ,73520007,CDM,482,RC,,,,,,Inpatient,,,1670.45,1670.45,Wellcare,Wellcare,1670.45,,,,,,,case rate,1670.45,1670.45,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Meritain Health PPO CPD,Meritain Health PPO CPD,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Aetna/Commercial Product,Aetna/Commercial Product,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Meritain Health CPD,Meritain Health CPD,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Starmark CPD,Starmark CPD,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Aetna Medicare,Aetna Medicare,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Ambetter ,Ambetter ,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Blue Access,Anthem Blue Access,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Blue Access Choice,Anthem Blue Access Choice,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Blue Preferred,Anthem Blue Preferred,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Pathway,Anthem Pathway,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Alliance,Anthem Alliance,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Anthem Medicare,Anthem Medicare,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Cigna,Cigna,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Cigna PPO,Cigna PPO,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Cigna Medicare Advantage,Cigna Medicare Advantage,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Essence,Essence,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Healthlink HMO,Healthlink HMO,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Healthlink PPO,Healthlink PPO,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,HomeState Health Plan,HomeState Health Plan,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Humana Gold,Humana Gold,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Medicaid MO,Medicaid MO,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Medica,Medica,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Tricare,Tricare,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,UHC All Payer,UHC All Payer,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,UHC Exchange,UHC Exchange,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,UHC Medicaid,UHC Medicaid,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,UMR CPD,UMR CPD,226.93,,,,,,,per diem,226.93,226.93,"Per diem rate, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,UHC Medicare,UHC Medicare,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECG 1-3 LEAD TRACING ONLY     ,73520008,CDM,730,RC,,,,,,Inpatient,,,226.93,226.93,Wellcare,Wellcare,226.93,,,,,,,case rate,226.93,226.93,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Meritain Health PPO CPD,Meritain Health PPO CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Aetna/Commercial Product,Aetna/Commercial Product,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Meritain Health CPD,Meritain Health CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Starmark CPD,Starmark CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Aetna Medicare,Aetna Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Ambetter ,Ambetter ,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Access,Anthem Blue Access,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Access Choice,Anthem Blue Access Choice,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Blue Preferred,Anthem Blue Preferred,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Pathway,Anthem Pathway,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Alliance,Anthem Alliance,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Anthem Medicare,Anthem Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Cigna,Cigna,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Cigna PPO,Cigna PPO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Cigna Medicare Advantage,Cigna Medicare Advantage,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Essence,Essence,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Healthlink HMO,Healthlink HMO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Healthlink PPO,Healthlink PPO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,HomeState Health Plan,HomeState Health Plan,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Humana Gold,Humana Gold,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Medicaid MO,Medicaid MO,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Medica,Medica,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Tricare,Tricare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,UHC All Payer,UHC All Payer,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,UHC Exchange,UHC Exchange,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,UHC Medicaid,UHC Medicaid,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,UMR CPD,UMR CPD,1660.36,,,,,,,per diem,1660.36,1660.36,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,UHC Medicare,UHC Medicare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR COM WOCON     ,73520009,CDM,483,RC,,,,,,Inpatient,,,1660.36,1660.36,Wellcare,Wellcare,1660.36,,,,,,,case rate,1660.36,1660.36,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health PPO CPD,Meritain Health PPO CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/Commercial Product,Aetna/Commercial Product,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health CPD,Meritain Health CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Starmark CPD,Starmark CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna Medicare,Aetna Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Ambetter ,Ambetter ,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access,Anthem Blue Access,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access Choice,Anthem Blue Access Choice,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Preferred,Anthem Blue Preferred,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Pathway,Anthem Pathway,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Alliance,Anthem Alliance,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Medicare,Anthem Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna,Cigna,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna PPO,Cigna PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna Medicare Advantage,Cigna Medicare Advantage,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Essence,Essence,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink HMO,Healthlink HMO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink PPO,Healthlink PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,HomeState Health Plan,HomeState Health Plan,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Humana Gold,Humana Gold,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medicaid MO,Medicaid MO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medica,Medica,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Tricare,Tricare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC All Payer,UHC All Payer,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Exchange,UHC Exchange,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicaid,UHC Medicaid,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UMR CPD,UMR CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicare,UHC Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W ECG      ,73520010,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Wellcare,Wellcare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Meritain Health PPO CPD,Meritain Health PPO CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Aetna/Commercial Product,Aetna/Commercial Product,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Meritain Health CPD,Meritain Health CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Starmark CPD,Starmark CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Aetna Medicare,Aetna Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Ambetter ,Ambetter ,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Access,Anthem Blue Access,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Access Choice,Anthem Blue Access Choice,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Blue Preferred,Anthem Blue Preferred,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Pathway,Anthem Pathway,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Alliance,Anthem Alliance,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Anthem Medicare,Anthem Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Cigna,Cigna,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Cigna PPO,Cigna PPO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Cigna Medicare Advantage,Cigna Medicare Advantage,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Essence,Essence,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Healthlink HMO,Healthlink HMO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Healthlink PPO,Healthlink PPO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,HomeState Health Plan,HomeState Health Plan,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Humana Gold,Humana Gold,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Medicaid MO,Medicaid MO,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Medica,Medica,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Tricare,Tricare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,UHC All Payer,UHC All Payer,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,UHC Exchange,UHC Exchange,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,UHC Medicaid,UHC Medicaid,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,UMR CPD,UMR CPD,736.47,,,,,,,per diem,736.47,736.47,"Per diem rate, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,UHC Medicare,UHC Medicare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG DURING NONCRANIA SURG     ,73520011,CDM,740,RC,,,,,,Inpatient,,,736.47,736.47,Wellcare,Wellcare,736.47,,,,,,,case rate,736.47,736.47,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Meritain Health PPO CPD,Meritain Health PPO CPD,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Aetna/Commercial Product,Aetna/Commercial Product,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Meritain Health CPD,Meritain Health CPD,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Starmark CPD,Starmark CPD,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Aetna Medicare,Aetna Medicare,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Ambetter ,Ambetter ,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Blue Access,Anthem Blue Access,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Blue Access Choice,Anthem Blue Access Choice,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Blue Preferred,Anthem Blue Preferred,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Pathway,Anthem Pathway,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Alliance,Anthem Alliance,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Anthem Medicare,Anthem Medicare,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Cigna,Cigna,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Cigna PPO,Cigna PPO,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Cigna Medicare Advantage,Cigna Medicare Advantage,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Essence,Essence,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Healthlink HMO,Healthlink HMO,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Healthlink PPO,Healthlink PPO,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,HomeState Health Plan,HomeState Health Plan,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Humana Gold,Humana Gold,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Medicaid MO,Medicaid MO,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Medica,Medica,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Tricare,Tricare,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,UHC All Payer,UHC All Payer,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,UHC Exchange,UHC Exchange,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,UHC Medicaid,UHC Medicaid,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,UMR CPD,UMR CPD,2134.82,,,,,,,per diem,2134.82,2134.82,"Per diem rate, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,UHC Medicare,UHC Medicare,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EEG SEIZURE 8-CH/ 24 HR       ,73520012,CDM,740,RC,,,,,,Inpatient,,,2134.82,2134.82,Wellcare,Wellcare,2134.82,,,,,,,case rate,2134.82,2134.82,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Meritain Health PPO CPD,Meritain Health PPO CPD,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Aetna/Commercial Product,Aetna/Commercial Product,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Meritain Health CPD,Meritain Health CPD,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Starmark CPD,Starmark CPD,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Aetna Medicare,Aetna Medicare,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Ambetter ,Ambetter ,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Blue Access,Anthem Blue Access,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Blue Access Choice,Anthem Blue Access Choice,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Blue Preferred,Anthem Blue Preferred,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Pathway,Anthem Pathway,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Alliance,Anthem Alliance,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Anthem Medicare,Anthem Medicare,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Cigna,Cigna,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Cigna PPO,Cigna PPO,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Cigna Medicare Advantage,Cigna Medicare Advantage,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Essence,Essence,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Healthlink HMO,Healthlink HMO,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Healthlink PPO,Healthlink PPO,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,HomeState Health Plan,HomeState Health Plan,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Humana Gold,Humana Gold,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Medicaid MO,Medicaid MO,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Medica,Medica,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Tricare,Tricare,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,UHC All Payer,UHC All Payer,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,UHC Exchange,UHC Exchange,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,UHC Medicaid,UHC Medicaid,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,UMR CPD,UMR CPD,384.52,,,,,,,per diem,384.52,384.52,"Per diem rate, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,UHC Medicare,UHC Medicare,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
EMG CRAN NRV BIL              ,73520013,CDM,922,RC,,,,,,Inpatient,,,384.52,384.52,Wellcare,Wellcare,384.52,,,,,,,case rate,384.52,384.52,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Meritain Health PPO CPD,Meritain Health PPO CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna/Commercial Product,Aetna/Commercial Product,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Meritain Health CPD,Meritain Health CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Starmark CPD,Starmark CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna Medicare,Aetna Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Ambetter ,Ambetter ,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Access,Anthem Blue Access,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Access Choice,Anthem Blue Access Choice,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Preferred,Anthem Blue Preferred,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Pathway,Anthem Pathway,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Alliance,Anthem Alliance,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Medicare,Anthem Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna,Cigna,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna PPO,Cigna PPO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna Medicare Advantage,Cigna Medicare Advantage,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Essence,Essence,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthlink HMO,Healthlink HMO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthlink PPO,Healthlink PPO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,HomeState Health Plan,HomeState Health Plan,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Humana Gold,Humana Gold,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Medicaid MO,Medicaid MO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Medica,Medica,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Tricare,Tricare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC All Payer,UHC All Payer,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Exchange,UHC Exchange,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Medicaid,UHC Medicaid,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UMR CPD,UMR CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Medicare,UHC Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ FOR MICROBUBBLE STUDY     ,73520014,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Wellcare,Wellcare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Meritain Health PPO CPD,Meritain Health PPO CPD,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Aetna/Commercial Product,Aetna/Commercial Product,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Meritain Health CPD,Meritain Health CPD,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Starmark CPD,Starmark CPD,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Aetna Medicare,Aetna Medicare,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Ambetter ,Ambetter ,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Blue Access,Anthem Blue Access,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Blue Access Choice,Anthem Blue Access Choice,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Blue Preferred,Anthem Blue Preferred,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Pathway,Anthem Pathway,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Alliance,Anthem Alliance,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Anthem Medicare,Anthem Medicare,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Cigna,Cigna,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Cigna PPO,Cigna PPO,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Cigna Medicare Advantage,Cigna Medicare Advantage,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Essence,Essence,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Healthlink HMO,Healthlink HMO,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Healthlink PPO,Healthlink PPO,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,HomeState Health Plan,HomeState Health Plan,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Humana Gold,Humana Gold,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Medicaid MO,Medicaid MO,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Medica,Medica,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Tricare,Tricare,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,UHC All Payer,UHC All Payer,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,UHC Exchange,UHC Exchange,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,UHC Medicaid,UHC Medicaid,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,UMR CPD,UMR CPD,127.12,,,,,,,per diem,127.12,127.12,"Per diem rate, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,UHC Medicare,UHC Medicare,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
INTRAOP MON IN OR EA15MIN     ,73520015,CDM,920,RC,,,,,,Inpatient,,,127.12,127.12,Wellcare,Wellcare,127.12,,,,,,,case rate,127.12,127.12,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
ISCH LIMB EXERCISE W SPEC     ,73520016,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Meritain Health PPO CPD,Meritain Health PPO CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna/Commercial Product,Aetna/Commercial Product,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Meritain Health CPD,Meritain Health CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Starmark CPD,Starmark CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna Medicare,Aetna Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Ambetter ,Ambetter ,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Access,Anthem Blue Access,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Access Choice,Anthem Blue Access Choice,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Preferred,Anthem Blue Preferred,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Pathway,Anthem Pathway,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Alliance,Anthem Alliance,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Medicare,Anthem Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna,Cigna,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna PPO,Cigna PPO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna Medicare Advantage,Cigna Medicare Advantage,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Essence,Essence,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthlink HMO,Healthlink HMO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthlink PPO,Healthlink PPO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,HomeState Health Plan,HomeState Health Plan,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Humana Gold,Humana Gold,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Medicaid MO,Medicaid MO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Medica,Medica,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Tricare,Tricare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC All Payer,UHC All Payer,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Exchange,UHC Exchange,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Medicaid,UHC Medicaid,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UMR CPD,UMR CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Medicare,UHC Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON CMP EA     ,73520017,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Wellcare,Wellcare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Meritain Health PPO CPD,Meritain Health PPO CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna/Commercial Product,Aetna/Commercial Product,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Meritain Health CPD,Meritain Health CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Starmark CPD,Starmark CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Aetna Medicare,Aetna Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Ambetter ,Ambetter ,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Access,Anthem Blue Access,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Access Choice,Anthem Blue Access Choice,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Blue Preferred,Anthem Blue Preferred,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Pathway,Anthem Pathway,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Alliance,Anthem Alliance,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Anthem Medicare,Anthem Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna,Cigna,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna PPO,Cigna PPO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Cigna Medicare Advantage,Cigna Medicare Advantage,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Essence,Essence,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthlink HMO,Healthlink HMO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Healthlink PPO,Healthlink PPO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,HomeState Health Plan,HomeState Health Plan,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Humana Gold,Humana Gold,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Medicaid MO,Medicaid MO,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Medica,Medica,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Tricare,Tricare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC All Payer,UHC All Payer,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Exchange,UHC Exchange,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Medicaid,UHC Medicaid,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UMR CPD,UMR CPD,467.52,,,,,,,per diem,467.52,467.52,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,UHC Medicare,UHC Medicare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON LTD EA     ,73520018,CDM,922,RC,,,,,,Inpatient,,,467.52,467.52,Wellcare,Wellcare,467.52,,,,,,,case rate,467.52,467.52,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Meritain Health PPO CPD,Meritain Health PPO CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Aetna/Commercial Product,Aetna/Commercial Product,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Meritain Health CPD,Meritain Health CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Starmark CPD,Starmark CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Aetna Medicare,Aetna Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Ambetter ,Ambetter ,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Blue Access,Anthem Blue Access,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Blue Access Choice,Anthem Blue Access Choice,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Blue Preferred,Anthem Blue Preferred,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Pathway,Anthem Pathway,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Alliance,Anthem Alliance,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Anthem Medicare,Anthem Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Cigna,Cigna,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Cigna PPO,Cigna PPO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Cigna Medicare Advantage,Cigna Medicare Advantage,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Essence,Essence,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Healthlink HMO,Healthlink HMO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Healthlink PPO,Healthlink PPO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,HomeState Health Plan,HomeState Health Plan,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Humana Gold,Humana Gold,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Medicaid MO,Medicaid MO,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Medica,Medica,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Tricare,Tricare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,UHC All Payer,UHC All Payer,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,UHC Exchange,UHC Exchange,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,UHC Medicaid,UHC Medicaid,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,UMR CPD,UMR CPD,245.84,,,,,,,per diem,245.84,245.84,"Per diem rate, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,UHC Medicare,UHC Medicare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
MUSC TST W/NRV CON NONEXT     ,73520019,CDM,922,RC,,,,,,Inpatient,,,245.84,245.84,Wellcare,Wellcare,245.84,,,,,,,case rate,245.84,245.84,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health PPO CPD,Meritain Health PPO CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Aetna/Commercial Product,Aetna/Commercial Product,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Meritain Health CPD,Meritain Health CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Starmark CPD,Starmark CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Aetna Medicare,Aetna Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Ambetter ,Ambetter ,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access,Anthem Blue Access,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Access Choice,Anthem Blue Access Choice,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Blue Preferred,Anthem Blue Preferred,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Pathway,Anthem Pathway,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Alliance,Anthem Alliance,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Anthem Medicare,Anthem Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Cigna,Cigna,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Cigna PPO,Cigna PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Cigna Medicare Advantage,Cigna Medicare Advantage,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Essence,Essence,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink HMO,Healthlink HMO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Healthlink PPO,Healthlink PPO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,HomeState Health Plan,HomeState Health Plan,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Humana Gold,Humana Gold,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Medicaid MO,Medicaid MO,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Medica,Medica,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Tricare,Tricare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,UHC All Payer,UHC All Payer,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,UHC Exchange,UHC Exchange,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicaid,UHC Medicaid,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,UMR CPD,UMR CPD,294.17,,,,,,,per diem,294.17,294.17,"Per diem rate, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,UHC Medicare,UHC Medicare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 1 EXTREMITY        ,73520020,CDM,922,RC,,,,,,Inpatient,,,294.17,294.17,Wellcare,Wellcare,294.17,,,,,,,case rate,294.17,294.17,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Meritain Health PPO CPD,Meritain Health PPO CPD,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Aetna/Commercial Product,Aetna/Commercial Product,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Meritain Health CPD,Meritain Health CPD,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Starmark CPD,Starmark CPD,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Aetna Medicare,Aetna Medicare,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Ambetter ,Ambetter ,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Blue Access,Anthem Blue Access,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Blue Access Choice,Anthem Blue Access Choice,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Blue Preferred,Anthem Blue Preferred,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Pathway,Anthem Pathway,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Alliance,Anthem Alliance,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Anthem Medicare,Anthem Medicare,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Cigna,Cigna,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Cigna PPO,Cigna PPO,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Cigna Medicare Advantage,Cigna Medicare Advantage,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Essence,Essence,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Healthlink HMO,Healthlink HMO,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Healthlink PPO,Healthlink PPO,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,HomeState Health Plan,HomeState Health Plan,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Humana Gold,Humana Gold,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Medicaid MO,Medicaid MO,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Medica,Medica,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Tricare,Tricare,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,UHC All Payer,UHC All Payer,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,UHC Exchange,UHC Exchange,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,UHC Medicaid,UHC Medicaid,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,UMR CPD,UMR CPD,475.92,,,,,,,per diem,475.92,475.92,"Per diem rate, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,UHC Medicare,UHC Medicare,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 2 EXTREMITIES      ,73520021,CDM,922,RC,,,,,,Inpatient,,,475.92,475.92,Wellcare,Wellcare,475.92,,,,,,,case rate,475.92,475.92,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Meritain Health PPO CPD,Meritain Health PPO CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Aetna/Commercial Product,Aetna/Commercial Product,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Meritain Health CPD,Meritain Health CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Starmark CPD,Starmark CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Aetna Medicare,Aetna Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Ambetter ,Ambetter ,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Blue Access,Anthem Blue Access,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Blue Access Choice,Anthem Blue Access Choice,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Blue Preferred,Anthem Blue Preferred,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Pathway,Anthem Pathway,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Alliance,Anthem Alliance,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Anthem Medicare,Anthem Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Cigna,Cigna,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Cigna PPO,Cigna PPO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Cigna Medicare Advantage,Cigna Medicare Advantage,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Essence,Essence,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Healthlink HMO,Healthlink HMO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Healthlink PPO,Healthlink PPO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,HomeState Health Plan,HomeState Health Plan,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Humana Gold,Humana Gold,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Medicaid MO,Medicaid MO,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Medica,Medica,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Tricare,Tricare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,UHC All Payer,UHC All Payer,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,UHC Exchange,UHC Exchange,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,UHC Medicaid,UHC Medicaid,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,UMR CPD,UMR CPD,550.51,,,,,,,per diem,550.51,550.51,"Per diem rate, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,UHC Medicare,UHC Medicare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 3 EXTREMITIES      ,73520022,CDM,922,RC,,,,,,Inpatient,,,550.51,550.51,Wellcare,Wellcare,550.51,,,,,,,case rate,550.51,550.51,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Meritain Health PPO CPD,Meritain Health PPO CPD,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Aetna/Commercial Product,Aetna/Commercial Product,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Meritain Health CPD,Meritain Health CPD,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Starmark CPD,Starmark CPD,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Aetna Medicare,Aetna Medicare,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Ambetter ,Ambetter ,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Blue Access,Anthem Blue Access,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Blue Access Choice,Anthem Blue Access Choice,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Blue Preferred,Anthem Blue Preferred,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Pathway,Anthem Pathway,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Alliance,Anthem Alliance,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Anthem Medicare,Anthem Medicare,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Cigna,Cigna,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Cigna PPO,Cigna PPO,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Cigna Medicare Advantage,Cigna Medicare Advantage,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Essence,Essence,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Healthlink HMO,Healthlink HMO,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Healthlink PPO,Healthlink PPO,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,HomeState Health Plan,HomeState Health Plan,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Humana Gold,Humana Gold,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Medicaid MO,Medicaid MO,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Medica,Medica,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Tricare,Tricare,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,UHC All Payer,UHC All Payer,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,UHC Exchange,UHC Exchange,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,UHC Medicaid,UHC Medicaid,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,UMR CPD,UMR CPD,807.91,,,,,,,per diem,807.91,807.91,"Per diem rate, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,UHC Medicare,UHC Medicare,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NEEDLE EMG 4 EXTREMITIES      ,73520023,CDM,922,RC,,,,,,Inpatient,,,807.91,807.91,Wellcare,Wellcare,807.91,,,,,,,case rate,807.91,807.91,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health PPO CPD,Meritain Health PPO CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/Commercial Product,Aetna/Commercial Product,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health CPD,Meritain Health CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Starmark CPD,Starmark CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna Medicare,Aetna Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Ambetter ,Ambetter ,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access,Anthem Blue Access,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access Choice,Anthem Blue Access Choice,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Preferred,Anthem Blue Preferred,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Pathway,Anthem Pathway,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Alliance,Anthem Alliance,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Medicare,Anthem Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna,Cigna,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna PPO,Cigna PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna Medicare Advantage,Cigna Medicare Advantage,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Essence,Essence,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink HMO,Healthlink HMO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink PPO,Healthlink PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,HomeState Health Plan,HomeState Health Plan,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Humana Gold,Humana Gold,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medicaid MO,Medicaid MO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medica,Medica,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Tricare,Tricare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC All Payer,UHC All Payer,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Exchange,UHC Exchange,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicaid,UHC Medicaid,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UMR CPD,UMR CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicare,UHC Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 1-2 STUDIES     ,73520024,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Wellcare,Wellcare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health PPO CPD,Meritain Health PPO CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/Commercial Product,Aetna/Commercial Product,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health CPD,Meritain Health CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Starmark CPD,Starmark CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna Medicare,Aetna Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Ambetter ,Ambetter ,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access,Anthem Blue Access,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access Choice,Anthem Blue Access Choice,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Preferred,Anthem Blue Preferred,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Pathway,Anthem Pathway,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Alliance,Anthem Alliance,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Medicare,Anthem Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna,Cigna,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna PPO,Cigna PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna Medicare Advantage,Cigna Medicare Advantage,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Essence,Essence,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink HMO,Healthlink HMO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink PPO,Healthlink PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,HomeState Health Plan,HomeState Health Plan,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Humana Gold,Humana Gold,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medicaid MO,Medicaid MO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medica,Medica,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Tricare,Tricare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC All Payer,UHC All Payer,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Exchange,UHC Exchange,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicaid,UHC Medicaid,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UMR CPD,UMR CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicare,UHC Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 3-4 STUDIES     ,73520025,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Wellcare,Wellcare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health PPO CPD,Meritain Health PPO CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/Commercial Product,Aetna/Commercial Product,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health CPD,Meritain Health CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Starmark CPD,Starmark CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna Medicare,Aetna Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Ambetter ,Ambetter ,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access,Anthem Blue Access,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access Choice,Anthem Blue Access Choice,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Preferred,Anthem Blue Preferred,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Pathway,Anthem Pathway,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Alliance,Anthem Alliance,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Medicare,Anthem Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna,Cigna,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna PPO,Cigna PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna Medicare Advantage,Cigna Medicare Advantage,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Essence,Essence,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink HMO,Healthlink HMO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink PPO,Healthlink PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,HomeState Health Plan,HomeState Health Plan,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Humana Gold,Humana Gold,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medicaid MO,Medicaid MO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medica,Medica,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Tricare,Tricare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC All Payer,UHC All Payer,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Exchange,UHC Exchange,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicaid,UHC Medicaid,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UMR CPD,UMR CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicare,UHC Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 5-6 STUDIES     ,73520026,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Wellcare,Wellcare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health PPO CPD,Meritain Health PPO CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna/Commercial Product,Aetna/Commercial Product,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Meritain Health CPD,Meritain Health CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Starmark CPD,Starmark CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Aetna Medicare,Aetna Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Ambetter ,Ambetter ,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access,Anthem Blue Access,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Access Choice,Anthem Blue Access Choice,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Blue Preferred,Anthem Blue Preferred,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Pathway,Anthem Pathway,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Alliance,Anthem Alliance,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Anthem Medicare,Anthem Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna,Cigna,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna PPO,Cigna PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Cigna Medicare Advantage,Cigna Medicare Advantage,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Essence,Essence,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink HMO,Healthlink HMO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Healthlink PPO,Healthlink PPO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,HomeState Health Plan,HomeState Health Plan,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Humana Gold,Humana Gold,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medicaid MO,Medicaid MO,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Medica,Medica,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Tricare,Tricare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC All Payer,UHC All Payer,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Exchange,UHC Exchange,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicaid,UHC Medicaid,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UMR CPD,UMR CPD,240.59,,,,,,,per diem,240.59,240.59,"Per diem rate, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,UHC Medicare,UHC Medicare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT 7-8 STUDIES     ,73520027,CDM,922,RC,,,,,,Inpatient,,,240.59,240.59,Wellcare,Wellcare,240.59,,,,,,,case rate,240.59,240.59,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health PPO CPD,Meritain Health PPO CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/Commercial Product,Aetna/Commercial Product,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health CPD,Meritain Health CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Starmark CPD,Starmark CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna Medicare,Aetna Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Ambetter ,Ambetter ,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access,Anthem Blue Access,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access Choice,Anthem Blue Access Choice,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Preferred,Anthem Blue Preferred,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Pathway,Anthem Pathway,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Alliance,Anthem Alliance,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Medicare,Anthem Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna,Cigna,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna PPO,Cigna PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna Medicare Advantage,Cigna Medicare Advantage,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Essence,Essence,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink HMO,Healthlink HMO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink PPO,Healthlink PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,HomeState Health Plan,HomeState Health Plan,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Humana Gold,Humana Gold,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medicaid MO,Medicaid MO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medica,Medica,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Tricare,Tricare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC All Payer,UHC All Payer,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Exchange,UHC Exchange,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicaid,UHC Medicaid,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UMR CPD,UMR CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicare,UHC Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT>=13 STUDIES     ,73520028,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Wellcare,Wellcare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health PPO CPD,Meritain Health PPO CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/Commercial Product,Aetna/Commercial Product,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health CPD,Meritain Health CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Starmark CPD,Starmark CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna Medicare,Aetna Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Ambetter ,Ambetter ,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access,Anthem Blue Access,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access Choice,Anthem Blue Access Choice,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Preferred,Anthem Blue Preferred,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Pathway,Anthem Pathway,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Alliance,Anthem Alliance,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Medicare,Anthem Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna,Cigna,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna PPO,Cigna PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna Medicare Advantage,Cigna Medicare Advantage,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Essence,Essence,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink HMO,Healthlink HMO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink PPO,Healthlink PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,HomeState Health Plan,HomeState Health Plan,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Humana Gold,Humana Gold,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medicaid MO,Medicaid MO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medica,Medica,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Tricare,Tricare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC All Payer,UHC All Payer,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Exchange,UHC Exchange,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicaid,UHC Medicaid,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UMR CPD,UMR CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicare,UHC Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT11-12STUDIES     ,73520029,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Wellcare,Wellcare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health PPO CPD,Meritain Health PPO CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna/Commercial Product,Aetna/Commercial Product,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Meritain Health CPD,Meritain Health CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Starmark CPD,Starmark CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Aetna Medicare,Aetna Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Ambetter ,Ambetter ,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access,Anthem Blue Access,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Access Choice,Anthem Blue Access Choice,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Blue Preferred,Anthem Blue Preferred,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Pathway,Anthem Pathway,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Alliance,Anthem Alliance,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Anthem Medicare,Anthem Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna,Cigna,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna PPO,Cigna PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Cigna Medicare Advantage,Cigna Medicare Advantage,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Essence,Essence,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink HMO,Healthlink HMO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Healthlink PPO,Healthlink PPO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,HomeState Health Plan,HomeState Health Plan,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Humana Gold,Humana Gold,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medicaid MO,Medicaid MO,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Medica,Medica,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Tricare,Tricare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC All Payer,UHC All Payer,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Exchange,UHC Exchange,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicaid,UHC Medicaid,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UMR CPD,UMR CPD,444.4,,,,,,,per diem,444.4,444.4,"Per diem rate, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,UHC Medicare,UHC Medicare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NERVE CONDUCT9-10 STUDIES     ,73520030,CDM,922,RC,,,,,,Inpatient,,,444.4,444.4,Wellcare,Wellcare,444.4,,,,,,,case rate,444.4,444.4,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health PPO CPD,Meritain Health PPO CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna/Commercial Product,Aetna/Commercial Product,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Meritain Health CPD,Meritain Health CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Starmark CPD,Starmark CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Aetna Medicare,Aetna Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Ambetter ,Ambetter ,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access,Anthem Blue Access,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Access Choice,Anthem Blue Access Choice,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Blue Preferred,Anthem Blue Preferred,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Pathway,Anthem Pathway,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Alliance,Anthem Alliance,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Anthem Medicare,Anthem Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna,Cigna,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna PPO,Cigna PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Cigna Medicare Advantage,Cigna Medicare Advantage,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Essence,Essence,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink HMO,Healthlink HMO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Healthlink PPO,Healthlink PPO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,HomeState Health Plan,HomeState Health Plan,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Humana Gold,Humana Gold,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Medicaid MO,Medicaid MO,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Medica,Medica,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Tricare,Tricare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC All Payer,UHC All Payer,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Exchange,UHC Exchange,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicaid,UHC Medicaid,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UMR CPD,UMR CPD,185.96,,,,,,,per diem,185.96,185.96,"Per diem rate, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,UHC Medicare,UHC Medicare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
NEUROMSC JNCT TST EA NRVE     ,73520031,CDM,922,RC,,,,,,Inpatient,,,185.96,185.96,Wellcare,Wellcare,185.96,,,,,,,case rate,185.96,185.96,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Meritain Health PPO CPD,Meritain Health PPO CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Aetna/Commercial Product,Aetna/Commercial Product,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Meritain Health CPD,Meritain Health CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Starmark CPD,Starmark CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Aetna Medicare,Aetna Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Ambetter ,Ambetter ,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Access,Anthem Blue Access,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Access Choice,Anthem Blue Access Choice,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Preferred,Anthem Blue Preferred,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Pathway,Anthem Pathway,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Alliance,Anthem Alliance,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Medicare,Anthem Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Cigna,Cigna,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Cigna PPO,Cigna PPO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Cigna Medicare Advantage,Cigna Medicare Advantage,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Essence,Essence,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Healthlink HMO,Healthlink HMO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Healthlink PPO,Healthlink PPO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,HomeState Health Plan,HomeState Health Plan,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Humana Gold,Humana Gold,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Medicaid MO,Medicaid MO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Medica,Medica,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Tricare,Tricare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,UHC All Payer,UHC All Payer,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,UHC Exchange,UHC Exchange,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,UHC Medicaid,UHC Medicaid,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,UMR CPD,UMR CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,UHC Medicare,UHC Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PF TEE CONGENITAL ANOMAL      ,73520032,CDM,983,RC,,,,,,Inpatient,,,735.42,735.42,Wellcare,Wellcare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Meritain Health PPO CPD,Meritain Health PPO CPD,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Aetna/Commercial Product,Aetna/Commercial Product,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Meritain Health CPD,Meritain Health CPD,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Starmark CPD,Starmark CPD,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Aetna Medicare,Aetna Medicare,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Ambetter ,Ambetter ,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Blue Access,Anthem Blue Access,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Blue Access Choice,Anthem Blue Access Choice,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Blue Preferred,Anthem Blue Preferred,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Pathway,Anthem Pathway,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Alliance,Anthem Alliance,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Anthem Medicare,Anthem Medicare,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Cigna,Cigna,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Cigna PPO,Cigna PPO,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Cigna Medicare Advantage,Cigna Medicare Advantage,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Essence,Essence,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Healthlink HMO,Healthlink HMO,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Healthlink PPO,Healthlink PPO,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,HomeState Health Plan,HomeState Health Plan,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Humana Gold,Humana Gold,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Medicaid MO,Medicaid MO,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Medica,Medica,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Tricare,Tricare,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,UHC All Payer,UHC All Payer,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,UHC Exchange,UHC Exchange,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,UHC Medicaid,UHC Medicaid,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,UMR CPD,UMR CPD,4273.84,,,,,,,per diem,4273.84,4273.84,"Per diem rate, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,UHC Medicare,UHC Medicare,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/>P W CPAP >=6YRS      ,73520033,CDM,740,RC,,,,,,Inpatient,,,4273.84,4273.84,Wellcare,Wellcare,4273.84,,,,,,,case rate,4273.84,4273.84,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Meritain Health PPO CPD,Meritain Health PPO CPD,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Aetna/Commercial Product,Aetna/Commercial Product,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Meritain Health CPD,Meritain Health CPD,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Starmark CPD,Starmark CPD,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Aetna Medicare,Aetna Medicare,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Ambetter ,Ambetter ,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Blue Access,Anthem Blue Access,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Blue Access Choice,Anthem Blue Access Choice,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Blue Preferred,Anthem Blue Preferred,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Pathway,Anthem Pathway,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Alliance,Anthem Alliance,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Anthem Medicare,Anthem Medicare,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Cigna,Cigna,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Cigna PPO,Cigna PPO,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Cigna Medicare Advantage,Cigna Medicare Advantage,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Essence,Essence,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Healthlink HMO,Healthlink HMO,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Healthlink PPO,Healthlink PPO,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,HomeState Health Plan,HomeState Health Plan,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Humana Gold,Humana Gold,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Medicaid MO,Medicaid MO,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Medica,Medica,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Tricare,Tricare,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,UHC All Payer,UHC All Payer,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,UHC Exchange,UHC Exchange,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,UHC Medicaid,UHC Medicaid,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,UMR CPD,UMR CPD,4060.57,,,,,,,per diem,4060.57,4060.57,"Per diem rate, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,UHC Medicare,UHC Medicare,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
PSS W 4/> PAR W TECH>=6YR     ,73520034,CDM,740,RC,,,,,,Inpatient,,,4060.57,4060.57,Wellcare,Wellcare,4060.57,,,,,,,case rate,4060.57,4060.57,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Meritain Health PPO CPD,Meritain Health PPO CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Aetna/Commercial Product,Aetna/Commercial Product,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Meritain Health CPD,Meritain Health CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Starmark CPD,Starmark CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Aetna Medicare,Aetna Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Ambetter ,Ambetter ,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Blue Access,Anthem Blue Access,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Blue Access Choice,Anthem Blue Access Choice,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Blue Preferred,Anthem Blue Preferred,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Pathway,Anthem Pathway,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Alliance,Anthem Alliance,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Anthem Medicare,Anthem Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Cigna,Cigna,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Cigna PPO,Cigna PPO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Cigna Medicare Advantage,Cigna Medicare Advantage,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Essence,Essence,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Healthlink HMO,Healthlink HMO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Healthlink PPO,Healthlink PPO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,HomeState Health Plan,HomeState Health Plan,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Humana Gold,Humana Gold,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Medicaid MO,Medicaid MO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Medica,Medica,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Tricare,Tricare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,UHC All Payer,UHC All Payer,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,UHC Exchange,UHC Exchange,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,UHC Medicaid,UHC Medicaid,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,UMR CPD,UMR CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,UHC Medicare,UHC Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
SOMATOSEN TSTNG LOW EXT       ,73520035,CDM,920,RC,,,,,,Inpatient,,,1059,1059,Wellcare,Wellcare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Meritain Health PPO CPD,Meritain Health PPO CPD,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Aetna/Commercial Product,Aetna/Commercial Product,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Meritain Health CPD,Meritain Health CPD,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Starmark CPD,Starmark CPD,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Aetna Medicare,Aetna Medicare,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Ambetter ,Ambetter ,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Blue Access,Anthem Blue Access,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Blue Access Choice,Anthem Blue Access Choice,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Blue Preferred,Anthem Blue Preferred,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Pathway,Anthem Pathway,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Alliance,Anthem Alliance,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Anthem Medicare,Anthem Medicare,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Cigna,Cigna,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Cigna PPO,Cigna PPO,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Cigna Medicare Advantage,Cigna Medicare Advantage,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Essence,Essence,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Healthlink HMO,Healthlink HMO,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Healthlink PPO,Healthlink PPO,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,HomeState Health Plan,HomeState Health Plan,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Humana Gold,Humana Gold,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Medicaid MO,Medicaid MO,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Medica,Medica,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Tricare,Tricare,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,UHC All Payer,UHC All Payer,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,UHC Exchange,UHC Exchange,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,UHC Medicaid,UHC Medicaid,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,UMR CPD,UMR CPD,1829.09,,,,,,,per diem,1829.09,1829.09,"Per diem rate, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,UHC Medicare,UHC Medicare,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
TEE CONG SPEC COMP WO CON     ,73520036,CDM,483,RC,,,,,,Inpatient,,,1829.09,1829.09,Wellcare,Wellcare,1829.09,,,,,,,case rate,1829.09,1829.09,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Meritain Health PPO CPD,Meritain Health PPO CPD,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Aetna/Commercial Product,Aetna/Commercial Product,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Meritain Health CPD,Meritain Health CPD,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Starmark CPD,Starmark CPD,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Aetna Medicare,Aetna Medicare,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Ambetter ,Ambetter ,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Blue Access,Anthem Blue Access,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Blue Access Choice,Anthem Blue Access Choice,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Blue Preferred,Anthem Blue Preferred,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Pathway,Anthem Pathway,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Alliance,Anthem Alliance,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Anthem Medicare,Anthem Medicare,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Cigna,Cigna,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Cigna PPO,Cigna PPO,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Cigna Medicare Advantage,Cigna Medicare Advantage,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Essence,Essence,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Healthlink HMO,Healthlink HMO,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Healthlink PPO,Healthlink PPO,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,HomeState Health Plan,HomeState Health Plan,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Humana Gold,Humana Gold,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Medicaid MO,Medicaid MO,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Medica,Medica,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Tricare,Tricare,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,UHC All Payer,UHC All Payer,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,UHC Exchange,UHC Exchange,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,UHC Medicaid,UHC Medicaid,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,UMR CPD,UMR CPD,1124.14,,,,,,,per diem,1124.14,1124.14,"Per diem rate, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,UHC Medicare,UHC Medicare,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
VEP TEST CNS CHECKER/FLAS     ,73520037,CDM,920,RC,,,,,,Inpatient,,,1124.14,1124.14,Wellcare,Wellcare,1124.14,,,,,,,case rate,1124.14,1124.14,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Meritain Health PPO CPD,Meritain Health PPO CPD,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Aetna/Commercial Product,Aetna/Commercial Product,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Meritain Health CPD,Meritain Health CPD,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Starmark CPD,Starmark CPD,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Aetna Medicare,Aetna Medicare,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Ambetter ,Ambetter ,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Blue Access,Anthem Blue Access,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Blue Access Choice,Anthem Blue Access Choice,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Blue Preferred,Anthem Blue Preferred,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Pathway,Anthem Pathway,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Alliance,Anthem Alliance,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Anthem Medicare,Anthem Medicare,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Cigna,Cigna,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Cigna PPO,Cigna PPO,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Cigna Medicare Advantage,Cigna Medicare Advantage,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Essence,Essence,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Healthlink HMO,Healthlink HMO,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Healthlink PPO,Healthlink PPO,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,HomeState Health Plan,HomeState Health Plan,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Humana Gold,Humana Gold,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Medicaid MO,Medicaid MO,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Medica,Medica,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Tricare,Tricare,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,UHC All Payer,UHC All Payer,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,UHC Exchange,UHC Exchange,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,UHC Medicaid,UHC Medicaid,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,UMR CPD,UMR CPD,408.45,,,,,,,per diem,408.45,408.45,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,UHC Medicare,UHC Medicare,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR COM WCON     ,73520038,CDM,483,RC,,,,,,Inpatient,,,408.45,408.45,Wellcare,Wellcare,408.45,,,,,,,case rate,408.45,408.45,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Meritain Health PPO CPD,Meritain Health PPO CPD,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Aetna/Commercial Product,Aetna/Commercial Product,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Meritain Health CPD,Meritain Health CPD,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Starmark CPD,Starmark CPD,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Aetna Medicare,Aetna Medicare,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Ambetter ,Ambetter ,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Blue Access,Anthem Blue Access,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Blue Access Choice,Anthem Blue Access Choice,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Blue Preferred,Anthem Blue Preferred,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Pathway,Anthem Pathway,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Alliance,Anthem Alliance,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Anthem Medicare,Anthem Medicare,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Cigna,Cigna,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Cigna PPO,Cigna PPO,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Cigna Medicare Advantage,Cigna Medicare Advantage,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Essence,Essence,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Healthlink HMO,Healthlink HMO,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Healthlink PPO,Healthlink PPO,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,HomeState Health Plan,HomeState Health Plan,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Humana Gold,Humana Gold,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Medicaid MO,Medicaid MO,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Medica,Medica,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Tricare,Tricare,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,UHC All Payer,UHC All Payer,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,UHC Exchange,UHC Exchange,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,UHC Medicaid,UHC Medicaid,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,UMR CPD,UMR CPD,2997.36,,,,,,,per diem,2997.36,2997.36,"Per diem rate, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,UHC Medicare,UHC Medicare,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO CNG TRNSTHR LTD WCON     ,73520039,CDM,483,RC,,,,,,Inpatient,,,2997.36,2997.36,Wellcare,Wellcare,2997.36,,,,,,,case rate,2997.36,2997.36,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Meritain Health PPO CPD,Meritain Health PPO CPD,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Aetna/Commercial Product,Aetna/Commercial Product,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Meritain Health CPD,Meritain Health CPD,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Starmark CPD,Starmark CPD,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Aetna Medicare,Aetna Medicare,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Ambetter ,Ambetter ,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Blue Access,Anthem Blue Access,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Blue Access Choice,Anthem Blue Access Choice,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Blue Preferred,Anthem Blue Preferred,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Pathway,Anthem Pathway,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Alliance,Anthem Alliance,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Anthem Medicare,Anthem Medicare,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Cigna,Cigna,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Cigna PPO,Cigna PPO,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Cigna Medicare Advantage,Cigna Medicare Advantage,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Essence,Essence,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Healthlink HMO,Healthlink HMO,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Healthlink PPO,Healthlink PPO,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,HomeState Health Plan,HomeState Health Plan,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Humana Gold,Humana Gold,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Medicaid MO,Medicaid MO,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Medica,Medica,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Tricare,Tricare,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,UHC All Payer,UHC All Payer,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,UHC Exchange,UHC Exchange,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,UHC Medicaid,UHC Medicaid,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,UMR CPD,UMR CPD,1216.59,,,,,,,per diem,1216.59,1216.59,"Per diem rate, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,UHC Medicare,UHC Medicare,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D COMP W CON            ,73520040,CDM,483,RC,,,,,,Inpatient,,,1216.59,1216.59,Wellcare,Wellcare,1216.59,,,,,,,case rate,1216.59,1216.59,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Meritain Health PPO CPD,Meritain Health PPO CPD,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Aetna/Commercial Product,Aetna/Commercial Product,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Meritain Health CPD,Meritain Health CPD,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Starmark CPD,Starmark CPD,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Aetna Medicare,Aetna Medicare,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Ambetter ,Ambetter ,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Blue Access,Anthem Blue Access,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Blue Access Choice,Anthem Blue Access Choice,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Blue Preferred,Anthem Blue Preferred,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Pathway,Anthem Pathway,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Alliance,Anthem Alliance,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Anthem Medicare,Anthem Medicare,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Cigna,Cigna,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Cigna PPO,Cigna PPO,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Cigna Medicare Advantage,Cigna Medicare Advantage,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Essence,Essence,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Healthlink HMO,Healthlink HMO,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Healthlink PPO,Healthlink PPO,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,HomeState Health Plan,HomeState Health Plan,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Humana Gold,Humana Gold,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Medicaid MO,Medicaid MO,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Medica,Medica,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Tricare,Tricare,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,UHC All Payer,UHC All Payer,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,UHC Exchange,UHC Exchange,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,UHC Medicaid,UHC Medicaid,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,UMR CPD,UMR CPD,1067.41,,,,,,,per diem,1067.41,1067.41,"Per diem rate, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,UHC Medicare,UHC Medicare,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO 2D LMTD W CON            ,73520041,CDM,483,RC,,,,,,Inpatient,,,1067.41,1067.41,Wellcare,Wellcare,1067.41,,,,,,,case rate,1067.41,1067.41,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health PPO CPD,Meritain Health PPO CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/Commercial Product,Aetna/Commercial Product,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health CPD,Meritain Health CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Starmark CPD,Starmark CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna Medicare,Aetna Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Ambetter ,Ambetter ,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access,Anthem Blue Access,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access Choice,Anthem Blue Access Choice,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Preferred,Anthem Blue Preferred,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Pathway,Anthem Pathway,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Alliance,Anthem Alliance,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Medicare,Anthem Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna,Cigna,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna PPO,Cigna PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna Medicare Advantage,Cigna Medicare Advantage,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Essence,Essence,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink HMO,Healthlink HMO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink PPO,Healthlink PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,HomeState Health Plan,HomeState Health Plan,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Humana Gold,Humana Gold,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medicaid MO,Medicaid MO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medica,Medica,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Tricare,Tricare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC All Payer,UHC All Payer,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Exchange,UHC Exchange,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicaid,UHC Medicaid,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UMR CPD,UMR CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicare,UHC Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TEST COMP W CON      ,73520042,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Wellcare,Wellcare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Meritain Health PPO CPD,Meritain Health PPO CPD,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Aetna/Commercial Product,Aetna/Commercial Product,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Meritain Health CPD,Meritain Health CPD,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Starmark CPD,Starmark CPD,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Aetna Medicare,Aetna Medicare,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Ambetter ,Ambetter ,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Blue Access,Anthem Blue Access,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Blue Access Choice,Anthem Blue Access Choice,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Blue Preferred,Anthem Blue Preferred,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Pathway,Anthem Pathway,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Alliance,Anthem Alliance,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Anthem Medicare,Anthem Medicare,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Cigna,Cigna,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Cigna PPO,Cigna PPO,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Cigna Medicare Advantage,Cigna Medicare Advantage,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Essence,Essence,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Healthlink HMO,Healthlink HMO,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Healthlink PPO,Healthlink PPO,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,HomeState Health Plan,HomeState Health Plan,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Humana Gold,Humana Gold,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Medicaid MO,Medicaid MO,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Medica,Medica,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Tricare,Tricare,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,UHC All Payer,UHC All Payer,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,UHC Exchange,UHC Exchange,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,UHC Medicaid,UHC Medicaid,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,UMR CPD,UMR CPD,2720.31,,,,,,,per diem,2720.31,2720.31,"Per diem rate, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,UHC Medicare,UHC Medicare,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
TTE COMP W SPEC/CF W CON      ,73520043,CDM,483,RC,,,,,,Inpatient,,,2720.31,2720.31,Wellcare,Wellcare,2720.31,,,,,,,case rate,2720.31,2720.31,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health PPO CPD,Meritain Health PPO CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna/Commercial Product,Aetna/Commercial Product,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Meritain Health CPD,Meritain Health CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Starmark CPD,Starmark CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Aetna Medicare,Aetna Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Ambetter ,Ambetter ,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access,Anthem Blue Access,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Access Choice,Anthem Blue Access Choice,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Blue Preferred,Anthem Blue Preferred,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Pathway,Anthem Pathway,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Alliance,Anthem Alliance,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Anthem Medicare,Anthem Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna,Cigna,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna PPO,Cigna PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Cigna Medicare Advantage,Cigna Medicare Advantage,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Essence,Essence,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink HMO,Healthlink HMO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Healthlink PPO,Healthlink PPO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,HomeState Health Plan,HomeState Health Plan,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Humana Gold,Humana Gold,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medicaid MO,Medicaid MO,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Medica,Medica,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Tricare,Tricare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC All Payer,UHC All Payer,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Exchange,UHC Exchange,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicaid,UHC Medicaid,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UMR CPD,UMR CPD,1857.46,,,,,,,per diem,1857.46,1857.46,"Per diem rate, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,UHC Medicare,UHC Medicare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECHO STR TST COMP ECG CON     ,73520044,CDM,483,RC,,,,,,Inpatient,,,1857.46,1857.46,Wellcare,Wellcare,1857.46,,,,,,,case rate,1857.46,1857.46,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Meritain Health PPO CPD,Meritain Health PPO CPD,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Aetna/Commercial Product,Aetna/Commercial Product,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Meritain Health CPD,Meritain Health CPD,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Starmark CPD,Starmark CPD,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Aetna Medicare,Aetna Medicare,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Ambetter ,Ambetter ,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Blue Access,Anthem Blue Access,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Blue Access Choice,Anthem Blue Access Choice,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Blue Preferred,Anthem Blue Preferred,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Pathway,Anthem Pathway,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Alliance,Anthem Alliance,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Anthem Medicare,Anthem Medicare,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Cigna,Cigna,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Cigna PPO,Cigna PPO,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Cigna Medicare Advantage,Cigna Medicare Advantage,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Essence,Essence,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Healthlink HMO,Healthlink HMO,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Healthlink PPO,Healthlink PPO,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,HomeState Health Plan,HomeState Health Plan,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Humana Gold,Humana Gold,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Medicaid MO,Medicaid MO,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Medica,Medica,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Tricare,Tricare,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,UHC All Payer,UHC All Payer,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,UHC Exchange,UHC Exchange,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,UHC Medicaid,UHC Medicaid,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,UMR CPD,UMR CPD,1172.47,,,,,,,per diem,1172.47,1172.47,"Per diem rate, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,UHC Medicare,UHC Medicare,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
ECH CNG TRNSTHR LTD WOCON     ,73520045,CDM,483,RC,,,,,,Inpatient,,,1172.47,1172.47,Wellcare,Wellcare,1172.47,,,,,,,case rate,1172.47,1172.47,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Meritain Health PPO CPD,Meritain Health PPO CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Aetna/Commercial Product,Aetna/Commercial Product,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Meritain Health CPD,Meritain Health CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Starmark CPD,Starmark CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Aetna Medicare,Aetna Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Ambetter ,Ambetter ,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Access,Anthem Blue Access,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Access Choice,Anthem Blue Access Choice,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Blue Preferred,Anthem Blue Preferred,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Pathway,Anthem Pathway,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Alliance,Anthem Alliance,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Anthem Medicare,Anthem Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Cigna,Cigna,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Cigna PPO,Cigna PPO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Cigna Medicare Advantage,Cigna Medicare Advantage,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Essence,Essence,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Healthlink HMO,Healthlink HMO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Healthlink PPO,Healthlink PPO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,HomeState Health Plan,HomeState Health Plan,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Humana Gold,Humana Gold,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Medicaid MO,Medicaid MO,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Medica,Medica,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Tricare,Tricare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,UHC All Payer,UHC All Payer,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,UHC Exchange,UHC Exchange,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,UHC Medicaid,UHC Medicaid,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,UMR CPD,UMR CPD,735.42,,,,,,,per diem,735.42,735.42,"Per diem rate, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,UHC Medicare,UHC Medicare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
TEE PROBE PLACEMENT ONLY      ,73520046,CDM,483,RC,,,,,,Inpatient,,,735.42,735.42,Wellcare,Wellcare,735.42,,,,,,,case rate,735.42,735.42,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Meritain Health PPO CPD,Meritain Health PPO CPD,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Aetna/Commercial Product,Aetna/Commercial Product,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Meritain Health CPD,Meritain Health CPD,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Starmark CPD,Starmark CPD,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Aetna Medicare,Aetna Medicare,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Ambetter ,Ambetter ,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Blue Access,Anthem Blue Access,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Blue Access Choice,Anthem Blue Access Choice,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Blue Preferred,Anthem Blue Preferred,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Pathway,Anthem Pathway,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Alliance,Anthem Alliance,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Anthem Medicare,Anthem Medicare,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Cigna,Cigna,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Cigna PPO,Cigna PPO,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Cigna Medicare Advantage,Cigna Medicare Advantage,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Essence,Essence,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Healthlink HMO,Healthlink HMO,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Healthlink PPO,Healthlink PPO,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,HomeState Health Plan,HomeState Health Plan,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Humana Gold,Humana Gold,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Medicaid MO,Medicaid MO,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Medica,Medica,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Tricare,Tricare,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,UHC All Payer,UHC All Payer,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,UHC Exchange,UHC Exchange,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,UHC Medicaid,UHC Medicaid,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,UMR CPD,UMR CPD,262.65,,,,,,,per diem,262.65,262.65,"Per diem rate, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,UHC Medicare,UHC Medicare,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
DOP ECHO LMTD STUDY ADDON     ,73520047,CDM,483,RC,,,,,,Inpatient,,,262.65,262.65,Wellcare,Wellcare,262.65,,,,,,,case rate,262.65,262.65,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Meritain Health PPO CPD,Meritain Health PPO CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna/Commercial Product,Aetna/Commercial Product,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Meritain Health CPD,Meritain Health CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Starmark CPD,Starmark CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Aetna Medicare,Aetna Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Ambetter ,Ambetter ,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Access,Anthem Blue Access,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Access Choice,Anthem Blue Access Choice,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Blue Preferred,Anthem Blue Preferred,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Pathway,Anthem Pathway,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Alliance,Anthem Alliance,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Anthem Medicare,Anthem Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna,Cigna,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna PPO,Cigna PPO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Cigna Medicare Advantage,Cigna Medicare Advantage,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Essence,Essence,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthlink HMO,Healthlink HMO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Healthlink PPO,Healthlink PPO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,HomeState Health Plan,HomeState Health Plan,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Humana Gold,Humana Gold,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Medicaid MO,Medicaid MO,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Medica,Medica,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Tricare,Tricare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC All Payer,UHC All Payer,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Exchange,UHC Exchange,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Medicaid,UHC Medicaid,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UMR CPD,UMR CPD,663.98,,,,,,,per diem,663.98,663.98,"Per diem rate, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,UHC Medicare,UHC Medicare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
INJ MICROBUB STDY EXST IV     ,73520048,CDM,480,RC,,,,,,Inpatient,,,663.98,663.98,Wellcare,Wellcare,663.98,,,,,,,case rate,663.98,663.98,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Meritain Health PPO CPD,Meritain Health PPO CPD,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Aetna/Commercial Product,Aetna/Commercial Product,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Meritain Health CPD,Meritain Health CPD,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Starmark CPD,Starmark CPD,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Aetna Medicare,Aetna Medicare,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Ambetter ,Ambetter ,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Blue Access,Anthem Blue Access,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Blue Access Choice,Anthem Blue Access Choice,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Blue Preferred,Anthem Blue Preferred,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Pathway,Anthem Pathway,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Alliance,Anthem Alliance,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Anthem Medicare,Anthem Medicare,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Cigna,Cigna,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Cigna PPO,Cigna PPO,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Cigna Medicare Advantage,Cigna Medicare Advantage,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Essence,Essence,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Healthlink HMO,Healthlink HMO,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Healthlink PPO,Healthlink PPO,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,HomeState Health Plan,HomeState Health Plan,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Humana Gold,Humana Gold,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Medicaid MO,Medicaid MO,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Medica,Medica,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Tricare,Tricare,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,UHC All Payer,UHC All Payer,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,UHC Exchange,UHC Exchange,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,UHC Medicaid,UHC Medicaid,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,UMR CPD,UMR CPD,816.32,,,,,,,per diem,816.32,816.32,"Per diem rate, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,UHC Medicare,UHC Medicare,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
MYOCARDIAL STRAIN IMAGING     ,73520049,CDM,480,RC,,,,,,Inpatient,,,816.32,816.32,Wellcare,Wellcare,816.32,,,,,,,case rate,816.32,816.32,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Meritain Health PPO CPD,Meritain Health PPO CPD,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Aetna/Commercial Product,Aetna/Commercial Product,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Meritain Health CPD,Meritain Health CPD,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Starmark CPD,Starmark CPD,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Aetna Medicare,Aetna Medicare,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Ambetter ,Ambetter ,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Blue Access,Anthem Blue Access,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Blue Access Choice,Anthem Blue Access Choice,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Blue Preferred,Anthem Blue Preferred,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Pathway,Anthem Pathway,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Alliance,Anthem Alliance,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Anthem Medicare,Anthem Medicare,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Cigna,Cigna,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Cigna PPO,Cigna PPO,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Cigna Medicare Advantage,Cigna Medicare Advantage,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Essence,Essence,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Healthlink HMO,Healthlink HMO,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Healthlink PPO,Healthlink PPO,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,HomeState Health Plan,HomeState Health Plan,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Humana Gold,Humana Gold,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Medicaid MO,Medicaid MO,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Medica,Medica,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Tricare,Tricare,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,UHC All Payer,UHC All Payer,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,UHC Exchange,UHC Exchange,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,UHC Medicaid,UHC Medicaid,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,UMR CPD,UMR CPD,5851.84,,,,,,,per diem,5851.84,5851.84,"Per diem rate, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,UHC Medicare,UHC Medicare,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
TONGUE BASE VOL REDUCTION     ,73520050,CDM,361,RC,,,,,,Inpatient,,,5851.84,5851.84,Wellcare,Wellcare,5851.84,,,,,,,case rate,5851.84,5851.84,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Meritain Health PPO CPD,Meritain Health PPO CPD,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Aetna/Commercial Product,Aetna/Commercial Product,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Meritain Health CPD,Meritain Health CPD,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Starmark CPD,Starmark CPD,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Aetna Medicare,Aetna Medicare,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Ambetter ,Ambetter ,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Blue Access,Anthem Blue Access,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Blue Access Choice,Anthem Blue Access Choice,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Blue Preferred,Anthem Blue Preferred,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Pathway,Anthem Pathway,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Alliance,Anthem Alliance,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Anthem Medicare,Anthem Medicare,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Cigna,Cigna,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Cigna PPO,Cigna PPO,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Cigna Medicare Advantage,Cigna Medicare Advantage,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Essence,Essence,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Healthlink HMO,Healthlink HMO,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Healthlink PPO,Healthlink PPO,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,HomeState Health Plan,HomeState Health Plan,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Humana Gold,Humana Gold,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Medicaid MO,Medicaid MO,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Medica,Medica,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Tricare,Tricare,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,UHC All Payer,UHC All Payer,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,UHC Exchange,UHC Exchange,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,UHC Medicaid,UHC Medicaid,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,UMR CPD,UMR CPD,397.13,,,,,,,per diem,397.13,397.13,"Per diem rate, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,UHC Medicare,UHC Medicare,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ECHO STR CONTRAST AGENT       ,73520051,CDM,483,RC,,,,,,Inpatient,,,397.13,397.13,Wellcare,Wellcare,397.13,,,,,,,case rate,397.13,397.13,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Meritain Health PPO CPD,Meritain Health PPO CPD,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Aetna/Commercial Product,Aetna/Commercial Product,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Meritain Health CPD,Meritain Health CPD,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Starmark CPD,Starmark CPD,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Aetna Medicare,Aetna Medicare,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Ambetter ,Ambetter ,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Blue Access,Anthem Blue Access,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Blue Access Choice,Anthem Blue Access Choice,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Blue Preferred,Anthem Blue Preferred,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Pathway,Anthem Pathway,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Alliance,Anthem Alliance,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Anthem Medicare,Anthem Medicare,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Cigna,Cigna,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Cigna PPO,Cigna PPO,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Cigna Medicare Advantage,Cigna Medicare Advantage,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Essence,Essence,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Healthlink HMO,Healthlink HMO,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Healthlink PPO,Healthlink PPO,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,HomeState Health Plan,HomeState Health Plan,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Humana Gold,Humana Gold,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Medicaid MO,Medicaid MO,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Medica,Medica,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Tricare,Tricare,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,UHC All Payer,UHC All Payer,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,UHC Exchange,UHC Exchange,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,UHC Medicaid,UHC Medicaid,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,UMR CPD,UMR CPD,1.63,,,,,,,per diem,1.63,1.63,"Per diem rate, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,UHC Medicare,UHC Medicare,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
ELECT SLVR MACTRO PLUS        ,73520052,CDM,730,RC,,,,,,Inpatient,,,1.63,1.63,Wellcare,Wellcare,1.63,,,,,,,case rate,1.63,1.63,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Meritain Health PPO CPD,Meritain Health PPO CPD,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Aetna/Commercial Product,Aetna/Commercial Product,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Meritain Health CPD,Meritain Health CPD,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Starmark CPD,Starmark CPD,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Aetna Medicare,Aetna Medicare,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Ambetter ,Ambetter ,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Blue Access,Anthem Blue Access,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Blue Access Choice,Anthem Blue Access Choice,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Blue Preferred,Anthem Blue Preferred,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Pathway,Anthem Pathway,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Alliance,Anthem Alliance,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Anthem Medicare,Anthem Medicare,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Cigna,Cigna,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Cigna PPO,Cigna PPO,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Cigna Medicare Advantage,Cigna Medicare Advantage,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Essence,Essence,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Healthlink HMO,Healthlink HMO,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Healthlink PPO,Healthlink PPO,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,HomeState Health Plan,HomeState Health Plan,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Humana Gold,Humana Gold,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Medicaid MO,Medicaid MO,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Medica,Medica,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Tricare,Tricare,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,UHC All Payer,UHC All Payer,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,UHC Exchange,UHC Exchange,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,UHC Medicaid,UHC Medicaid,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,UMR CPD,UMR CPD,47.61,,,,,,,per diem,47.61,47.61,"Per diem rate, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,UHC Medicare,UHC Medicare,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
PAPER PREM THERM RED GRID     ,73520053,CDM,730,RC,,,,,,Inpatient,,,47.61,47.61,Wellcare,Wellcare,47.61,,,,,,,case rate,47.61,47.61,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Meritain Health PPO CPD,Meritain Health PPO CPD,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Aetna/Commercial Product,Aetna/Commercial Product,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Meritain Health CPD,Meritain Health CPD,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Starmark CPD,Starmark CPD,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Aetna Medicare,Aetna Medicare,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Ambetter ,Ambetter ,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Blue Access,Anthem Blue Access,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Blue Access Choice,Anthem Blue Access Choice,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Blue Preferred,Anthem Blue Preferred,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Pathway,Anthem Pathway,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Alliance,Anthem Alliance,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Anthem Medicare,Anthem Medicare,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Cigna,Cigna,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Cigna PPO,Cigna PPO,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Cigna Medicare Advantage,Cigna Medicare Advantage,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Essence,Essence,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Healthlink HMO,Healthlink HMO,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Healthlink PPO,Healthlink PPO,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,HomeState Health Plan,HomeState Health Plan,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Humana Gold,Humana Gold,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Medicaid MO,Medicaid MO,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Medica,Medica,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Tricare,Tricare,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,UHC All Payer,UHC All Payer,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,UHC Exchange,UHC Exchange,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,UHC Medicaid,UHC Medicaid,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,UMR CPD,UMR CPD,1.18,,,,,,,per diem,1.18,1.18,"Per diem rate, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,UHC Medicare,UHC Medicare,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
NERVE COND MOTOR W/FWAVE      ,73520054,CDM,920,RC,95903,CPT,,,,Inpatient,,,1.18,1.18,Wellcare,Wellcare,1.18,,,,,,,case rate,1.18,1.18,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Meritain Health PPO CPD,Meritain Health PPO CPD,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Aetna/Commercial Product,Aetna/Commercial Product,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Meritain Health CPD,Meritain Health CPD,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Starmark CPD,Starmark CPD,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Aetna Medicare,Aetna Medicare,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Ambetter ,Ambetter ,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Blue Access,Anthem Blue Access,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Blue Access Choice,Anthem Blue Access Choice,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Blue Preferred,Anthem Blue Preferred,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Pathway,Anthem Pathway,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Alliance,Anthem Alliance,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Anthem Medicare,Anthem Medicare,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Cigna,Cigna,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Cigna PPO,Cigna PPO,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Cigna Medicare Advantage,Cigna Medicare Advantage,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Essence,Essence,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Healthlink HMO,Healthlink HMO,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Healthlink PPO,Healthlink PPO,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,HomeState Health Plan,HomeState Health Plan,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Humana Gold,Humana Gold,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Medicaid MO,Medicaid MO,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Medica,Medica,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Tricare,Tricare,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,UHC All Payer,UHC All Payer,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,UHC Exchange,UHC Exchange,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,UHC Medicaid,UHC Medicaid,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,UMR CPD,UMR CPD,1.72,,,,,,,per diem,1.72,1.72,"Per diem rate, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,UHC Medicare,UHC Medicare,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
ELECTRODE SLVR MACTRODE PLUS  ,73520055,CDM,730,RC,,,,,,Inpatient,,,1.72,1.72,Wellcare,Wellcare,1.72,,,,,,,case rate,1.72,1.72,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Meritain Health PPO CPD,Meritain Health PPO CPD,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Aetna/Commercial Product,Aetna/Commercial Product,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Meritain Health CPD,Meritain Health CPD,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Starmark CPD,Starmark CPD,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Aetna Medicare,Aetna Medicare,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Ambetter ,Ambetter ,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Blue Access,Anthem Blue Access,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Blue Access Choice,Anthem Blue Access Choice,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Blue Preferred,Anthem Blue Preferred,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Pathway,Anthem Pathway,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Alliance,Anthem Alliance,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Anthem Medicare,Anthem Medicare,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Cigna,Cigna,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Cigna PPO,Cigna PPO,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Cigna Medicare Advantage,Cigna Medicare Advantage,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Essence,Essence,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Healthlink HMO,Healthlink HMO,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Healthlink PPO,Healthlink PPO,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,HomeState Health Plan,HomeState Health Plan,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Humana Gold,Humana Gold,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Medicaid MO,Medicaid MO,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Medica,Medica,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Tricare,Tricare,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,UHC All Payer,UHC All Payer,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,UHC Exchange,UHC Exchange,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,UHC Medicaid,UHC Medicaid,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,UMR CPD,UMR CPD,292.71,,,,,,,per diem,292.71,292.71,"Per diem rate, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,UHC Medicare,UHC Medicare,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
SET UP FEE                    ,73520056,CDM,920,RC,Q0092,HCPCS,,,,Inpatient,,,292.71,292.71,Wellcare,Wellcare,292.71,,,,,,,case rate,292.71,292.71,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Meritain Health PPO CPD,Meritain Health PPO CPD,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Aetna/Commercial Product,Aetna/Commercial Product,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Meritain Health CPD,Meritain Health CPD,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Starmark CPD,Starmark CPD,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Aetna Medicare,Aetna Medicare,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Ambetter ,Ambetter ,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Blue Access,Anthem Blue Access,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Blue Access Choice,Anthem Blue Access Choice,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Blue Preferred,Anthem Blue Preferred,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Pathway,Anthem Pathway,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Alliance,Anthem Alliance,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Anthem Medicare,Anthem Medicare,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Cigna,Cigna,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Cigna PPO,Cigna PPO,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Cigna Medicare Advantage,Cigna Medicare Advantage,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Essence,Essence,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Healthlink HMO,Healthlink HMO,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Healthlink PPO,Healthlink PPO,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,HomeState Health Plan,HomeState Health Plan,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Humana Gold,Humana Gold,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Medicaid MO,Medicaid MO,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Medica,Medica,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Tricare,Tricare,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,UHC All Payer,UHC All Payer,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,UHC Exchange,UHC Exchange,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,UHC Medicaid,UHC Medicaid,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,UMR CPD,UMR CPD,660.68,,,,,,,per diem,660.68,660.68,"Per diem rate, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,UHC Medicare,UHC Medicare,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EMG ADD-ON 5 OR MORE MUSCLE   ,73570057,CDM,922,RC,95886,CPT,,,,Inpatient,,,660.68,660.68,Wellcare,Wellcare,660.68,,,,,,,case rate,660.68,660.68,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Meritain Health PPO CPD,Meritain Health PPO CPD,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Aetna/Commercial Product,Aetna/Commercial Product,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Meritain Health CPD,Meritain Health CPD,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Starmark CPD,Starmark CPD,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Aetna Medicare,Aetna Medicare,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Ambetter ,Ambetter ,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Blue Access,Anthem Blue Access,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Blue Access Choice,Anthem Blue Access Choice,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Blue Preferred,Anthem Blue Preferred,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Pathway,Anthem Pathway,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Alliance,Anthem Alliance,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Anthem Medicare,Anthem Medicare,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Cigna,Cigna,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Cigna PPO,Cigna PPO,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Cigna Medicare Advantage,Cigna Medicare Advantage,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Essence,Essence,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Healthlink HMO,Healthlink HMO,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Healthlink PPO,Healthlink PPO,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,HomeState Health Plan,HomeState Health Plan,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Humana Gold,Humana Gold,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Medicaid MO,Medicaid MO,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Medica,Medica,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Tricare,Tricare,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,UHC All Payer,UHC All Payer,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,UHC Exchange,UHC Exchange,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,UHC Medicaid,UHC Medicaid,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,UMR CPD,UMR CPD,1631.58,,,,,,,per diem,1631.58,1631.58,"Per diem rate, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,UHC Medicare,UHC Medicare,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
EEG EVOKE POT MED             ,73599995,CDM,740,RC,95925,CPT,,,,Inpatient,,,1631.58,1631.58,Wellcare,Wellcare,1631.58,,,,,,,case rate,1631.58,1631.58,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Meritain Health PPO CPD,Meritain Health PPO CPD,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Aetna/Commercial Product,Aetna/Commercial Product,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Meritain Health CPD,Meritain Health CPD,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Starmark CPD,Starmark CPD,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Aetna Medicare,Aetna Medicare,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Ambetter ,Ambetter ,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Blue Access,Anthem Blue Access,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Blue Access Choice,Anthem Blue Access Choice,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Blue Preferred,Anthem Blue Preferred,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Pathway,Anthem Pathway,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Alliance,Anthem Alliance,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Anthem Medicare,Anthem Medicare,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Cigna,Cigna,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Cigna PPO,Cigna PPO,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Cigna Medicare Advantage,Cigna Medicare Advantage,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Essence,Essence,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Healthlink HMO,Healthlink HMO,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Healthlink PPO,Healthlink PPO,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,HomeState Health Plan,HomeState Health Plan,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Humana Gold,Humana Gold,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Medicaid MO,Medicaid MO,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Medica,Medica,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Tricare,Tricare,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,UHC All Payer,UHC All Payer,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,UHC Exchange,UHC Exchange,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,UHC Medicaid,UHC Medicaid,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,UMR CPD,UMR CPD,541.06,,,,,,,per diem,541.06,541.06,"Per diem rate, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,UHC Medicare,UHC Medicare,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN W/OBLIQUE & CONE VIEWS,74000005,CDM,320,RC,74010,CPT,,,,Inpatient,,,541.06,541.06,Wellcare,Wellcare,541.06,,,,,,,case rate,541.06,541.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABDOMEN SINGLE AP VIEW        ,74000006,CDM,320,RC,74018,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Meritain Health PPO CPD,Meritain Health PPO CPD,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Aetna/Commercial Product,Aetna/Commercial Product,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Meritain Health CPD,Meritain Health CPD,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Starmark CPD,Starmark CPD,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Aetna Medicare,Aetna Medicare,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Ambetter ,Ambetter ,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Blue Access,Anthem Blue Access,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Blue Access Choice,Anthem Blue Access Choice,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Blue Preferred,Anthem Blue Preferred,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Pathway,Anthem Pathway,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Alliance,Anthem Alliance,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Anthem Medicare,Anthem Medicare,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Cigna,Cigna,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Cigna PPO,Cigna PPO,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Cigna Medicare Advantage,Cigna Medicare Advantage,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Essence,Essence,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Healthlink HMO,Healthlink HMO,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Healthlink PPO,Healthlink PPO,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,HomeState Health Plan,HomeState Health Plan,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Humana Gold,Humana Gold,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Medicaid MO,Medicaid MO,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Medica,Medica,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Tricare,Tricare,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,UHC All Payer,UHC All Payer,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,UHC Exchange,UHC Exchange,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,UHC Medicaid,UHC Medicaid,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,UMR CPD,UMR CPD,344.79,,,,,,,per diem,344.79,344.79,"Per diem rate, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,UHC Medicare,UHC Medicare,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
ABD FLAT & ERECT &/OR DECUB   ,74000010,CDM,320,RC,74020,CPT,,,,Inpatient,,,344.79,344.79,Wellcare,Wellcare,344.79,,,,,,,case rate,344.79,344.79,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Meritain Health PPO CPD,Meritain Health PPO CPD,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Aetna/Commercial Product,Aetna/Commercial Product,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Meritain Health CPD,Meritain Health CPD,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Starmark CPD,Starmark CPD,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Aetna Medicare,Aetna Medicare,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Ambetter ,Ambetter ,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Blue Access,Anthem Blue Access,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Blue Access Choice,Anthem Blue Access Choice,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Blue Preferred,Anthem Blue Preferred,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Pathway,Anthem Pathway,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Alliance,Anthem Alliance,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Anthem Medicare,Anthem Medicare,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Cigna,Cigna,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Cigna PPO,Cigna PPO,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Cigna Medicare Advantage,Cigna Medicare Advantage,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Essence,Essence,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Healthlink HMO,Healthlink HMO,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Healthlink PPO,Healthlink PPO,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,HomeState Health Plan,HomeState Health Plan,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Humana Gold,Humana Gold,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Medicaid MO,Medicaid MO,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Medica,Medica,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Tricare,Tricare,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,UHC All Payer,UHC All Payer,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,UHC Exchange,UHC Exchange,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,UHC Medicaid,UHC Medicaid,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,UMR CPD,UMR CPD,337.33,,,,,,,per diem,337.33,337.33,"Per diem rate, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,UHC Medicare,UHC Medicare,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
SHOULDER 1 VIEW BILATERAL     ,74000023,CDM,320,RC,73020,CPT,,,50,Inpatient,,,337.33,337.33,Wellcare,Wellcare,337.33,,,,,,,case rate,337.33,337.33,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Meritain Health PPO CPD,Meritain Health PPO CPD,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Aetna/Commercial Product,Aetna/Commercial Product,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Meritain Health CPD,Meritain Health CPD,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Starmark CPD,Starmark CPD,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Aetna Medicare,Aetna Medicare,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Ambetter ,Ambetter ,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Blue Access,Anthem Blue Access,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Blue Access Choice,Anthem Blue Access Choice,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Blue Preferred,Anthem Blue Preferred,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Pathway,Anthem Pathway,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Alliance,Anthem Alliance,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Anthem Medicare,Anthem Medicare,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Cigna,Cigna,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Cigna PPO,Cigna PPO,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Cigna Medicare Advantage,Cigna Medicare Advantage,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Essence,Essence,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Healthlink HMO,Healthlink HMO,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Healthlink PPO,Healthlink PPO,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,HomeState Health Plan,HomeState Health Plan,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Humana Gold,Humana Gold,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Medicaid MO,Medicaid MO,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Medica,Medica,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Tricare,Tricare,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,UHC All Payer,UHC All Payer,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,UHC Exchange,UHC Exchange,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,UHC Medicaid,UHC Medicaid,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,UMR CPD,UMR CPD,226.24,,,,,,,per diem,226.24,226.24,"Per diem rate, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,UHC Medicare,UHC Medicare,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
A-C JOINTS BILATERAL          ,74000030,CDM,320,RC,73050,CPT,,,,Inpatient,,,226.24,226.24,Wellcare,Wellcare,226.24,,,,,,,case rate,226.24,226.24,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Meritain Health PPO CPD,Meritain Health PPO CPD,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Aetna/Commercial Product,Aetna/Commercial Product,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Meritain Health CPD,Meritain Health CPD,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Starmark CPD,Starmark CPD,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Aetna Medicare,Aetna Medicare,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Ambetter ,Ambetter ,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Blue Access,Anthem Blue Access,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Blue Access Choice,Anthem Blue Access Choice,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Blue Preferred,Anthem Blue Preferred,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Pathway,Anthem Pathway,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Alliance,Anthem Alliance,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Anthem Medicare,Anthem Medicare,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Cigna,Cigna,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Cigna PPO,Cigna PPO,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Cigna Medicare Advantage,Cigna Medicare Advantage,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Essence,Essence,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Healthlink HMO,Healthlink HMO,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Healthlink PPO,Healthlink PPO,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,HomeState Health Plan,HomeState Health Plan,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Humana Gold,Humana Gold,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Medicaid MO,Medicaid MO,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Medica,Medica,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Tricare,Tricare,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,UHC All Payer,UHC All Payer,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,UHC Exchange,UHC Exchange,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,UHC Medicaid,UHC Medicaid,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,UMR CPD,UMR CPD,313.12,,,,,,,per diem,313.12,313.12,"Per diem rate, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,UHC Medicare,UHC Medicare,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANGIO RENAL UNILATERAL RT     ,74000055,CDM,320,RC,75722,CPT,,,RT,Inpatient,,,313.12,313.12,Wellcare,Wellcare,313.12,,,,,,,case rate,313.12,313.12,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Meritain Health PPO CPD,Meritain Health PPO CPD,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Aetna/Commercial Product,Aetna/Commercial Product,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Meritain Health CPD,Meritain Health CPD,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Starmark CPD,Starmark CPD,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Aetna Medicare,Aetna Medicare,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Ambetter ,Ambetter ,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Blue Access,Anthem Blue Access,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Blue Access Choice,Anthem Blue Access Choice,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Blue Preferred,Anthem Blue Preferred,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Pathway,Anthem Pathway,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Alliance,Anthem Alliance,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Anthem Medicare,Anthem Medicare,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Cigna,Cigna,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Cigna PPO,Cigna PPO,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Cigna Medicare Advantage,Cigna Medicare Advantage,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Essence,Essence,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Healthlink HMO,Healthlink HMO,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Healthlink PPO,Healthlink PPO,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,HomeState Health Plan,HomeState Health Plan,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Humana Gold,Humana Gold,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Medicaid MO,Medicaid MO,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Medica,Medica,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Tricare,Tricare,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,UHC All Payer,UHC All Payer,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,UHC Exchange,UHC Exchange,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,UHC Medicaid,UHC Medicaid,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,UMR CPD,UMR CPD,351.64,,,,,,,per diem,351.64,351.64,"Per diem rate, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,UHC Medicare,UHC Medicare,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 2 VIEWS BILATERAL       ,74000060,CDM,320,RC,73600,CPT,,,50,Inpatient,,,351.64,351.64,Wellcare,Wellcare,351.64,,,,,,,case rate,351.64,351.64,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Meritain Health PPO CPD,Meritain Health PPO CPD,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Aetna/Commercial Product,Aetna/Commercial Product,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Meritain Health CPD,Meritain Health CPD,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Starmark CPD,Starmark CPD,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Aetna Medicare,Aetna Medicare,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Ambetter ,Ambetter ,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Blue Access,Anthem Blue Access,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Blue Access Choice,Anthem Blue Access Choice,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Blue Preferred,Anthem Blue Preferred,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Pathway,Anthem Pathway,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Alliance,Anthem Alliance,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Anthem Medicare,Anthem Medicare,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Cigna,Cigna,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Cigna PPO,Cigna PPO,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Cigna Medicare Advantage,Cigna Medicare Advantage,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Essence,Essence,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Healthlink HMO,Healthlink HMO,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Healthlink PPO,Healthlink PPO,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,HomeState Health Plan,HomeState Health Plan,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Humana Gold,Humana Gold,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Medicaid MO,Medicaid MO,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Medica,Medica,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Tricare,Tricare,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,UHC All Payer,UHC All Payer,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,UHC Exchange,UHC Exchange,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,UHC Medicaid,UHC Medicaid,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,UMR CPD,UMR CPD,338.02,,,,,,,per diem,338.02,338.02,"Per diem rate, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,UHC Medicare,UHC Medicare,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
ANKLE 3+ VIEWS BILATERAL      ,74000070,CDM,320,RC,73610,CPT,,,50,Inpatient,,,338.02,338.02,Wellcare,Wellcare,338.02,,,,,,,case rate,338.02,338.02,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Meritain Health PPO CPD,Meritain Health PPO CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Aetna/Commercial Product,Aetna/Commercial Product,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Meritain Health CPD,Meritain Health CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Starmark CPD,Starmark CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Aetna Medicare,Aetna Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Ambetter ,Ambetter ,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Blue Access,Anthem Blue Access,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Blue Access Choice,Anthem Blue Access Choice,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Blue Preferred,Anthem Blue Preferred,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Pathway,Anthem Pathway,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Alliance,Anthem Alliance,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Anthem Medicare,Anthem Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Cigna,Cigna,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Cigna PPO,Cigna PPO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Cigna Medicare Advantage,Cigna Medicare Advantage,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Essence,Essence,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Healthlink HMO,Healthlink HMO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Healthlink PPO,Healthlink PPO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,HomeState Health Plan,HomeState Health Plan,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Humana Gold,Humana Gold,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Medicaid MO,Medicaid MO,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Medica,Medica,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Tricare,Tricare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,UHC All Payer,UHC All Payer,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,UHC Exchange,UHC Exchange,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,UHC Medicaid,UHC Medicaid,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,UMR CPD,UMR CPD,1059,,,,,,,per diem,1059,1059,"Per diem rate, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,UHC Medicare,UHC Medicare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
BARIUM ENEMA W/WO KUB         ,74000081,CDM,320,RC,74270,CPT,,,,Inpatient,,,1059,1059,Wellcare,Wellcare,1059,,,,,,,case rate,1059,1059,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Meritain Health PPO CPD,Meritain Health PPO CPD,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Aetna/Commercial Product,Aetna/Commercial Product,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Meritain Health CPD,Meritain Health CPD,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Starmark CPD,Starmark CPD,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Aetna Medicare,Aetna Medicare,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Ambetter ,Ambetter ,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Blue Access,Anthem Blue Access,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Blue Access Choice,Anthem Blue Access Choice,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Blue Preferred,Anthem Blue Preferred,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Pathway,Anthem Pathway,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Alliance,Anthem Alliance,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Anthem Medicare,Anthem Medicare,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Cigna,Cigna,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Cigna PPO,Cigna PPO,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Cigna Medicare Advantage,Cigna Medicare Advantage,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Essence,Essence,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Healthlink HMO,Healthlink HMO,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Healthlink PPO,Healthlink PPO,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,HomeState Health Plan,HomeState Health Plan,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Humana Gold,Humana Gold,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Medicaid MO,Medicaid MO,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Medica,Medica,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Tricare,Tricare,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,UHC All Payer,UHC All Payer,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,UHC Exchange,UHC Exchange,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,UHC Medicaid,UHC Medicaid,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,UMR CPD,UMR CPD,473.8,,,,,,,per diem,473.8,473.8,"Per diem rate, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,UHC Medicare,UHC Medicare,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
FLUOROSCOPY/C-ARM>1 HOUR      ,74000100,CDM,320,RC,76001,CPT,,,,Inpatient,,,473.8,473.8,Wellcare,Wellcare,473.8,,,,,,,case rate,473.8,473.8,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CERVICAL SP 2 OR 3 VIEWS      ,74000120,CDM,320,RC,72040,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health PPO CPD,Meritain Health PPO CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Aetna/Commercial Product,Aetna/Commercial Product,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health CPD,Meritain Health CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Starmark CPD,Starmark CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Aetna Medicare,Aetna Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Ambetter ,Ambetter ,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access,Anthem Blue Access,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access Choice,Anthem Blue Access Choice,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Preferred,Anthem Blue Preferred,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Pathway,Anthem Pathway,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Alliance,Anthem Alliance,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Anthem Medicare,Anthem Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Cigna,Cigna,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Cigna PPO,Cigna PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Cigna Medicare Advantage,Cigna Medicare Advantage,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Essence,Essence,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Healthlink HMO,Healthlink HMO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Healthlink PPO,Healthlink PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,HomeState Health Plan,HomeState Health Plan,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Humana Gold,Humana Gold,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Medicaid MO,Medicaid MO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Medica,Medica,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Tricare,Tricare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,UHC All Payer,UHC All Payer,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,UHC Exchange,UHC Exchange,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicaid,UHC Medicaid,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,UMR CPD,UMR CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicare,UHC Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST SPECIAL VIEWS           ,74000139,CDM,320,RC,71035,CPT,,,,Inpatient,,,151.49,151.49,Wellcare,Wellcare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2 VIEWS FRONTAL & LAT   ,74000140,CDM,320,RC,71046,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/APICAL LORDOTIC,74000160,CDM,320,RC,71047,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health PPO CPD,Meritain Health PPO CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Aetna/Commercial Product,Aetna/Commercial Product,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Meritain Health CPD,Meritain Health CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Starmark CPD,Starmark CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Aetna Medicare,Aetna Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Ambetter ,Ambetter ,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access,Anthem Blue Access,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Access Choice,Anthem Blue Access Choice,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Blue Preferred,Anthem Blue Preferred,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Pathway,Anthem Pathway,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Alliance,Anthem Alliance,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Anthem Medicare,Anthem Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Cigna,Cigna,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Cigna PPO,Cigna PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Cigna Medicare Advantage,Cigna Medicare Advantage,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Essence,Essence,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Healthlink HMO,Healthlink HMO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Healthlink PPO,Healthlink PPO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,HomeState Health Plan,HomeState Health Plan,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Humana Gold,Humana Gold,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Medicaid MO,Medicaid MO,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Medica,Medica,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Tricare,Tricare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,UHC All Payer,UHC All Payer,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,UHC Exchange,UHC Exchange,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicaid,UHC Medicaid,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,UMR CPD,UMR CPD,245.07,,,,,,,per diem,245.07,245.07,"Per diem rate, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,UHC Medicare,UHC Medicare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHEST 2VIEWS W/OBLIQUES       ,74000170,CDM,320,RC,71022,CPT,,,,Inpatient,,,245.07,245.07,Wellcare,Wellcare,245.07,,,,,,,case rate,245.07,245.07,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Meritain Health PPO CPD,Meritain Health PPO CPD,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Aetna/Commercial Product,Aetna/Commercial Product,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Meritain Health CPD,Meritain Health CPD,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Starmark CPD,Starmark CPD,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Aetna Medicare,Aetna Medicare,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Ambetter ,Ambetter ,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Blue Access,Anthem Blue Access,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Blue Access Choice,Anthem Blue Access Choice,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Blue Preferred,Anthem Blue Preferred,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Pathway,Anthem Pathway,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Alliance,Anthem Alliance,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Anthem Medicare,Anthem Medicare,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Cigna,Cigna,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Cigna PPO,Cigna PPO,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Cigna Medicare Advantage,Cigna Medicare Advantage,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Essence,Essence,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Healthlink HMO,Healthlink HMO,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Healthlink PPO,Healthlink PPO,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,HomeState Health Plan,HomeState Health Plan,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Humana Gold,Humana Gold,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Medicaid MO,Medicaid MO,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Medica,Medica,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Tricare,Tricare,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,UHC All Payer,UHC All Payer,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,UHC Exchange,UHC Exchange,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,UHC Medicaid,UHC Medicaid,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,UMR CPD,UMR CPD,1498.16,,,,,,,per diem,1498.16,1498.16,"Per diem rate, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,UHC Medicare,UHC Medicare,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CHOLANGIOGRAM INTRAOP         ,74000180,CDM,320,RC,74300,CPT,,,,Inpatient,,,1498.16,1498.16,Wellcare,Wellcare,1498.16,,,,,,,case rate,1498.16,1498.16,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Meritain Health PPO CPD,Meritain Health PPO CPD,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Aetna/Commercial Product,Aetna/Commercial Product,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Meritain Health CPD,Meritain Health CPD,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Starmark CPD,Starmark CPD,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Aetna Medicare,Aetna Medicare,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Ambetter ,Ambetter ,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Blue Access,Anthem Blue Access,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Blue Access Choice,Anthem Blue Access Choice,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Blue Preferred,Anthem Blue Preferred,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Pathway,Anthem Pathway,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Alliance,Anthem Alliance,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Anthem Medicare,Anthem Medicare,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Cigna,Cigna,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Cigna PPO,Cigna PPO,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Cigna Medicare Advantage,Cigna Medicare Advantage,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Essence,Essence,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Healthlink HMO,Healthlink HMO,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Healthlink PPO,Healthlink PPO,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,HomeState Health Plan,HomeState Health Plan,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Humana Gold,Humana Gold,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Medicaid MO,Medicaid MO,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Medica,Medica,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Tricare,Tricare,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,UHC All Payer,UHC All Payer,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,UHC Exchange,UHC Exchange,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,UHC Medicaid,UHC Medicaid,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,UMR CPD,UMR CPD,364.11,,,,,,,per diem,364.11,364.11,"Per diem rate, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,UHC Medicare,UHC Medicare,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
CLAVICLE BILATERAL            ,74000190,CDM,320,RC,73000,CPT,,,50,Inpatient,,,364.11,364.11,Wellcare,Wellcare,364.11,,,,,,,case rate,364.11,364.11,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Meritain Health PPO CPD,Meritain Health PPO CPD,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Aetna/Commercial Product,Aetna/Commercial Product,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Meritain Health CPD,Meritain Health CPD,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Starmark CPD,Starmark CPD,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Aetna Medicare,Aetna Medicare,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Ambetter ,Ambetter ,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Blue Access,Anthem Blue Access,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Blue Access Choice,Anthem Blue Access Choice,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Blue Preferred,Anthem Blue Preferred,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Pathway,Anthem Pathway,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Alliance,Anthem Alliance,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Anthem Medicare,Anthem Medicare,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Cigna,Cigna,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Cigna PPO,Cigna PPO,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Cigna Medicare Advantage,Cigna Medicare Advantage,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Essence,Essence,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Healthlink HMO,Healthlink HMO,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Healthlink PPO,Healthlink PPO,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,HomeState Health Plan,HomeState Health Plan,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Humana Gold,Humana Gold,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Medicaid MO,Medicaid MO,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Medica,Medica,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Tricare,Tricare,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,UHC All Payer,UHC All Payer,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,UHC Exchange,UHC Exchange,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,UHC Medicaid,UHC Medicaid,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,UMR CPD,UMR CPD,1482.4,,,,,,,per diem,1482.4,1482.4,"Per diem rate, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,UHC Medicare,UHC Medicare,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
BARIUM ENEMA AIR W/WO KUB     ,74000210,CDM,320,RC,74280,CPT,,,,Inpatient,,,1482.4,1482.4,Wellcare,Wellcare,1482.4,,,,,,,case rate,1482.4,1482.4,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Meritain Health PPO CPD,Meritain Health PPO CPD,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Aetna/Commercial Product,Aetna/Commercial Product,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Meritain Health CPD,Meritain Health CPD,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Starmark CPD,Starmark CPD,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Aetna Medicare,Aetna Medicare,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Ambetter ,Ambetter ,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Blue Access,Anthem Blue Access,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Blue Access Choice,Anthem Blue Access Choice,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Blue Preferred,Anthem Blue Preferred,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Pathway,Anthem Pathway,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Alliance,Anthem Alliance,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Anthem Medicare,Anthem Medicare,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Cigna,Cigna,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Cigna PPO,Cigna PPO,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Cigna Medicare Advantage,Cigna Medicare Advantage,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Essence,Essence,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Healthlink HMO,Healthlink HMO,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Healthlink PPO,Healthlink PPO,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,HomeState Health Plan,HomeState Health Plan,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Humana Gold,Humana Gold,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Medicaid MO,Medicaid MO,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Medica,Medica,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Tricare,Tricare,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,UHC All Payer,UHC All Payer,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,UHC Exchange,UHC Exchange,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,UHC Medicaid,UHC Medicaid,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,UMR CPD,UMR CPD,796.72,,,,,,,per diem,796.72,796.72,"Per diem rate, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,UHC Medicare,UHC Medicare,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
CYSTOGRAM 3+ VIEWS            ,74000220,CDM,320,RC,74430,CPT,,,,Inpatient,,,796.72,796.72,Wellcare,Wellcare,796.72,,,,,,,case rate,796.72,796.72,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Meritain Health PPO CPD,Meritain Health PPO CPD,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Aetna/Commercial Product,Aetna/Commercial Product,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Meritain Health CPD,Meritain Health CPD,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Starmark CPD,Starmark CPD,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Aetna Medicare,Aetna Medicare,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Ambetter ,Ambetter ,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Blue Access,Anthem Blue Access,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Blue Access Choice,Anthem Blue Access Choice,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Blue Preferred,Anthem Blue Preferred,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Pathway,Anthem Pathway,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Alliance,Anthem Alliance,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Anthem Medicare,Anthem Medicare,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Cigna,Cigna,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Cigna PPO,Cigna PPO,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Cigna Medicare Advantage,Cigna Medicare Advantage,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Essence,Essence,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Healthlink HMO,Healthlink HMO,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Healthlink PPO,Healthlink PPO,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,HomeState Health Plan,HomeState Health Plan,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Humana Gold,Humana Gold,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Medicaid MO,Medicaid MO,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Medica,Medica,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Tricare,Tricare,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,UHC All Payer,UHC All Payer,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,UHC Exchange,UHC Exchange,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,UHC Medicaid,UHC Medicaid,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,UMR CPD,UMR CPD,732.07,,,,,,,per diem,732.07,732.07,"Per diem rate, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,UHC Medicare,UHC Medicare,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
GI TUBE PLACEMENT RAD GUIDANCE,74000222,CDM,320,RC,74340,CPT,,,,Inpatient,,,732.07,732.07,Wellcare,Wellcare,732.07,,,,,,,case rate,732.07,732.07,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
THORACIC SP 3 VIEWS           ,74000239,CDM,320,RC,72072,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Meritain Health PPO CPD,Meritain Health PPO CPD,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Aetna/Commercial Product,Aetna/Commercial Product,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Meritain Health CPD,Meritain Health CPD,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Starmark CPD,Starmark CPD,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Aetna Medicare,Aetna Medicare,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Ambetter ,Ambetter ,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Blue Access,Anthem Blue Access,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Blue Access Choice,Anthem Blue Access Choice,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Blue Preferred,Anthem Blue Preferred,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Pathway,Anthem Pathway,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Alliance,Anthem Alliance,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Anthem Medicare,Anthem Medicare,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Cigna,Cigna,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Cigna PPO,Cigna PPO,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Cigna Medicare Advantage,Cigna Medicare Advantage,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Essence,Essence,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Healthlink HMO,Healthlink HMO,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Healthlink PPO,Healthlink PPO,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,HomeState Health Plan,HomeState Health Plan,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Humana Gold,Humana Gold,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Medicaid MO,Medicaid MO,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Medica,Medica,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Tricare,Tricare,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,UHC All Payer,UHC All Payer,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,UHC Exchange,UHC Exchange,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,UHC Medicaid,UHC Medicaid,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,UMR CPD,UMR CPD,228.66,,,,,,,per diem,228.66,228.66,"Per diem rate, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,UHC Medicare,UHC Medicare,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 2 VIEWS BILATERAL       ,74000260,CDM,320,RC,73070,CPT,,,50,Inpatient,,,228.66,228.66,Wellcare,Wellcare,228.66,,,,,,,case rate,228.66,228.66,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Meritain Health PPO CPD,Meritain Health PPO CPD,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Aetna/Commercial Product,Aetna/Commercial Product,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Meritain Health CPD,Meritain Health CPD,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Starmark CPD,Starmark CPD,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Aetna Medicare,Aetna Medicare,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Ambetter ,Ambetter ,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Blue Access,Anthem Blue Access,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Blue Access Choice,Anthem Blue Access Choice,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Blue Preferred,Anthem Blue Preferred,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Pathway,Anthem Pathway,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Alliance,Anthem Alliance,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Anthem Medicare,Anthem Medicare,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Cigna,Cigna,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Cigna PPO,Cigna PPO,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Cigna Medicare Advantage,Cigna Medicare Advantage,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Essence,Essence,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Healthlink HMO,Healthlink HMO,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Healthlink PPO,Healthlink PPO,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,HomeState Health Plan,HomeState Health Plan,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Humana Gold,Humana Gold,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Medicaid MO,Medicaid MO,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Medica,Medica,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Tricare,Tricare,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,UHC All Payer,UHC All Payer,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,UHC Exchange,UHC Exchange,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,UHC Medicaid,UHC Medicaid,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,UMR CPD,UMR CPD,289.65,,,,,,,per diem,289.65,289.65,"Per diem rate, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,UHC Medicare,UHC Medicare,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ELBOW 3+ VIEWS BILATERAL      ,74000261,CDM,320,RC,73080,CPT,,,50,Inpatient,,,289.65,289.65,Wellcare,Wellcare,289.65,,,,,,,case rate,289.65,289.65,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Meritain Health PPO CPD,Meritain Health PPO CPD,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Aetna/Commercial Product,Aetna/Commercial Product,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Meritain Health CPD,Meritain Health CPD,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Starmark CPD,Starmark CPD,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Aetna Medicare,Aetna Medicare,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Ambetter ,Ambetter ,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Blue Access,Anthem Blue Access,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Blue Access Choice,Anthem Blue Access Choice,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Blue Preferred,Anthem Blue Preferred,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Pathway,Anthem Pathway,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Alliance,Anthem Alliance,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Anthem Medicare,Anthem Medicare,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Cigna,Cigna,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Cigna PPO,Cigna PPO,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Cigna Medicare Advantage,Cigna Medicare Advantage,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Essence,Essence,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Healthlink HMO,Healthlink HMO,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Healthlink PPO,Healthlink PPO,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,HomeState Health Plan,HomeState Health Plan,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Humana Gold,Humana Gold,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Medicaid MO,Medicaid MO,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Medica,Medica,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Tricare,Tricare,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,UHC All Payer,UHC All Payer,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,UHC Exchange,UHC Exchange,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,UHC Medicaid,UHC Medicaid,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,UMR CPD,UMR CPD,911.85,,,,,,,per diem,911.85,911.85,"Per diem rate, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,UHC Medicare,UHC Medicare,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
ESOPHAGUS                     ,74000270,CDM,320,RC,74220,CPT,,,,Inpatient,,,911.85,911.85,Wellcare,Wellcare,911.85,,,,,,,case rate,911.85,911.85,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Meritain Health PPO CPD,Meritain Health PPO CPD,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Aetna/Commercial Product,Aetna/Commercial Product,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Meritain Health CPD,Meritain Health CPD,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Starmark CPD,Starmark CPD,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Aetna Medicare,Aetna Medicare,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Ambetter ,Ambetter ,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Blue Access,Anthem Blue Access,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Blue Access Choice,Anthem Blue Access Choice,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Blue Preferred,Anthem Blue Preferred,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Pathway,Anthem Pathway,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Alliance,Anthem Alliance,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Anthem Medicare,Anthem Medicare,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Cigna,Cigna,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Cigna PPO,Cigna PPO,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Cigna Medicare Advantage,Cigna Medicare Advantage,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Essence,Essence,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Healthlink HMO,Healthlink HMO,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Healthlink PPO,Healthlink PPO,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,HomeState Health Plan,HomeState Health Plan,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Humana Gold,Humana Gold,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Medicaid MO,Medicaid MO,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Medica,Medica,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Tricare,Tricare,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,UHC All Payer,UHC All Payer,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,UHC Exchange,UHC Exchange,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,UHC Medicaid,UHC Medicaid,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,UMR CPD,UMR CPD,848.72,,,,,,,per diem,848.72,848.72,"Per diem rate, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,UHC Medicare,UHC Medicare,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
SWALLOW FUNCTION W/VIDEORAD   ,74000271,CDM,320,RC,74230,CPT,,,,Inpatient,,,848.72,848.72,Wellcare,Wellcare,848.72,,,,,,,case rate,848.72,848.72,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Meritain Health PPO CPD,Meritain Health PPO CPD,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Aetna/Commercial Product,Aetna/Commercial Product,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Meritain Health CPD,Meritain Health CPD,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Starmark CPD,Starmark CPD,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Aetna Medicare,Aetna Medicare,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Ambetter ,Ambetter ,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Blue Access,Anthem Blue Access,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Blue Access Choice,Anthem Blue Access Choice,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Blue Preferred,Anthem Blue Preferred,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Pathway,Anthem Pathway,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Alliance,Anthem Alliance,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Anthem Medicare,Anthem Medicare,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Cigna,Cigna,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Cigna PPO,Cigna PPO,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Cigna Medicare Advantage,Cigna Medicare Advantage,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Essence,Essence,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Healthlink HMO,Healthlink HMO,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Healthlink PPO,Healthlink PPO,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,HomeState Health Plan,HomeState Health Plan,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Humana Gold,Humana Gold,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Medicaid MO,Medicaid MO,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Medica,Medica,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Tricare,Tricare,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,UHC All Payer,UHC All Payer,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,UHC Exchange,UHC Exchange,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,UHC Medicaid,UHC Medicaid,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,UMR CPD,UMR CPD,536.74,,,,,,,per diem,536.74,536.74,"Per diem rate, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,UHC Medicare,UHC Medicare,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES < 3 VIEWS        ,74000290,CDM,320,RC,70140,CPT,,,,Inpatient,,,536.74,536.74,Wellcare,Wellcare,536.74,,,,,,,case rate,536.74,536.74,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health PPO CPD,Meritain Health PPO CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Aetna/Commercial Product,Aetna/Commercial Product,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health CPD,Meritain Health CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Starmark CPD,Starmark CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Aetna Medicare,Aetna Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Ambetter ,Ambetter ,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access,Anthem Blue Access,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access Choice,Anthem Blue Access Choice,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Preferred,Anthem Blue Preferred,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Pathway,Anthem Pathway,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Alliance,Anthem Alliance,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Anthem Medicare,Anthem Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Cigna,Cigna,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Cigna PPO,Cigna PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Cigna Medicare Advantage,Cigna Medicare Advantage,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Essence,Essence,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Healthlink HMO,Healthlink HMO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Healthlink PPO,Healthlink PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,HomeState Health Plan,HomeState Health Plan,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Humana Gold,Humana Gold,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Medicaid MO,Medicaid MO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Medica,Medica,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Tricare,Tricare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,UHC All Payer,UHC All Payer,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,UHC Exchange,UHC Exchange,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicaid,UHC Medicaid,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,UMR CPD,UMR CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicare,UHC Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FACIAL BONES 3+ VIEWS         ,74000300,CDM,320,RC,70150,CPT,,,,Inpatient,,,151.49,151.49,Wellcare,Wellcare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Meritain Health PPO CPD,Meritain Health PPO CPD,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Aetna/Commercial Product,Aetna/Commercial Product,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Meritain Health CPD,Meritain Health CPD,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Starmark CPD,Starmark CPD,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Aetna Medicare,Aetna Medicare,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Ambetter ,Ambetter ,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Blue Access,Anthem Blue Access,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Blue Access Choice,Anthem Blue Access Choice,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Blue Preferred,Anthem Blue Preferred,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Pathway,Anthem Pathway,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Alliance,Anthem Alliance,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Anthem Medicare,Anthem Medicare,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Cigna,Cigna,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Cigna PPO,Cigna PPO,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Cigna Medicare Advantage,Cigna Medicare Advantage,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Essence,Essence,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Healthlink HMO,Healthlink HMO,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Healthlink PPO,Healthlink PPO,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,HomeState Health Plan,HomeState Health Plan,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Humana Gold,Humana Gold,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Medicaid MO,Medicaid MO,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Medica,Medica,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Tricare,Tricare,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,UHC All Payer,UHC All Payer,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,UHC Exchange,UHC Exchange,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,UHC Medicaid,UHC Medicaid,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,UMR CPD,UMR CPD,347.63,,,,,,,per diem,347.63,347.63,"Per diem rate, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,UHC Medicare,UHC Medicare,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FEMUR 2+ VIEWS BILATERAL      ,74000310,CDM,320,RC,73550,CPT,,,50,Inpatient,,,347.63,347.63,Wellcare,Wellcare,347.63,,,,,,,case rate,347.63,347.63,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Meritain Health PPO CPD,Meritain Health PPO CPD,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Aetna/Commercial Product,Aetna/Commercial Product,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Meritain Health CPD,Meritain Health CPD,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Starmark CPD,Starmark CPD,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Aetna Medicare,Aetna Medicare,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Ambetter ,Ambetter ,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Blue Access,Anthem Blue Access,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Blue Access Choice,Anthem Blue Access Choice,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Blue Preferred,Anthem Blue Preferred,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Pathway,Anthem Pathway,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Alliance,Anthem Alliance,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Anthem Medicare,Anthem Medicare,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Cigna,Cigna,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Cigna PPO,Cigna PPO,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Cigna Medicare Advantage,Cigna Medicare Advantage,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Essence,Essence,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Healthlink HMO,Healthlink HMO,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Healthlink PPO,Healthlink PPO,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,HomeState Health Plan,HomeState Health Plan,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Humana Gold,Humana Gold,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Medicaid MO,Medicaid MO,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Medica,Medica,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Tricare,Tricare,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,UHC All Payer,UHC All Payer,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,UHC Exchange,UHC Exchange,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,UHC Medicaid,UHC Medicaid,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,UMR CPD,UMR CPD,201.88,,,,,,,per diem,201.88,201.88,"Per diem rate, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,UHC Medicare,UHC Medicare,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
FINGER(S) 2+ VIEWS BILATERAL  ,74000350,CDM,320,RC,73140,CPT,,,50,Inpatient,,,201.88,201.88,Wellcare,Wellcare,201.88,,,,,,,case rate,201.88,201.88,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Meritain Health PPO CPD,Meritain Health PPO CPD,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Aetna/Commercial Product,Aetna/Commercial Product,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Meritain Health CPD,Meritain Health CPD,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Starmark CPD,Starmark CPD,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Aetna Medicare,Aetna Medicare,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Ambetter ,Ambetter ,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Blue Access,Anthem Blue Access,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Blue Access Choice,Anthem Blue Access Choice,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Blue Preferred,Anthem Blue Preferred,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Pathway,Anthem Pathway,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Alliance,Anthem Alliance,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Anthem Medicare,Anthem Medicare,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Cigna,Cigna,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Cigna PPO,Cigna PPO,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Cigna Medicare Advantage,Cigna Medicare Advantage,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Essence,Essence,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Healthlink HMO,Healthlink HMO,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Healthlink PPO,Healthlink PPO,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,HomeState Health Plan,HomeState Health Plan,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Humana Gold,Humana Gold,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Medicaid MO,Medicaid MO,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Medica,Medica,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Tricare,Tricare,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,UHC All Payer,UHC All Payer,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,UHC Exchange,UHC Exchange,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,UHC Medicaid,UHC Medicaid,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,UMR CPD,UMR CPD,754.31,,,,,,,per diem,754.31,754.31,"Per diem rate, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,UHC Medicare,UHC Medicare,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
ABSCESS FISTULA SINUS TRACT ST,74000360,CDM,320,RC,76080,CPT,,,,Inpatient,,,754.31,754.31,Wellcare,Wellcare,754.31,,,,,,,case rate,754.31,754.31,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Meritain Health PPO CPD,Meritain Health PPO CPD,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Aetna/Commercial Product,Aetna/Commercial Product,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Meritain Health CPD,Meritain Health CPD,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Starmark CPD,Starmark CPD,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Aetna Medicare,Aetna Medicare,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Ambetter ,Ambetter ,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Blue Access,Anthem Blue Access,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Blue Access Choice,Anthem Blue Access Choice,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Blue Preferred,Anthem Blue Preferred,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Pathway,Anthem Pathway,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Alliance,Anthem Alliance,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Anthem Medicare,Anthem Medicare,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Cigna,Cigna,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Cigna PPO,Cigna PPO,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Cigna Medicare Advantage,Cigna Medicare Advantage,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Essence,Essence,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Healthlink HMO,Healthlink HMO,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Healthlink PPO,Healthlink PPO,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,HomeState Health Plan,HomeState Health Plan,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Humana Gold,Humana Gold,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Medicaid MO,Medicaid MO,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Medica,Medica,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Tricare,Tricare,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,UHC All Payer,UHC All Payer,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,UHC Exchange,UHC Exchange,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,UHC Medicaid,UHC Medicaid,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,UMR CPD,UMR CPD,811.11,,,,,,,per diem,811.11,811.11,"Per diem rate, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,UHC Medicare,UHC Medicare,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FLUOROSCOPY 1HR OR LESS       ,74000370,CDM,320,RC,76000,CPT,,,,Inpatient,,,811.11,811.11,Wellcare,Wellcare,811.11,,,,,,,case rate,811.11,811.11,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Meritain Health PPO CPD,Meritain Health PPO CPD,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Aetna/Commercial Product,Aetna/Commercial Product,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Meritain Health CPD,Meritain Health CPD,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Starmark CPD,Starmark CPD,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Aetna Medicare,Aetna Medicare,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Ambetter ,Ambetter ,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Blue Access,Anthem Blue Access,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Blue Access Choice,Anthem Blue Access Choice,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Blue Preferred,Anthem Blue Preferred,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Pathway,Anthem Pathway,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Alliance,Anthem Alliance,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Anthem Medicare,Anthem Medicare,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Cigna,Cigna,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Cigna PPO,Cigna PPO,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Cigna Medicare Advantage,Cigna Medicare Advantage,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Essence,Essence,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Healthlink HMO,Healthlink HMO,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Healthlink PPO,Healthlink PPO,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,HomeState Health Plan,HomeState Health Plan,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Humana Gold,Humana Gold,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Medicaid MO,Medicaid MO,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Medica,Medica,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Tricare,Tricare,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,UHC All Payer,UHC All Payer,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,UHC Exchange,UHC Exchange,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,UHC Medicaid,UHC Medicaid,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,UMR CPD,UMR CPD,238.27,,,,,,,per diem,238.27,238.27,"Per diem rate, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,UHC Medicare,UHC Medicare,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 2 VIEWS BILATERAL        ,74000390,CDM,320,RC,73620,CPT,,,50,Inpatient,,,238.27,238.27,Wellcare,Wellcare,238.27,,,,,,,case rate,238.27,238.27,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Meritain Health PPO CPD,Meritain Health PPO CPD,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Aetna/Commercial Product,Aetna/Commercial Product,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Meritain Health CPD,Meritain Health CPD,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Starmark CPD,Starmark CPD,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Aetna Medicare,Aetna Medicare,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Ambetter ,Ambetter ,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Blue Access,Anthem Blue Access,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Blue Access Choice,Anthem Blue Access Choice,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Blue Preferred,Anthem Blue Preferred,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Pathway,Anthem Pathway,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Alliance,Anthem Alliance,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Anthem Medicare,Anthem Medicare,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Cigna,Cigna,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Cigna PPO,Cigna PPO,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Cigna Medicare Advantage,Cigna Medicare Advantage,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Essence,Essence,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Healthlink HMO,Healthlink HMO,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Healthlink PPO,Healthlink PPO,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,HomeState Health Plan,HomeState Health Plan,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Humana Gold,Humana Gold,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Medicaid MO,Medicaid MO,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Medica,Medica,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Tricare,Tricare,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,UHC All Payer,UHC All Payer,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,UHC Exchange,UHC Exchange,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,UHC Medicaid,UHC Medicaid,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,UMR CPD,UMR CPD,306.94,,,,,,,per diem,306.94,306.94,"Per diem rate, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,UHC Medicare,UHC Medicare,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOOT 3+ VIEWS BILATERAL       ,74000400,CDM,320,RC,73630,CPT,,,50,Inpatient,,,306.94,306.94,Wellcare,Wellcare,306.94,,,,,,,case rate,306.94,306.94,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Meritain Health PPO CPD,Meritain Health PPO CPD,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Aetna/Commercial Product,Aetna/Commercial Product,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Meritain Health CPD,Meritain Health CPD,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Starmark CPD,Starmark CPD,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Aetna Medicare,Aetna Medicare,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Ambetter ,Ambetter ,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Blue Access,Anthem Blue Access,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Blue Access Choice,Anthem Blue Access Choice,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Blue Preferred,Anthem Blue Preferred,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Pathway,Anthem Pathway,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Alliance,Anthem Alliance,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Anthem Medicare,Anthem Medicare,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Cigna,Cigna,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Cigna PPO,Cigna PPO,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Cigna Medicare Advantage,Cigna Medicare Advantage,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Essence,Essence,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Healthlink HMO,Healthlink HMO,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Healthlink PPO,Healthlink PPO,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,HomeState Health Plan,HomeState Health Plan,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Humana Gold,Humana Gold,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Medicaid MO,Medicaid MO,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Medica,Medica,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Tricare,Tricare,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,UHC All Payer,UHC All Payer,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,UHC Exchange,UHC Exchange,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,UHC Medicaid,UHC Medicaid,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,UMR CPD,UMR CPD,306.68,,,,,,,per diem,306.68,306.68,"Per diem rate, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,UHC Medicare,UHC Medicare,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
FOREARM 2 VIEWS BILATERAL     ,74000410,CDM,320,RC,73090,CPT,,,50,Inpatient,,,306.68,306.68,Wellcare,Wellcare,306.68,,,,,,,case rate,306.68,306.68,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Meritain Health PPO CPD,Meritain Health PPO CPD,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Aetna/Commercial Product,Aetna/Commercial Product,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Meritain Health CPD,Meritain Health CPD,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Starmark CPD,Starmark CPD,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Aetna Medicare,Aetna Medicare,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Ambetter ,Ambetter ,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Blue Access,Anthem Blue Access,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Blue Access Choice,Anthem Blue Access Choice,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Blue Preferred,Anthem Blue Preferred,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Pathway,Anthem Pathway,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Alliance,Anthem Alliance,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Anthem Medicare,Anthem Medicare,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Cigna,Cigna,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Cigna PPO,Cigna PPO,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Cigna Medicare Advantage,Cigna Medicare Advantage,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Essence,Essence,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Healthlink HMO,Healthlink HMO,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Healthlink PPO,Healthlink PPO,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,HomeState Health Plan,HomeState Health Plan,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Humana Gold,Humana Gold,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Medicaid MO,Medicaid MO,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Medica,Medica,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Tricare,Tricare,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,UHC All Payer,UHC All Payer,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,UHC Exchange,UHC Exchange,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,UHC Medicaid,UHC Medicaid,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,UMR CPD,UMR CPD,758.53,,,,,,,per diem,758.53,758.53,"Per diem rate, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,UHC Medicare,UHC Medicare,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
GALLBLADDER W/ ORAL CONTRAST  ,74000420,CDM,320,RC,74290,CPT,,,,Inpatient,,,758.53,758.53,Wellcare,Wellcare,758.53,,,,,,,case rate,758.53,758.53,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Meritain Health PPO CPD,Meritain Health PPO CPD,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Aetna/Commercial Product,Aetna/Commercial Product,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Meritain Health CPD,Meritain Health CPD,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Starmark CPD,Starmark CPD,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Aetna Medicare,Aetna Medicare,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Ambetter ,Ambetter ,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Blue Access,Anthem Blue Access,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Blue Access Choice,Anthem Blue Access Choice,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Blue Preferred,Anthem Blue Preferred,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Pathway,Anthem Pathway,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Alliance,Anthem Alliance,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Anthem Medicare,Anthem Medicare,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Cigna,Cigna,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Cigna PPO,Cigna PPO,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Cigna Medicare Advantage,Cigna Medicare Advantage,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Essence,Essence,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Healthlink HMO,Healthlink HMO,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Healthlink PPO,Healthlink PPO,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,HomeState Health Plan,HomeState Health Plan,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Humana Gold,Humana Gold,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Medicaid MO,Medicaid MO,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Medica,Medica,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Tricare,Tricare,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,UHC All Payer,UHC All Payer,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,UHC Exchange,UHC Exchange,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,UHC Medicaid,UHC Medicaid,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,UMR CPD,UMR CPD,55.7,,,,,,,per diem,55.7,55.7,"Per diem rate, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,UHC Medicare,UHC Medicare,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
HIP 1 VIEW UNILATERAL RT      ,74000421,CDM,320,RC,73500,CPT,,,RT,Inpatient,,,55.7,55.7,Wellcare,Wellcare,55.7,,,,,,,case rate,55.7,55.7,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Meritain Health PPO CPD,Meritain Health PPO CPD,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Aetna/Commercial Product,Aetna/Commercial Product,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Meritain Health CPD,Meritain Health CPD,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Starmark CPD,Starmark CPD,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Aetna Medicare,Aetna Medicare,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Ambetter ,Ambetter ,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Blue Access,Anthem Blue Access,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Blue Access Choice,Anthem Blue Access Choice,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Blue Preferred,Anthem Blue Preferred,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Pathway,Anthem Pathway,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Alliance,Anthem Alliance,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Anthem Medicare,Anthem Medicare,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Cigna,Cigna,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Cigna PPO,Cigna PPO,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Cigna Medicare Advantage,Cigna Medicare Advantage,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Essence,Essence,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Healthlink HMO,Healthlink HMO,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Healthlink PPO,Healthlink PPO,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,HomeState Health Plan,HomeState Health Plan,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Humana Gold,Humana Gold,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Medicaid MO,Medicaid MO,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Medica,Medica,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Tricare,Tricare,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,UHC All Payer,UHC All Payer,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,UHC Exchange,UHC Exchange,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,UHC Medicaid,UHC Medicaid,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,UMR CPD,UMR CPD,449.29,,,,,,,per diem,449.29,449.29,"Per diem rate, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,UHC Medicare,UHC Medicare,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
GASTROGRAFIN                  ,74000430,CDM,255,RC,,,,,,Inpatient,1,EA,449.29,449.29,Wellcare,Wellcare,449.29,,,,,,,case rate,449.29,449.29,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Meritain Health PPO CPD,Meritain Health PPO CPD,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Aetna/Commercial Product,Aetna/Commercial Product,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Meritain Health CPD,Meritain Health CPD,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Starmark CPD,Starmark CPD,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Aetna Medicare,Aetna Medicare,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Ambetter ,Ambetter ,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Blue Access,Anthem Blue Access,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Blue Access Choice,Anthem Blue Access Choice,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Blue Preferred,Anthem Blue Preferred,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Pathway,Anthem Pathway,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Alliance,Anthem Alliance,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Anthem Medicare,Anthem Medicare,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Cigna,Cigna,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Cigna PPO,Cigna PPO,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Cigna Medicare Advantage,Cigna Medicare Advantage,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Essence,Essence,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Healthlink HMO,Healthlink HMO,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Healthlink PPO,Healthlink PPO,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,HomeState Health Plan,HomeState Health Plan,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Humana Gold,Humana Gold,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Medicaid MO,Medicaid MO,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Medica,Medica,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Tricare,Tricare,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,UHC All Payer,UHC All Payer,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,UHC Exchange,UHC Exchange,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,UHC Medicaid,UHC Medicaid,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,UMR CPD,UMR CPD,357.75,,,,,,,per diem,357.75,357.75,"Per diem rate, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,UHC Medicare,UHC Medicare,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 2 VIEWS BILATERAL        ,74000440,CDM,320,RC,73120,CPT,,,50,Inpatient,,,357.75,357.75,Wellcare,Wellcare,357.75,,,,,,,case rate,357.75,357.75,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Meritain Health PPO CPD,Meritain Health PPO CPD,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Aetna/Commercial Product,Aetna/Commercial Product,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Meritain Health CPD,Meritain Health CPD,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Starmark CPD,Starmark CPD,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Aetna Medicare,Aetna Medicare,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Ambetter ,Ambetter ,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Blue Access,Anthem Blue Access,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Blue Access Choice,Anthem Blue Access Choice,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Blue Preferred,Anthem Blue Preferred,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Pathway,Anthem Pathway,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Alliance,Anthem Alliance,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Anthem Medicare,Anthem Medicare,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Cigna,Cigna,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Cigna PPO,Cigna PPO,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Cigna Medicare Advantage,Cigna Medicare Advantage,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Essence,Essence,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Healthlink HMO,Healthlink HMO,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Healthlink PPO,Healthlink PPO,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,HomeState Health Plan,HomeState Health Plan,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Humana Gold,Humana Gold,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Medicaid MO,Medicaid MO,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Medica,Medica,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Tricare,Tricare,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,UHC All Payer,UHC All Payer,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,UHC Exchange,UHC Exchange,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,UHC Medicaid,UHC Medicaid,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,UMR CPD,UMR CPD,250.08,,,,,,,per diem,250.08,250.08,"Per diem rate, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,UHC Medicare,UHC Medicare,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
HAND 3+ VIEWS BILATERAL       ,74000441,CDM,320,RC,73130,CPT,,,50,Inpatient,,,250.08,250.08,Wellcare,Wellcare,250.08,,,,,,,case rate,250.08,250.08,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health PPO CPD,Meritain Health PPO CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Aetna/Commercial Product,Aetna/Commercial Product,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health CPD,Meritain Health CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Starmark CPD,Starmark CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Aetna Medicare,Aetna Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Ambetter ,Ambetter ,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access,Anthem Blue Access,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access Choice,Anthem Blue Access Choice,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Preferred,Anthem Blue Preferred,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Pathway,Anthem Pathway,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Alliance,Anthem Alliance,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Anthem Medicare,Anthem Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Cigna,Cigna,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Cigna PPO,Cigna PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Cigna Medicare Advantage,Cigna Medicare Advantage,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Essence,Essence,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Healthlink HMO,Healthlink HMO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Healthlink PPO,Healthlink PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,HomeState Health Plan,HomeState Health Plan,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Humana Gold,Humana Gold,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Medicaid MO,Medicaid MO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Medica,Medica,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Tricare,Tricare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,UHC All Payer,UHC All Payer,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,UHC Exchange,UHC Exchange,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicaid,UHC Medicaid,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,UMR CPD,UMR CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicare,UHC Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
PELVIS & LATERAL BOTH HIPS    ,74000450,CDM,320,RC,73520,CPT,,,,Inpatient,,,151.49,151.49,Wellcare,Wellcare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Meritain Health PPO CPD,Meritain Health PPO CPD,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Aetna/Commercial Product,Aetna/Commercial Product,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Meritain Health CPD,Meritain Health CPD,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Starmark CPD,Starmark CPD,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Aetna Medicare,Aetna Medicare,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Ambetter ,Ambetter ,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Blue Access,Anthem Blue Access,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Blue Access Choice,Anthem Blue Access Choice,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Blue Preferred,Anthem Blue Preferred,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Pathway,Anthem Pathway,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Alliance,Anthem Alliance,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Anthem Medicare,Anthem Medicare,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Cigna,Cigna,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Cigna PPO,Cigna PPO,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Cigna Medicare Advantage,Cigna Medicare Advantage,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Essence,Essence,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Healthlink HMO,Healthlink HMO,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Healthlink PPO,Healthlink PPO,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,HomeState Health Plan,HomeState Health Plan,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Humana Gold,Humana Gold,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Medicaid MO,Medicaid MO,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Medica,Medica,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Tricare,Tricare,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,UHC All Payer,UHC All Payer,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,UHC Exchange,UHC Exchange,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,UHC Medicaid,UHC Medicaid,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,UMR CPD,UMR CPD,349.69,,,,,,,per diem,349.69,349.69,"Per diem rate, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,UHC Medicare,UHC Medicare,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
HUMERUS 2+ VIEWS BILATERAL    ,74000470,CDM,320,RC,73060,CPT,,,50,Inpatient,,,349.69,349.69,Wellcare,Wellcare,349.69,,,,,,,case rate,349.69,349.69,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 1-2 VIEWS BILATERAL      ,74000480,CDM,320,RC,73560,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Meritain Health PPO CPD,Meritain Health PPO CPD,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Aetna/Commercial Product,Aetna/Commercial Product,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Meritain Health CPD,Meritain Health CPD,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Starmark CPD,Starmark CPD,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Aetna Medicare,Aetna Medicare,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Ambetter ,Ambetter ,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Blue Access,Anthem Blue Access,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Blue Access Choice,Anthem Blue Access Choice,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Blue Preferred,Anthem Blue Preferred,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Pathway,Anthem Pathway,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Alliance,Anthem Alliance,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Anthem Medicare,Anthem Medicare,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Cigna,Cigna,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Cigna PPO,Cigna PPO,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Cigna Medicare Advantage,Cigna Medicare Advantage,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Essence,Essence,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Healthlink HMO,Healthlink HMO,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Healthlink PPO,Healthlink PPO,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,HomeState Health Plan,HomeState Health Plan,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Humana Gold,Humana Gold,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Medicaid MO,Medicaid MO,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Medica,Medica,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Tricare,Tricare,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,UHC All Payer,UHC All Payer,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,UHC Exchange,UHC Exchange,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,UHC Medicaid,UHC Medicaid,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,UMR CPD,UMR CPD,400.16,,,,,,,per diem,400.16,400.16,"Per diem rate, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,UHC Medicare,UHC Medicare,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 3 VIEWS BILATERAL        ,74000481,CDM,320,RC,73562,CPT,,,50,Inpatient,,,400.16,400.16,Wellcare,Wellcare,400.16,,,,,,,case rate,400.16,400.16,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Meritain Health PPO CPD,Meritain Health PPO CPD,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Aetna/Commercial Product,Aetna/Commercial Product,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Meritain Health CPD,Meritain Health CPD,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Starmark CPD,Starmark CPD,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Aetna Medicare,Aetna Medicare,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Ambetter ,Ambetter ,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Blue Access,Anthem Blue Access,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Blue Access Choice,Anthem Blue Access Choice,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Blue Preferred,Anthem Blue Preferred,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Pathway,Anthem Pathway,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Alliance,Anthem Alliance,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Anthem Medicare,Anthem Medicare,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Cigna,Cigna,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Cigna PPO,Cigna PPO,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Cigna Medicare Advantage,Cigna Medicare Advantage,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Essence,Essence,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Healthlink HMO,Healthlink HMO,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Healthlink PPO,Healthlink PPO,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,HomeState Health Plan,HomeState Health Plan,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Humana Gold,Humana Gold,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Medicaid MO,Medicaid MO,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Medica,Medica,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Tricare,Tricare,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,UHC All Payer,UHC All Payer,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,UHC Exchange,UHC Exchange,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,UHC Medicaid,UHC Medicaid,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,UMR CPD,UMR CPD,369.08,,,,,,,per diem,369.08,369.08,"Per diem rate, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,UHC Medicare,UHC Medicare,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
KNEE 4+ VIEWS BILATERAL       ,74000482,CDM,320,RC,73564,CPT,,,50,Inpatient,,,369.08,369.08,Wellcare,Wellcare,369.08,,,,,,,case rate,369.08,369.08,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Meritain Health PPO CPD,Meritain Health PPO CPD,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Aetna/Commercial Product,Aetna/Commercial Product,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Meritain Health CPD,Meritain Health CPD,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Starmark CPD,Starmark CPD,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Aetna Medicare,Aetna Medicare,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Ambetter ,Ambetter ,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Blue Access,Anthem Blue Access,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Blue Access Choice,Anthem Blue Access Choice,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Blue Preferred,Anthem Blue Preferred,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Pathway,Anthem Pathway,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Alliance,Anthem Alliance,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Anthem Medicare,Anthem Medicare,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Cigna,Cigna,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Cigna PPO,Cigna PPO,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Cigna Medicare Advantage,Cigna Medicare Advantage,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Essence,Essence,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Healthlink HMO,Healthlink HMO,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Healthlink PPO,Healthlink PPO,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,HomeState Health Plan,HomeState Health Plan,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Humana Gold,Humana Gold,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Medicaid MO,Medicaid MO,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Medica,Medica,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Tricare,Tricare,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,UHC All Payer,UHC All Payer,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,UHC Exchange,UHC Exchange,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,UHC Medicaid,UHC Medicaid,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,UMR CPD,UMR CPD,921.38,,,,,,,per diem,921.38,921.38,"Per diem rate, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,UHC Medicare,UHC Medicare,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
ARTHROGRAM KNEE               ,74000490,CDM,320,RC,73580,CPT,,,,Inpatient,,,921.38,921.38,Wellcare,Wellcare,921.38,,,,,,,case rate,921.38,921.38,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 2-3 VIEWS      ,74000500,CDM,320,RC,72100,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Meritain Health PPO CPD,Meritain Health PPO CPD,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Aetna/Commercial Product,Aetna/Commercial Product,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Meritain Health CPD,Meritain Health CPD,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Starmark CPD,Starmark CPD,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Aetna Medicare,Aetna Medicare,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Ambetter ,Ambetter ,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Blue Access,Anthem Blue Access,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Blue Access Choice,Anthem Blue Access Choice,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Blue Preferred,Anthem Blue Preferred,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Pathway,Anthem Pathway,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Alliance,Anthem Alliance,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Anthem Medicare,Anthem Medicare,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Cigna,Cigna,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Cigna PPO,Cigna PPO,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Cigna Medicare Advantage,Cigna Medicare Advantage,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Essence,Essence,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Healthlink HMO,Healthlink HMO,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Healthlink PPO,Healthlink PPO,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,HomeState Health Plan,HomeState Health Plan,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Humana Gold,Humana Gold,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Medicaid MO,Medicaid MO,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Medica,Medica,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Tricare,Tricare,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,UHC All Payer,UHC All Payer,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,UHC Exchange,UHC Exchange,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,UHC Medicaid,UHC Medicaid,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,UMR CPD,UMR CPD,155.16,,,,,,,per diem,155.16,155.16,"Per diem rate, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,UHC Medicare,UHC Medicare,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBOSACRAL SP 4+ VIEWS       ,74000501,CDM,320,RC,72110,CPT,,,,Inpatient,,,155.16,155.16,Wellcare,Wellcare,155.16,,,,,,,case rate,155.16,155.16,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Meritain Health PPO CPD,Meritain Health PPO CPD,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Aetna/Commercial Product,Aetna/Commercial Product,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Meritain Health CPD,Meritain Health CPD,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Starmark CPD,Starmark CPD,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Aetna Medicare,Aetna Medicare,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Ambetter ,Ambetter ,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Blue Access,Anthem Blue Access,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Blue Access Choice,Anthem Blue Access Choice,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Blue Preferred,Anthem Blue Preferred,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Pathway,Anthem Pathway,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Alliance,Anthem Alliance,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Anthem Medicare,Anthem Medicare,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Cigna,Cigna,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Cigna PPO,Cigna PPO,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Cigna Medicare Advantage,Cigna Medicare Advantage,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Essence,Essence,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Healthlink HMO,Healthlink HMO,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Healthlink PPO,Healthlink PPO,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,HomeState Health Plan,HomeState Health Plan,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Humana Gold,Humana Gold,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Medicaid MO,Medicaid MO,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Medica,Medica,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Tricare,Tricare,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,UHC All Payer,UHC All Payer,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,UHC Exchange,UHC Exchange,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,UHC Medicaid,UHC Medicaid,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,UMR CPD,UMR CPD,976.07,,,,,,,per diem,976.07,976.07,"Per diem rate, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,UHC Medicare,UHC Medicare,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
LUMBAR SP COMP W FLEX/EXT     ,74000502,CDM,320,RC,72114,CPT,,,,Inpatient,,,976.07,976.07,Wellcare,Wellcare,976.07,,,,,,,case rate,976.07,976.07,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Meritain Health PPO CPD,Meritain Health PPO CPD,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Aetna/Commercial Product,Aetna/Commercial Product,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Meritain Health CPD,Meritain Health CPD,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Starmark CPD,Starmark CPD,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Aetna Medicare,Aetna Medicare,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Ambetter ,Ambetter ,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Blue Access,Anthem Blue Access,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Blue Access Choice,Anthem Blue Access Choice,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Blue Preferred,Anthem Blue Preferred,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Pathway,Anthem Pathway,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Alliance,Anthem Alliance,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Anthem Medicare,Anthem Medicare,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Cigna,Cigna,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Cigna PPO,Cigna PPO,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Cigna Medicare Advantage,Cigna Medicare Advantage,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Essence,Essence,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Healthlink HMO,Healthlink HMO,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Healthlink PPO,Healthlink PPO,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,HomeState Health Plan,HomeState Health Plan,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Humana Gold,Humana Gold,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Medicaid MO,Medicaid MO,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Medica,Medica,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Tricare,Tricare,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,UHC All Payer,UHC All Payer,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,UHC Exchange,UHC Exchange,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,UHC Medicaid,UHC Medicaid,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,UMR CPD,UMR CPD,468.92,,,,,,,per diem,468.92,468.92,"Per diem rate, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,UHC Medicare,UHC Medicare,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM DIAG BILATERAL      ,74000510,CDM,401,RC,77066,CPT,G0204,HCPCS,,Inpatient,,,468.92,468.92,Wellcare,Wellcare,468.92,,,,,,,case rate,468.92,468.92,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Meritain Health PPO CPD,Meritain Health PPO CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Aetna/Commercial Product,Aetna/Commercial Product,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Meritain Health CPD,Meritain Health CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Starmark CPD,Starmark CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Aetna Medicare,Aetna Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Ambetter ,Ambetter ,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Blue Access,Anthem Blue Access,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Blue Access Choice,Anthem Blue Access Choice,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Blue Preferred,Anthem Blue Preferred,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Pathway,Anthem Pathway,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Alliance,Anthem Alliance,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Anthem Medicare,Anthem Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Cigna,Cigna,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Cigna PPO,Cigna PPO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Cigna Medicare Advantage,Cigna Medicare Advantage,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Essence,Essence,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Healthlink HMO,Healthlink HMO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Healthlink PPO,Healthlink PPO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,HomeState Health Plan,HomeState Health Plan,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Humana Gold,Humana Gold,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Medicaid MO,Medicaid MO,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Medica,Medica,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Tricare,Tricare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,UHC All Payer,UHC All Payer,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,UHC Exchange,UHC Exchange,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,UHC Medicaid,UHC Medicaid,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,UMR CPD,UMR CPD,206.97,,,,,,,per diem,206.97,206.97,"Per diem rate, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,UHC Medicare,UHC Medicare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MAMMOGRAM SCREEN BILATERAL    ,74000515,CDM,403,RC,77067,CPT,,,,Inpatient,,,206.97,206.97,Wellcare,Wellcare,206.97,,,,,,,case rate,206.97,206.97,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Meritain Health PPO CPD,Meritain Health PPO CPD,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Aetna/Commercial Product,Aetna/Commercial Product,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Meritain Health CPD,Meritain Health CPD,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Starmark CPD,Starmark CPD,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Aetna Medicare,Aetna Medicare,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Ambetter ,Ambetter ,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Blue Access,Anthem Blue Access,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Blue Access Choice,Anthem Blue Access Choice,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Blue Preferred,Anthem Blue Preferred,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Pathway,Anthem Pathway,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Alliance,Anthem Alliance,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Anthem Medicare,Anthem Medicare,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Cigna,Cigna,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Cigna PPO,Cigna PPO,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Cigna Medicare Advantage,Cigna Medicare Advantage,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Essence,Essence,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Healthlink HMO,Healthlink HMO,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Healthlink PPO,Healthlink PPO,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,HomeState Health Plan,HomeState Health Plan,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Humana Gold,Humana Gold,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Medicaid MO,Medicaid MO,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Medica,Medica,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Tricare,Tricare,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,UHC All Payer,UHC All Payer,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,UHC Exchange,UHC Exchange,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,UHC Medicaid,UHC Medicaid,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,UMR CPD,UMR CPD,929.28,,,,,,,per diem,929.28,929.28,"Per diem rate, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,UHC Medicare,UHC Medicare,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE 4+ VIEWS             ,74000530,CDM,320,RC,70110,CPT,,,,Inpatient,,,929.28,929.28,Wellcare,Wellcare,929.28,,,,,,,case rate,929.28,929.28,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MANDIBLE PARTIAL<4 VIEWS      ,74000540,CDM,320,RC,70100,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Meritain Health PPO CPD,Meritain Health PPO CPD,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Aetna/Commercial Product,Aetna/Commercial Product,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Meritain Health CPD,Meritain Health CPD,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Starmark CPD,Starmark CPD,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Aetna Medicare,Aetna Medicare,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Ambetter ,Ambetter ,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Blue Access,Anthem Blue Access,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Blue Access Choice,Anthem Blue Access Choice,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Blue Preferred,Anthem Blue Preferred,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Pathway,Anthem Pathway,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Alliance,Anthem Alliance,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Anthem Medicare,Anthem Medicare,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Cigna,Cigna,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Cigna PPO,Cigna PPO,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Cigna Medicare Advantage,Cigna Medicare Advantage,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Essence,Essence,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Healthlink HMO,Healthlink HMO,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Healthlink PPO,Healthlink PPO,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,HomeState Health Plan,HomeState Health Plan,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Humana Gold,Humana Gold,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Medicaid MO,Medicaid MO,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Medica,Medica,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Tricare,Tricare,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,UHC All Payer,UHC All Payer,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,UHC Exchange,UHC Exchange,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,UHC Medicaid,UHC Medicaid,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,UMR CPD,UMR CPD,1877.89,,,,,,,per diem,1877.89,1877.89,"Per diem rate, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,UHC Medicare,UHC Medicare,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYLEOGRAM LUMBAR              ,74000580,CDM,320,RC,72265,CPT,,,,Inpatient,,,1877.89,1877.89,Wellcare,Wellcare,1877.89,,,,,,,case rate,1877.89,1877.89,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Meritain Health PPO CPD,Meritain Health PPO CPD,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Aetna/Commercial Product,Aetna/Commercial Product,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Meritain Health CPD,Meritain Health CPD,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Starmark CPD,Starmark CPD,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Aetna Medicare,Aetna Medicare,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Ambetter ,Ambetter ,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Blue Access,Anthem Blue Access,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Blue Access Choice,Anthem Blue Access Choice,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Blue Preferred,Anthem Blue Preferred,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Pathway,Anthem Pathway,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Alliance,Anthem Alliance,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Anthem Medicare,Anthem Medicare,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Cigna,Cigna,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Cigna PPO,Cigna PPO,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Cigna Medicare Advantage,Cigna Medicare Advantage,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Essence,Essence,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Healthlink HMO,Healthlink HMO,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Healthlink PPO,Healthlink PPO,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,HomeState Health Plan,HomeState Health Plan,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Humana Gold,Humana Gold,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Medicaid MO,Medicaid MO,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Medica,Medica,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Tricare,Tricare,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,UHC All Payer,UHC All Payer,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,UHC Exchange,UHC Exchange,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,UHC Medicaid,UHC Medicaid,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,UMR CPD,UMR CPD,1218.91,,,,,,,per diem,1218.91,1218.91,"Per diem rate, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,UHC Medicare,UHC Medicare,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM THORACIC            ,74000581,CDM,320,RC,72255,CPT,,,,Inpatient,,,1218.91,1218.91,Wellcare,Wellcare,1218.91,,,,,,,case rate,1218.91,1218.91,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Meritain Health PPO CPD,Meritain Health PPO CPD,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Aetna/Commercial Product,Aetna/Commercial Product,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Meritain Health CPD,Meritain Health CPD,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Starmark CPD,Starmark CPD,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Aetna Medicare,Aetna Medicare,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Ambetter ,Ambetter ,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Blue Access,Anthem Blue Access,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Blue Access Choice,Anthem Blue Access Choice,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Blue Preferred,Anthem Blue Preferred,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Pathway,Anthem Pathway,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Alliance,Anthem Alliance,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Anthem Medicare,Anthem Medicare,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Cigna,Cigna,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Cigna PPO,Cigna PPO,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Cigna Medicare Advantage,Cigna Medicare Advantage,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Essence,Essence,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Healthlink HMO,Healthlink HMO,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Healthlink PPO,Healthlink PPO,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,HomeState Health Plan,HomeState Health Plan,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Humana Gold,Humana Gold,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Medicaid MO,Medicaid MO,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Medica,Medica,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Tricare,Tricare,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,UHC All Payer,UHC All Payer,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,UHC Exchange,UHC Exchange,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,UHC Medicaid,UHC Medicaid,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,UMR CPD,UMR CPD,1957.27,,,,,,,per diem,1957.27,1957.27,"Per diem rate, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,UHC Medicare,UHC Medicare,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
MYELOGRAM CERVICAL            ,74000582,CDM,320,RC,72240,CPT,,,,Inpatient,,,1957.27,1957.27,Wellcare,Wellcare,1957.27,,,,,,,case rate,1957.27,1957.27,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Meritain Health PPO CPD,Meritain Health PPO CPD,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Aetna/Commercial Product,Aetna/Commercial Product,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Meritain Health CPD,Meritain Health CPD,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Starmark CPD,Starmark CPD,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Aetna Medicare,Aetna Medicare,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Ambetter ,Ambetter ,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Blue Access,Anthem Blue Access,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Blue Access Choice,Anthem Blue Access Choice,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Blue Preferred,Anthem Blue Preferred,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Pathway,Anthem Pathway,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Alliance,Anthem Alliance,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Anthem Medicare,Anthem Medicare,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Cigna,Cigna,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Cigna PPO,Cigna PPO,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Cigna Medicare Advantage,Cigna Medicare Advantage,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Essence,Essence,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Healthlink HMO,Healthlink HMO,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Healthlink PPO,Healthlink PPO,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,HomeState Health Plan,HomeState Health Plan,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Humana Gold,Humana Gold,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Medicaid MO,Medicaid MO,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Medica,Medica,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Tricare,Tricare,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,UHC All Payer,UHC All Payer,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,UHC Exchange,UHC Exchange,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,UHC Medicaid,UHC Medicaid,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,UMR CPD,UMR CPD,543.41,,,,,,,per diem,543.41,543.41,"Per diem rate, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,UHC Medicare,UHC Medicare,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NASAL BONES 3+ VIEWS          ,74000590,CDM,320,RC,70160,CPT,,,,Inpatient,,,543.41,543.41,Wellcare,Wellcare,543.41,,,,,,,case rate,543.41,543.41,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Meritain Health PPO CPD,Meritain Health PPO CPD,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Aetna/Commercial Product,Aetna/Commercial Product,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Meritain Health CPD,Meritain Health CPD,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Starmark CPD,Starmark CPD,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Aetna Medicare,Aetna Medicare,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Ambetter ,Ambetter ,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Blue Access,Anthem Blue Access,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Blue Access Choice,Anthem Blue Access Choice,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Blue Preferred,Anthem Blue Preferred,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Pathway,Anthem Pathway,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Alliance,Anthem Alliance,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Anthem Medicare,Anthem Medicare,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Cigna,Cigna,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Cigna PPO,Cigna PPO,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Cigna Medicare Advantage,Cigna Medicare Advantage,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Essence,Essence,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Healthlink HMO,Healthlink HMO,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Healthlink PPO,Healthlink PPO,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,HomeState Health Plan,HomeState Health Plan,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Humana Gold,Humana Gold,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Medicaid MO,Medicaid MO,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Medica,Medica,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Tricare,Tricare,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,UHC All Payer,UHC All Payer,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,UHC Exchange,UHC Exchange,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,UHC Medicaid,UHC Medicaid,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,UMR CPD,UMR CPD,348.99,,,,,,,per diem,348.99,348.99,"Per diem rate, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,UHC Medicare,UHC Medicare,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
NECK SOFT TISSUE              ,74000596,CDM,320,RC,70360,CPT,,,,Inpatient,,,348.99,348.99,Wellcare,Wellcare,348.99,,,,,,,case rate,348.99,348.99,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Meritain Health PPO CPD,Meritain Health PPO CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Aetna/Commercial Product,Aetna/Commercial Product,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Meritain Health CPD,Meritain Health CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Starmark CPD,Starmark CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Aetna Medicare,Aetna Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Ambetter ,Ambetter ,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Access,Anthem Blue Access,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Access Choice,Anthem Blue Access Choice,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Blue Preferred,Anthem Blue Preferred,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Pathway,Anthem Pathway,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Alliance,Anthem Alliance,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Anthem Medicare,Anthem Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Cigna,Cigna,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Cigna PPO,Cigna PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Cigna Medicare Advantage,Cigna Medicare Advantage,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Essence,Essence,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Healthlink HMO,Healthlink HMO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Healthlink PPO,Healthlink PPO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,HomeState Health Plan,HomeState Health Plan,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Humana Gold,Humana Gold,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Medicaid MO,Medicaid MO,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Medica,Medica,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Tricare,Tricare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,UHC All Payer,UHC All Payer,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,UHC Exchange,UHC Exchange,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,UHC Medicaid,UHC Medicaid,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,UMR CPD,UMR CPD,231.75,,,,,,,per diem,231.75,231.75,"Per diem rate, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,UHC Medicare,UHC Medicare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
IVP INFUSION W/ TOMOGRAMS     ,74000600,CDM,320,RC,74415,CPT,,,,Inpatient,,,231.75,231.75,Wellcare,Wellcare,231.75,,,,,,,case rate,231.75,231.75,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health PPO CPD,Meritain Health PPO CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Aetna/Commercial Product,Aetna/Commercial Product,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Meritain Health CPD,Meritain Health CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Starmark CPD,Starmark CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Aetna Medicare,Aetna Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Ambetter ,Ambetter ,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access,Anthem Blue Access,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Access Choice,Anthem Blue Access Choice,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Blue Preferred,Anthem Blue Preferred,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Pathway,Anthem Pathway,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Alliance,Anthem Alliance,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Anthem Medicare,Anthem Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Cigna,Cigna,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Cigna PPO,Cigna PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Cigna Medicare Advantage,Cigna Medicare Advantage,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Essence,Essence,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Healthlink HMO,Healthlink HMO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Healthlink PPO,Healthlink PPO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,HomeState Health Plan,HomeState Health Plan,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Humana Gold,Humana Gold,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Medicaid MO,Medicaid MO,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Medica,Medica,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Tricare,Tricare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,UHC All Payer,UHC All Payer,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,UHC Exchange,UHC Exchange,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicaid,UHC Medicaid,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,UMR CPD,UMR CPD,151.49,,,,,,,per diem,151.49,151.49,"Per diem rate, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,UHC Medicare,UHC Medicare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
ORBITS COMP 4+ VIEWS          ,74000605,CDM,320,RC,70200,CPT,,,,Inpatient,,,151.49,151.49,Wellcare,Wellcare,151.49,,,,,,,case rate,151.49,151.49,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Meritain Health PPO CPD,Meritain Health PPO CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Aetna/Commercial Product,Aetna/Commercial Product,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Meritain Health CPD,Meritain Health CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Starmark CPD,Starmark CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Aetna Medicare,Aetna Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Ambetter ,Ambetter ,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Blue Access,Anthem Blue Access,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Blue Access Choice,Anthem Blue Access Choice,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Blue Preferred,Anthem Blue Preferred,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Pathway,Anthem Pathway,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Alliance,Anthem Alliance,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Anthem Medicare,Anthem Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Cigna,Cigna,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Cigna PPO,Cigna PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Cigna Medicare Advantage,Cigna Medicare Advantage,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Essence,Essence,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Healthlink HMO,Healthlink HMO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Healthlink PPO,Healthlink PPO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,HomeState Health Plan,HomeState Health Plan,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Humana Gold,Humana Gold,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Medicaid MO,Medicaid MO,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Medica,Medica,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Tricare,Tricare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,UHC All Payer,UHC All Payer,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,UHC Exchange,UHC Exchange,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,UHC Medicaid,UHC Medicaid,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,UMR CPD,UMR CPD,273.98,,,,,,,per diem,273.98,273.98,"Per diem rate, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,UHC Medicare,UHC Medicare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
CALCANEUS 2+ VIEWS BILATERAL  ,74000610,CDM,320,RC,73650,CPT,,,50,Inpatient,,,273.98,273.98,Wellcare,Wellcare,273.98,,,,,,,case rate,273.98,273.98,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 1-2 VIEWS              ,74000630,CDM,320,RC,72170,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Meritain Health PPO CPD,Meritain Health PPO CPD,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Aetna/Commercial Product,Aetna/Commercial Product,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Meritain Health CPD,Meritain Health CPD,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Starmark CPD,Starmark CPD,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Aetna Medicare,Aetna Medicare,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Ambetter ,Ambetter ,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Blue Access,Anthem Blue Access,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Blue Access Choice,Anthem Blue Access Choice,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Blue Preferred,Anthem Blue Preferred,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Pathway,Anthem Pathway,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Alliance,Anthem Alliance,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Anthem Medicare,Anthem Medicare,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Cigna,Cigna,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Cigna PPO,Cigna PPO,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Cigna Medicare Advantage,Cigna Medicare Advantage,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Essence,Essence,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Healthlink HMO,Healthlink HMO,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Healthlink PPO,Healthlink PPO,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,HomeState Health Plan,HomeState Health Plan,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Humana Gold,Humana Gold,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Medicaid MO,Medicaid MO,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Medica,Medica,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Tricare,Tricare,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,UHC All Payer,UHC All Payer,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,UHC Exchange,UHC Exchange,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,UHC Medicaid,UHC Medicaid,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,UMR CPD,UMR CPD,427.54,,,,,,,per diem,427.54,427.54,"Per diem rate, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,UHC Medicare,UHC Medicare,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
PELVIS 3+ VIEWS               ,74000631,CDM,320,RC,72190,CPT,,,,Inpatient,,,427.54,427.54,Wellcare,Wellcare,427.54,,,,,,,case rate,427.54,427.54,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Meritain Health PPO CPD,Meritain Health PPO CPD,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Aetna/Commercial Product,Aetna/Commercial Product,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Meritain Health CPD,Meritain Health CPD,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Starmark CPD,Starmark CPD,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Aetna Medicare,Aetna Medicare,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Ambetter ,Ambetter ,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Blue Access,Anthem Blue Access,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Blue Access Choice,Anthem Blue Access Choice,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Blue Preferred,Anthem Blue Preferred,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Pathway,Anthem Pathway,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Alliance,Anthem Alliance,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Anthem Medicare,Anthem Medicare,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Cigna,Cigna,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Cigna PPO,Cigna PPO,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Cigna Medicare Advantage,Cigna Medicare Advantage,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Essence,Essence,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Healthlink HMO,Healthlink HMO,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Healthlink PPO,Healthlink PPO,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,HomeState Health Plan,HomeState Health Plan,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Humana Gold,Humana Gold,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Medicaid MO,Medicaid MO,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Medica,Medica,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Tricare,Tricare,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,UHC All Payer,UHC All Payer,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,UHC Exchange,UHC Exchange,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,UHC Medicaid,UHC Medicaid,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,UMR CPD,UMR CPD,944.85,,,,,,,per diem,944.85,944.85,"Per diem rate, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,UHC Medicare,UHC Medicare,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
IVP RETROGRADE                ,74000660,CDM,320,RC,74420,CPT,,,,Inpatient,,,944.85,944.85,Wellcare,Wellcare,944.85,,,,,,,case rate,944.85,944.85,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL 3 VIEWS        ,74000670,CDM,320,RC,71110,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,UHC All Payer,UHC All Payer,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,UHC Exchange,UHC Exchange,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicaid,UHC Medicaid,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,UMR CPD,UMR CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,UHC Medicare,UHC Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
RIBS BILATERAL WITH PA CHEST  ,74000671,CDM,320,RC,71111,CPT,,,,Inpatient,,,210.06,210.06,Wellcare,Wellcare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Meritain Health PPO CPD,Meritain Health PPO CPD,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Aetna/Commercial Product,Aetna/Commercial Product,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Meritain Health CPD,Meritain Health CPD,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Starmark CPD,Starmark CPD,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Aetna Medicare,Aetna Medicare,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Ambetter ,Ambetter ,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Blue Access,Anthem Blue Access,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Blue Access Choice,Anthem Blue Access Choice,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Blue Preferred,Anthem Blue Preferred,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Pathway,Anthem Pathway,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Alliance,Anthem Alliance,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Anthem Medicare,Anthem Medicare,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Cigna,Cigna,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Cigna PPO,Cigna PPO,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Cigna Medicare Advantage,Cigna Medicare Advantage,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Essence,Essence,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Healthlink HMO,Healthlink HMO,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Healthlink PPO,Healthlink PPO,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,HomeState Health Plan,HomeState Health Plan,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Humana Gold,Humana Gold,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Medicaid MO,Medicaid MO,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Medica,Medica,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Tricare,Tricare,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,UHC All Payer,UHC All Payer,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,UHC Exchange,UHC Exchange,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,UHC Medicaid,UHC Medicaid,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,UMR CPD,UMR CPD,371.32,,,,,,,per diem,371.32,371.32,"Per diem rate, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,UHC Medicare,UHC Medicare,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACROILIAC JOINTS < 3 VIEWS   ,74000688,CDM,320,RC,72200,CPT,,,,Inpatient,,,371.32,371.32,Wellcare,Wellcare,371.32,,,,,,,case rate,371.32,371.32,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Aetna/ Managed Choice POS Elect Choice and PPO Products,Aetna/ Managed Choice POS Elect Choice and PPO Products,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health PPO CPD,Meritain Health PPO CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Aetna/Commercial Product,Aetna/Commercial Product,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Meritain Health CPD,Meritain Health CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Starmark CPD,Starmark CPD,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Aetna Medicare,Aetna Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Ambetter ,Ambetter ,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access,Anthem Blue Access,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Access Choice,Anthem Blue Access Choice,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Blue Preferred,Anthem Blue Preferred,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Pathway,Anthem Pathway,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Alliance,Anthem Alliance,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Healthy Blue (Missouri Care),Healthy Blue (Missouri Care),210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Anthem Medicare,Anthem Medicare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Cigna,Cigna,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Cigna PPO,Cigna PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Cigna Medicare Advantage,Cigna Medicare Advantage,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Essence,Essence,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Healthlink HMO,Healthlink HMO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Healthlink PPO,Healthlink PPO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,HomeState Health Plan,HomeState Health Plan,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Humana Gold,Humana Gold,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Medicaid MO,Medicaid MO,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Medica,Medica,210.06,,,,,,,per diem,210.06,210.06,"Per diem rate, code is bundled with other services"
SACRUM & COCCYX MIN 2+ VIEWS  ,74000690,CDM,320,RC,72220,CPT,,,,Inpatient,,,210.06,210.06,Tricare,Tricare,210.06,,,,,,,case rate,210.06,210.06,"Case rate contract, code is bundled with other services"
SACRUM & COCCYX M